Feel Younger by Staying Flexible

 Many of us lose flexibility as we age, which makes us feel even older than we really are. Simple tasks like bending down and tying shoelaces or reaching for a bag in the back seat of the car become harder. Recreational activities grow more daunting as our range of motion and strength decrease. With an increasing fear of injury as we age, many of us shrink away from these health-maintaining activities.

Is losing flexibility with age inevitable? No. In fact, there are elderly people who can still do leg splits and other feats of flexibility that even contortionists would find enviable! While most of us won’t need that degree of flexibility, I think everyone would like to keep moving easily and freely even as the years go on.

Why do some people stay flexible while others get stiffer with time? While some people are naturally more flexible, the key lies in habits. Just like strength, if you don’t use it, you lose it. Flexibility is largely dependent on the stretchiness of your muscles. Like a rubber band, if you use it regularly, it stays pliable. Let it sit around and it becomes stiff, breaking the next time you stretch it. That’s how you end up with an injury.

On the microscopic level, muscles contain bundles of contractile fibers. They slide back and forth, enabling the muscle to stretch and shorten. When used regularly, these fibers slide readily. Through inactivity, these fibers get stuck to each other, reducing the amount the muscle can stretch as a whole. As more fibers get stuck, the less flexible you become. If enough fibers become stuck, you can end up with an immovable contracture.

When we were kids, we moved and played a lot, keeping us flexible. Now that we’re older, studying and working take up more of our time. These often stationary activities leech flexibility from our bodies. Stretching helps recondition our muscles and restore flexibility. But if you’re like most people, stretching a couple times a week at the gym fails to undo the damage from countless hours of inactivity. This exceedingly common experience is why people often think the loss of flexibility with age is unavoidable.

The best way to counter this kind of damage caused by daily inactivity is to stretch every day. Now, this doesn’t mean you need to do deep stretching sessions every day, which may paradoxically reduce your flexibility. Rather, stretch lightly many times throughout the day, focusing on a different body part each time. Each light stretch helps counter the stiffness that has accumulated since the last stretch. If you sit a lot, stretch standing up. If you stand for most of the day, do some floor and squatting stretches.

If you keep forgetting to stretch regularly, try incorporating it into common actions. For example, instead of spinning your office chair around to get the phone, carefully twist and reach to stretch your neck, back, and shoulders. When walking through a doorway, take a second and hold onto both sides of the door frame. Then lean forward to stretch your chest muscles or lean back to stretch your upper back muscles. When you tie your shoelaces or pick up a light object, stretch your hamstrings by bending over slowly with your knees straight or just bent enough to feel a light stretch.

Do these little stretches consistently and remember to push your limits slightly each time. This will gradually improve your flexibility. Before you know it, you’ll be moving better and feeling younger.

Should You Eat Less Carbs and More Fat?

If you’ve been following the health news recently, you’ve undoubtedly seen articles saying that carbs are evil and fats are no longer considered bad for you. They might even cite a study or two that suggests the notion. Considering how tasty fatty foods are, it is understandable for people to want to see these studies as a green light to eat as much fat as they want. Unfortunately, throwing caution to the wind is not wise in this case. To understand why, we’ll have to take a historical look at our diet.

Decades ago, dietary guidelines that encouraged eating more carbohydrates and less fat were published in an attempt to reduce the rate of heart attacks and heart disease. At that time, it was believed we were eating too much fat. As a result, we started to eat more carbs and fewer fat calories. However, this didn’t do much to improve heart disease and seemed to have caused other problems such as obesity and diabetes to grow in size.

Now, current studies show that the high-carb low-fat diet wasn’t such a great idea after all. Their results suggest that we should eat fewer carbs and more fats compared to that diet. But, they don’t show in absolute terms how much more fat and how much less carbs is healthy. They also don’t prove that a low-carb high-fat diet is good for you.

So yes, we should eat fewer carbohydrate calories than before. Yes, we can probably eat more fat than we were told to before. But no, that doesn’t mean we can safely eat as many fat calories as we want.

If you think about it, this shouldn’t be surprising. Considering that our bodies need fats, carbs, and proteins to function normally, it doesn’t make sense to deprive it of any one nutrient. Carbohydrates are not inherently bad for us. They are the easiest nutrient for our bodies to extract energy from. In fact, our brains run almost exclusively on glucose, a carbohydrate, for energy. Similarly, fats are not necessarily bad. They are an excellent way for our bodies to store energy and they also provide many other important functions throughout the body. Proteins serve as building blocks and also as a source of energy.

On the flip side, too much of anything, nutrient or otherwise, is bad for our bodies. The body can only process so much of any substance at a time. Get too much of it and it becomes toxic. Even absolute essentials such as oxygen and water can hurt and kill us if we get too much of either!

We’ve already seen the effects of high-fat and high-carb diets over the long term. Currently, I’m seeing a trend in articles about high-protein diets since people are avoiding carbs and fat. If these high-protein diets become wide-spread for long enough, I wouldn’t be surprised to see future studies showing deleterious effects. At that point, with strikes against carbs, fats and proteins, I wonder what direction the next trend will take. Perhaps then, people will remember that balance is the key to much of life and health.

As for now, the next time you see an article about a health food trend, skip the hype and take a step back. Look at the context from which the recommendation is being made and see if it makes sense. If a study is cited, consider looking at the actual publication and seeing what it actually says. It may be quite different from what articles about the study say.

Why Your Ergonomic Workstation Won’t Fix Your Pain

You’re at work sitting in front of the computer and your back or shoulder is hurting. This has been going on for longer than you care to remember so you think it’s time to improve your workspace. Maybe you’ll get an ergonomic chair or one of those standing desks. Unfortunately, after you spend all that money, it’s likely that you’ll still have pains, just in different parts of your body.

While ergonomic furniture may help, it’s not the true solution to the problem. Why? The problem isn’t your work space, but rather your habits. It’s not just that you’re sitting or standing poorly, but that you’re in the same position for too long. Even if you sit in an uncomfortable chair, you can actually avoid pain if you reposition yourself in your chair and stand up frequently enough. Ergonomically friendly furniture can help you stay in one position longer before developing symptoms, but then that also means you are being inactive that much longer.

We’re not meant to be stationary beings. Even when we sleep, we move around quite a bit. And there’s a good reason for this. Our bodies need to redistribute body weight so that pressure points don’t stay on any part of the body for too long. Pressure reduces blood flow to affected body tissue which causes damage over time. If this continues long enough, your tissues actually break down and you’ll develop open wounds called pressure sores. This is what happens to immobile people such as the critically patients in hospitals.

To prevent this, our bodies warn us far in advance by sending pain signals and motivating us to reposition ourselves. Don’t ignore those signals and keep working through the pain. Listen to what your body is telling you and move.

Some people, such as stroke patients and those with severe Type 2 diabetics, can’t feel the pain and are at high risk of developing these dangerous sores. If you have one of these conditions, you need to be even more vigilant and proactive about changing your position frequently.

Positional pain can also come from your muscles and joints. Muscles help maintain posture, both good and bad. When we stay in a position too long, muscles get tired and the weight it was working against is dumped onto your joints. Your joints are not meant to handle this kind of load for long periods of time and become damaged, leading to pain. In addition to joint pain, your muscles can also become stiff, causing the common muscle tightness and cramping between the shoulders and lower back.

Ergonomic furniture helps reduce the stresses on your body by distributing your weight better and supporting your posture to reduce the tension on your muscles. However, no matter how much the furniture helps, the fact remains that there is pressure and tension on your body. The only way to prevent positional pain is to move.

So, the next time you start feeling your leg go numb or your shoulders tighten up, stand up (or sit down if you’re standing)! Move around, take a few steps, or even do some light stretching or some exercises, such as those from The One Minute Workout. This will not only resolve your symptoms, but help you perform better by increasing blood flow throughout your body. As a bonus, physical activity will also help your brain change states, which may help you figure out a problem you’ve been stuck on!

Why Pull-Ups Shouldn’t Stop at Your Chin

I remember first learning about pull-ups during the physical fitness tests back in grade school. A repetition only counted if your chin went above the bar so there was lot of neck craning and leg kicking during those gym class pull-ups. When scrawny kids are only trying to beat their friends, they don’t care about form or the benefits of exercise.

As adults, pull-ups are no longer a mandatory activity (unless you’re in the military), and are a great way to build strength and functionality. Despite the change in goals, we often stick to doing them the way we first learned them, stopping with the chin just above the bar. While still effective, I would argue that this isn’t the most effective use of your time and effort.

Instead of artificially stopping with the chin just above bar-level, why not keep going? A chin-level pull-up is actually less than half of the range of motion that our arms are capable of. You can actually keep pulling higher until your lower chest is at bar-level. As you can imagine, this is even more difficult, which means a better workout for your muscles, and more bang for your workout time.

But it doesn’t stop there. If you keep going up, the movement transitions from mostly pulling to a pushing movement. That means you can work on even more muscle groups with the same exercise! At the very top, you’ll be supporting your body weight on the bar with your arms straight down, just like the top of a dip. This combined pull-push movement is called a muscle-up. When done in a controlled manner (little swinging or momentum), you can develop great strength throughout the entire range of motion with this exercise alone.

I emphasize the importance of relying on momentum as little as possible since that works your target muscles maximally and imparts the most strength building benefit. Just as in grade school, going quickly, kicking, or kipping like you often see in CrossFit may help you notch a couple more reps but that doesn’t maximize the strength-building benefits for your time spent.

Besides looking cool and being more time efficient, muscle-up training imparts more functionality. Training this combined pull-push movement erases the strength gap that most people have when they are transitioning between pulling and pushing. This means better performance for many sports. For those of you who like more extreme sports, it’s also quite handy if you ever find yourself hanging off a building or cliff and need to climb up.

So, the next time you do pull-ups, don’t stop at the chin. Keep going up as high as you can. You may not be able to do as many repetitions this way but you’ll gain more benefit in less workout time.

For the best muscle-up I've seen to date, check out the video of Olympic gymnast Andreas Aguilar below. The applause is definitely well-deserved!

 

Lifting Patients Too Dangerous To Be Done Safely?

A few weeks ago, I came across an article titled “Even‘Proper’ Technique Exposes Nurse’s Spines to Dangerous Forces”. Not unexpectedly, it started with the story of a nurse that was injured on the job while trying to help move a patient in the intensive care unit despite using the “proper lifting technique” taught in nursing school. The injury was quite serious, requiring several surgeries, and jeopardized her career. The article then talked about a research study that suggested it is impossible to lift patients safely with just human body mechanics. It went on listing several reasons why and also described the compressive forces that people’s spines are subjected to when lifting patients. It even noted that lifting in teams does not reduce those forces to safe levels while increasing shear forces, a force our spines are more vulnerable to. It basically concluded with the idea that we need mechanical patient lift devices throughout the hospital to make it safer, but not necessarily 100% safe, for workers to move patients around.

As I read the article, I reflected on my experiences working in the hospital, especially the times I helped move comatose patients weighing 300, 400, or more pounds. I’ll tell you, it’s definitely not easy to do, even with 4 or more people. Most healthcare professionals know what proper lifting mechanics should look like but with the way patients are located and positioned, it is not always possible to use optimal lifting mechanics. If you’re lucky, you may have a patient hoist handy but even then it’s not necessarily trivial getting a person into it in the first place. Sometimes you are able to figure out a way to use bed sheets and have enough people around to help push and pull, slowly working the patient into the best position for the actual move. Whatever the situation may be, lifting a person is nowhere near as mechanically simple as deadlifting a barbell at the gym.

So what’s the answer? I don’t know if there is a failproof solution, at least not with our current technology. Mechanical lifts will definitely help but there are limits to those. First of all, they are quite expensive so they aren’t available everywhere in the hospital. Second, they do have weight limits which some patients exceed. Finally, there is always the issue of getting the patient loaded onto the lift. Despite these problems, hopefully they’ll become more widespread so healthcare professionals can work more safely, and for longer.

Meanwhile, I strongly urge all of you to do your best to stay in good physical condition. It is your best chance of protecting yourself from serious career-ending injury. Make sure you exercise regularly. When you work out, focus on your functional strength throughout your entire kinetic chain. Substantial core strength and a strong kinetic chain will help reduce the micro-damage on your spine when lifting patients. The less damage you take, the less likely you’ll suffer a debilitating injury. DO NOT just do cardio. Cardio is not going to help you here and it can actually make things worse if you ignore strength training.

As a healthcare professional, you’re probably very busy. But for you, exercise is not a luxury. It is a necessity. Think of it as part of your job. It’s no longer just about looking good, but keeping you, your career, and your patients safe.

How to Shovel Heavy Snow Like a Boss

My first article about shoveling snow described a technique I use to shovel faster with less stress on the back. That technique works great with lighter snow loads. We’ve been getting more snow in the Midwest recently so I wanted to go over another technique I use for heavier snow falls.

In the first technique, the back hand is tucked in front of the hip to better control the shovel. The other hand holds onto the shovel as close to the other end as is comfortable. On most snow shovels, this means the forward hand is still a distance away from the snow. While this is fine for lighter loads, it is less effective for heavier loads due to leverage issues.

To adjust for this, move the forward hand almost all the way to the snow end of the shovel and let the back hand go back behind your hips. This allows you to keep the load as close to your body as possible when lifting.

When you stand up and lift, keep the front arm straight so it acts like the hoist lines on a construction crane. This will reduce the work your smaller arms muscles need to do. On a crane, the lifting isn’t done by the hoist lines but rather by the motor that winds it up. The lines just transmit the forces to the load.

In this case, the “lifting motor” is your legs and your torso and arms transmit those forces. Your back hand functions to keep the shovel level and to steer it when you throw the snow away. When you pivot to dump the snow, you can use your hips and torso together. Since the load is essentially next to your body, twisting your torso won’t be as stressful on your body compared to the other technique where it is farther away.

This method should feel similar to lifting a box with proper form (using the legs, not the back). Your back and other core muscles just function to maintain your posture. They don’t do any lifting.

Finally, since your center of gravity is kept near your center of balance throughout the technique, you don’t have to reset your balance for each load. Essentially, you are just doing leg squats with weights. This allows you to perform each repetition more quickly.

Remember, if the snow is particularly heavy or high, shovel each spot in layers. Work all the way vertically down the snow pile before moving your forward. This technique is especially well suited for working vertically through snow since you don’t even need to move your feet for each repetition. Use this technique and you can plow throw piles of snow in record time!

Picking the Right Cold Medicine – Part 2

In my last article, I covered how to pick cold medicines for coughs. Now, we’ll go over medications for other common cold symptoms.

Stuffy noses and sinus congestion is caused by swelling in the mucous membranes lining the nasal cavities. Besides making it harder to breathe, it can prevent drainage of excess mucous, leading to build up and painful pressure. Given enough time, germs living in this retained mucous can fester and cause sinus and ear infections.

If your symptoms are unbearable, you can consider trying a nasal decongestant. Pseudoephedrine and phenylephrine are commonly found in oral cold medicines. Both have vasoconstricting properties that shrink blood vessels and may help reduce swelling in the mucous membranes. However, they can also raise blood pressure so if you have blood pressure issues, be sure to check with your doctor first.

Research studies suggest pseudoephedrine is the more effective of the two but due to concerns of people converting it into illegal drugs, you’ll have to ask the pharmacist for it. Phenylephrine has not been shown to be more effective than placebo but if it works for you, that’s all that really matters.

You can also find nasal decongestants as topical sprays that you squirt into your nose. Oxymetazoline is a common active ingredient in these sprays. Effectiveness varies from person to person so you’ll have to try it to see if it works for you. Follow the directions and do not exceed the recommended dosage. Otherwise, you’ll have a higher chance of rebound nasal congestion when you stop using it, even after your cold is gone.

If you have a runny nose or sneeze frequently, you can try medications that contain an antihistamine. Although histamines are responsible for these symptoms when you have allergies, they have not been shown to be involved during a cold. Despite this, the older generation antihistamines used in allergy medications may help reduce symptoms in some people. If your runny nose becomes intolerable, you can consider trying an antihistamine, such as chlorpheniramine which is commonly found in OTC cold medicines.

Please keep in mind that antihistamines may make you drowsy so be careful when using them and heed the safety warnings. On the other hand, when your cold prevents you from getting enough rest at night, this side effect may be helpful. You’ll often find diphenhydramine, also known by the brand name Benadryl®, in medications marketed as night-time cold medications.

Fevers are common with bad colds and especially the flu. Since it is one of your body’s methods of fighting the germs causing your illness, you generally don’t need to treat a fever. But if the fever and accompanying chills are making you miserable, you can consider taking an antipyretic (fever reducer) such as ibuprofen or acetaminophen, the active ingredient in Tylenol®. Never give aspirin to children with fevers or suspected viral illnesses as it can potentially cause a serious and even fatal reaction known as Reye’s Syndrome.

Finally, you may have aches and pains, called myalgias, with your cold. They are generally short-lived but if they become too bothersome, you can consider taking an analgesic such as ibuprofen or acetaminophen. When taking these pain killers, make sure you follow the directions. Do not exceed the maximum daily dosage among all of medications you are taking since that can lead to serious organ damage. Also, do not drink alcohol when you are going to, or have taken, acetaminophen. This can lead to serious and even fatal liver damage.

Remember, always consult your healthcare professional if you are unsure whether a certain medication is appropriate for you.