Author: rajani patil

Health & Wellness

Midlife Fitness or Midlife Crisis?

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As one crosses the threshold of 40 various things start to happen. The first one might be your friends making fun of you for being on the ‘wrong side of 40’ but more importantly, you might start to feel not as vitalized or energized as before. This happens not only because of the physical aspects of aging but also the fact that in your 40s you are juggling several different things leading to stress and exhaustion. If you haven’t been particularly careful about keeping fit till now, you may feel that it is now a lost cause. Tons of people think that unless you have a history of exercise, it is too late to start or that it is not viable to be doing what those in their 20’s and 30’s might be doing easily.

But let me assure you, this is not so. Anecdotally I have seen many patients and friends who have taken up workout regimes late in life while up until now the only exercise they got was the non-existent walk from their car to office. In fact many people have completely turned their lives around after 40 and are reaping the benefits of it much later in life. I have watched and admired my father-in-law’s lifestyle for the past one decade. He follows a simple but consistent regime of food and exercise daily without any excuses or any ‘missed days’. The only days that I have seen him not adhere to his routine is on the wedding days of his three children! At 70, he stands tall with radiant skin and capable of physical activity that any other 70 year old would flinch away from. He is also devoid of any chronic illness his peers discuss about and the only medication he takes are daily vitamins. I had assumed that he was always like this. Much to my surprise, he was a smoker till he hit his midlife. I am not sure what spurred the radical change but he took up exercise and a well-balanced diet regime then and has stuck to it ever since. This is truly inspiring.

In our 40’s we start to take stock of our life, question our mortality and wonder if we will continue to lead active fit lives in the future. 50’s and 60’s can herald the onset of many diseases such as heart disease, diabetes, bone loss, muscle and joint pains, hypertension, stroke and many others. We no longer feel invincible and immortal like we did in our 20’s. Add to this the fact that we are juggling parenting, aging parents and our careers and we struggle to make time and effort for exercise. If we decide in our 40s to begin the journey towards fitness then it is not too late. Even research has looked into this with positive results. In 2007, Dr Dana King of the Medical University of South Carolina, Charleston looked at the adoption of healthy habits in middle age. The report brings encouraging news to any middle aged people who feel it is too late to get fit- it showed that those who adopted healthier lifestyles by eating better and exercising more had a 35% less chance of cardiovascular disease and their mortality risks went down by 40%. Another recent study by Dr Benjamin Lewis showed the same results. Hence, even if you haven’t been very active so far doesn’t mean that it is futile to start now.

Understanding that the amount of physical activity required to attain fitness is not high might motivate many to begin as well. According to the 2008 Physical Activity guidelines published by the US department of health and human services, substantial health benefits can be achieved with just

a. 2.5 hours of moderate aerobic activity per week (only 21 minutes every day) OR

b. 75 minutes of vigorous aerobic activity per week (only 10 minutes a day)

Moderate aerobic activities are brisk waking at 3 mph or faster, bicycling slower than 10 mph, tennis doubles, dancing and gardening. Vigorous aerobic activities are jogging, running, swimming, tennis singles, biking faster than 10 mph, jumping rope, heavy gardening, hiking uphill. Remember that weight training either at home or the gym can assist greatly in maintaining muscle mass, bone health and in attaining fitness.

So depending on your history of exercise and physical status opt for one of these options and say Yes to Midlife Fitness and No to Midlife Crisis!

Health & Wellness

Stay energized all day!

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Many people suffer from fatigue and low motivation to carry on through the day and may be wondering why. Sometimes it could be due to some medical problems like diabetes, thyroid, blood pressure variations and others but more often than not it is just pure lifestyle!

There are simple ways to keep yourself energized through the day- just by keeping your metabolism up. A few simple tricks about how you move and what you eat can completely alter how you feel. So go ahead and try some of these.

Get moving in the a.m. 

Start every day with 15 minutes of cardio intervals, such as brisk walking or jumping jacks or push ups- before you even think about eating breakfast. Doing cardio on an empty stomach is scientifically proven to burn fat and it will seriously prep you for the day ahead.

Eat clean

I hate the word ‘diet’ and instead believe in eating clean or eating mindfully. Clean eating is more about a lifestyle change and forming new habits. This means choosing unprocessed foods like fresh fruits and veggies, whole grains and lean proteins instead of fast food. Fueling yourself with the right food is the key to transforming your body, sustaining energy, gaining muscle, and dropping fat. Heavy processed food, while feels good on the palate can zap you of your energy and make you feel bloated and lethargic. Clean light food can keep your energy up much longer by making sure your metabolism stays boosted.

Have the most important meal of the day

Most of us understand how important breakfast is because studies show people who maintain the right weight are regular breakfast eaters, but few of us make the time to eat in the morning. Making sure your breakfast includes a combination of protein, fat, and healthy carbs will give your metabolism and YOU the right jumpstart it needs.

Refuel often- Aim to eat three meals and two smart snacks (like nuts, eggs, curd, etc) a day to keep satiated so you’re less likely to give in to your junk food cravings. You should be eating less calories and minimizing carbs as the day progresses.

Work out smarter, not harder. Focus on fat loss and not weight loss. Rather than focusing on losing weight you should be focusing on staying fit, staying healthy and changing your body shape by lifting weights, eating well, and doing a small amount of cardio. Weight training three to four times a week can help you build muscle while burning fat, and muscle boosts your metabolism because it torches calories all day long.

Follow these ways to keep energized all day. Remember, to achieve your dreams you have to be alert and focused!

Fitness

How to build your ultimate home gym

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If you thought working out effectively means that you MUST invest in a gym, then this article is for you. It is fairly easy and inexpensive to build a gym at home. But before you get all excited about this, make absolutely sure that a home gym is right for you. There are a few questions you must ask yourself. Are you highly motivated to work out? Are you finding the travel to the gym and back tedious and cutting into other aspects of your life? Does being in a group setting working out do nothing for you? Are you finding it difficult to accommodate several sessions a week at the gym due to the demands of your job? Do you think you are paying through your nose for your gym membership? If you have answered yes to all these questions, then building a home gym may be right for you. However, If you draw motivation from being in a group, enjoy being in a like-minded group discussing ideas and tips for training, find the gym adds to your social scene or lack the motivation to workout on your own then you must not invest in a home gym. The equipment might just lie around gathering dust only to be discarded years later!

Now, if you are ready to take the plunge then some space and a small investment is all you need. Lets get started.

Step 1: Decide where your home gym will be set up. Since space can be a constraint may times, plan for a small nook that can be a part of the rest of your home, maybe your bedroom or the living room instead of being tucked away in a spare or guest room. The more often you see the gym, the more likely you are to use it.

Step 2: Make it as appealing as possible so that you are motivated to use it. Keeping your home gym light and airy with good natural light makes it very conducive to being used to a maximum. Putting up pictures of celebrities who inspire you to reach your fitness goals goes a long way also. Keep the space clutter free and distractions except for the TV if you are planning to use it for the workout. Plants and music enhance the ambience beautifully. Mirrors according to me are at a must since paying attention to form is most crucial to avoid injuries. Mirrors also can make the home gym appear larger which in turn makes you feel less cramped during your training.

Step 3: Now let’s stock your home gym. Yes the idea of fancy bulky equipment sounds great but it may not be very practical for a home gym. Especially because you could reach your fitness goals easily with smaller inexpensive equipment. Here’s some of my must-have’s!

  • Cardio: For cardiovascular exercise, doing jumping jacks, ‘suryanamaskars’ and jump- ropes(skipping ropes) are excellent for quick cardio. Just make sure to land light to avoid too much impact on your knees. For additional cardio, going for a run outside, taking the stairs or walking can be utilized.
  • Strength and conditioning: Adjustable weights are great to use for weight training- you can chose the weights according to your goal- toning, bulking or strengthening. I love using resistance bands and resistance loops since they offer such a wide variety of exercises that can be done. Using varied resistances for different exercises can help you push yourself. If you have space, you could use stability balls, Bosu and TRX equipment as well. Balance discs are excellent for lots of different workouts as well.
  • Recovery: Foam rollers, yoga mats and stretch ropes are essential to finish your workout. Without a proper cool down, you are basically inviting injuries and also sabotaging your next workout. Foam rollers are such a versatile tool that you could even use it as a part of your workout to do your core training and strength training.

Start with these basics and as and when your goals change you could keep adding more equipment being mindful to space. The last thing you want is a home gym cluttered with tons of equipment making it appear cramped and eventually gathering dust!

Step 4: Figure out your workout routine. This might be harder that you thought. Functional training, crossfit, TRX etc are the options to choose from. Since having a certified fitness trainer is very important when you begin your fitness journey, you should consider doing a session or so to understand proper forms of exercises. The fitness trainer can also design a program for you that suits your goals. If you have any painful niggles, speak to your sports physiotherapist before beginning any fitness routines. I am not a big proponent of online workouts but if you do pick an online fitness routine, do some research on the credibility of the instructor. Only a well certified trainer or fitness specialist is qualified to teach fitness routines so be sure to do your homework!

Step 5: Use your home gym. Now that you are all set up- go for it. Invite a friend, a like-minded buddy or just go for it solo.

Fitness

No pain No gain?

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Do you believe in the cliché No pain No gain? This probably depends on who you have heard this say or in what context. Pain means different things to different people. When I treat patients with spine or sports injuries in the clinic, I often ask what kind of pain they have. Yes – what kind of pain- because different kinds of pain mean different things. For example soreness is vastly different from constant dull ache whereas dull aching pain is very different pain from sharp shooting pain. This helps me identify the nature and the source of pain. A majority of people know the type of pain they are experience but there are some who have trouble determining whether they have muscle soreness or pain. This is a critical thing to understand if you work out.

Traditionally No pain, no gain is an exercise motto that promises greater value rewards for the price of hard and even painful work. In relationship to fitness training, this phrase first originated in the early 1980s. Since then, people have adopted the idea that in order to gain any benefit from their fitness exercise program, it needs to hurt and perhaps even hurt badly. This is farthest from the truth. In fact, if you experience pain after your exercise routine and still continue to exercise in spite of the pain, you may be traumatizing your joints and muscles which may lead to further injury. 

Frankly instead of “No pain No gain”, the saying should be “No soreness, No gain” or “no discomfort, No gain. But this doesn’t rhyme and that’s probably why the saying exists as it does. While soreness is a natural response to exercise, actual pain is a sign that something somewhere is wrong and needs to be addressed. Exercise releases endorphins, relieves stress, increases energy levels, aids sleep, and enhances the ability to enjoy recreational activities. A solid workout can leave you feeling great all day long after it’s over. It’s not supposed to feel soothing; exercise works because you place your body under stress and it strengthens itself to prepare for the duress of your next workout. While you’re doing it, it should feel uncomfortable but it shouldn’t be unbearable and it shouldn’t feel painful.

So if you believe that without pain your workouts are useless, you might continue to damage your joints and muscles leading to injuries. Pain is a sign that your body is giving you signaling that some damage is either being done or already done. While working out you want to do reps till you fatigue but not to the point of pain. Working out should be uncomfortable; if the workout is too easy then you may not be getting the exercise benefits you desire. However, working past that point is dangerous- you may be damaging tissues! Aching, soreness and fatigue are normal signs of a good workout. In fact if you don’t have soreness after a workout you may not have pushed enough. Sharp, stabbing, grinding pains are the bad kind of pains that you want to sit up and take notice.

Anyone who wants to seriously follow an exercise regimen should keep in mind that pain is not necessary for a successful workout. A good rule of thumb to follow is: if it hurts, don’t continue to exercise. I know of several injuries that originated from a great workout going overboard. Even slight pain or swelling of a joint is an indication that the joint needs rest. If the pain persists for greater than 48 hours then you should consult a doctor.

Exercise should be a fun activity that you enjoy doing, not one that leaves you in pain. It should challenge your muscles and joints to greater strength and flexibility and yet be comfortable enough so that there is no pain.

So the next time you work out, listen to your body. Enjoy the soreness but be alert and mindful of pain.

Cycling

Cyclists- How to Effectively Avoid Knee Pain!

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Cycling is a wonderful sport – a fantastic way to get non-impact exercise while having fun. Many people enjoy riding in groups and some prefer to ride solo. Some switch to cycling from other impact sports since it is supposed to be not so harsh on joints. Some take up cycling after an injury while others might be training for a triathlon!

Whatever your reason to cycle, it is important to be aware that knee pain is quite common amongst cyclists and can get worse quickly if left untreated. Primary causes of cycling related knee pain range from bike alignment, quadriceps weakness, lack of warm up and cool downs, over-training and over-use. The key is to prevent knee pain in the first place!

Listed below are the most crucial methods to prevent knee pain.

  • Make sure you pay attention to your bike set-up. No two cycles are the same and no two cyclists are the same. Your bike needs to be fitted to your frame. This is called cycling ergonomics. If you need help with this seek professional advice from a sports health professional.
  • Ramp up your training sensibly. Take advice from your coach or an experienced peer. Making sudden changes and over-training are the major causes of knee pain.
  • Be diligent about a proper warm up and a cool down program. Avoiding warm ups or cool downs can lead to injuries must quicker. Different muscles undergo strain and stress during cycling as compared to running or other sports. Learn a short and simple routine that you can stick to. A sports physiotherapist will be the best person to guide you.
  • Take care of your legs. They undergo a lot of overuse each time you cycle. Incorporate a daily stretching or foam rolling routine that will prep your muscles for all your rides- no matter short or long distance. A rolling and stretching program for your quadriceps, hamstrings, glutes and calves is a must especially after the long- distance rides.
  • Take recovery into consideration. Treat your legs to a sports massage to get all the knots and kinks out. If you ride 2-3 times a week then a monthly sports massage is a smart idea.
  • Strengthen the knees and the core. Hit the gym; learn a home-based mat program; cross-train. The stronger your quadriceps muscles are the lower your chances of ever experiencing knee pain. Core muscle strength drives your rides- they can take the load away from the leg muscles. So invest in some time and effort outside of your cycling for strength training and enjoy improved cycling performance.
  • Lastly but most importantly- don’t ignore any pain, let along knee pain. The longer you ride with knee pain- not matter how minimal- the more serious the knee problem will become. Apply ice packs daily for a few days along with taking a short break from cycling; but if the pain has not subsided in a week’s time consult a sports physiotherapist or an orthopedic surgeon. Patella-femoral syndrome (muscular imbalance leading to patella tracking issues) and patellar tendonitis(inflammation of the patella tendon) are the two common cycling related knee problems. These can be treated effectively if addressed in a timely manner. Delaying treatment could mean having to give up cycling altogether.

So ride long, ride strong but keep knee pain at bay with these simple tips.

Cricket

Cricketers- Avoid knee pain with these tips

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Whether you are a batter, bowler or both, there are certain injuries that you are more at risk of than others. Knee pain is one that might make you sit out on the sidelines. No cricketer wants to do that. Hence understanding why knee injuries are so prevalent and how to prevent them becomes crucial.

There are two types of cricket injuries- acute and chronic. Acute injuries are those that occur instantly for example if you are struck by a ball or if you pull/tear a muscle or ligament while turning quickly. Chronic injuries happen over time through overuse such as repetitive bowling, etc.

The most common injuries associated with the knee in cricket occur while bowling. In the landing stride, bowlers are constantly twisting and putting extreme force through the knee joint; this can then result in a strain or more severely a tear to one or more ligaments or menisci supporting the knee joint. Being the major shock absorbers of the knee joint, injury to meniscus or ligaments could lead to a cascade of early onset degenerative changes in and around the joint. This kind of injury creates pain on the inside of the knee, while squatting or bending. Meniscus injuries should not be ignored since they may aggravate if you continue to play with the injury.

Another common knee injury in bowlers is patellar tendinopathy- inflammation of the quadriceps muscle tendon mainly resulting from overuse and poor technique. Due to the pace of the sport and excessive translatory motions, there always remains a risk of injury to the muscles around the knee joint, most commonly the hamstring, quadriceps, ITB(ilio-tibial band) and popliteus muscles. Improper technique, faulty shoes and poor strength can also contribute to stress fractures in and around the knee joint and particularly the shin.

In view of the above, good mobility, strength and flexibility training should be incorporated in the exercise routine. Strength training should involve core strength, arm strength, hip, knee and ankle strengthening.  This should be accompanied by a good warm up and cool down routine. Improving stability of the knee and ankle complex along with correction of faulty technique and footwear play a major part in injury prevention. Due to the high impact nature of the sport, good shock absorbing shoes with a medial arch support are suitable. Another vital part in training involves good rest periods in enhancing recovery of the player.

Cricket may not be a contact sport but injuries are common as the various actions that are involved place a strain on the body. Preventing these injuries is the ideal thing to do. You may visit your sports physiotherapist for a cricket injury risk screening and hence understand injury prevention strategies specific to you. This will enable you to stay ahead of the game. If already injured, immediate consultation with the sports physiotherapist is recommended. A thorough biomechanical analysis and speedy management will get you back in the game without any restrictions.

Back Pain

Back pain? Stop doing these exercises!

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“I hurt my back while I was doing crunches!” I have heard this not just once but numerous times. Back pain is one of the commonest ailments that afflict the modern man; partly because of sedentary life that weakens core muscles but partly also because in the race to get fit quickly, exercises that shouldn’t really be done are done with great zeal. This leads to a back injury and then of course all exercise is given up forever. The solution is to know the right kind of exercises for your body and this only comes from consulting a professional. Anyone who joins a gym without hiring a certified fitness trainer is looking for trouble. The same goes for anyone who begins an exercise program on their own at home by following online videos.

In my experience the worst five exercises to do if you want to injure your back are as follows:

1. Sit-ups or crunches. This may be the most unnecessary and most dangerous exercise done. In the elusive chase to get “six packs”, people end up doing a zillion sit-ups a day; mostly incorrectly. Even if they were done the right way, not only are sit-ups not very effective to strengthen to core and to get a “six pack”; it is also making your back more vulnerable to back pain and ‘slipped disc’. As an alternative do exercises that work on the core in a wholesome way without putting your back at risk. Doing planks and side planks are more challenging, fun and much more effective. So my advice is to completely eliminate sit-ups from your work-out routine.

2. Bilateral leg lifts: This one makes me cringe, not just the sight of seeing someone doing these but also just the mention of it. I can actually visualize the back undergoing enormous amounts of strain and about to give up! If you lift both your legs up while not maintaining your spine in a neutral position (back is arched a lot while lying on your back), your back muscles are in an inefficient position and very likely to go into a spasm; maybe even create enough pressure on the lumbar discs to cause a ‘slipped disc’. If these are done under the watchful eye of a certified trainer or a physiotherapist then its fine but otherwise this exercise must be eliminated if you want a pain-free back.

3. Weighted squats: Squats are wonderful to do for many reasons but these are also done wrong by most people. Keeping your back straight, not crossing your knees in front of the toes and keeping thighs parallel to each other are some points to keep in mind while doing squats. However, even if done the right way, if you keep weights on your shoulders or overhead, this creates a lot of compressive force on your spinal discs making them vulnerable to injury. Holding weights in your hands by your side is an alternative instead of overhead.

4. Weighted back extensions: To do this you lie on your stomach and raise your upper body with weights on your shoulders or hands while your feet are fixed. While back extension (bending backwards) is generally a great exercise and one that I prescribe most often; doing this with weights creates problems. To lift the weight, you may arch your back excessively or cause torsion at a particular spinal segment in turn causing the back muscles to spasm. Alternatively do these without weights or do superman (lying on stomach lifting both arms and legs up). These are more effective while also protecting your back from injury.

5. Foam rolling the lower back: Foam rolling works wonders for a lot of things from loosening up tight muscles to becoming an adjunct for a core workout. Often people look up videos online to use the foam roller and end up using it incorrectly. The foam roller is supposed to be used on muscles groups and not on bone or joints. Using the foam roller on the back is one of the things that should be avoided since it may cause awkward twisting or compression leading to back problems.

So do a killer workout to attain all your fitness and health goals but keep in mind to avoid these 5 exercises to keep your back healthy.

Running

Is your running performance affected by your sitting?

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A lot of runners are recreational runners; some may be sedentary runners or even weekend warriors. All these terms vary in the attitude of the runner and also the time and effort put into the running. But the bottom line is that they all have day jobs and the running (whether it is daily or once a month) happens outside of the working hours. What is wonderful is that their bodies are getting the exercise that they need; however attention must be paid to whether sitting all day in a poor posture is affecting your running in some way. If you don’t pay attention to this, you might be allowing yourself to short change your performance or pick up several persisting injuries along the way. So seriously ask yourself- is my sitting killing my running?

The posture you adopt whilst at work can have significant effects on your muscle length and strength and can ultimately affect how you function and move when away from work. Read on to see how your day-to-day posture can affect your body position when running and what you can do to prevent negative impacts on your form.

Good posture can be thought of as when adjacent body parts are aligned in an anatomically ‘optimal’ position and bad posture when they are aligned away from the optimum. In order to understand ‘optimum’ think of a series of wooden blocks stacked one on top of each other. When they are positioned optimally, and each block is perfectly aligned with its neighbour, it is possible to build a tall and stable tower of blocks. The further away from this optimum position the blocks are stacked, the more prone the tower is to becoming unstable and potentially fall over. For example, ankle weakness and over pronation of the foot can lead to compensatory rotations in the tibia that have a knock-on effect to the knee, hip and spine; likewise a forward head posture can lead to rounding of the shoulders, and curving of the spine.

Although all runners are different it is generally accepted that optimal alignment when running will reduce the risk of injury and maximise efficiency. Naturally, there are exceptions to this rule, where runners manage to be extremely efficient despite outrageous body positioning but generally greatest efficiency and reduced injury risk is attained by sticking to the optimal alignment. So how does all of this relate to your posture at work?

Work posture affects your running posture because your body will always try and adapt to the demands placed upon it. To understand this better, think about how your body responds to training. As a runner, every time you train your neural, muscular and skeletal systems adapt to the type of training you do. If you do more long slow running, your body will get better at long slow running; if you do more fast short running you will get better at shorter faster events. Your body will adapt to the loads placed upon it; therefore, when a large percentage of your waking time is spent seated, your body will adapt to being seated. Some of the postural adaptations resulting from daily work habits become permanent adaptations that stay with you when you are running. Unfortunately, some of these acquired postures are not conducive to optimal running alignment. The good news is that being more aware of what these postures are and the negative impact they can have on your running, make it easier to identify and adopt strategies to prevent your desk job killing your running.

Below are the three main examples I believe are most relevant to the runner:

Forward head posture/rounded shoulders:

Workplace Causes: Habitually adopting a slouched position – commonly when using a computer.

Effect on running: A forward head posture and rounded shoulders stays with you away from the desk. When you run with this type of posture your arms tend to swing more across the body, your pectoral muscles become tight reducing expansion of the ribs, and other parts of the spine curve to compensate for the imbalance caused by the head being forward. All of this can lead to inefficiency and injury.

Solution: Set up your workstation so that it is easy to sit well with shoulders back and neck straight- think ears over shoulders! Get up from your seat regularly and stretch your shoulder blades backwards and tuck your chin downwards.

Poor Achilles tendon length:

Workplace Causes: Wearing shoes with a raised heel (not just for the ladies – many men’s shoes will have a 2cm raise).

Effect on running: Habitually working the calf muscle in a short position can lead to calf tightness and a reduction in ankle range of motion. The effects of this can be far reaching, leading to compensatory movements such as excessive pronation of the foot and tibial rotation. Injuries like with achilles tendonopathy, plantar fasciitis and knee pain can crop up.

Solution: Wear shoes with a minimal differential between heel and toe height (drop). Regularly get out of your heeled shoes and stretch your calf muscles.

Poor hamstrings length:

Workplace causes: Prolonged sitting with knees bent. This places your hamstrings in a shortened position which makes them tight. The longer you sit the tighter they get.

Effect on running: For striding while running, decent hamstring length is important else there is a lot of sheer at the knee. This may lead to knee pain or ITB syndrome due to compensatory mechanisms forming.

Solution: Stretch your hamstrings daily even on non- running days and take a quick standing/walking break every hour at work.

Taking care of your body when you are at work can be beneficial to your running and can reduce your likelihood of injury. So follow these tips and don’t let your work posture kill your running.