What Does It Mean To Be Physically Fit?

December 10, 2018 / Thomas Cohn, MD

fitness Everyone is told to exercise and become physically fit. However, what does it mean to be “physically fit?” The definition that is commonly used is as follows; a set of attributes that people have or achieve that relates to the ability to perform physical activity. Fitness can help prevent some diseases, improves body composition, strengthen the heart and circulation and improve muscle fiber ability. Factors involved in fitness include cardiovascular fitness, muscular strength and endurance, body composition and flexibility.

The Components Of Fitness

The first factor often discussed with physical fitness is the cardiovascular and respiratory components of fitness. It includes the ability to perform aerobic activities like walking, to more intense exercise like sprinting. Aerobic activities increase the heart rate for a sustained period and improve the strength of the heart as a muscle and maintain the integrity of the vascular system. The lungs are a partner in this system moving air, extracting and delivering the needed oxygen. The recommended amount of aerobic conditioning is five times a week for 30 minutes total at 65% maximum heart rate for your age. Exercise can be done in small segments daily, 5-10 minutes at a time, while maximum heart rate is calculated from (210) – (your age) = (maximum heart rate).

Muscular strength is the ability of muscles to exert adequate force during activity. Any activity that works muscles against resistance and that causes muscle fatigue will increase strength. Muscle strengthening can be done by any number of activities such as weight training, using a rowing machine, performing Pilates, doing Tai Chi, or even just using gravity and your body for resistance. A physical therapist or an athletic trainer can often set one up with a program to build muscle strength. Along with exercise, protein from your diet is required for muscle development.

A third component of fitness is endurance, which is classified as the ability of muscles to continue to exert effort over a period of time without tiring. Two types of muscle fibers are used for endurance activities and they are slow twitch and fast twitch fibers. The slow twitch fibers are those used to perform endurance activities. They need lots of oxygen and can carry out prolonged tasks without fatigue. The fast twitch fibers contract quickly, can be used for sprint type activities and do not require significant blood and oxygen.

The most nebulous component of fitness is body composition. This is the relative amount of muscle, bone, water and fat in a person’s body. Your genetics, your fitness routine and your diet help to determine your body composition. The body type of a distance runner will be different from a weightlifter or a swimmer. The overall issue would be to have an appropriate body composition for the activities that one wants to perform and avoid having a high level of body fat.

The last component of physical fitness is having overall flexibility, the range movement across your joints. It is dependent on the tightness of muscles, tendons and ligaments across your joints. As one becomes older, deterioration of the joints from the natural aging process can sometimes limit flexibility. Surgical procedures such as fracture repairs, spinal fusions or joint replacements can also limit flexibility. Stretching exercises are often necessary to maintain flexibility. Again, some exercises like yoga and Tai Chi are excellent ways to maintain flexibility as part of a fitness program. If you have low back or neck issues, flexibility and stretching are helpful to reduce pain by preventing excessive muscle tightness. Muscles naturally try to tighten to prevent too much movement of a possibly painful area such as a joint. However, maintaining more normal motion in an area tends to improve structure health and decreases pain from abnormal stress on the region.

Physical fitness means maintaining regular exercise to benefit your health. It involves five aspects: cardiorespiratory performance, strength, endurance, flexibility and body composition. Optimizing each of the above components leads to becoming physically fit. It is a process and needs to be done on a daily basis.

The Benefits Of Brain Exercise

November 19, 2018 / Thomas Cohn, MD

A new study reported from the University of California – Irvine in the Proceedings of the National Academy of Sciences revealed that even a brief amount of exercise improves the brain. It is well known that prolonged exercise has benefits from the heart to the brain. Exercise improves circulation and helps to reduce the effects of aging. Animal studies have shown that exercise increases the formation of new cells in the hippocampal region of the brain. This region is essential for memory creation and storage. Unfortunately, what works in animals is not necessarily true in humans.

Your Brain on Exercise

The twist in this study was whether a memory type of activity could be improved by participating in a low grade exercise. The subjects chosen were the usual paid college student (eager victims with minimal chance of other medical issues), and they were first asked to perform a computerized memory test. They were then sat on an exercise bike for ten minutes and either asked to do nothing (the control group) or slowly pedal in order to increase the heart rate by 30% for ten minutes.

After either the rest or exercise, the memory test was repeated. Interestingly, the light exercise group showed a clear improvement in memory tasks. The reason for the immediate boost in memory ability is not clear. The main theory is that the light exercise improved blood flow to the brain and hormone levels may have been involved.

The main message is that light exercise is beneficial to the brain and memory. Light exercise can be walking or many other types of activities. The exercise does not need to be intense, and it does not need to be prolonged. Daily exercise for ten minutes at a time appears to be beneficial to the brain. As we get older, we need to keep the brain healthy. It is important to exercise and even the simple things from walking to things like yoga or tai chi move the body and improve the brain.

Son if you find yourself with 10-15 minutes of free time throughout the day, try to do something active and stimulate your brain!

Why We Choose Not To Exercise

October 29, 2018 / Thomas Cohn, MD

Exercise for healthy individuals is often challenging, and if you have chronic pain, even the thought of exercise can leave you riddled with anxiety and the worry of more pain. In an article recently published in the New York Times, it describes a new neurologic study that finds our brains are wired to tell our bodies to be mostly sedentary. It may be that we are suppose to be less active to conserve our energy.

The study was interesting, examining what motivates us to be active. Most people want to be active but find excuses not to be active. Common excuses we all know, like it takes too much time or that one is tired. Exercise takes commitment and often is at an inconvenient time either early in the morning or after work. Neither time seems enjoyable, especially when you could be doing more enjoyable things, like eating or sleeping.

Exercise Motivations

The New York Times study took healthy young people and then monitored how their brains reacted to visual representations of either physical activity or sedentary things like resting on the couch. The study looked at the brain activity while watching a variety of these images. While watching physical activity, the brain needed to use multiple areas to process the information. When sedentary types of activity, appeared the brain waves were much calmer. The implication was that the brain prefers the calm activities like laying on a couch or in a hammock. The conclusion the authors propose based on monitoring 29 people is that we are hard wired to be sedentary.

Exercise is clearly more work than just sitting around and not being active. The benefits are rarely seen right away and usually are difficult to decipher until time has passed. It is much easier to sit and watch television, sleep or enjoy a big meal. To benefit from exercise one must take a long look at the advantages. For those with chronic pain, exercise keeps the muscles loose and strong, and gives the person the endurance to get through the day. For many, exercise decreases the pain one has overall and keeps them functional in daily activities. The most common response for those who consistently exercise is that I am going to hurt regardless if I do or do not exercise, and without it I would likely not be able to move well at all, so I might as well exercise.

Maybe we have brains that are wired to enjoy restful activity over physical activity. The body, however, is designed for being active. The most appropriate saying that applies is “use it or lose it”. As a pain physician and someone who does have chronic pain, I can hurt and slowly lose function or choose to be active and maintain as much ability as I can. It is a choice to be active, it takes work, and it is not fun, but it pays off in the ability to maintain function.

Could Music and Art Lower Chronic Pain Risk?

August 14, 2018 / Thomas Cohn, MD

If you’re a frequent reader of this blog, you know that we like to pitch certain conservative treatment options for chronic pain. Activities like controlled exercise, stretching techniques and a healthy diet can help to control chronic pain and decrease your likelihood of flare ups. But what if other activities could provide similar benefits? Activities like going to a concert or checking out an art exhibit?

According to a new study published in the Journal of Pain, adding some culture to your regular routine could help to reduce your likelihood of chronic pain. For their study, researchers looked at data from a 10-year study that tracked the progression of pain in more than 2,600 older adults living in England. None of the participants were experiencing pain at the beginning of the study, but after 10 years, more than 42 percent said they experienced moderate to severe chronic pain.

Chronic Pain and Culture

Some of the findings were not all that surprising. Researchers found that individuals with poor sleep patterns, those who had mental health problems and those who were poorer and less educated were more likely to suffer from chronic pain. But one aspect they found interesting was the association between participation in cultural or social events and the development of chronic pain. Researchers noticed that stretching and endurance training were more likely to reduce the risk of developing chronic pain when those activities were paired with participation in cultural and social events.

“This study also found evidence that psychosocial factors may be protective against the development of chronic pain, in particular engagement in cultural activities such as going to museums, art galleries, exhibitions, concerts, the theatre or the opera,” wrote lead author Daisy Fancourt, PhD, a senior research associate at University College London. “It is notable that the odds ratios for cultural engagement were directly comparable with those of vigorous physical activity, suggesting a reduction of 25-26% in risk of chronic pain incidence.”

Why The Reduction In Chronic Pain?

So why do researchers believe that chronic pain likelihood may be reduced by visiting a museum or checking out a summer concert? According to them, the event is likely paired with some gentle physical activity, which can be beneficial for your body, as well as psychological benefits that come from social engagement and positive cultural experiences.

“This study is the first to explore simultaneously potential physical and psychosocial protective factors for the development of chronic pain in older adults. Our results demonstrate that both vigorous weekly activity and regular cultural engagement appear to reduce risk of incident chronic moderate-severe pain,” the researchers concluded.

Although the study was observational in nature, it points to an interesting correlation. Get outside, explore new places and find an enjoyable cultural experience, and you may be able to reduce your chronic pain risk. A visit to the museum shouldn’t be your only treatment technique, but when added to a regular care plan, it may have some rewarding effects!

The Overall Health Benefits Of Exercise

April 6, 2018 / Thomas Cohn, MD

Exercise isn’t just a way to stay in shape or calm inflammation, it also has enormous benefits for our overall health. In fact, new research shows that it doesn’t really matter whether your walk or run, so long as you are getting regular exercise.

According to new research, if you want to improve your overall health and reduce your risk of all-cause mortality, make sure you get some type of exercise on a regular basis. It doesn’t really matter whether it’s bi-weekly kickboxing classes or a 30-minute walk around the neighborhood with your dog, so long as you’re moving and working muscle groups.

The findings come on the heels of a study of more than 4,800 adults by the Journal of the American Heart Association. For their study, researchers sorted activity into two different categories – total minutes of activity per day and total minutes of intense or concentrated activity.

The Benefits Of Activity

You may assume that individuals who participated in more concentrated exercise would fare better than individuals who just walked or moved around, but that wasn’t really the case. The study found that neither type of activity had a significant edge over the other. According to researchers, individuals who clocked roughly 30 minutes of moderate to vigorous exercise a day were significantly less likely to die from any cause than people who got none. Participants who exercised an hour or more each day fared even better.

“The key message based on the results presented is that total physical activity (i.e., of any bout duration) provides important health benefits,” the study authors wrote.

Cardio workouts not only help with your overall health, but they can provide some other benefits as well, like increased blood flow, enhanced memory and improved mood. The overall message from the study is that the more you move, the healthier you are likely to be.