exercise is medicine! the importance of regular physical activity on health and your overall well...
TRANSCRIPT
Exercise is Medicine!
The importance of Regular Physical Activity on Health and Your Overall Well Being
Traye McGehee, MA, ATC
Clinical Coordinator UF Health Fitness and Wellness Center
Learning Objectives:
Benefits of Regular Physical Activity/Exercise
Physiological Adaptations of the Body to Exercise
Health Concerns When Beginning an Exercise Program
Normal Vital Signs and Their Importance
• Flexibility and its importance
• Exercise at Work/Exercising at Your Desk/Basic Exercises anyone can do at home
• Ergonomics and Proper Lifting Techniques/Mechanics
• Potentially Harmful Exercises and Possible Modification
• Exercise and Physical Activity for Adolescents
Fitness for AllThe Benefits of Fitness
Fitness and Health
The word health is often associated only with physical fitness, but there are other components of health.
FITNESS means “readiness”. Fit people are better equipped than non-fit people.
The level of fitness includes all aspects of health and life.
It affects physical, mental, and social health.
What is Physical Fitness?Physical Fitness is the
ability of your body systems to work efficiently. A fit person is able to carry out the typical activities of living, such as work, and still have enough energy and vigor to respond to emergency situations and to enjoy leisure time activities.
Physical Activity and ExercisePhysical activity is a
general term that includes sports, dance, and activities done at work or at home, such as walking, climbing stairs, or mowing the lawn.
When people do physical activity especially for the purpose of getting fit, we say they are doing exercise.
Health and Wellness Benefits of Physical Activity
Regular physical activity can do much to prevent disease and illness.
It can help you look your best (with proper nutrition, good posture, and good body mechanics).
Besides looking better, people who do regular physical activity feel better, do better on academic work, and are less depressed than people who are less active.
Regular physical activity results in physical fitness which is the key to being able to do more of things you want to do and enjoy life.
It allows you to be fit enough to meet emergencies and day-to-day demanding situations.
Being physically active can build fitness, which, in turn, provides you with many health and wellness benefits.
What is Fitness?Definition
Being in good Health or In Good Physical Condition
Four Health/Fitness Components
Cardiovascular Fitness
Body Composition
Flexibility
Muscular Strength and Endurance
Cardiovascular Fitness
ACSM’s RecommendationsFor those healthy adults under age 65
Do moderately intense cardio 30 minutes a day, five days a weekOR
Do vigorously intense cardio 20 minutes a day, 3 days a week
And• Do eight to 10 strength-training exercises,
eight to 12 repetitions of each exercise twice a week
Heart Rate TrainingTo find your target heart rate
220-age = Maximum Heart RateEasy: 50-60% of Max HRModerate: 75% of Max HRTraining: 85% or greater of Max HR220-40= 180 beat/min for a 40 year old
10,000 Steps/DayOne recommendation is to walk 10,000 steps
each day2000 steps equals one mileIf you are not at this point, gradually increase
your steps
10,000 Steps/Day
Receptionist 1120
Physician 2910
Physical Therapist 3820
Registered Nurse 7200
Licensed Practical Nurse 10,500
UPS Driver 18200
Grocery Stock Boy 21,000
Examples of Professions w/number of steps/day
Body CompositionBody composed of
Muscle, Bone, Blood, Organs, etc
What is Percent Body Fat?If you have 20% body fat, then you are 80%
everything else
What is fat used for?Insulates, Protects, Used as Fuel
% Body Fat: Measured with calipers, under water weighing, Electrical Impedence, Bod pod
Muscular Strength/EnduranceMuscular Strength
Ability to do a taskLift a Weight
Muscular Endurancebeing able to contract muscles over and over again
Resistance TrainingBenefits
Effect on Bone Improved bone density
Decrease risk of osteoporosisEffect on Muscle Increased muscle strength/sizeDecreased risk of injuryDecreased risk of low back injuries
Before Beginning an Exercise Program
Screening/ClearanceACSM recommends symptom-limited exercise testing before
vigorous exercise by men over 45 yo and women over 55 yoACSM recommends those who have 2 or more: major cardiac risk factorspersons with any signs or symptoms of coronary artery diseasethose with known cardiac, pulmonary, or metabolic disease
consult a MD prior to beginning an exercise program
ContraindicationsStop exercising and seek medical care if you
experience any of the warning signs during exerciseChest pain or tightnessDizziness or faintnessPain in an arm or your jawSevere shortness of breathAn irregular heartbeatExcessive Fatigue
How to Start an Exercise Program
Work out in short boutsMinimum of 10 minutes to be effective
How to Start an Exercise Program
Set a scheduleDetermine what time of the day works best for you
to trainExample: if you are a morning person, then that
may be the best time for you to train
How to Start an Exercise Program
You can train anywhereNo need to join a gymJust a pair of running or cross training shoes
and a desire to improve your wellness is all you need
How to Start an Exercise Program
Do something that you enjoyIt does not have to be a structured program
Tennis, Cycling, Gardening are all very good activities
You do not have to run to become fit
Benefits of Exercise Increase Self Esteem
Improved Mood
Boosts Energy
Strengthens Heart
Burns Calories
Improves Cholesterol Levels
Relieves Stress
Lowers risk of heart disease, hypertension, diabetes
Prevents bone loss
Decreases the risk of some cancers
Benefits of ExerciseAerobic and resistive exercise have a
very positive effect on muscle performance and overall disease control
Are you in shape?
Your aerobic fitness level, not your body weight, is the best measure of your overall health
-Cooper Institute for Aerobic Research
In terms of longevity, your fitness level is far more important than weight
Extra Benefits of Exercise
Individuals who are fit not only burn calories during exercise, but even when not exercising!!!!!!!!!!
Basics of Exercise PhysiologyExercise is a complex molecular, cellular and systemic
physiological stimulus
With every single bout of exercise, skeletal muscles, heart, brain, vascular
tissue, bone, liver, etc. experience some form of environmental “stress”.
The type and magnitude of an adaptation or response to exercise thus
results from a sum total of all these contributing factors. -
Specificity of Exercise: Adaptations that occur in response to training are specific to the nature of the training stimulus
Cardiovascular fitness: requires that the persontrain in a manner that challenges heart rate, cardiacoutput, capillarity … with the underlying change beingimproved oxygen delivery to working tissues
Muscular strength: requires that the person train in a mannerthat challenges the recruitment and force output of specificmuscle groups … with the underlying change being increasedmuscle mass.
Basic Principles of Exercise Training
Frequency - how often is the exercise performedeach week? For cardiovascular training effects3-4x per week is suggested
Intensity - the exercise must be performed at a level that challenges the cell/tissue/system for adaptations to occur.Totally dependent on starting state. Lower the starting fitnesslevel the lower the starting intensity. Must build to continue adaptations Most important variable in training regimen.
Duration - length of each training session. For cardiovascularAdaptations it is suggested to start at 30 minutes/session
MORE IS NOT NECESSARILY BETTER!overtraining/system failure
Known adaptations to endurance exercise
Skeletal MuscleÝ mitochondriaÝ capillary density
Heart Ý heart volumeÝ max stroke volumeÝ max cardiac output Decreased resting heart rateÛ blood pressure
Brain (very new studies)Ý neurogenesisÝ protection from seizures, injury
BoneÝ density? Type of exercise
Known adaptations to resistance exercise
Brain/NeuralÝ improved recruitment
Skeletal MuscleÝ Fiber sizeÝ Mitochondria?
BoneÝ density
Role of exercise in weight and/or body fat control
Exercise can increase caloric expenditure
Exercise can spare loss of lean body mass during times of caloric deficit
Increases in lean body mass will increase basal metabolic rate10lbs of lean body mass will lead to about 70-80kcal/day
ALL forms of exercise will burn fat
Amount of fat burned during exercise is NOT important.
Total calories used during exercise IS important
For patients/clients, pick an exercise/activity modality thatthey will do and do regularly. Type of exercise less important
Calories in vs. Calories out
Decreased risk of CancerEndometrial
Breast
Colon
prostate
- Obesity is reaching "epidemic proportions” in the United States- could soon cause as much preventable disease and death as cigarette smoking.
Application for Health ObesityType II Diabetes
For the vast majority of individuals, overweight and obesity result from excess calorie consumption and/or inadequate physical activity.
Unhealthy dietary habits and sedentary behavior together account for approximately 300,000 deaths every year.
Exercise and Type II Diabetes
About 10.3 million diagnosed cases and about 5.4 million undiagnosed
Accounts for 90-95% of all cases of diabetes
Characterized by insulin resistance and moderate insulin deficiency
Skeletal muscle: site of about 80-90% of glucose uptake
Physiological Benefits of Exercise for those with Type II Diabetes
Lower resting heart rateLower submaximal exercise heart rateIncreased stroke volumeIncreased cardiac outputEnhanced oxygen extractionLower resting BPLower exercise BPInfluence lipid profile
Exercise and Chronic Diseases
Cardiovascular DiseaseType II DiabetesObesityObesity related diseases
While all these diseases have some contribution from genetics the rapid increases in the last 20+ years aredue to environmental factors.
Sedentary living is responsible for about 34% of deaths due to coronary heart disease, colon cancer and Type II diabetes
CDC has concluded that “physical inactivity is one of the major underlying causes of premature mortality in the US”
1. Consider exercise/physical activity for both disease prevention as well as treatment
2. When considering exercise think movement or activity not athletic performance
3. Consider the importance of exercisefor children. Growing evidence for mental as well asphysical development. Educate for healthy lifestyle
• Good resource for exercise and health informationAmerican College of Sports Medicine www.acsm.org
Initiating an Exercise Program
Emphasize the importance of regular exercise
Look at long-term goals, exercise modalities
If a highly sedentary individual starting and exercise programbreak up exercise into 2 or 3, 10-15 minute
blocks daily
Start SimpleFind time to begin a gradual exercise program
Don’t do too much too soon, avoid injury
If deconditioned begin with 10 minutes of walking, then add 1 minute each day
It takes 12 weeks to see measurable results
Be patient, don’t do the scale dance!!
Start SimpleHealthy eating, monitor portions
5 Fruit and Vegetable servings each day
Start moving, follow ACSM guidelinesWork on your flexibilityConsult an expert on developing your exercise program
EASY TO DO ANYTIME
ANYWHERE
UPPER BODY
BICEP CURLS w/ water bottle
Hold water bottle in right hand and, with abs in and spine straight, curl bottle towards
shoulder. Repeat for other side.
TRICEP DIPS w/ chair
Make sure chair is stable and place hands next to
hips. Move hips in front of chair and bend the
elbows, lowering the body until the elbows are at 90 degrees. Push back up
and repeat.
TRICEPS EXTENSION w/ water bottle
Sit tall with the abs in and hold a full water bottle in the left hand. Lift the bottle up to
shoulder level, pause, and then continue lifting all the
way up over the head. When the arm is next to the ear, bend the elbow, taking the
water bottle behind you and contracting the triceps.
Straighten the arm and lower down.
SHOULDER PRESS w/ books or bottles
Position water bottle to each side of shoulders with elbows below wrists. Press bottles upward until arms are
extended overhead. Lower to sides of shoulders and repeat.
SHOULDER SHRUGS w/ water bottles
Stand holding bottles to sides.Elevate shoulders as high as possible.
Lower and repeat.
PUSH UPS on desk, wall, or floor
Place your hands on the floor just beyond shoulder width apart. Keep your back straight and your knees straight and parallel to the floor. Slowly lower your body so as to touch your nose to the floor and then return to the start position by explosively pressing yourself upward. Again, it is
imperative to keep your back and body as straight as possible throughout this movement.
CORE
CRUNCHESLie down on the floor (you can
use a floor mat to rest on). Bend your knees and then hold your hands below the neck. Now,
while exhaling, lift the upper part of your body. Remember, do not tuck your chin in the chest, your
chin must be in a straight direction. Then while inhaling, go in the downward direction. This is the regular type of crunches, the
other types of crunches are a slight variation of this type. You must increase the count weekly, so that your body does not reach
a plateau.
RUSSIAN TWISTSBegin sitting on the floor with your
knees bent and your feet flat on the floor. Press your hands together or hold a water bottle, extending your arms out in front of you, and recline
back so that your body is angled about 45 degrees.
Keeping your lower body still, twist your body to the right and then to
the left.To increase intensity, simply lean
back. Use an angle that is comfortable, yet still gives your
abdominal muscles a challenge.
PLANKSLie facedown on the
floor, prop yourself up on your forearms, and flex
your toes. Your body should form a straight
line from head to heels. Contract your abs and
glutes tightly. Hold.
Try SIDE PLANKS for a challenge
BRIDGES Lie flat on your back on a mat
with your knees bent pointing up to the ceiling and your arms at your sides. Simply raise your
pelvis up toward the ceiling to a point where your body will be at
a about a 45 degree angle relative to the floor. At the top of the movement, be sure to really flex your butt for a one-count.
Return to the start position and repeat.
For a challenge, try marching while you are in bridge formation
as shown.
FIRE HYDRANTSGet down on your hands and knees. Then slowly raise one knee out the side until it is parallel with the ground. Finish by slowly
lowering the leg.
Repeat
LOWER BODY
CHAIR SQUATS
While sitting, lift up until your hips are just
hovering over the chair, arms out for balance. Hold for 2-3 seconds,
stand all the way up and repeat.
ISOMETRIC WALL SITS
Stand against a wall. Lower into a squat (as if you're sitting into a chair), until
your knees are bent 90 degrees. Push
down into your heels and hold.
LUNGESStand with right foot forward, left foot back about 3 feet apart.Hold weights in each hand if desired and bend the knees to lower the body towards the floor. Keep the front knee behind the toes and be sure to lower straight down rather than forward.Keep the torso straight and abs in as you push through the front heel and back to starting position.Don't lock the knees at the top of the movement.
Seated LEG EXTENSIONS
Sit tall with the abs in and extend the left leg until it's level with hip,
squeezing the quadriceps. Hold for 2
seconds, lower. Repeat on the other
side.
Standing LEG EXTENSIONSRest hands on chair.
Slowly kick right leg back, keeping knee straight.
It should be a small movement. If you start to lean forward you are
kicking too far.Do not let leg drop back to starting
position, control it's decent.Repeat 10 times with each leg.
CALF RAISESWith Water bottles in hands, raise heels by extending ankles as
high as possible. Lower heels by
bending ankles until calves are stretched.
Repeat.
HIP ADDUCTION
Place towel, firm water bottle or an empty coffee cup
between the knees as you sit up tall with the abs in.
Squeeze the bottle or cup, release halfway and squeeze
again.
HIP FLEXION
Sit tall with the abs in and lift the left foot
off the floor a few inches, knee bent. Hold for 2 seconds, lower and repeat.
Repeat on the other side.
Calestenics
Park in the furthest parking spot!!
If you can find time to do 10 minutes of exercise 3 times per day, you will meet the
ACSM recommendations of 30 minutes per day
Lifting Techniques
Lifting processBEFORE YOU LIFT
Plan Your Route: Path clear? Trip hazards removed? Dry?
Assess the Load: Too heavy? Can I use a hand truck or forklift? Can I slide it?
WHEN YOU LIFT
Lift It Right: Position your body close to the object. Keep your back straight.
Move It Right: Don't twist your back.
Lower It Right: When you put the load down, bend your knees not your waist.
GET HELP IF YOU NEED IT
Work Together: Don't be a hero. Communicate with your partner!
Plan ahead• Size up the load:
– Can it be split into multiple loads?
– Smaller loads cause less strain on the back.
– Can you slide it rather then lift?
• Use material handling equipment if load is too heavy:– Forklifts
– Hoists
– Dollies
9b
Plan aheadAvoid using lower rack for moderately heavy to heavy
items or awkward items.
Get help when lifting heavy, awkward, or long items.
9a
Basic rules of good lifting
• Size up the load before you lift.
• Can you lift a corner?
• Can you get to the item?
• Do you need to move something
to gain better access?
1a
Basic rules of good lifting
• Bend your knees.
• Get a good hand hold.
• Center yourself over the load.
• Lift straight up - let your legs do the work.
• Don’t twist or turn.
1b
Basic rules of good lifting
Have a clear path.
Set the load down properly.
Always push a cart or dolly.
Get help for long loads.
Split up heavy loads when you can.
Pushing a load is easier on the back; easier to control.
1c
Never twist or turn when liftingAdds strain to the back’s discs, muscles, ligaments,
tendons.
Plan your lift to avoid awkward positions.
Set load down if you’re losing your grip.
Don’t twist and turn or juggle load to regain grip.
Keep back as straight as possible.
5a
Carrying the loadEnsure a clear path.
Ensure a place where load can be set down.
Check for stability of load.
Can you get a good grip?
6a
Carrying the load
• Use mechanical equipment if load is too heavy.
• Get help if load is too heavy - lift at the same time to keep load balanced.
6c
Lowering the loadBend the knees to let leg muscles support the weight.
Slowly lower it; do not drop the load.
Avoid sudden movements.
Lower the load at the same time if working with a partner.
7a
Awkward Lifting
Lifts that are:
• Above the shoulders
• Below the knees
• At arms’ length
Principles for reducing heavy lifting
Reduce the weight
Increase the weight (to balance load)
Use mechanical assistance
Slide instead of lift
Team lifting
Reducing heavy lifting
Reduce the weight of the load
Wood pallet
60 pounds
Plastic pallet
20 pounds
Reducing heavy lifting
Slide instead of lifting
Principles for reducing frequent lifting• Use mechanical assistance
• Avoid unnecessary lifting
• Use mobile storage shelves
Principles for reducing awkward lifting/Reaching
Remove obstacles
Slide closer
Reduce shelf depth
Reduce package size
Use mechanical assistance
Team lifting
Reducing awkward lifting/
ReachingReduce package size
Principles for reducing awkward lifting/
BendingUse mechanical assistance to raise
the load
Add handles
Arrange storage
Avoid unnecessary lifting
Principles for reducing awkward lifting/ Reaching above shoulders
Arrange storage
Use mechanical assistance
Use a rolling stair or “safety ladder”
Lifting techniques trainingTeach lifting techniques to employees:
• Training alone is not effective.• Making changes to jobs and
equipment is better.• Making changes along with
training is most effective.
Lifting techniques training
• Job-specific, on-site, hands-on training is more effective than classroom.
• Have employees demonstrate proper lifting techniques before “graduating.”
Other factors in back injuriesAge of employee
Improper postures when sleeping, standing, sitting
Physical condition of employee
Repetitive motions
10a
Conclusion
• When lifting a box, think out of the box! • Is there a better way?• Don’t wait for someone to get injured before changing a job.• Just because we have done it this way. Do we have to continue to use the same method to handle loading and unloading of materials?
1. Use a good chair with a dynamic chair back and sit back in this
2. Top of monitor casing 2-3" (5-8 cm) above eye level
3. No glare on screen, use an optical glass anti-glare filter where needed
4. Sit at arms length from monitor 5. Feet on floor or stable footrest 6. Use a document holder, preferably in-
line with the computer screen 7. Wrists flat and straight in relation to
forearms to use keyboard/mouse/input device
8. Arms and elbows relaxed close to body
9. Center monitor and keyboard in front of you
10. Use a negative tilt keyboard tray with an upper mouse platform or downward tiltable platform adjacent to keyboard
11. Use a stable work surface and stable (no bounce) keyboard tray
12. Take frequent short breaks (microbreaks)
12 tips for an Ergonomic Computer Workstation
FLEXIBILITY
109
Flexibility Activity• Flexibility is an
important, but often neglected part of an exercise program.
• The importance of flexibility for health and well-being becomes more important with age.
Flexibility Fundamentals• Not the same as stretching.• The range of motion in a joint or joints is used to reflect
flexibility at that joint.– ROM= the extent and direction of movement that is
possible.– Joint specific
• Specific vocabulary is used to describe the movement of joints.– Flexion/extension, abduction/adduction, internal and
external rotation, etc.
111
Common Movements• Flexion• Extension• Abduction• Adduction• Rotation
112
Flexibility Fundamentals continued
• ROM at a joint depends on the type of joint. The unique nature of the different joints causes some to allow for greater mobility than others.– Ball-and-socket joint– Hinge joint
• Assessed– Static = without movement– Dynamic = active functional activity
113
Factors Influencing Flexibility• Anatomy
– Long “muscle-tendon units” (MTUs)– Properties of connective tissue and muscle– Type of joint
• Gender– Females more flexible
• Possibly related to:– bone structure (e.g., wider hips)– hormonal influences– physical choices (e.g., dance, gymnastics,
swimming) that require good flexibility
114
Factors Influencing Flexibility continued
• Genetics (loose joints)
• Lack of use or misuse– Lack of physical activity / muscle imbalances
• Race• Age (see next slide)
115
Influence of Age on Flexibility
10 20 30 40 50 60 70
F L E X I B I L I T Y
FLEXIBILITY
PHYSICAL ACTIVITY
AGE (years)
ACTIVITY
Health Benefits of Flexibility
No ideal standard for flexibility exists.Necessary for optimal posture.Extremes of inflexibility and hyperflexibility increase the likelihood of injury.May help prevent muscle strain and such orthopedic problems as back pain (see next 2 slides).Stretching may help to relieve muscle cramps, stiffness, and some local or referred pain.
117
Flexibility & Back Pain
• Short and tight muscles cause poor posture which leads to back pain.
118
Flexibility & Back Pain
Long and strong muscles keep the body in good alignment and reduce risk of back pain.
119
Health Benefits of Flexibility• Stretching is probably ineffective in
preventing muscle soreness.• Overstretching may make a person
susceptible to injury or hamper performance.
• Freedom of movement• Improved athletic performance
120
Stretching Methods
• Static–Active assistance–Passive assistance
• Ballistic• PNF
121
Static Stretching
• Safer and less likely to cause injury• Stretch slowly until tension • Hold stretch for 10 - 30 sec.• Relax the muscle • Increase stretch a bit more
122
Static Stretching• Active stretching• Passive stretching
See next slide (Figure 3)
123
124
Ballistic Stretching• Dynamic movement• Specificity of movement
125
Proprioceptive Neuromuscular Facilitation (PNF)
• Combines (active and passive) methods
• Most effective method forimproving flexibility
• Promotes increase in strength
126
PNF Stretching Technique
(C.R.A.C. Method)• Contract agonist isometrically• Relax muscle for a few seconds • Contract the antagonist for 15 seconds• Relax
127
How Much Flexibility is Enough?
How Much Stretching is Enough?
128
How much is enough?• Stretching exercises should be done regularly to
achieve optimal benefits.• For flexibility to be increased, you must stretch and
hold muscles beyond normal length for an adequate amount of time.Performing warm-up exercises is not the same as doing a stretching workout for flexibility development.
• The best time for stretching is when the muscles are warm.
129
FIT Formula (Static Stretching)
F 3 - 7 times per week
I 10% beyond normal length of muscle
T 15-60 seconds, 3-5 reps (rest 30 sec between reps)
130
Flexibility-Based Activities
• Yoga• Tai Chi• Pilates
131
Stretching Aids / Technology•Stretching ropes can make it easier to execute and hold stretches properly.
•Foam rollers can improve strength, balance, and flexibility.
132
Guidelines for Safe & Effective Stretching Exercise
• Do not force the stretch to the point of pain.
• Choose safe exercises.• Avoid overstretching weak muscles.• Use good technique.
133
Summary• Flexibility is often neglected• Joint specific• Many influencing factors• Many health benefits• Static stretching is the most widely
recommended.• 3-7 days per week target
Dynamic Flexibility & Strengthening
http://www.youtube.com/watch?v=E7ghNKOH9To
Potentially Dangerous Exercises
and Some Modifications
QUESTIONS????
THANK YOU!!