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Health: Vital to your Life

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Leg Strengthening Exercises

February 3rd 2011 17:40

It's the exercises we all love to hate: Leg Exercises. When were in the gym we look at lunges like their poison and stare at the leg press like it's the harbinger of the apocalypse. They can indeed be hard to do and the recovery process after a long leg workout can be grueling if we're not careful. However, leg exercises are vital if we want to bulk both our lower and upper body up. You may be asking yourself why, and I'll tell you. Despite the obvious reasons it helps hard-gainers gain weight (by building an area that is typically neglected) and helps body builders maintain a healthy balanced physique, leg strengthening exercises force our body to balance itself out. It may sound crazy, but our body acts to maintain a certain degree of equilibrium through constant homeostatic regulation. This of course doesn't mean if we only do lunges and squats five days a week our arms will turn into cannon balls. However, it does cause our body to send blood to areas that otherwise aren't getting too much (e.g. your arms or pectorals) to maintain that equilibrium I mentioned earlier. As a result, when we do work our upper body, our gains can increase exponentially much faster than before. Don't believe me? Try it out yourself! Below are some general non-machine leg exercises with a recommended amount of reps and sets that you can use to supplement your workout regime.

Lunges (with or without weights) - 3 to 5 sets of 12 to 15 reps

Squats (with or without weights) - 3 to 5 sets of 10 to 12 reps

Dead lifts (Romanian or normal) - At least 50 to 70 pounds if your just starting, with 3 to 5 sets of 10 to 12 reps

Good mornings - 50 to 70 pounds (for beginners) with 3 to 5 sets of 10 to 12 reps

There are a billion more to mention, but for starters I just wanted to list these four. These are simple, easily done (with proper form of course!), and easily incorporated into a routine you're already used to. Comment on this blog if you have good things, bad things, or success stories!

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Nutrition Essentials

January 27th 2011 03:28

Nutrition is the most important part of health, period. The most important parts of nutrition we should all focus on are: vitamins and minerals, fats, proteins and carbohyrdrates. Essentially the building blocks of any healthy diet. Keep in mind: variety is key and over doing it can be painful, uncomfortable, or potentially dangerous.

We get all of these nutrition essentials from the food we eat. Most vitamins and minerals come from fruits, vegetables and liquids, while our fats, proteins and carbohyrdrates mostly come from sugars, meats and wheats.

Like before: variety is key. If you eat too much meat, your liver may begin to "malfunction" due to overproduction of creatine phosphate. If you consume too much sugar, your blood may desensitize itself to insulin production, or maybe stop insulin production completely. If you take in too many vitamins and minerals, your body simply doesn't digest the excess material and dispels it through your urine or (at the worst) as a kidney stone through your urinary tract.

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Physical Therapy: Multi-Modal Treatment

January 26th 2011 03:38

Physical therapy is a very well known and effective form of treatment and therapy for people who have developed chronic musculoskeletal ailments like back pain or who have experienced abrupt musculoskeletal changes like broken or complete loss of limbs. What’s not quite as well known is the multitude of modalities, or forms of treatment, available to treat these many musculoskeletal ailments. Modalities in physical therapy fall under two categories: manual modalities and non-manual modalities. Manual and non-manual modalities are associated with very different forms of treatment. Manual, otherwise known as physical treatment, involves the use of exercise, manipulative therapy, mobilization, etc, to treat patients (Moffet, Anne, Klinik). Non-manual on the other hand is knows as non-physical treatment and involves the use of topical agents, psychological treatment, etc, as a form of treatment (Hurley, Lindsay). Though manual and non-manual modalities differ greatly in their forms, these modalities are what make physical therapy effective and long lasting. However, when used individually these modalities only provide short term benefits to any one patient. The true long lasting benefits become apparent when a multi-modal approach that involves both manual and non-manual modalities is used (Feine, Lund). The question many researchers are asking, however, isn’t whether multi-modal treatment works or not, but whether multimodal treatment is better than individual treatment. “(1) Are specific techniques more effective than others in general? (2) Are specific techniques more effective than others for specific categories of musculoskeletal complaints? (3) Given a specific musculoskeletal symptom, when in the course of treatment should the clinician and patient reasonably expect to achieve improvement” (Evans). Asking questions such as these, the conclusion many researchers have come to in many cases is multi-modal treatment is indeed better than individual modalities, especially in the long term.

Manual modalities are a form of treatment and therapy that are the most widely known of the two modalities. As a result, it’s widely believed that manual modalities are the best form of therapy, especially with musculoskeletal conditions. Musculoskeletal conditions are conditions that encompass the body as a whole, typically seen externally but in some cases internally as well. Ailments of the internal musculoskeletal region involve stomach pains, neural problems like balance, uncoordinated movement, or persistent migraines, and problems with any number of internal organs like the intestinal tract. External ailments on the other hand involve back pain, joint pain, muscle aches, etc. Manual therapy can indeed be useful in some of these cases like lower back pain. “Exercise therapy has long enjoyed a major role in the armoury of effective treatments for chronic LBP (lower back pain), and most national and international guidelines recommend that supervised exercise therapy is used as a first-line treatment in the management of chronic LBP” (Moffet, Anne, Klinik). Lower back pain, or LBP, is one of the most common forms of musculoskeletal pain known due to our typical sedentary lifestyles. Reducing pain is of the utmost importance in the treatment of musculoskeletal conditions like LBP, and manual modalities like exercise therapy and strength conditioning help bring that outcome to fruition. Another very well known and common ailment in which manual modalities are used is neck pain. One study proposed in Manual Therapy concluded that manipulation and mobilization used along with exercise were sufficient forms of treatment for neck pain. “Neck pain is common, can decrease function, and poses a great cost to the health care system. While Spinal mobilisation or manipulation can have mechanical effects, physical medicine modalities (like exercise) have additional physiological effects on analgesia, inflammation and force-coupling production”(Manual therapy with or without physical medicine). This suggests that manual therapies like mobilization and exercise provide adequate relief to the patient. Another study provided by the Archives of Physical Medicine and Rehabilitation gives evidence that other exercises like strength training or aerobic exercises rather than mobilization and manipulation provide relief for muscle disorders like LBP or neck pain. “Our best evidence synthesis resulted in level II evidence (likely to be effective) for strengthening exercises in combination with aerobic exercises for patients with muscle disorders” (Exercise Therapy and Other Types of Physical Therapy) However, even though manual modalities are indeed a vital form of treatment in physical therapy, they are not always as effective for both the short and long term benefit of the patient. “Level III evidence was found for aerobic exercises in patients with muscle disorders and for the combination of muscle strengthening and aerobic exercises in a heterogeneous group of patients with muscle disorders. Finally, there is level III evidence for breathing exercises for patients” (Exercise Therapy and Other Types of Physical Therapy). Level III evidence, as stated in the study, indicates a lack of progress using only aerobic exercises in patients with muscle disorders. Though manual modalities are indeed valuable and effective with certain ailments, their use can be limited when used individually rather than together, such as aerobic exercises being used alone rather than with strength training. Manual modalities are also restricted in the ailments they can properly treat, like sprained ankles, chronic muscle fatigue, or chronic muscle pain in which they can potentially damage further.

Non-manual modalities are an effective but less known form of therapy that most have never heard of outside of professional circles. This is due mostly to the stereotypical image of a physical therapist massaging or stretching his/her patient’s arms or legs. Even though non-manual therapy is less known, this doesn’t mean it’s any less effective than the manual side of therapy. Non-manual forms of therapy provide vital treatment to musculoskeletal ailments such as chronic muscle aches, pain, and chronic fatigue that manual modalities have no effect on or can even damage further because of their neuromuscular origins. In neuromuscular disorders, the brain finds it difficult to send signals or even can’t send signals to muscles to order them to contract, to stop contracting, or to even move at all. Otherwise automatic reactions and movements that most of us do everyday are painful or unresponsive in those individuals who have neuromuscular disorders. According to one study in Best Practice & Research Clinical Rheumatology, “There is some evidence that thermotherapy, TENS and massage can relieve pain, and these interventions are relatively inexpensive and easy to self-administer, making them attractive treatment options” (Hurley, Lindsay). It’s very important to realize that even if non-manual therapy individually doesn’t promote complete healing over the long-term, it’s short term benefits are numerous and vital to the patient’s physical and mental health. This is especially important in painful and debilitating chronic neuromuscular disorders like chronic muscle aches. Another good example of a non-manual therapy for chronic conditions is the use of TENS, or transcutaneous electrical nerve stimulation. Electrical stimulation of the nerves is especially useful in neuromuscular conditions because it prompts the brain to send signals that are otherwise ignored or aren’t sent at all. “Documentation of greater than 50% reduction in pain with a treatment trial may help substantiate its true beneficial effects” (Malanga) It’s important to note that according to the same study done in Best Practice & Research Clinical Rheumatology, the placebo effect of these therapies is just as important as the therapies themselves. “The popularity and powerful placebo effects of physiotherapeutic interventions can be utilized when delivering and advising patients about less popular, burdensome interventions that require considerable time and effort (weight loss and regular exercise)” (Hurley, Lindsay). This suggests that though some non-manual therapies such as heat pads or massage provide relief to certain ailments like muscle aches or pain, other non-manual therapies like electrotherapy (which has little to no effect on the patient physically) have powerful placebo effects if utilized correctly. The main point: non-manual therapies deal mostly with the mental aspects of physical therapy, as explained in the placebo’s effectively used in therapy. Therapies like massage and thermotherapy, which can be self-administered, help promote the mental and physical aspect of non-manual therapy. If you can provide therapy to yourself rather than from a professional, which (when going to a professional) may or may not cost vast amounts of money, your attitude towards the therapy can progress and grow much more positive. However, as with manual therapies used individually, non-manual therapies used individually only provide relief to the patient over the short term. The long term benefit of multimodal treatment to the patient far outweighs any short term benefit provided by either manual or non-manual therapies individually. "The efficacy of various modalities for the treatment of musculoskeletal pain according to the most recent scientific evidence was presented… Included in the holistic approach to patient-centred management were thermotherapy, transcutaneous electrical nerve stimulation, and alternative therapies such as acupuncture, massage and yoga, with a review of cognitive–behavioural strategies in pain management. Furthermore, knowledge of biomechanics is important, to correct for abnormal forces at the particular musculoskeletal region of concern for successful outcome, and the concept and importance of the ‘kinetic chain’ were presented...Emphasis on patient participation in active treatment was emphasized, with patients enrolling in self-management programmes to improve health outcome and to decrease utilization of health care services with subsequently reduced costs" (Hanada). As we’ve seen above, they each provide vital treatments for musculoskeletal conditions of all kinds and are utterly valuable to any one patient. However, when these therapies are used in conjunction, otherwise known as a multi-modal or biopsychosocial approach, the results are vastly superior to what any individual modality can do. As the name suggest, these multi-modal treatments involve the use of physical treatment and psychological treatment. “A patient could be told to take something to relieve pain while also being told to accept the presence of the pain and to exercise despite the pain… There is mounting evidence that a strategy of combining treatments aimed at different targets in chronic pain patients can lead to better results than a single treatment on its own” (Nicholas). The long-term benefits of multi-modal treatment are the true advantage it has over individual treatment. For example, heat pads are a widely used topical agent for aching muscles and relaxation to increase mobility and decrease pain in musculoskeletal conditions. It is an effective modality, but only for a short period of time. However, when used in conjunction with manipulative therapy or stretching exercises, the benefits stretch (no pun intended) for a longer period of time and promote faster healing. Furthermore, when these two are used with psychological treatment, the patient not only learns to treat themselves physically but learns to eliminate thoughts that can prevent further treatment and progression. The goal all physical therapists have in mind, and the ultimate outcome of proper multi-modal treatment, is the discontinuation of clinical or professional therapy by the therapist and the continuation of self-administered therapy by the patient over the course of the patient’s lifetime. Combining either behavioral or psychological therapy with exercise for chronic muscle fatigue is another prime example. In chronic muscle fatigue, patients often experience depression and “bad thoughts” because of the constant fatigue, which prevent long-term success in therapy (Bergman). Behavioral or psychological therapy comes into play here to help discourage those thoughts and promote a positive outlook on the therapy being administered. However, what about the muscle fatigue? To prevent fatigue in muscles and in the body overall, exercise and conditioning is vital to promote muscle growth and efficient use of energy in the body. These two modalities combined allow the patient to experience a faster and more constant rate of mental healing as well as promote continuous exercise after therapy has run its course. This example highlights true long term and short term benefit of multi-modal treatment through successful administration of the said treatment as well as the continuous treatment administered by the patient himself/herself. Another good example of successful multi-modal treatment comes from a study done in Brazil comparing the effectiveness of hydro distention, a process in which your bladder is filled with fluid to stretch the walls of the bladder, used individually and the effectiveness of pharmacological and behavioral therapy used in conjunction in a bladder disorder known as painful bladder syndrome (Figure below)

Image courtesy of google images

In the graph shown, The different bars represent different forms of treatment ranging from strictly hydro distention (“Shydro”, “Phydro”, Sf/u, Pf/u) to behavioral and pharmacological treatment used in conjunction (“Spb”, “Ppb”) over a ten month period. If we look at the “Spb” and “Ppb” bars, which represent change in symptom using pharmacological and behavioral therapy, the progression from the other therapies used individually is drastic and vastly superior. This example highlights the benefits associated with each, but ultimately gives us reason to believe that multi-modal treatment is indeed superior to treatment with individual modalities.

If physical therapy treatment is provided with a multi-modal approach, for example cognitive/behavioral therapy with strength and flexibility exercises for patients with chronic back pain; both short term and long term results show not only better healing but healing that lasts (Feine, Lund). Does this mean that multi-modal treatment is better than treatment with individual modalities? Yes, it does. "There is also strong evidence that demonstrates the benefits of improved health outcomes, with decreased health care utilization and subsequent costs, in patients who undergo training to become self-managing ‘expert patients’. This may be encouraged by instilling confidence in the patient by providing support, encouraging collaboration with other patients who practise self-management, assisting in setting short-term goals, and by being available for consultation should the patient require further positive reinforcement" (Hanada). A very important aspect of physical therapy and the true goal of the physical therapist aren’t just the effective use of those modalities, but the promotion of continuous self-administered treatment in the patient after the therapy has run its course. Without these two things clearly explained and shown to the patient, true long term healing and benefit is never achieved. Multi-modal treatment, when used effectively, achieves this and gives us a vastly superior outcome to any one individual treatment.

References:

Feine, Jocelyn S., Lund, James P. “An assessment of the efficacy of physical therapy and physical modalities for the control of chronic musculoskeletal pain” Pain 71.1 (1997) 5-23. Print

Hanada, Edwin Y. Md “Efficacy of rehabilitative therapy in regional musculoskeletal conditions” Best Practice & Research Clinical Rheumatology 17.1 (2003) 151-166. Print

Moffett , Jennifer Klaber MCSP, MSc, PhD, Professor of Rehabilitation and Therapies Deputy Director of the Institute of Rehabilitation and Mannion, Anne F. BSc, PhD, Head of Musculoskeletal Research, Klinik, Schulthess, Zürich, Switzerland Senior Research Fellow “What is the value of physical therapies for back pain?” Best Practice & Research Clinical Rheumatology 19.4 (2005) 623-638. Print

Hurley , Michael V. PhD, MCSP, Professor of Physiotherapy and Bearne, Lindsay M. PhD, MSc, MSCP, Lecturer in Physiotherapy “Non-exercise physical therapies for musculoskeletal conditions” Best Practice & Research Clinical Rheumatology 22.3 (2008) 419-433. Print

Bergman, Stefan MD, PhD, GP and Research Director “Management of musculoskeletal pain” Best Practice & Research Clinical Rheumatology 21.1 (2007) 153-166. Print

D’Sylva , Jonathan, Miller, Jordan, Gross, Anita, Burnie, Stephen J., Goldsmith, Charles H., Graham, Nadine, Haines, Ted, Brønfort, Gert, Hoving, Jan L. and for the Cervical Overview Group “Manual Therapy with or without physical medicine modalities for neck pain: a systematic review” Manual Therapy 15.5 (2010) 415-433. Print

Cup, Edith H. MSc, OT , Pieterse, Allan J. PT, ten Broek-Pastoor, Jessica M. MSc, PT, Munneke, Marten PhD, PT, van Engelen, Baziel G. MD, PhD, Hendricks, Henk T. MD, PhD, van der Wilt, Gert J. PhD and Oostendorp, Rob A. PhD, PT “Exercise Therapy and Other Types of Physical Therapy for Patients With Neuromuscular Diseases: A Systematic Review” Archives of Physical Medicine and Rehabilitation 88.11 (2007) 1452-1464. Print

Evans, Joseph M. PhD “A Proposed Method for Estimating the Efficiency and Effectiveness of Techniques of Musculoskeletal Therapy” Journal of Manipulative and Physiological Therapeutics 28.3 (2005) 206-210. Print

Stanos, Steven P. DO “Topical Agents for the Management of Musculoskeletal Pain” Journal of Pain and Symptom Management 33.3 (2007) 342-355. Print

Nicholas, Michael K. PhD, Associate Professor “Pain management in musculoskeletal conditions” Best Practice & Research Clinical Rheumatology 22.3 (2008) 451-470. Print

Malanga, Gerard MD “Physical Therapy: TENS, Ultrasound, Heat and Cryotherapy” Spine Universe 7 March 2002. Web. 3 May 2010

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The Gentle Way: An Analysis of Jigoro Kano and His Founding of Judo

January 22nd 2011 17:08

Born in 1860 and raised in Japan, Jigoro Kano grew up a small boy, weighing around 90 pounds for the majority of his pubescent years. Jigoro truly wished he were stronger, and so he was introduced to jiujitsu, “the gentle form”, at an early age by family friend Nakai Basiei. So he began his formal training in the martial arts in 1874. Through jiujitsu he learned two essential lessons that are relative to any martial art: size and strength do not matter. Jigoro trained hard in jiujitsu and learned very quickly how to efficiently bring down someone larger and stronger than himself, but for a while he would be no match for the masters that taught him. However, throughout the seven years of thorough training Jigoro began to look into and teach himself other fighting arts, like western wrestling and sumo wrestling. This brought a variation that his masters didn’t expect from anyone under their tutelage, and through this he began to exceed their own technique and develop his own. This eventually became what we know today as Kodokan Judo. Jigoro developed a purpose for Kodokan Judo, or “the gentle way”, that is quite similar to jiujitsu, but exceeds the simple purpose of jiujitsu and other martial arts. The translation itself is a slight glimpse into judo’s true nature and Jigoro’s true purpose for his martial art: judo is not only a system of self defense but a way to live life with a certain degree of perfection. Jigoro sought to convey seiryoku zenyo, or maximum efficiency with one’s energy and spent his entire life educating anyone interested how to apply the principles of judo to everyday living in and out of the dojo. Jigoro’s goal was to show judo as it truly was. Not a rough and tough wrestling sport, but a simple and efficient martial art meant to teach everyone looking for it the gentle way of life.
Martial arts have been around for centuries. Their hierarchal systems and complex movements can take years to master. More often than not it takes an entire lifetime. To develop a martial art and bring it to its full potential takes many lifetimes. Jigoro mastered jiujitsu, developed judo, and watched it come to fruition in his own lifetime. He had an advantage that some don’t have, however; the keen interest and dedication any master must have. Because he grew up such a small boy, his interest in the martial arts was easily ingrained, especially martial arts that placed a large amount of emphasis on leverage and using opponents’ force against them. His education began with jiujitsu, a well established martial art well known for it’s emphasis on joint locks and effective take downs which not unlike judo translates as “gentle art form”. Jiujitsu was introduced to Jigoro when he was around fourteen years old through a close family friend, Nakai Basiei, who just so happened to be a member of the shogun’s guard. For those of you who haven’t read much Japanese history, the shogun of Japan was equivalent to today’s general, albeit with a little more power. Nakai had enough knowledge to impart this advice to Jigoro. Jigoro took a true liking to jiujitsu, quickly finding a teacher to show him the ropes and taking the first step into what would be his life’s goal. This was the beginning. Indeed, Jigoro Kano continued his jiujitsu training until he was about twenty-two years of age, only a couple years before he founded Kodokan Judo. Near the twenty two mark, Jigoro began to modify his fighting style after he felt he had mastered the techniques of jiujitsu. He began to look into sumo wrestling and western wrestling, practicing techniques like the fireman’s carry, which is essentially throwing someone over the shoulder(s). These techniques were relatively unknown to his masters at the time, especially in jiujitsu where such great emphasis is placed on joint locks and leg sweeps. Soon enough, instead of Jigoro’s masters throwing him to the mat, the contrary began to occur. Jigoro began to outmatch and outmaneuver the very teachers that taught him for so very long. This lifelong training and adaptive attitude helped Jigoro build principles stemming from jiujitsu, principles like fluidity and seiryoku zenyo, and transform them into his own unique outlook.
The roots of jiujitsu, like any martial art, are planted deep in the idea of combat and self defense. It was indeed that in the beginning. Great emphasis was placed on killing strikes and striking vital points on the body to bring an opponent down quickly and efficiently. Like many martial arts that developed successfully and were taught for many generations, jiujitsu eventually became more than a simple war art. Eventually, its unique system evolved into a more complex form of physical and mental education. “There is little dispute that because training to fight involves moving the body in various ways, jujutsu indirectly became a form of physical education, but for that reason it also became a method of training the mind.” (Kano, 17) Jigoro was well aware that learning various tricks and variations required a certain degree of ingenuity and cunning. This, whether intentional or not, brought a level of training exclusive to the mind. He also believed that through training, courage and composure (among others) were brought to the surface, of which are beneficial to anyone’s quality of life. Upon this foundation of jiujitsu and principle, Jigoro believed a method of training that brought about a physical, mental, and moral education could be developed. He knew it was absolutely possible, and through that possibility he developed and named the martial art Kodokan Judo

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Fighting Arts: A Change in Behavior

January 22nd 2011 03:01

The fighting arts, more commonly known as the martial arts, have been known for years to have specific effects on an individual’s behavior. Targets of research involve the positives of regular training and participation. An example is the topic body dissatisfaction, which many researchers claim is significantly decreased because of the small emphasis placed on muscular prowess, mainly muscular bulk, in many martial arts circles (Lakes, Hoyt). Another example is self control, which in many martial arts circles is the greatest positive through training. Self control through the martial arts is of particular interest to researchers involved in the study of children with special needs, where improved conduct and reduced anxiety are the foundations upon which they can grow into functioning adults (Baron, Faubert). Many believe that if taught properly, the fighting arts can indeed manifest these positive outcomes in any one individual. In some cases however, little or no difference is observed (Swari). Two of the most researched psychological topics are self control and body dissatisfaction, both of which have positive and negative effects associated with the fighting arts.

Body dissatisfaction is extremely common in today’s image driven world. We look around each and every day at “perfect” bodies with the desire to look just like that. It’s only natural that we experience a certain amount of dissatisfaction with our own bodies, but this is especially true for athletes. If we look at the research done, we can see a difference between your run of the mill athlete and those who participate in the fighting arts. A study proposed by Psychology of Sport and Exercise suggested that between female track athletes, non-athletes, and martial artists there was a significant difference in body satisfaction (Swari, Steadman, Tovee).The track athletes experienced a high level of body dissatisfaction because of their need to be physically fit. Martial artists and non-athletes on the other hand experienced similar but low levels of dissatisfaction because of the lack of emphasis placed on physical prowess and muscular bulk. This suggests that body satisfaction doesn’t increase through the martial arts, but it’s actually quite the contrary. In many cases, especially those dealing with women, body satisfaction does increase. “Five program evaluations have shown that participation in training is related to increased self-esteem at immediate post tests” (Brecklin, Aggression and Violent Behavior). Through a deeper understanding of their bodies, the women who participated in the self-defense training showed a clear increase in body satisfaction. Though body satisfaction doesn’t stay at a high level during short intervals of training, results do show that those who experience continuous participation and training show a higher level of body satisfaction than those with no training at all. These studies suggest that a higher level of physical competence, ex. higher coordination, faster reflexes, increased awareness of one’s surroundings, is directly related to increased body satisfaction. A higher emphasis on physical prowess and muscular bulk on the other hand is directly related to body dissatisfaction as shown in track athletes

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It's only the beginning

January 22nd 2011 02:37

It's a fitting title for the very first post for a new blog. What's this blog about, you may be asking. It's about a topic that can never be exhausted, that never runs out of new material, and always keeps us guessing. Health falls under a thousand different categories that all branch up into two main tiers: Good health and bad health. Well, this is all about the good side of life. What's on the good side? Is the grass really greener? Nutrition, exercise, mentality, emotion, spirituality, and many different other subjects fall into the good life. This is my opportunity to show you if the grass really is greener, but you have to take the step over the fence and see for yourself.

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