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Fitness Health

The Thyroid and Metabolism

Metabolism is a word that the weight loss industry uses freely when pushing its various weight loss programs. What many of these programs do not tell you is how the endocrine system relates to our metabolism and how changes to that system can drastically affect our ability to lose or even gain weight.

At the center of the body’s hormonal system is the thyroid, a small butterfly shaped gland that sits atop the adams apple. The thyroid and the hormones it release’s control most of the body’s metabolism. When the thyroid begins to malfunction or a disease affects its processes the metabolism of the body can become seriously affected. One of the biggest changes that can occur as a result of a thyroid problem is weight gain or weight loss. With a weight gain because of thyroid problems one can find it that much more difficult to loose that weight.

What many people who are trying to loose weight do not take into account is how well their metabolism is functioning with regards to their thyroid. The main problem is most weight loss experts and programs recommend cutting calories. For many people this does work, but for those with a malfunctioning thyroid cutting calories can do more damage then good.

There are two forms of thyroid disorders, hypothyroidism and hyperthyroidism. Both conditions can have profound affects on a person’s metabolism.
Hypothyroidism occurs when the thyroid does not release adequate amounts of the hormones T3 and T4. When this happens the metabolism slows, causing fatigue, weakness and rapid weight gain. For people trying to loose weight an under-active thyroid can make attaining any sort of weight loss nearly impossible. Cutting calories will not help with weight loss when suffering from this condition. In fact, because of the already slowed metabolism the body will start hoarding what little calories it is getting, further exacerbating the fatigue and weakness associated with hypothyroidism.

Hyperthyroidism, on the other hand, occurs when the thyroid releases too much thyroid hormone. When this happens the person’s metabolism raises drastically. While this may seem like a good thing for someone trying to loose weight the truth is that both forms of thyroid dysfunction are extremely dangerous and must be treated with thyroid hormone replacement therapy.

For those with normal thyroid function loosing and gaining weight is a matter of calories in and calories out. But for those who are having difficulty loosing weight despite trying all the normal routes making sure the thyroid is functioning properly may be the first step to restoring the body’s hormonal balance.

Twelve Ways to Revive and Boost Your Metabolism – When You’re Hypothyroid, What You Can Do to Jumpstart Your Metabolism

When you’re hypothyroid, fatigue, difficulty losing weight, or continued weight gain can all be attributable to a drop in the metabolism that frequently accompanies hypothyroidism. Even after your hypothyroidism is properly treated with thyroid hormone replacement, you may find that your metabolism has not bounced back to where it was before. This sluggishness in your metabolism can leave you feeling exhausted, and finding that you can’t lose weight, despite a healthy low-calorie diet.

Here are some ways you can help revive and boost your metabolism.

Make sure you eat breakfast.  If you don’t eat breakfast, you slow down your metabolism and send the body into “hoard mode,” thinking it’s starving because you’re going a long period of time frequently 8 to 10 hours or more, without food.

Eat the majority of your food earlier in the day. Dinner should be your lightest meal, and some experts recommend you don’t anything after 8 p.m., or any later than 3 to 4 hours before bedtime. This helps your body process and burn the food when you’re aware and moving around and burning more calories per hour.

Don’t starve. Dropping your calorie intake below 1,000 calories a day will signal to your body that you are in starvation mode, and will slow down your metabolism.

Eat smaller meals more frequently. Smaller, more frequent meals keeps your blood sugar stable and provides a steady source of energy to fuel metabolism.

Get enough aerobic exercise. As much as you can is really a help for your metabolism, and if you do it in the morning, you’ll raise your metabolism all day.

Build muscle with weight training or resistance exercise. At least two to three times a week, you should add weight training or progressive resistance exercise that builds muscle. Muscle burns more calories than fat, and the more muscle you have, the more calories you burn, even at rest!

Water, water, water!! You’ve heard it before, but drink those 8 8-ounce glasses of water every day. The energy burning process of metabolism needs water to work effectively.

Get enough B vitamins. Among supplements, if you are suffering from flagging energy, you need to make sure that you are getting enough B vitamins. Vitamin B-12 in particular is one that is essential for energy. To ensure you’re getting enough B vitamins, consider taking a B complex, plus a separate sublingual B-12.

Try a supplement for fatigue. Another type of supplement useful for fatigue is in the area of substances that the body naturally produces for energy production.
Supplements in this category include:
        – Co-enzyme Q10, also known as CoQ10, which supplies energy to muscles 
        – L- Carnitine 
        – NADH (Nicotinamide Adenine Finucleotide) which helps cells convert food into energy 
        – Green Tea extract 
        – Try Chinese Herbs

In terms of herbal remedies, while you should avoid ephedra and ma huang stimulants, you can ask your practitioner about schizandra–a Chinese herb that is used for fatigue. Ginseng is also popular for energy. Before trying any herbs, supplements, or vitamins, you should of course consult with your practitioner to ensure they are safe for you. Ginseng, for example, is not recommended for someone with high blood pressure and many herbs and supplements are not recommended during pregnancy.

Try mate tea.  In the process of writing my book, Living Well With Hypothyroidism: What Your Doctor Doesn’t Tell You…That You Need to Know, I had the opportunity to interview herbal and aromatherapy expert Mindy Green of the Herbal Research Foundation. I asked her what, as a person with hypothyroidism, I should reach for when I’m just completely out of steam, and am ready for a giant double espresso in order to make it through the day. Mindy, said, unquestionably, mate tea. Mate, pronounced, “mah-tay,” is an herbal tea native to South America. Mate is considered far more nutritious than black tea or coffee, and though it also has some caffeine, its effects are energizing, rather than making people jittery.

Consider Energy Work. Energy and bodywork , such as yoga, tai chi, qigong (pronounced chee-gung), and Reiki, can all help in adding and balancing energy. In qigong, tai chi, and yoga, gentle movements are used to move energy along the energy pathways of the body. In Reiki, a practitioner helps open up energy channels.

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Sports Drinks or Water

sportdrinkStaying well-hydrated is crucial when working out. But does a sports drink offer more benefits than water? The answer depends on the length, type and intensity of exercise and personal preferences. Exercise raises the body temperature, which causes sweating and loss of water and salts. For most people who work out at moderate intensity for less than 60 minutes, water is a perfect choice. It’s refreshing, calorie-free, moves quickly from the stomach to the bloodstream and costs less than sports drinks. When it comes to just replacing fluids, water is wonderful. But sports drinks have more going for them than just marketing hype. The carbohydrates and electrolytes they contain can help endurance athletes who work out for 60 minutes at high intensity or 90 minutes or more at moderate intensity.

Sports drinks offer their greatest benefits during a workout by helping to delay muscle fatigue, but their primary purpose is to keep the body hydrated. During exercise, the body loses more water than many people realize, and most frequently those fluids are not adequately replaced.

Dehydration
Sweating is the way in which the body maintains its core temperature at 37 degrees centigrade. This results in the loss of body fluid and electrolytes (minerals such as chloride, calcium, magnesium, sodium and potassium) and if unchecked will lead to dehydration and eventually circulatory collapse and heat stroke.

The effect of fluid loss on the body is as follows: (% body weight lost as sweat and Physiological Effect)
2% – Impaired performance
4%  – Capacity for muscular work declines
5%  – Heat exhaustion
7%  – Hallucinations
10%  – Circulatory collapse and heat stroke

Electrolytes
Electrolytes serve three general functions in the body:
Many are essential minerals
Control osmosis of water between body compartments
Maintain the acid-base balance required for normal cellular activities

 
The sweat that evaporates from the skin contains a variety of electrolytes. The electrolyte composition of sweat is variable but comprises of the following components:
Sodium
Potassium
Calcium
Magnesium
Chloride
Bicarbonate
Phosphate
Sulphate

A litre of sweat typically contains 0.02g Calcium, 0.05g Magnesium, 1.15g Sodium, 0.23g Potassium and 1.48g Chloride. This composition will vary from person to person.

Carbohydrate is stored as glucose in the liver and muscles and is the most efficient source of energy as it requires less oxygen to be burnt than either protein or fat. The normal body stores of carbohydrate in a typical athlete are:

70kg male athlete – Liver glycogen 90g and muscle glycogen 400g
60kg female athlete – Liver glycogen 70g and muscle glycogen 300g.

During hard exercise, carbohydrate can be depleted at a rate of 3-4 grams per minute. If this is sustained for 2 hours or more, a very large fraction of the total body carbohydrate stores will be exhausted and if not checked will result in reduced performance. Recovery of the muscle and liver glycogen stores after exercise will normally require 24-48 hours for complete recovery. During exercise, there is in an increased uptake of blood glucose by the muscles and to prevent blood glucose levels falling the liver produces glucose from the liver stores and lactate.

Consuming carbohydrate before, during and after exercise will help prevent blood glucose levels falling too low and help maintain the body’s glycogen stores. Many athletes cannot consume food before or during exercise and therefore a formulated drink that will provide carbohydrate is required.

Rehydration
Fluid absorption:  Two main factors affect the speed at which fluid from a drink gets into the body:
– The speed at which it is emptied from the stomach
-The rate at which it is absorbed through the walls of the small intestine

The higher the carbohydrate levels in a drink the slower the rate of stomach emptying. Isotonic drinks with a carbohydrate level of between 6 and 8% are emptied from the stomach at a rate similar to water. Electrolytes, especially sodium and potassium, in a drink will reduce urine output, enable the fluid to empty quickly from the stomach, promote absorption from the intestine and encourage fluid retention.

Water
Drinking plain water causes bloating, suppresses thirst and thus further drinking. A poor choice where high fluid intake is required. Water contains no carbohydrate or electrolytes.

Calculating personal fluid needs
During an endurance event, you should drink just enough to be sure you lose no more than 2% of pre-race weight. This can be achieved in the following way:

1. Record your naked body weight immediately before and after a number of training sessions, along with details of distance/duration, clothing and weather conditions
2. Add the amount of fluid taken during the session to the amount of weight lost – 1 kilogram (kg) is roughly equivalent to 1 litre of fluid (1lb approx. 0.5 litre)
3. After a few weeks you should begin to see some patterns emerging and can calculate your sweat rate per hour

Once you know what your sweat losses are likely to be in any given set of environmental conditions, you can plan your drinking strategy for any particular event

Sports Drinks
There are three types of sports drink all of which contain various levels of fluid, electrolytes and carbohydrate.
Isotonic Fluids – contains electrolytes and 6 to 8% carbohydrate
Hypotonic Fluids – contain electrolytes and a low level of carbohydrate
Hypertonic High level of carbohydrate

The osmolality of a fluid is a measure of the number of particles in a solution. In a drink, these particles will comprise of carbohydrate, electrolytes, sweeteners and preservatives. In blood plasma the particles will comprise of sodium, proteins and glucose. Blood has an osmolality of 280 to 330mOsm/kg. Drinks with an osmolality of 270 to 330mOsm/kg are said to be in balance with the body’s fluid and are called Isotonic. Hypotonic fluids have fewer particles than blood and Hypertonic have more particles than blood.

Consuming fluids with a low osmolality, e.g. water, results in a fall in the blood plasma osmolality and reduces the drive to drink well before sufficient fluid has been consumed to replace losses.

Which is most suitable?
Isotonic – quickly replaces fluids lost by sweating and supplies a boost of carbohydrate. This drink is the choice for most athletes – middle and long distance running or team sports. Glucose is the body’s preferred source of energy therefore it may be appropriate to consume Isotonic drinks where the carbohydrate source is glucose in a concentration of 6% to 8% – e.g. High Five, SiS Go, Boots Isotonic, Lucozade Sport.

Hypotonic – quickly replaces fluids lost by sweating. Suitable for athletes who need fluid without the boost of carbohydrate e.g. jockeys and gymnasts.

Hypertonic – used to supplement daily carbohydrate intake normally after exercise to top up muscle glycogen stores. In ultra distance events, high levels of energy are required and Hypertonic drinks can be taken during exercise to meet the energy requirements. If used during exercise Hypertonic drinks need to be used in conjunction with Isotonic drinks to replace fluids.

Make your own?
Isotonic – 200ml of orange squash (concentrated orange), 1 litre of water and a pinch of salt (1g). Mix all the ingredients together and keep chilled

Hypotonic – 100ml of orange squash (concentrated orange), 1 litre of water and a pinch of salt (1g). Mix all the ingredients together and keep chilled.

Hypertonic – 400ml of orange squash (concentrated orange), 1 litre of water and a pinch of salt (1g). Mix all the ingredients together and keep chilled.

Note: In a trial conducted by scientists in the city of Aberdeen it was determined that a 2% carbohydrate-electrolyte drink provided a more effective combat to exercise fatigue in a hot climate when compared to a 15% carbohydrate-electrolyte mixture.

Dental Health: Sports drinks commonly contain citric acid. All acids have an erosive potential but the method of drinking will influence whether or not those acids affect the teeth. Sports drinks should be consumed as quickly as possible, preferably with a straw and not be held or swished around the mouth. Retaining drinks in the mouth will only increase the risk of erosion. Refrigerated drinks will have a reduced erosive potential, as the acid dissolution constant is temperature dependant.
Seven Rules of Hydration

  1. The rate of passage of water from your stomach into your small intestine depends on how much fluid is actually in your stomach. If there is lots of water there, fluid flow from stomach to intestine is like a springtime flood; if there is little water, the movement resembles a lightly dripping tap. Therefore, to increase stomach-intestinal flow (and overall absorption of water) you need to deposit a fair amount of liquid in your stomach just before you begin your exercise. In fact, 10-12 ounces of fluid is a good start. This will feel uncomfortable at first, so practice funneling this amount of beverage into your “tank” several times before an actual competition.
  2. To sustain a rapid movement of fluid into your small intestine during your exertions, take three to four sips of beverage every 10 minutes if possible, or five to six swallows every 15 minutes.
  3. If you are going to be exercising for less than 60 minutes, do not worry about including carbohydrate in your drink; plain water is fine. For exercise that is more prolonged you will want the carbohydrate.
  4. Years of research have suggested that the correct concentration of carbohydrate in your drink is about 5 to 7%. Most commercial sports drinks fall within this range, and you can make your own 6% drink by mixing five tablespoons of table sugar with each litre of water that you use. A bit of sodium boosts absorption; one-third teaspoon of salt per litre of water is about right. Although 5 to 7% carbohydrate solutions seem to work best for most individuals, there is evidence that some endurance athletes can fare better with higher concentrations. In research carried out at Liverpool John Moores University, for example, cyclists who ingested a 15% maltodextrin solution improved their endurance by 30 per cent compared to individuals who used a 5% glucose drink. The 15% drink also drained from the stomach as quickly as the 5% one, though many other studies have linked such concentrated drinks with a slowdown in water movement.
  5. A 6% “simple sugar” drink will empty from your stomach at about the same rate as a fancy 6% “glucose polymer” beverage, so do not fall for the idea that the latter can boost water absorption or enhance your performance more than the former, and don’t pay more for the glucose-polymer concoction.
  6. Contrary to what you have heard, cold drinks are not absorbed into your body more quickly than warm ones. However, cold drinks are often more palatable than warm ones during exercise, so if coldness helps you to drink large quantities of fluid while you exert yourself, then keep your drinks cool.
  7. Swilling drinks during exercise does NOT increase your risk of digestive-system problems. In actuality, most gut disorders that arise during exercise are caused by dehydration, not from taking in fluid. Dehydration induces nausea and discomfort by reducing blood flow to the digestive system, so keep drinking!

Water Intoxication: Intracellular fluid and interstitial fluid have the same osmotic pressures under normal circumstances. The principal cation inside the cell is K+ (Potassium), whereas the principal cation outside is Na+ (Sodium). When a fluid imbalance between these two compartments occurs, it is usually caused by a change in the Na+ or K+ concentration. Sodium balance in the body normally is controlled by aldosterone and ADH (antidiuretic hormone). ADH regulates extracellular fluid electrolyte concentration by adjusting the amount of water reabsorbed into the blood by the distal convoluted tubules and collecting tubules of the kidneys. Aldosterone regulates extracellular fluid volume by adjusting the amount of sodium reabsorbed by the blood from the kidneys that directly affects the amount of water reabsorbed from the filtrate.

Certain conditions, however, may result in an eventual decrease in the sodium concentration in interstitial fluid. For instance, during sweating the skin excretes sodium as well as water. Coupled with replacement of fluid volume with plain water, these conditions can quickly produce a sodium deficit. The decrease in sodium concentration in the interstitial fluid lowers the interstitial fluid osmotic pressure and establishes an effective water concentration gradient between the interstitial fluid and the intracellular fluid. Water moves from the interstitial fluid into the cells, producing two results that can be quite serious:

The first result, an increase in intracellular water concentration, called over hydration, is particularly disruptive to nerve cell function. In fact, severe over hydration, or water intoxication, produces neurological symptoms ranging from disoriented behaviour to convulsions, coma, and even death.
The second result of the fluid shift is a loss of interstitial fluid volume that leads to a decrease in the interstitial fluid hydrostatic pressure. As the interstitial hydrostatic pressure drops, water moves out of the plasma, resulting in a loss of blood volume that may lead to circulatory shock.

Alcohol
Alcohol is a high octane fuel but it cannot be metabolised to provide energy except in the liver and then only at a very slow constant rate. Energy provided by alcohol tends to be converted to fat and excessive consumption may cause liver damage. As a diuretic it will cause dehydration and evidence suggests that vitamin B and C may be depleted. Excessive alcohol will diminish aerobic capacity and impair motor function.


Reality Check

Fact: virtually every human being will have a health crisis at some point in their life.

head
Most people wait for a major health crisis like cancer, heart problems or macular degeneration before they are motivated to improve their health. However, when a crisis occurs, the human body has already arrived at a broken-down state and it may be too late. When this happens most people are left feeling afraid, worried, helpless and discouraged… hardly the emotions needed to produce a successful outcome. In fact, the stresses produced by these emotions further break down the body at a time when it needs to be built up. There is now not only a crisis in one’s health, but a crisis in the mind and spirit. In addition, if there was no prior wellness planning or preparation, then there are no “tools” emotionally, spiritually or physically to effectively deal with a health crisis. At this point, the effort required to get out of a health crisis and pursue wellness, and the stress of negative emotions can be overwhelming. Massive efforts in the whole person (body, mind and spirit) have to be rallied if there will be any hope of overcoming the health crisis.

Wellness is defined the condition of good physical and mental health, especially when maintained by proper diet, exercise, and habits.
Wellness is about the whole person. It’s about balance. If one of these important issues is ignored, and there is a gross imbalance, the results could be devastating. It’s like knocking one leg out from under a three legged chair. Even though most of a chair’s legs are strong, the chair will fall if one leg is broken. Please explore these important issues in order to obtain the most effective plan for wellness.

“We invest in our own disease.” It is our action or inaction that eventually contribute to our overall state of health. You don’t choose your future, You choose your habits, That lead you to your future. The right or wrong diet, a lifestyle void of fitness habits. All this adds up. You choose every day proverbially, Life or Death. The high sodium chips over the fruit, the negative conversation over positivity. Violent movie over meditation/prayer. The soda over the water.

Question: Will you be successful at preventing a health crisis in your life?
“The difference between a successful person and an unsuccessful person is that the successful person does what the unsuccessful person does not want to to.”

What do you want to do? Will you put off wellness or do you want to plan and work now for a healthier future?
You can begin a continuous wellness journey that will start now, leading the way to a healthy and fun future. Why not start by learning about wellness?

You don’t have to be an olympic-level runner or Crossfit Beast just start where you are moving toward your own wellness.


Common Running Injuries

Running is a sport of passion; we torture our bodies with miles of punishment every day? Running injuries are an unfortunate, but all too common, occurrence. Understanding a running injury is the key to effective treatment. The following are  common running injuries with what they are and how to deal with them – everything from whether or not to run through them, to when it is time to see a doctor.

Achilles Tendonitis
Definition: Inflammation of the Achilles tendon.The Achilles is the large tendon connectibeg the two major calf muscles, gastrocnemius and soleus, to the back of the heel bone. Under too much stress, the tendon tightens and is forced to work too hard. This causes it to become inflamed (that is tendinitis), and, over time, can produce a covering of scar tissue, which is less flexible than the tendon. If the inflamed Achilles continues to be stressed, it can tear or rupture.2achilles

Symptoms: Dull or sharp pain anywhere along the back of the tendon, but usually close to the heel. limited ankle flexibility redness or heat over the painful area a nodule (a lumpy build-up of scar tissue) that can be felt on the tendon a cracking sound (scar tissue rubbing against tendon) with ankle movement.

Causes: Tight or fatigued calf muscles, which transfer the burden of running to the Achilles. This can be due to poor stretching, rapidly increasing distance, or over-training excessive hill running or speed work, both of which stress the Achilles more than other types of running.
Inflexible running shoes, which, in some cases, may force the Achilles to twist.
Runners who overpronate (feet rotate too far inward on impact) are most susceptible to Achilles tendinitis

Self-treatment:
Stop running
Take a course (5 – 7 days) of non-steroidal anti-inflammatory drugs(ibuprofen/voltaren/cataflam/mobic) available from your general practitioner or pharmacist
Apply ice to the Achilles – for 10 minutes every 2 hours, in order to reduce the inflammation.
Avoid weight-bearing activities and keep foot elevated where possible
Self-massage – using arnica oil or anti-inflammatory gel. Rub in semi-circles in all directions away from the knotted tissue, three times a day once the nodule is gone, stretch the calf muscle gently do not start running until you can do heel raises and jumping exercises without pain return to running gradually full recovery is usually between six to eight weeks.

Medical treatment: If injury doesn’t respond to self-treatment in two weeks, see a physiotherapist or orthopaedic surgeon, surgery to scrape scar tissue off the tendon is a last resort, but not very effective.

Alternative exercises: Swimming, pool running, cycling (in low gear) “spinning”  No weight-bearing exercises

Preventative measures: Stretching of the gastrocnemius (keep knee straight) and soleus (keep knee bent) muscles. Hold each stretch for 30 seconds, relax slowly. Repeat stretches 2 – 3 times per day. Remember to stretch well before running strengthening of foot and calf muscles (eg, heel raises) correct shoes, specifically motion-control shoes and orthotics to correct overpronation.
Gradual progression of training program.
Avoid excessive hill training
Incorporate rest into training program
 
Runner’s Knee
Definition: A softening or wearing away and cracking of the cartilage under the kneecap, resulting in pain and inflammation. The cartilage becomes like sandpaper because the kneecap is not riding smoothly over the knee.1runknee1

Symptoms:  Pain beneath or on the sides of the kneecap crepitus (grinding noise), as the rough cartilage rubs against cartilage when the knee is flexed.
Pain is most severe after hill running
Swelling of the knee

Causes: Overpronation (feet rotate too far inward on impact) – can cause the kneecap to twist sideways fatigued or weak quadriceps muscle. The quadriceps muscle assists in the proper tracking of the kneecap.  Weakness, especially of the inside part of the quadriceps, can prevent the kneecap from tracking smoothly muscle imbalance – between weak quadricepsand tight hamstring and iliotibial band (ITB) Muscles can also affect proper tracking hill running (especially down hills) and running on cambered surfaces
Incorrect or worn shoes
Overtraining 
 
Self-treatment:
Stop running
Take a course (5 – 7 days) of non-steroidal anti-inflammatory drugs(ibuprofen/voltaren/cataflam/mobic) available from your general practitioner or pharmacist
Apply ice to the shin area – for 10 minutes every 2 hours, in order to reduce the inflammation
Avoid weight-bearing activities and keep foot elevated where possible
Self-massage – using arnica oil or anti-inflammatory gel, on the sore spots around the kneestretch 2 – 3 times per day.
Strengthen the quadriceps muscle only when pain-free.
Exercises include:
1) Place pillow under knee, tighten quadriceps, push knee down into pillow and lift foot up. 20 times
2) Repeat exercise as above with foot turned out in order to strengthen the inside of the quadriceps muscle. Repeat 20.
3) Squats. Perform with back against wall. Bend knees slowly to between 45 – 60. Ensure that knee travels over line between bigand second toes. Hold for a count of 5 seconds. Relax slowly. 20 times
4) Step-downs. Stand on step or box. Tighten quadriceps and lower opposite leg slowly to the ground.Ensure that knee travels over line and between big and second toes.Then raise the leg up onto the step,relax. Repeat 20.  Increase the number of repetitions in increments of 5 every two days, all the way up to 60 reps.
Stretching – of the quadriceps, hamstring, iliotibial band (ITB) and gluteal muscles
Return to running gradually
Full recovery is usually between four to six weeks

Medical treatment:
If injury doesn’t respond to self-treatment in two weeks, see a physiotherapist or orthopaedic surgeon
Orthotist or podiatrist for custom-made orthotics to control overpronation
Orthopaedic surgeon – surgery to scrape away rough edges of cartilage may alleviate some pain.
Cortisone injections are ineffective

Alternative exercises: Swimming, pool running, cycling (in low gear) “spinning”
Avoid any exercise that places strain onto the knee

Preventative measures: Stretching of the quadriceps, hamstring, iliotibial band (ITB) and gluteal muscles. Hold each stretch for 30 seconds, relax slowly. Repeat stretches 2 – 3 times per day. Remember to stretch well before running, strengthening of quadriceps, hamstring and calf muscles correct shoes, specifically motion-control shoes and orthotics to correct overpronation
Avoid excessive downhill running, and cambered roads (stay on the flattest part of the road) .
Gradual progression of training program
Incorporate rest into training program
 
Iliotibial Band Syndrome
Definition: Pain and inflammation on the outside of the knee, where the iliotibial band (a muscle on the outside of the thigh) becomes tendinous, and results in a friction syndrome by rubbing against the femur (thigh bone) as it runs alongside the knee joint.1itb

Symptoms:  Initially, a dull ache 1-2 kilometres into a run, with pain  remaining for the duration of the run. The pain disappears soon after stopping running, later, severe sharp pain which prevents running pain is worse on running downhills, or on cambered surfaces pain may be present when walking up or downstairs.
Local tenderness and inflammation

Causes: Anything that causes the leg to bend inwards, stretching the ITB against the femur overpronation (feet rotate too far inward on impact) tightness of the ITB muscle lack of stretching of the ITB incorrect or worn shoes excessive hill running (especially downhills) and running on cambered surfaces overtraining

Self-treatment: Stop running, especially in the case of severe pain if pain is mild, then reduce training load and intensity,  and avoid downhill running and running on cambered surfaces.
Take a course (5 – 7 days) of non-steroidal anti-inflammatory drugs  (ibuprofen/voltaren/cataflam/mobic) available from your general practitioner or pharmacist.
Apply ice to the knee (for 10minutes every 2 hours) in order to reduce the inflammation
Self-massage, using arnica oil or an anti-inflammatory gel, to the muscle only (along the outside of the thigh). Do not massage the side of the knee where you feel the pain, as this will only aggravate the friction syndrome stretching of the ITB. Stand with the right leg crossed in the back of the left leg. Extend the left arm against a wall/pole/chair/other stable object. Lean your weight against the object while pushing your right hip in the  opposite direction. Keep your right foot anchored while allowing your left knee to flex. You should feel the stretch in the ITB muscle in the right hip and along the outside of the right thigh. Hold for 30 sec. Relax slowly.

Repeat to opposite side. Repeat stretch 2 – 3 times per day.
Remember to stretch well before running
Return to running gradually
Full recovery is usually between three to six weeks

Medical treatment:  Physiotherapy, if injury doesn’t respond to self-treatment in 2 to 3 weeks
Orthotist or podiatrist for custom-made orthotics to control overpronation
Orthopaedic surgeon – if injury does not respond to physiotherapy treatment, a cortisone injection into the ITB, or surgery to release the ITB may be indicated.

Alternative exercises: Swimming, pool running, cycling (in low gear) “spinning”
Avoid any exercise that places strain onto the ITB, specifically, avoid stair-climbing

Preventative measures: Stretching of the ITB, quadriceps, hamstring, and gluteal muscles. Hold each stretch for 30 seconds, relax slowly. Repeat stretches 2 – 3 times per day. Remember to stretch well before running. Strengthening of quadriceps, hamstring and calf muscles.
Correct shoes, specifically motion-control shoes and orthotics to correct  overpronation
Gradual progression of training program
Avoid excessive downhill running, and cambered roads (stay on the flattest part of the road)
Incorporate rest into training program
 
Plantar Fasciitis
Definition: An inflammation of the plantar fascia, a thick fibrous band of tissue in the bottom of the foot which runs from the heel to the base of the toes. When placed under too much stress, the plantar fascia stretches too far and tears, resulting in inflammation of the fascia and the surrounding tissues. The tears are soon covered with scar tissue, which is less flexible than the fascia and only aggravates the problem.1plantar

Symptoms: Pain at the base of the heel. Pain is most severe in the mornings on getting out of bed, and at the beginning of a run. The pain may fade as you walk or change running stride, in an attempt to alleviate the pain. This provides only temporary relief

Causes: Stress, tension and pulling on the plantar fascia
Inflexible calf muscles and tight Achilles tendons – place more stress onto the plantar fascia.
Overpronation (feet rotate too far inward on impact)
High arches and rigid feet
Incorrect or worn shoes
Overtraining

 Self-treatment: Stop running, especially in the case of severe pain, if pain is mild, then reduce training load and intensity take a course (5 – 7 days) of non-steroidal anti-inflammatory drugs (ibuprofen/voltaren/cataflam/mobic) available from your general practitioner or pharmacist
Apply ice to the plantar fascia – for 10 minutes every 2 hours, in order to reduce the inflammation. An effective way of icing is to fill a plastic 500 ml Coke bottle with water, and to freeze it. Apply the ice as instructed by rolling the bottle under the foot
Self-massage, using arnica oil or an anti-inflammatory gel, to the plantar fasciastretching of the gastrocnemius and soleus muscles
Return to running gradually
Full recovery is usually between six to eight weeks

Medical treatment: Physiotherapy, if injury doesn’t respond to self-treatment in 2 to 3 weeks
Orthotist or podiatrist for custom-made orthotics to control overpronation, or to reduce stress on the heel area
X-rays – to check for a heel spur.
Orthopaedic surgeon – if injury does not respond to physiotherapy treatment, a cortisone injection, or surgery to release the plantar fascia may be indicated.

Alternative exercises: Swimming, pool running, cycling (in low gear) “spinning”
Avoid any exercise that places strain onto the plantar fascia

Preventative measures: Stretching of the gastrocnemius and soleus muscles. Hold each stretchfor 30 seconds, relax slowly. Repeat stretches two – three times per day. Remember to stretch well before running stretching of the plantar fascia. Sit on the floor with one knee bent and theankle flexed towards you. Pull the toes back towards the ankle. Hold for 30 seconds. Relax slowly. Repeat to opposite foot. Repeat 2 – 3 times per day. Remember to stretch well before running strengthening of the muscles of the foot. 1) Pick up marbles or golf balls with your toes. 2) Pull a towel towards you with your toes. Grab some of the towel with your toes and pull, then release, grab, and pull some more to loosen the plantar fascia, place a golf ball under the foot, and roll the foot over the ball. Start with the ball at the base of the big toe, and roll the foot forwards over the ball, then back again. Move the ball to the base of  toe and repeat. Repeat for each toe. Always exert enough pressure so that you feel a little tenderness. correct shoes, specifically motion-control shoes and orthotics to correct overpronation always apply ice after running 
Gradual progression of training program 
Incorporate rest into training program
 
Shin Splints
Definition: Inflammation of the muscle attachments and interosseous  membranes to the tibia (shin bone) on the inside of the front of the lower leg. Note: “shin splints” is a very widely used phrase and can refer to several lower leg injuries. The focus of this description is specifically on the inflammation described above. 1shin

Symptoms: Pain or tenderness along the inside of the shin, usually about halfway down the shin. Pain and tenderness may extend to the knee
Pain on palpation of the shin. Pain is most severe at the start of a run, but may disappear during a run, as the muscles loosen up. This is different to a stress fracture, where there is pain during weight bearing activities (walking, stair-climbing)

Causes: Inflexible calf muscles and tight
Achilles tendons – place more stress on to the muscle attachments
Overpronation (feet rotate too far inward on impact) excessive running on hard surfaces, such as concrete pavements
Incorrect or worn shoes
Overtraining, or a rapid increase in training load or intensity
Beginner runners are more susceptible to this problem for a variety of reasons, but most commonly due to the fact that the leg muscles have not been stressed in such a way before they started running. 
 
Self-treatment: Stop running, especially in the case of severe pain, if pain is mild, then reduce training load and intensity, and avoid downhill running and running on cambered surfaces
Take a course (5 – 7 days) of non-steroidal anti-inflammatory drugs(ibuprofen/voltaren/cataflam/mobic) available from your general practitioner or pharmacist
Apply ice to the shin area – for 10 minutes every 2 hours, in order to reduce the inflammation
Self-massage, using arnica oil or an anti-inflammatory gel, to the muscle only (along the inside of the shin).
Stretching of the gastrocnemius and soleus muscles. Hold for 30 secs. Relax slowly. Repeat to opposite side. Repeat stretch 2 – 3 times per day.
Remember to stretch well before running
Return to running gradually; full recovery is usually between two to four weeks

Medical treatment: Physiotherapy, if injury doesn’t respond to self-treatment in 2 to 3 weeks
Orthotist or podiatrist for custom-made orthotics to control overpronation
Orthopaedic surgeon – if injury does not respond to physiotherapy treatment, a bone scan, diagnostic ultrasound or X-ray may be necessary to check for a stress fracture.

Alternative exercises: Swimming, pool running, cycling (in low gear) “spinning”
avoid any weight-bearing exercises

Preventative measures: Stretching of the gastrocnemius and soleus muscles. Hold each stretch for  30 seconds, relax slowly.
Repeat stretches 2 – 3 times per day. Remember to stretch well before running.
Strengthening of foot and calf muscles.
1) Place a weight around the foot, and move your foot up and down from the ankle, with no movement in the rest of the leg. Or use a partner to grasp the foot and provide manual resistance.
2) Band exercises. Anchor one end of an exercise band (e.g; inner tubing of bicycle) to a heavy object, such as the leg of a couch. Loop the other end around the foot. Move the foot up, down, and from side to side against the band’s resistance to exercise different muscle groups.

Correct shoes, specifically motion-control shoes and orthotics to correct  overpronation
Always apply ice after running
Run on soft surfaces
Avoid overstriding, which places more stress onto the shins
Gradual progression of training program
Incorporate rest into training program


Is it a Sprain or a Strain?

LigamentSprains and strains often occur together in or near a joint, since joints absorb the stress of movement and are vulnerable to be being twisted or wrenched. The ankle and the knee are the most common sites of such injuries.

 A sprain (from the French espraindre – to wring) is an injury which occurs to ligaments caused by being stretched beyond their normal capacity and possibly torn. Muscular tears caused in the same manner are referred to as a strain. In cases where either ligament or muscle tissue is torn, immobilization and surgical repair may be necessary
Although some signs and symptoms can be used to assess the severity of a sprain, the most definitive method is with the use of Magnetic Resonance Imaging (MRI). Sprains are graded in five degrees.

The first degree is only a minor tear or stretch of a ligament.
The second degree is a tear of a ligament, which is usually followed by pain or swelling
The third degree is a complete rupture.
The fourth degree breaks the ligament, along with some small bones if severe enough, and requires surgery to repair.
The fifth degree tears all the ligaments and actually breaks all the surrounding bones; sometimes cannot be repaired and results in amputation.

A strain is an injury to a muscle or tendon in which the muscle fibers tear as a result of overstretching. Strains are also colloquially known as pulled muscles. The equivalent injury to a ligament is a sprain. Strained muscles usually happen at the point where tendon meets muscle, although you can get them at any point on the muscle. When you get a muscle strain, it might be severe, but it could also just be mild or moderate.  A mild or moderate muscle tear is usually just stretched and painful.  A severe one, on the other hand, can actually cause your muscle to detach from the tendon and roll up. In mild cases, the force of the injury tears a few fibers of the ligament or muscle, causing mild to moderate pain and swelling, which usually subside within a few days. A more violent injury may completely tear a ligament or muscle and involve bone damage such as a dislocation or fracture. With proper care, most sprains and strains heal completely without complication.

The ankles are among the most vulnerable elements of the body. These complex hinges of bone, ligament, tendon and muscle support the entire body weight and may transmit a force of impact equal to three times your weight. Thus, ankle injuries, usually the tearing or straining of a ligament, are the most common of all joint injuries.

The great majority of sprains are inversion sprains. This happens when the sole of the foot turns inward, injuring the ligaments on the outside of the ankle. Eversion injuries occur when the foot turns outward, affecting ligaments on the inner side. Some sprains are minor and can be successfully treated at home, but many need medical attention. Any ankle sprain can put you at risk for another, since when the injury heals, it leaves the tendon weakened and less flexible – and thus more susceptible to injury.

anklesprain

Causes and Risk Factors of Sprains and Strains
Sprains and strains occur as a result of an injury, when the joint is subjected to more physical force that it can withstand. Athletes, dancers, and those who perform manual labor commonly suffer such injuries. Previous sprains may so weaken the ligaments that recurrence is possible with only minor pressure. The risk of sprains and strains increases with obesity and poor muscular conditioning.

Symptoms of Sprains and Strains
Symptoms include mild-to-severe pain in the affected joint that worsens with movement or application of pressure; swelling, redness, or bruising around the affected joint; and, in severe cases, loss of mobility in the affected joint.

Typical symptoms of a strain include: localized pain, stiffness, inflammation, and bruising around the strained muscle, loss of function, loss of normal limb function or elasticity of ligament decrease

Treatment of Sprains and Strains
First aid measures for a sprain or strain can best be remembered by the acronym RICE – Rest, Ice, Compression, and Elevation.

  • Rest the injured area. Try not to move or put pressure on the affected joint. A sling or splint may be recommended to immobilize the joint and allow damaged ligaments or muscles to heal.
  • Ice the affected area to reduce swelling. After 24 hours, either ice or heat may be applied to reduce pain.
  • Compress the joint by wrapping it in an Ace bandage to help reduce swelling and pain.
  • Elevate the joint to reduce swelling.

Take over-the-counter pain relievers to treat minor pain. Your doctor may prescribe stronger analgesics for more severe pain. After the pain has subsided, gently exercise the joint to regain strength and mobility. A physician or physical therapist may help to devise an exercise program to aid in rehabilitation. Surgery may be required in severe cases to repair torn ligaments or muscles.

Prevention of Sprains and Strains
Perform warm-up exercises before undertaking any strenuous activity. Wear a brace or elastic support, or tape or wrap joints before engaging in vigorous physical activity. Engage in regular, moderate exercise to keep muscles and joints strong and flexible.


Exercise-Induced Asthma (EIA)

What is exercise-induced asthma?
Exercise-induced asthma (EIA) is airway narrowing brought on by vigorous exercise. The symptoms of EIA — wheeze, breathlessness, cough or chest tightness — may start during exercise but usually worsen in the 5-10 minutes after you stop exercising. Some people with EIA get asthma symptoms only after exercise, while others find that their asthma also occurs in other situations.

EIAExactly how EIA happens is not clear. However, it is thought that EIA may involve loss of heat and water from the airways, as they try to warm and moisten large volumes of incoming cool dry air. The cooler and drier the air you breathe in while you exercise, the more severe the symptoms of EIA. Rapid rewarming of the airways after exercise is also put forward as a cause of EIA.

What causes EIA?

If you train intensely and frequently, especially in cold dry air, your risk of developing EIA increases. Other factors that make EIA more likely are allergens (substances that can trigger an allergic reaction, such as pollen) or irritants in the environment.

Symptoms of Exercise-Induced Asthma
Symptoms of EIA include wheezing, tightness or pain in the chest, coughing, and sometimes prolonged shortness of breath.

People with EIA will often start having symptoms 5 to 10 minutes after they begin working out. Symptoms usually peak 5 to 10 minutes after the person stops exercising then go away within an hour. Some people with EIA also have symptoms for hours after they exercise. Sometimes symptoms appear only after the person has stopped exercising. Really cold weather can make EIA worse.

Some people with EIA think that their problem is that they are out of shape. But there’s an easy way to tell the difference. If someone is simply winded from being out of shape, he or she will soon start breathing normally again after finishing exercising. But for someone with EIA, it may take up to an hour for the person to recover and breathe normally again.

If you think you have EIA, you should see a doctor.

Diagnosis and Treatment of Exercise-Induced Asthma
If your doctor suspects EIA, he or she may ask you questions about whether people in your family have asthma and what has triggered your symptoms in the past.

After taking a detailed history and performing a physical exam, the doctor may want to check your breathing after exercise. For 6 to 8 minutes, you might run on a treadmill, run outside, or do the activity that caused the flare-ups. Then, the doctor can see how you’re breathing and if it seems like EIA.

If so, your doctor might recommend something called pretreatment, which means taking medication before exercise or strenuous activity. This is often the same fast-acting medication used for flare-ups, called rescue medication, which is usually inhaled directly into the lungs and works immediately to open up the airways. When taken before exercise, this can help to prevent symptoms of EIA.

If pretreatment isn’t enough, your doctor may recommend that you also take daily controller medication. Controller medication works over time to help keep the airways in the lungs open.

Medication is an important part of controlling EIA. Many people find that if they take their medicine as prescribed by their doctors, they can work out with few or no symptoms.

Recommended Sports
Exercise is a good idea for everyone. There’s no reason for you to stop participating in sports or working out because you have EIA. In addition to keeping you fit and keeping your weight healthy, exercise can improve your lung function by strengthening the breathing muscles in the chest. For this reason, doctors no longer tell people with asthma to avoid exercising and may in fact recommend it as part of asthma treatment.

Some sports are less likely to cause problems for people with EIA than others, though. Some recommended activities include:

  • walking
  • jogging
  • hiking
  • golf
  • baseball
  • football
  • gymnastics
  • shorter track and field events

Endurance sports, like long-distance running and cycling, and those that require extended energy output, like soccer and basketball, may be more challenging. This is especially true for cold-weather endurance sports like cross-country skiing or ice hockey. But that doesn’t mean you can’t participate in these sports if you truly enjoy them. In fact, many athletes with asthma have found that with proper training and medication, they can participate in — and even excel at — any sport they choose.

Tips for Dealing With Exercise-Induced Asthma
When it comes to EIA, staying one step ahead of your symptoms is a good strategy. Ask your doctor about precautions you should take before exercising or playing sports. These are common recommendations for people who have EIA:

  • Warm up carefully before any exercise to prevent chest tightening.
  • Take prescribed medication as close to the start of exercise as possible.
  • Breathe through your nose during exercise.
  • Take brief rests during exercise and use rescue medication as prescribed if symptoms start.
  • Cool down after exercise.
  • Avoid exercising outside during really cold weather; if you have to, wear a scarf around your nose and mouth or a ski mask.
  • If pollen or pollution also trigger your asthma, work out indoors on days when the air quality is bad or the pollen count is high.
  • Don’t exercise when you have a cold or the flu.
  • Don’t exercise if you are having asthma symptoms.
  • Taking medication exactly as your doctor prescribes is the most important tip of all. Skipping controller medications can make symptoms worse. Forgetting to take medication before exercise can lead to severe flare-ups and even emergency department visits.

Be sure to keep your inhaler with you when exercising.