Sports Medicine

How Do You Beat Exercise Boredom?

If you exercise year-round you probably find yourself dealing with a lack of motivation at some point during the year. Some of the  Most Common Ways to Recharge a Stale Workout include: adding music, changing your routine, hiring a trainer, signing up for an event, etc...
These ideas work well for some, but not everyone. Do you have any great, novel ways to get your exercise mojo back?
What's your best, or most unique, tip for reviving a boring exercise routine?

How to Safely Use Free Weights

When it comes to exercise, everyone is getting back to basics and nothing is more basic than free weight workouts. But if you haven't gone through weight lifting 101, free weights can be, not only intimidating, but they can be dangerous. Check out the American College of Sports Medicine guidelines for safely using free weights, and then read Paul Rodger's article about the Basics of Weight Training to learn everything you need to get the most from your weight workouts.

Undernourished Female Athletes Risk Serious Health Complications

When female athletes fail to consume adequate calories to fuel excessive or intense exercise, they not only suffer from decreased sports performance, but they risk serious health complications related to the female athlete triad.
The female athlete triad refers to three interrelated, serious conditions in female athletes including:

• Energy deficits and eating disorders
• Menstrual irregularities including amenorrhea
• Low bone density and increased risk of stress fractures and osteoporosis

The condition can arise slowly, or come on fast. And while many women feel compelled to intentionally decrease body fat due to pressures from society, the media and even family and friends, there are some athletes who struggle to eat enough to keep up with a heavy training schedule.
In either case, women who are engaged in extreme exercise and have inadequate nutrition practices risk severe health complications. Low energy reserves, nutrient deficiencies, fluid/electrolyte imbalance and dehydration can lead to a malnourished and starved athlete.  Resulting health problems may include an increased risk of fractures, frequent infections and illness, loss of reproductive function, heart arrhythmias and even sudden death.
If you recognize signs of the triad in yourself or another athlete, it's important to reach out for help quickly. Waiting or postponing treatment often makes the condition harder to treat. Early prevention and treatment programs can reestablish health and improve sorts performance. Learn more about the female athlete triad, and where to go for help.

Fitness Test: Push Ups

The Push up is more than a great upper body strength and endurance exercise. You can modify this basic training exercise and use it to track your fitness progress over time. The push up test also lets you compare your results to others of your age & gender.
Did you know?
While performing the standard push up, you are supporting nearly 75% of your total body weight. By using a modified push-up position (on your knees) you can reduce this to about 60% of your total body weight.
Either way, the push up is still a great overall exercise that you can do any where.

Arthritis & Joint Conditions

Data on Tofacitinib Offers Mixed Results for Safety and Effectiveness

Many arthritis patients are anxious to know how the clinical trials are progressing for Pfizer's oral biologic drug, tofacitinib, which is being developed as a treatment for rheumatoid arthritis. New data released this month revealed that tofacitinib was as effective as Abbott's self-injectable drug Humira. However, more patients experienced serious side effects. Sounds like mixed results, right?
Actually, the incidence of overall adverse events was considered similar for tofacitinib and Humira -- although the proportion of patients who developed serious side effects was numerically higher for tofacitinib. But it's important to note, while the number was higher, the number was still considered small. These findings were derived from a 12-month trial comparing tofacitinib and Humira, called ORAL Standard. The trial involved 717 patients with moderate to severe rheumatoid arthritis who continued taking methotrexate. The patients were divided into four treatment groups: 5 mg tofacitinib twice daily, 10 mg tofacitinib twice daily, Humira injections every two weeks, or placebo.
While more study details will be released at the American College of Rheumatology in November, it looks like Pfizer will seek FDA approval by the end of this year for tofacitinib (possibly for both doses). While effectiveness seems not to be in question, safety will get some scrutiny. Also released were results from a pooled analysis of late-stage tofacitinib trials, altogether involving 6,200 patients. Pfizer concluded that mortality rates were consistent with what is typically associated with standard treatments given to slow progression of arthritis symptoms. Stay tuned.

How to Handle Unsolicited Advice About Arthritis

I don't know anyone with arthritis who hasn't encountered a well-meaning person armed with unsolicited advice for how to deal with the disease. It can be a friend, family member, or even a stranger. The recipient of the advice has two goals: to remember the person likely meant well, and not to become too annoyed. But let's face it, unsolicited advice can be annoying.
If you have arthritis, you have some experience in dealing with it. That's not to say you know everything or that you are unwelcoming of suggestions that have some basis. You have a treatment plan that has been recommended by your doctor. Unsolicited advice is not usually more valuable than your existing treatment. What is the best way to handle unsolicited advice? What should you say? Check out our suggestions in How to Handle Unsolicited Advice About Arthritis.

Share Your Arthritis Story

If you have arthritis, you have a story to tell. We learn from each other, so sharing your story can be very helpful to others. How old were you when you were diagnosed with arthritis? Was it a prolonged process to get an appointment with a doctor and go through diagnostic procedures? Without discussing specific treatments (because they are so individual to each person's case), did you go through several changes in your treatment plan?
How has arthritis affected your quality of life? How has arthritis impacted your role as a spouse, parent, employee, or friend? Share the highs and lows of living and coping with arthritis. Share Your Arthritis Story.

Osteoporosis Medications: FDA Panel Wants Label to Clarify Duration of Use

Fosamax was the first bisphosphonate approved by the FDA in 1995. Today, there are several, including Boniva, Actonel, and Reclast, as well as generic versions. They are widely-prescribed drugs for the prevention or treatment of osteoporosis. Bisphosphonates work by inhibiting bone resorption to prevent loss of bone mass and are very effective for decreasing the risk of fractures due to osteoporosis. However, safety concerns have become as issue within the last few years. Bisphosphonates have been associated with atypical subtrochanteric and femoral fractures, osteonecrosis of the jaw, and esophageal cancer. These concerns have brought forward questions regarding long-term use of bisphosphonates.
According to MedPageToday.com, on September 9, 2011, an advisory panel to the FDA voted 17 to 6 to recommend that labeling for bisphosphonates should further clarify the duration of use. The panel stopped short of defining exactly what it should be though. The confusion comes from a lack of data. There was discussion of recommending drug holidays to patients (meaning, patients would stop use of bisphosphonates for a period of time) but there is insufficient data to support the recommendation. Bottom line -- there is a lack of strong clinical evidence that bisphosphonates work better with long-term use, but also a lack of solid evidence that long-term use is harmful. It seems there is plenty of concern however.

Skin Cancer

New Drug Option for Patients with Melanoma

Last month, the FDA approved the drug Zelboraf (vemurafenib) for patients with melanoma, the deadliest form of skin cancer. The drug is designed to work only for late-stage melanoma patients whose tumors have a specific genetic defect known as the BRAF V600E mutation, which is present in approximately half of melanoma cases. The FDA also approved a diagnostic test that determines whether a patient's melanoma cells have this mutation.
The drug is the second to be approved this year for patients with late-stage melanoma -- Yervoy (ipilumumab) was approved last March. These approvals are an important advance, given the dearth of treatment options for late-stage melanoma.
Unfortunately, neither drug is a cure for the disease. Clinical trials have revealed that Zelboraf extends survival by a few months on average, compared with those taking traditional chemotherapy. What's more, it comes with a hefty price tag of about $9,400 per month.
To read more about the initial trials of Zelboraf (originally known as PLX4032) in humans and the path of this drug to market, see this fascinating series of articles by The New York Times reporter Amy Harmon.

iPhone App Aids Early Detection of Melanoma

Got a suspicious-looking mole that you're concerned about? There's an app for that. MelApp for iPhone lets you take a picture of your lesion using your smartphone's camera and analyzes it for risk of melanoma. The app could help you to detect melanoma in its earliest stages, when it is most easily cured.
After uploading your image, you'll be asked to answer two simple questions about your lesion or mole. Then the app uses "image-based pattern recognition technology" (which has been validated using a database of images licensed by Johns Hopkins University Medical Center, according to the app's creator, Health Discovery Corporation) to give you an estimated risk of melanoma. The program also allows you to store your pictures and collect them in albums by date, enabling you to review your suspicious moles or lesions for changes that occur over time. Users that receive a "high" risk of melanoma are directed to a nearby physician for follow-up using the smartphone's GPS technology.
While the app is certainly not intended to diagnose melanoma or to replace regular evaluations by your physician, at the very least it may help you to keep better track of your moles between check-ups. And for only $1.99, if it helps get you to the doctor more regularly, then it will be worth it's salt.

Regular Sunscreen Use Helps Prevent Melanoma

Numerous studies have shown that regular sunscreen use can prevent squamous cell carcinoma, but whether it's useful for preventing other skin cancers, such as melanoma, has remained controversial. New research published in the January 20 issue of the Journal of Clinical Oncology provides convincing evidence that sunscreen is indeed effective for preventing melanoma, the deadliest form of skin cancer.
Researchers at the Queensland Institute of Medical Research in Brisbane, Australia, randomly assigned 1,621 participants to two groups: sunscreen use, or discretionary use (which included no use). The first group was given an unlimited supply of broad-spectrum sunscreen with a sun protection factor (SPF) of 16 and was instructed to apply the product to their head, neck, arms, and hands each morning. Participants were also advised to reapply after bathing, heavy sweating, or prolonged sun exposure. People in the discretionary group were asked to continue using (or not using) sunscreen of any SPF as they always had.
Fifteen years after the start of the study, the researchers found half as many melanomas in the sunscreen group as in the control group (11 vs. 22, respectively), and an even greater difference in the number of invasive melanomas (3 vs. 11).
The results show that you can greatly reduce your risk of developing melanoma by regularly using sunscreen. However, sunscreen use is just one part of a more comprehensive sun protection strategy, which includes wearing a wide-brim hat, sunglasses, and long-sleeved shirts and pants.
Source: "Reduced Melanoma After Regular Sunscreen Use: Randomized Trial Follow-Up." Adèle C. Green, et al. Journal of Clinical Oncology, Vol. 29 no. 3, pp 257-263 (2011).

It's official: Tanning is an addiction

According to a recently published article in the Archives of Dermatology indoor tanning qualifies as an addiction.
The study surveyed University of Albany, in Albany, NY, college students. Of the 229 responders who have used tanning beds, 39.3% met the criteria for addiction. Those that were considered addicted to tanning showed classic signs of addiction - several unsuccessful attempts to completely stop or cut back on tanning; feeling annoyed when they were told they should stop; and skipping work, school or other scheduled activities to go to the tanning salon.
Slightly of two-thirds of the study participants were female.

Exercise for Depression

Silence Your Inner Critic

We all have little voices in our heads, telling us what to do and what not to do (at least, I hope I'm not the only one with voices in my head), but the most annoying one is The Criticizer. Whether this comes from a critical parent, a nagging teacher we once had or some odd strand of DNA, The Criticizer resides deep in the mind, just waiting to tell you that whatever you're doing is wrong, wrong, wrong.
The Criticizer especially delights in criticizing workouts. It likes to point out that, whatever you're doing, it isn't hard enough or long enough or good enough. It may tell you that you aren't working the right muscles, or choosing the right exercises or doing the right number of sets and reps. It might even convince you that, you're doing such a bad job, you should just give it up.
With all the conflicting information out there about exercise, it's easy to doubt yourself and The Criticizer only adds to the confusion. So, how do you tell that voice to shut up? There are some questions you can ask yourself to assess where you are, what you're doing and decide if you're on the right track.
That's what I'm talking about in my latest article about silencing your inner critic and I'd love to hear about your experiences. Do you have a Criticizer in your head? How do you deal with it and move forward with your workouts? Leave a comment and tell us about your inner critic.

Get Ready for Fall

People tell me that fall is their favorite season of the year and I can understand why. The weather becomes much more comfortable for outdoor exercise with crisp, chilly mornings that inspire more energy than the hot, muggy mornings of summer.
There's an art to dressing for outdoor workouts when the weather changes. In my case, I usually approach cool weather with all the aggression of a tsunami, wearing nothing less than my arctic gear for any temps that fall below 65 degrees. This is not a good idea. A better idea is to dress as though it's about 10 degrees warmer than the actual temperature, so you don't overheat. A rather reasonable idea that I may actually try this year.
Another good idea is to update your fall exercise wardrobe so that you have all the sweat-wicking comfort you need to stay warm and dry when it's chilly outside. Also, updating the wardrobe is a great way to ease the transition into a cooler season, if you're feeling a little blue about saying goodbye to summer.
If you're in the market, I've updated my top picks for fall essentials for men and women, as well as some ideas for how you can take advantage of fall for some great workouts:

• Exercise Essentials for Fall
• Women's Fall Fitness Gear
• Men's Fall Fitness Gear
• Get Ready for Fall

What about you? Is there anything special you do to get ready for fall? What's the one thing in your fall wardrobe you can't live without? Leave a comment and tell us your favorite thing about exercising in the fall.

Exercise of the Week - Elliptical Trainer

Us exercisers are an opinionated bunch, and never more than when discussing the age old controversy: Elliptical Trainer vs. the Treadmill. I once saw two trainers nearly come to blows defending their cardio machines, which only proves the long-held theory that most of us trainers desperately need a life.
One reason treadmillers are so gung-ho about the treadmill is that, not only does it mimic a movement we're familiar with, but it's easier to get your heart rate up with an impact activity. Add high impact to the mix (running, sprinting, etc.) and you get even more intensity, which adds to your overall calorie burn.
The elliptical trainer doesn't involve impact, so you may have to work harder to get your heart rate up. However, it's that no-impact thing that is so appealing to the elliptical crowd. You can protect your joints and there are a variety of ways to inject some intensity into your workouts by using the arm handles, adjusting the ramps and resistance and even going backwards.
Even if you're a diehard treadmill fan, the elliptical trainer is worth a try. It's great cross-training for high impact activities and there are plenty of ways to make your workouts more interesting. My favorite is interval training and I've put together a few of my favorites for your exercise pleasure:

• Elliptical Interval Workout
• Motion Traxx G-Series Elliptical Workouts - Deekron, my favorite Fitness DJ, offers two great (and free!) elliptical interval workouts through his G Series Fit Mixes.
• BeatBurn Elliptical Smartphone App - One of my favorite ways to spice up my elliptical workouts is with this handy little app. You move to the beat through a variety of intervals and your workouts change each time, keeping things fresh.

What about you? Are you a treadmiller or an elliptical fan? Do you find they're equally challenging or do you favor one over the other? Leave a comment and tell us about your elliptical experiences.

Vote in This Week's Poll: How often do you go to the gym?

"Did you know that you can have a gym membership and never go and they'll keep sending you bills and, even though you pay those bills and you know you're essentially throwing money away, you can still not go to the gym at all?"
That's what one new client asked me last week and I had to admit, yes I know all about that. In fact, I remember joining a gym in my early 20s and going exactly three times. I remember the guilt of getting the bill, writing out a check, promising myself I would start going (but, tomorrow because it's too late now and I'm exhausted from paying these bills anyway) and then...never following through.
Unfortunately, paying for a gym membership doesn't guarantee you'll actually go, so what can you do motivate yourself? I asked some of my friends and clients about this, some of whom go the gym daily and others who haven't been in months. Here's what they had to say:

• From pay-but-never-go-client: "I think I would be motivated if I kept my goals small - just making it a couple of times a week would make me feel better about myself."
• From a go-every-day-friend: "What motivates me is my butt...as in it's starting to get wider now that I'm in my 50's. I know I have to workout to keep it under control and the gym is the only place I'll work hard enough to do that."
• From another regular gym-goer: "When I'm tempted to skip the gym, I just think of this cute guy who always lifts weights at the same time I do. If I miss my workout, I won't get to spend half the time staring at him!" Hey, whatever works, right?

What about you? Do you have a gym membership and, if so, how many days a week do you go? Have you ever gone weeks or months without showing up? Vote in this week's poll and tell us how often you go to the gym.

Cholesterol

When You Don’t Want to Take Your Cholesterol-Lowering Medication

You feel fine - even healthy. So why do you still have to take the medication that your doctor prescribed to you to lower your cholesterol? There are two major sources that could be causing your high cholesterol: your lifestyle and your genes. Although it may seem like a good idea to quit taking your cholesterol-lowering medication, doing so may have unhealthy consequences. Studies have shown that persistently high cholesterol levels can contribute to causing a heart attack, stroke, or certain other conditions, such as peripheral vascular disease. Therefore, living a healthy lifestyle and taking the medication your doctor prescribed to you is important to keeping your cholesterol levels in check - and lower your risk of developing heart disease down the road.
In some cases, affording or remembering to take your cholesterol-lowering medication may cause you not to take them as prescribed. If this is the case.

Can Certain Diseases Cause High Cholesterol?

When we think about high cholesterol, we usually think about things such as a poor diet or not getting enough exercise. Having a family history of high cholesterol could also place you at risk for having high cholesterol and heart disease later on in life. However, in some cases, high cholesterol may also be caused by certain medical conditions. The good news is that keeping these medical conditions in check may also help keep your cholesterol levels healthy, too. However, left uncontrolled, certain diseases may raise your risk for more that high cholesterol - it could also raise your risk for heart disease.
Read more about diseases that can cause high cholesterol levels:

Constructing the Perfect, Cholesterol-Friendly Salad

>Salads can play an important role in your meal planning. From a full meal to serving as a side dish, many ingredients can be placed in a salad to make it delicious - and to give you a little variety. Unfortunately, some ingredients included in your salad could also add fat and calories, reducing the heart-healthy benefits of your salad. If you are looking for ways to spice up your salad, this article will guide you in selecting tasty and healthy ingredients to your next salad.
Additionally, you can also try some of these healthy salad recipes, which are high on taste -- not in fat:

• Tomato Rice Salad
• Low Fat Chicken Caesar Salad
• Five Healthy Salad Ideas

September 1st Kicks Off National Cholesterol Education Month

Do you know your cholesterol numbers? If not, now is a good time to get your cholesterol checked. September marks National Cholesterol Education Month, a month that is designed to raise awareness of high cholesterol levels and the potentially damaging effect it can have on your cardiovascular health if left unchecked. There are a variety of factors that can place you at risk for high cholesterol levels, including following an unhealthy lifestyle and your genes.

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Updated on 10-OCT-2009
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