Saturday, June 18, 2005

Someday -- One Day

People with visible or measurable medical conditions, such as diabetes or high blood pressure, are easy to treat. They know they have a problem that needs to be treated -- now. But "someday" illnesses, such as osteoporosis, are a much different story. An average woman will lose 1% to 2% a year of bone mass after the age of 30 if she doesn't do something about it. If you keep losing bone mass, osteopenia (early bone loss) becomes osteoporosis (potentially irreversible bone loss). Once you have osteoporosis, it is almost too late to rebuild bone strength and density... and drugs used to slow loss are not without their risk. A far better choice is a healthy diet and lifestyle that prevents the development of this life-limiting condition. The good news is that it doesn't take a lot of effort to ensure that you're still swinging a golf club for years to come. According to Liz Neporent, MA, CSCS, author of Weight Training for Dummies, the key to osteoporosis treatment is quite simple: "You have to lift weights," said Neporent. "You can throw calcium at the problem all day long, but unless you train your bones to hold onto that calcium, it's not going to do much good. Weight training teaches bones to hold on to calcium and stay strong. The act of weight-bearing exercise sends a signal to the bones that they need to be strong to endure the exercise." "The one thing most people don't realize," pointed out Neporent, "is that osteoporosis is site specific. What that means is that you might not get it in your legs, but you easily could get it in your upper body if you don't use your arms. That's why a weight-training program has to address all the major muscle groups of the body." "Walking is a great way to hold on to bone strength," said Neporent. "Running is great as well, if you do it in moderation." She defined moderation as whatever doesn't cause you to have joint pain. "Both running and walking are terrific for stimulating bone growth in the legs," she said. "They load the bones with weight -- your own -- and help you to keep calcium in the bones where it belongs. Water aerobics, on the other hand, won't stimulate bone growth because there's no impact or weight-bearing on the bones and joints." But what about the rest of the body? Weight training -- using enough weight to create increased resistance and strength, such as wearing a backpack loaded with some additional weight or using hand and ankle weights. Neporent designed a basic exercise program aimed at maintaining bone health that can be done in only 20 minutes. You can do it at home or at a gym. "You need to do one good exercise for each of your major body areas," said Neporent.
Choosing the right weight is critical to the success of the program -- you have to present the bones with enough of a challenge to stimulate growth. "Choose a weight that you can do eight to 15 repetitions with," Neporent explained. "If you feel like you can easily go on after the 15 repetitions, it's time to increase the weight." "Do one set of each exercise, and perform the entire routine twice a week," Neporent told me. This is also the protocol that the prestigious American College of Sports Medicine (ACSM) advocates for the maintenance of strong muscles and healthy bones. Here's the routine...
*Squat. Stand with feet hip-width apart. Bend your knees till your thighs are parallel to the floor. As you bend down, don't go too far forward with the upper body. Keep your abs tight and don't let your knees shoot out over your toes. (Pretend you have a chair behind you and you're aiming your butt for the chair. Then stand back up.) Add hand weights when you're comfortable. You can hold the weight at your sides or at shoulder level. You even can hold shopping bags filled with cans at your sides. "After all," said Neporent, "weight is weight."
*Calf raise. Stand on a step, hold onto something for balance and hang your heels off the edge of the step. Then lift up onto your toes and lower your heels down below the edge of the step. Repeat. When you can do it easily, hold a weight in your free hand.
*Leg curl. Kneel on your elbows and knees, extend and lift your right leg straight back, parallel to the floor. Bend the knee and bring the heel towards the ceiling. Lower back down to parallel position and repeat. Then do the left leg. When these become easy, you can add ankle weights. *Crunch. Lay on your back with your knees bent and feet hip-width apart. Bend you arms, and touch your fingers to your neck, right behind your ears. Don't lace your fingers together. Your elbows should be slightly rounded inward. There should be enough space for a grapefruit between your chin and your chest. Slowly curl your upper body up and forward off the floor, tightening up the abs. Go until your shoulder blades clear the floor. It's not necessary to go much higher to get benefit.
*Nonmilitary push-up. Get on your hands and knees and do push-ups to the floor with your upper body. This works the entire upper body, especially the chest and shoulders.
*Pullover. Stack a couple of big pillows on the floor and sit with them behind you. Lean back against them so that you are at an incline. Take a weight in both hands and hold it directly in front of your chest so you're laying back at an incline with your arms extended directly in front of your chest. Lower your arms over and behind your head, keeping your arms extended, then bring them back to the starting position in front of your chest. Repeat.
*Shoulder press. Hold a weight in each hand at shoulder level while sitting or standing. Raise the weights straight up to the ceiling and return to starting position at the shoulders.
*Bicep curl. Stand with weights in your hands, palms facing out and feet shoulder-width apart. Keep your upper arms at your sides and bring the weights up toward your shoulders by bending the elbows. Then lower them back down.
*Tricep dips. Sit on the edge of a bench or step with your hands on the edge of the bench, fingers facing forward, and feet on the ground in front of you. Lift your butt off the bench and lower it to the floor by bending your arms at the elbows. Stay perpendicular to the ground, with your back straight. Lift up by straightening your arms.
That's all there is to it. With a little practice, you can complete the entire workout in about 20 minutes. Note: Check with your doctor before starting this or any other exercise regimen. Neporent reminded me not to neglect nutrition. "It's not enough to just take calcium," she said. "We need some sunlight for vitamin D. Go for a 10-minute walk in the morning sun to get your vitamin D. Magnesium, manganese, boron and vitamin K are all important to bone health as well. Make sure your supplement includes them to help with the absorption of calcium." Check with your health-care provider for the best supplements for you, since there are vast differences in how different forms of calcium and magnesium are absorbed. While the above workout won't get you into a smaller size of clothing, it will help ensure that you are walking tall for years to come.

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