Tag: exercise

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There is a Price to Pay for Physical Inactivity

An overweight man sitting on a bench with take-out food. (Digital Vision/Thinkstock)
An overweight man sitting on a bench with take-out food. (Digital Vision/Thinkstock)

An article in the Lancet (July 21 2012) says worldwide mortality rate of inactivity is about one per cent which is same as mortality from smoking.

It says exercise has been called a miracle drug that can benefit every part of the body and substantially extend lifespan. Yet it receives little respect from doctors or society. This passive attitude towards inactivity, where exercise is viewed as a personal choice, is anachronistic, and is reminiscent of the battles still being fought over smoking.

Inactivity in our society is reaching pandemic proportion and has far reaching health, economic, environmental and social consequences, says the Lancet paper.

Is it too difficult to exercise two hours and thirty minutes a week? That is the recommended amount of time we should be physically active each week. Would you be surprised if I say only 15 per cent of the Canadians meet this goal? Yes, that is true. Only 15 per cent of us are physically active for two-and-half hours each week.

An average Canadian spends more than two hours watching television every day. Come to think of it, physical activity can be as easy as watching television. You can incorporate physical activity in your daily routine – going shopping, walking your children to school, delivering newspapers and visiting a friend. These are just a few examples. You can do more if you can. The more you do the better it is.

In 2005, Time magazine did a survey to see what kind of physical activity Americans like to do. The survey revealed 69 per cent take a brisk walk, 35 per cent use exercise machine, 32 per cent lift weights, 30 per cent ride a bike, 27 per cent jog or run, 22 per cent do aerobic exercise, 21 per cent swim, 19 per cent dance, 18 per cent play some kind of sport like soccer, 18 per cent go hiking, eight per cent play golf, seven per cent do yoga and seven per cent bowl.

Physical activity has many benefits. We know that. Smoking is harmful. We know that too. Yet we continue to be couch potatoes and we continue to smoke. What is the solution? Let us keep moving and stop smoking. Isn’t that easy?

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We Ultimately Define What is Possible in Our Own Lives

Mount Kilimanjaro Summit, Uhuru Peak (iStockphoto/Thinkstock)
Mount Kilimanjaro Summit, Uhuru Peak (iStockphoto/Thinkstock)

Here is a story of courage from the Globe and Mail (June 23, 2012). It is the story of 31-year-old Spencer West, who lost both his legs when he was just five-years-old. He was told he will never walk again. But he did more than that. He climbed Africa’s highest mountain, Mount Kilimanjaro in Tanzania, partly by wheelchair but for the most part by walking on only his hands to reach the summit. He did this for charity and make a point that you don’t need legs to overcome adversity in life.

He told the Globe reporter, “We ultimately define what is possible in our own lives.”

The summit of Mount Kilimanjaro (the world’s fourth-highest peak) is about 20,000 ft. The summit of Mount Everest is about 30,000 ft. About 25,000 people from all over the world try to climb Mount Kilimanjaro each year but one-third never make it up to the summit due to various reasons.

One of them was Martina Navratilova, the tennis superstar. In December, 2010, just months after completing six weeks of radiation treatment for noninvasive breast cancer, attempted to climb Mount Kilimanjaro for a charity. On the fifth day of a planned six-day journey, she became ill and was taken off the mountain. Navratilova, 54, was flown to a hospital, where it was determined she had high altitude pulmonary edema.

Altitude sickness kills 10 to 20 people each year attempting Kilimanjaro. More people die trying to climb Mount Everest each year. One of them was a Toronto resident. “They say the mountain took her, but not before she conquered it,” says Toronto Sun. Shriya Shah-Klorfine, 33, who made her dream come true when she reached the summit of Mount Everest. This was in May, 2012. She died while descending from the peak.

What is the secret of survival for mountaineers?

For Himalayan mountain climbers, neither personal experience nor participating in a traditional versus commercial expedition affects the chances of survival, reports a study in the June 30, 2012, British Medical Journal.

Mountaineering is a dangerous sport with a significant risk of death. The researchers conclude, “… that cumulative, collective knowledge and general innovation are more important than individual experience in improving the odds of survival.”

Factors like good health, courage, determination and training are important. Good preparation in any endeavour does bring success. Many young and old have set records climbing Kilimanjaro.

Seven-year-old Keats Boyd of Sherman Oaks, California is thought to be the youngest to have summited Kilimanjaro, he did so on January 21, 2008.

In the summer of 2010, granddad George Solt, a retired professor from Olney in Buckinghamshire, became the oldest man to reach the summit of Kilimanjaro, at the age of 82. In September, 2010, 83-year-old Bernice Buum managed to climb to the top of Kilimanjaro and became probably the oldest woman to get to the summit.

So, age or sex is not a determining factor. I know quite a few people from Medicine Hat have climbed Kilimanjaro. But my dream, since I was in high school in Tanzania, to climb Kilimanjaro has taken a back seat over the years. I don’t know why. Like anything else in life, the more you delay your venture, more difficult it gets to accomplish. Although it is never impossible.

So, there is hope for me and many others who have dreams and bucket lists. Just keep working hard and keep trying. Success will follow.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

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The Science Behind Massage Therapy

Hot stone massage therapy. (iStockphoto/Thinkstock)
Hot stone massage therapy. (iStockphoto/Thinkstock)

What do you do when you have tired aching muscles and joints? What do you do when you have stiff neck, low back pain and aching feet?

Your instinct would be to take some painkiller or phone your massage therapist. Painkillers are cheap, quick (you don’t need an appointment for that) and handy. But painkillers can have side-effects which may hurt your health. Massage therapist makes you relax, feel good, provide longer lasting relief of pain and discomfort. But they are not cheap and they are not available instantly when you need them. An aggressive massage therapist can leave you with sore muscles.

Massage involves the application of varying degrees of pressure on muscles and soft tissues to reduce tension and pain, improve circulation, and encourage relaxation. There are many kinds of massage therapies. From therapeutic massage to tantric massage. Massage therapy is performed by trained, licensed massage therapists.

A Swedish massage is the most common type of massage. It can be slow and gentle (relaxation), or vigorous and bracing (therapeutic), depending on what the therapist wants to achieve. It comprises five basic strokes (stroking, kneading, friction, percussion, and vibration). The movement is rhythmic and free-flowing. Like music or waves in the ocean. Surely, it puts me to sleep!

Therapeutic massage can be quite intense to achieve medical benefits for long-term or chronic issues. The most common examples would be a deep tissue massage or sports massage. The therapist uses more pressure and cross-fiber friction in order to get knots (also known as adhesions) to release.

It is estimated that 18 million individuals undergo massage therapy annually in the U.S., making it the fifth most widely used form of complementary and alternative medicine. Many clinical trials have proved that long-term massage therapy reduces chronic pain and improves range, but the biological effects of massage on muscles have remained unclear.

In a recent (February, 2012) study from McMaster University in Hamilton and the Buck Institute for Research on Aging in Novato, Calif., found that massage therapy triggers biochemical sensors that send inflammation-reducing signals to muscle cells. This reduces pain just like the painkillers.

Second important thing massage does is to send signals to boost the ability of muscles’ cells to make new mitochondria – the energy producing centres within cells – which can affect muscle endurance and recovery.

Third important finding debunked one long-held belief about massage. Some exercise specialists have assumed that massage aids the recovery of fatigued muscle by helping to flush away lactic acid, a byproduct of exercise. Researchers noted there was no difference in the lactic acid levels in the massaged and unmassaged leg.

Other studies of interest are: Massage Eases Low Back Pain in Randomized Controlled Trial (July 4, 2011), Adults Demonstrate Modified Immune Response After Receiving Massage (Sep. 8, 2010), Massage Therapy May Have Immediate Positive Effect On Pain And Mood For Advanced Cancer Patients (Sep. 15, 2008), Alexander Technique Offers Long-Term Relief For Back Pain (Aug. 19, 2008).

Finally, the importance of human touch is well established. Experiments of World War II and later experience in Eastern European orphanages, where babies who were fed and maintained in bed, but not held or given the benefit of human touch, showed that babies who were denied human touch withered and died.

So, massage provides therapy on two levels: physical and psychological. Add meditation to this and you can elevate yourself to a spiritual level – whether you are a believer or a non-believer in a higher being. If I can stay awake during massage therapy, then surely, there is hope for me as well.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

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Does ibuprofen help if taken before and during exercise?

Ibuprofen (also marketed as Advil and Motrin) is a non-steroidal anti-inflammatory drug (NSAID). That means it is an anti-inflammatory without cortison. It is one of the most common and widely used over-the-counter anti-inflammatory pain killers.

For adults, the dosage is 400-800 mg/dose three to four times a day (maximum: 3.2 g/day) to be taken by mouth. It should be taken with food or milk to avoid stomach irritation and development of a stomach ulcer. Bleeding from a stomach ulcer can be catastrophic, especially in elderly patients who are on blood thinners and/or Aspirin.

Ibuprofen should not be given to patients who have kidney or liver failure as it is metabolized in the liver and excreted by the kidneys. It reversibly inhibits cyclooxygenase-1 and 2 (COX-1 and 2) enzymes, which results in decreased formation of prostaglandin precursors. It has antipyretic (reduces fever), analgesic (pain killer), and anti-inflammatory properties.

You can feel the effect of the medication within 30-60 minutes. The effect lasts four to six hours.

The effect peaks in one to two hours and half of the drug is eliminated from the body in two to four hours. Preoperative use of ibuprofen at a dose of 400-600 mg every six hours 24 hours before the appointment decreases postoperative swelling and hastens healing time.

Ibuprofen can interfere with the anti-platelet effect of low-dose aspirin (81 mg/day), potentially rendering aspirin less effective when used for cardio-protection and stroke protection. Safer choice in these cases would be to use acetaminophen or prescription diclofenac in place of ibuprofen.

Athletes and people who exercise regularly put lot of stress on their bodies. It affects athlete’s immune system and muscles. Research has shown marathoners who take ibuprofen pills before and during the race displayed significantly more inflammation and other markers of high immune system response afterward than the runners who hadn’t taken anti-inflammatories.

The ibuprofen users also showed signs of mild kidney impairment and, both before and after the race, of low-level endotoxemia, a condition in which bacteria leak from the colon into the bloodstream, says an article in the New York Times.

Athletes take these anti-inflammatory pills before the event to prevent pain during and after exercise. But it does not work that way. In fact, there is no difference in the pain felt by runners who had taken anti-inflammatory and those who did not take it. Laboratory experiments on animal tissues, NSAIDs actually slowed the healing of injured muscles, tendons, ligament, and bones. Your bones don’t thicken and your tissues don’t strengthen as they should.

So, there is no indication to use anti-inflammatory painkillers before and during exercise. Ibuprofen can be used after the event to reduce inflammation from and acute injury. In this situation it is very effective.

There are other ways to reduce pain and stiffness after exercise. You can try stretching, do yoga, sit in a hot tub or go for a massage therapy. Ibuprofen is a good drug but has side effects and the pain relief with just one dose does not last too long. It is very useful for acute pain to get some immediate relief. Taken every six hours after surgery or sprained ankle (just one example) for two to three days does help relieve pain but you have to make sure you don’t take it on an empty stomach.

For chronic pain, you should talk to your doctor for better options. Take pain killers which last longer in pain relief and have fewer side effects.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!