Walking to Boost Fitness and Lower Blood Sugar: Breaking News from US News & World Report

Diabetes and Strength Training | Breaking News from US News & World Report

Stretching is Not Enough

If you feel like you've been stretching a tight muscle forever and not making progress, you're not alone.  Most people do static stretches and some myofascial release (foam rolling), either on their own or in stretching or yoga classes.  These are valuable techniques but they may not be enough to get the results you want and may not target you individualized needs.

Muscles become tight from extended periods of sitting and repetitive motion.  Remember isometric exercises?  Exercises where you hold a muscle in a contracted position to strengthen it?

Sit in front of a computer for extended periods of time and you're doing isometrics.  Literally strengthening and shortening the hip flexors, upper trapezius, chest lats, and anterior shoulder muscles.  At the same time, you're stretching and lengthening the glutes, middle trapezius and rhomboids and shoulder external rotators.


If a muscle is tight and short, the antagonist or opposite muscle is extended and relatively weaker.  That's why static stretching and myofascial release is not enough.  A flexibility programs needs to include active stretches and eccentric (negative phase) strengthening of the tight muscles and strengthening of the antagonist muscles .

The charts below show some examples of complete flexibility programs for common complaints.  Additional illustrated programs are available on my website at programs.caryraffle.com.

Unlike classes which take a one-size-fits-all approach, when we work together, we can personalize a program to your specific problem muscles, needs and goals.  We also will ensure proper form and exercise selection.

Contact me  if you have any questions or want to set up some sessions to develop your personalized program, or visit TrainerCary.com for more information.

Tight Calves - Plantar Fascitis - Achilles Tendinitis
Myofascial Release	Calf with foam roller, medicine ball, barbell, other implements Bottom of foot with lacrosse ball or frozen water bottle
Static Stretch	Calf
Active Stretch - Eccentric Strengthening	“Reverse calf raises” or heel drops - emphasize the “eccentric” or negative phase and isometric contraction
Reciprocal - Antagonist Strengthening	Heel raises to strengthen the anterior tibialis (opposite or antagonist muscle to the calf)

Tight Hip Flexors - Often with Arched Back and Knee Pain
Myofascial Release	Quads and hip flexors foam roller and medicine ball especially at the inguinal crease (hip)
Static Stretch	Quadriceps and Psoas, kneel with raised arm to lengthen Psoas
Active Stretch - Eccentric Strengthening	“Butt Raises” on floor or stability ball -  emphasize the “eccentric” or negative phase and isometric contraction
Reciprocal - Antagonist Strengthening	“Butt Raises” Glute strengthening exercises including single leg press and squats, hip extension, lunges

Rounded Shoulders - Often with Shoulder or Neck Pain
Myofascial Release	Chest/pectorals, anterior (front) of shoulders and lats with foam roller or medicine ball
Static Stretch	Chest stretches
Active Stretch - Eccentric Strengthening	Unweighted reverse fly, weighted reverse fly -  emphasize  “eccentric” or negative phase and isometric contraction
Reciprocal - Antagonist Strengthening	Scaption and Reverse fly - ensure shoulders are retracted, on reverse fly emphasize the negative phase when retracted Shoulder external rotation Close grip row, emphasize the “eccentric” or negative phase and isometric contraction when retracted At least a 3:2 ratio of back to chest exercises

Elevated Shoulders - Often with Shoulder or Neck Pain
Myofascial Release	Upper Trapezius, Lats, Rhomboids with Roller or medicine ball
Static Stretch	Neck Stretch - Sternocleidomastoid, Levator Scapula
Active Stretch - Eccentric Strengthening	Scapular Depression - “Reverse Shrugs” on a seated dip machine or dip bar.  Keep elbows straight, raise and slowly lower the shoulder carriage.  emphasize the “eccentric” or negative phase and isometric contraction at the bottom
Reciprocal - Antagonist Strengthening

Tight Low Back - Often with Arched Back
Myofascial Release	Hip flexors, quadriceps, lower back, lats, piriformis
Static Stretch	Lats, cobra for abdominals, piriformis
Active Stretch - Eccentric Strengthening	“Butt Raises” on floor or stability ball -  emphasize the “eccentric” or negative phase and isometric contraction
Reciprocal - Antagonist Strengthening	“Butt Raises” Glute strengthening exercises including single leg press and squats, hip extension, lunges Reduce “Crunches” instead incorporate planks, single leg exercises and other deep core strengthening exercises

15 Minutes Can Get You Better Results and Reduce Your Risk of Injury

Thanks for your readership of my fitness blog. To show my appreciation, I am pleased to offer a complimentary fitness program review .  We will discuss your goals, fitness level, current program and results, and give you a chance to ask questions.  This is a must if any of the following apply:

• you're just starting out or returning
• you've been working hard but aren't getting the results you want
• you've plateaued 
• you've had an injury, medical issue, pregnancy
• you're bored, routine has gotten stale
• you aren't working with a trainer
• you have a special event -- wedding, trip, beach, etc.
• you've been a reader for some time and just have some questions

Please note availability is limited and we need to schedule in advance. 

Add Horsepower to Your Cardio: Increase Your Cardiac Ouput

QUESTION: True or false:  to improve your cardiovascular conditioning,  get your heart rate as high as possible in aerobic exercise?

ANSWER: False.  You improve your cardio condition by increasing cardiac output at lower heart rates.   Here's the mathematical equation used by doctors and exercise physiologists:

Q = HR x SV

Your cardiac output, Q,  is the product of your heart rate times your stroke volume - that's the amount of blood exiting the heart from the left ventricle every time it beats.   A strong heart pumps more blood with every beat.  At rest, Q is typically about 5-6 liters per minute.  During exercise it can be 3-6 times as much.  

Extra Horsepower

To improve your cardiovascular conditioning, we focus on improving your Stroke Volume, conditioning the muscle fibers in the heart to pump more blood each time it beats.  Think of it as adding horsepower to a pump.

We do this with a training program designed to increase your heart rate reserve --- the difference between your Resting Heart Rate and your Maximum Heart Rate.  Your Maximum Heart Rate is most widely accepted at 220-age, it is a theoretical number that is the same for everyone.  

We can’t change your Maximum Heart Rate, but we can lower your Resting Heart Rate. Typical Resting Heart Rate for adults is 60-80 beats per minute, if you’re already well conditioned it is probably lower.

The Frank-Starling Law

For over 100 years, doctors have relied upon the Frank-Starling law or mechanism for patients with heart arrhythmias and cardiac failure.  It explains how the heart adapts to changes in heart rate and stroke volume, and applies equally to exercise.

If you train your heart to pump more blood what’s it going to do?  Pump more blood.  You will also see a lower resting heart rate and - as your heart rate reserve increases - an increase in potential cardiac output (Q in the formula discussed above).

If you train your heart to beat faster, what’s it going to do?  Beat faster.  You may not see improvement in cardiac output, in fact it may even decline.  Frank-Starling explains that  if the heart is literally beating so fast that the chambers don’t have time to fully fill with blood, the muscle contraction is not as strong. The muscle can actually weaken slightly over time.  You burn more calories at a higher heart rate, but there's a good chance that you're burning muscle and not just fat.  More about this in an upcoming article on Metabolic Training.

Your Cardio Training Heart Rate

We use the Karvonen Formula to calculate your training zone, also called the Heart Rate reserve formula.  (More elaborate athletic training facilities may use VO2 max as a measurement, but it is difficult to consistently monitor).

• 60-80% of your Maximum Heart Rate, using the Karvonen formula, is targeted to increase stroke volume, therefore increasing cardiac output and lowering your resting heart rate. Gradually increase intensity of exercise that you are able to do while keeping your heart rate in this range.
• Above 80% of MHR not indicated for improving cardiac output.  It provides other benefits such as improving lactic acid removal and strengthening fast twitch muscle fibers. So it is part of your program, but not the part that improves cardiac output.

To calculate your Target Heart Rate Zone, take your Resting Heart Rate early in the morning,. preferably when you wake up without alarm or kids or noise and use the following equation:

THR = (220-Age-RHR) * Desired Intensity % + RHR

Do I need a Heart Rate Monitor?

Ideally yes, but you can also use rate of perceived exertion.   The Borg Scale is widely used, easy and scientifically validated,  you rate your perceived level of exertion on a scale of 6-20, where 6 is no exertion and 20 is extremely difficult  A rule of thumb is that you can then multiply by 10 to get an approximate heart rate.   

Proceed with caution

Talk to a doctor and a fitness professional before beginning a new exercise program or substantially increasing the intensity.  I'd be happy to meet with you to discuss your questions, goals and program options.  Contact me  if you have any questions or want to set up some sessions to develop your personalized program, or visit TrainerCary.com for more information.

BUSTED: Haagen-Dazs Corn Syrup Ingredient Alert

If you think that paying the price for super-premium products is a way to avoid ingredients WE don't want - like corn syrup - think again. After reading the fine print ingredients when I got it home, I recently discovered that the pint of Haagen-Dazs gelato that I paid about $5 for was made with corn syrup. I wrote to complain and was a bit taken aback by their response shown below. Let's forget that he called me Ms Raffle instead of Mr Raffle, and misspelled Karo syrup. Can we talk about arrogance?

According to Haagen-Dazs, corn syrup is a "kitchen friendly" ingredient. Is Lard also kitchen friendly? I think they really mean "bottom-line friendly." The thing that concerns me is that I like Haagen-Dazs Ice Cream, and I don't think it contains corn syrup ... yet. But I don't want to have to read the fine print to make sure I am not getting ingredients I don't want.

No apology for my dissatisfaction. No refund. No suggestion that if I prefer to avoid corn syrup as an ingredient (as many people do), I try their other products. Shame on Haagen-Dazs!

Dear Ms. Raffle,

Thank you for your email regarding Häagen-Dazs®. We appreciate the time you have taken to pass your comments on to us. The use of corn syrup goes along with the Häagen-Dazs® philosophy of using only "kitchen-friendly" ingredients. Corn syrup can be found in the kitchen and has many uses such as, pecan pie, apple butter, glazed pork, Asian b.b.q. sauce, balsamic vinaigrette, chocolate chunk cookies and many other desserts and food products.

At this time there is no intention to remove corn syrup from our ingredients. Corn Syrup is a common house hold ingredient like Kayro Syrup. I will be happy to report your comments and concerns to the appropriate department for review.

We hope that your questions and concerns have now been sufficiently answered. Should you require additional information, please feel free to contact us.Thank you again for contacting us.

Sincerely,
Angel Osorio
Consumer Response Representative

Do You Need To Change Your Workout?

Whether your goal is to improve performance, slim down, cut-up, bulk-up, reduce risk of injury or work around a problem area, a carefully considered change up in your workout might be just what the doctor ordered.  In this issue, the signs that your fitness program needs a change and the changes that can take you to the next level.

If any of these statements are true, a change in program is overdue. You've been doing the same exercises for more than 6-8 weeks, the only change has been to increase weight.   Your body adapts to the exercises, you will experience a diminished return on investment in terms of muscle development, and changing body composition (gaining or losing weight). Planned changes, or periodization, can help you break through the plateau.   What's more, continually performing the same exact movements makes you more susceptible to repetitive motion injuries.  Read more here Machines vs. Free Weights You're taking up or increasing participation in a sport or activity (running, cycling, hiking, basketball, soccer, and so on).  Your fitness program can complement and enhance your activities and sports participation, or it can conflict with them.  You may have noticed a particular problem since increasing your new activity, small adaptations to your workout can make a big difference. Your goal or timeline has changed, you may want to get into shape for a vacation or wedding or the beach.  Simply doing more of the same thing may not be the optimal solution;  in fact, you're more likely to see diminished return and experience some sort of injury that prevents you from reaching your goal. You've got a new health issue, to name a few common ones: back, neck or shoulder pain; blood pressure; broken bones; cancer; depression; diabetes; GERD; hernia; plantar fascitis; pregnancy; surgery; tendinitis.   Programs can be modified to achieve results and help deal with most issues. In some cases, exercise can be part of "the cure" or recovery. You're bored or having trouble sticking with an exercise program.  A new routine can be just the thing to motivate you. Of course, it should also be relevant to your fitness goals and level. Ten Changes to Make Today 1.  Get off the Machines They're a great place to start and can be an important part of the program... but if you've gotten stuck in a machines-only exercise rut you're doing more to work the machines than to work your muscle in a meaningful way.  Plus, they may put you at risk of repetitive motion issues.   Read more here Machines vs. Free Weights 2.  Decrease Stability/Decrease Weight/Increase Repetitions Strengthen your core and burn more calories as you workout. Performing exercises standing, on an exercise ball, on balance boards or with suspension training like TRX are a good way to go.  A stronger core can also improve your performance in lifting and many sports and give you a tighter and fitter appearance. 3.  Increase Stability/Increase Weight/Decrease Repetitions Go heavy at almost any age to increase muscle - since muscle burns more calories than fat, you'll begin losing weight while you rest!  Carefully select exercises and pay attention to proper form. 4.  Change the Tempo  Increasing time spent on the eccentric (negative), adding an isometric contraction to exercises, or simply slowing the overall tempo - and increasing the time that the muscle is kept under tension rather than the weight - can help produce gains in strength, endurance and muscle size and break through plateaus.  Longer negatives increase strength and endurance, isometrics help cut and build muscle size. 5.  Plyometyrics   Increase explosive power, reduce risk of injury and have some fun with Plyometrics.  Participants in a well-designed program of stretching, plyometrics and weight training reduced landing forces from a jump by 20 percent, and increased their hamstrings strength by 44 percent.  Plyometrics can also be applied to upper body exercises and sport specific training. Click here to learn about how many sets and reps you should be doing and see program examples at trainercary.com. 6.  Assess, Correct, Emphasize and Eliminate  Bad posture and movements patterns can reduce performance and increase risk of injury.  A movement and postural assessment like the one on my website can identify which muscles are tight and need stretching and which are extended and need strengthening, and help determine which exercises and stretches to add or remove from your program.  You can learn how to assess yourself at trainercary.com/fitness-assessment. 7.  Change the Mix or Timing of Strength and Aerobic Training  As a rule, if you want to get improve your running speed do cardio before strength, if you want to increase strength or build muscle, do cardio after.  The timing change that has personally helped me the most is to alternate days so that I can go all-in every day. 8.  Work One Side of Your Body at a Time  One side may seem weaker or smaller than the other, but that's only the beginning. Unilateral exercises can help improve core strength, and improve your overall strength by improving "neuromuscular efficiency" - the way your brain "recruits" muscle fibers.  This is time consuming, so you may not do it every time or for every muscle.  Read my article The Brain Train. 9. Superset and Circuit   Combine two or more different exercises for the same muscle group, with no rest in between, such as a chest press followed by pushup, and you can work the muscles longer and harder before tiring or risking injury.  Alternate between front and back of body or upper and lower body so that you don't have to rest in between, you will buirn more calories and increase the number of exercises per session. 10.  Interval Training  Alternating between higher and lower intensity in your cardio workout could be right for you if you have a good cardio base and want to improve performance or increase weight loss.  You'll also burn more calories for a few hours after exercising with interval training.  Read my quotes in this article The Best Interval Training Technique for You, on fitbie.com, from he publishers of Men's health Still Stuck?  Get a Partner.  Join a Class,  Hire a Trainer  If two weeks or more pass by and you've skipped your exercise appointments, your plan isn't working.  Do you need an appointment with a friend or trainer so you don't cancel? Maybe a class? Or a written program to follow and log? Can you keep the commitment to exercise on your own? Do you get bored easily? Will you push yourself hard enough?   Do you need my help? Contact me  if you have any questions or want to set up some sessions to develop your personalized program, or visit TrainerCary.com for more information.

What NOT To Do: The Six DO NOTS of Weight Loss

In this issue, six simple tips about the things that don't work and alternative that do to help you get the most out of your efforts.   1.  Don't Starve - Watching your calories is good, starving yourself and skipping meals actually works against you. When you skip meals or reduce your calorie intake too low, your body thinks you're starving and goes into "survival mode." It actually lowers your metabolism so that you burn less calories. Instead, plan on increasing exercise and reducing caloric intake so that you have a daily "calorie deficit" of 500-1000 calories. At this rate, you should lose 1-2 pounds of fat per week. The American Dietetic Association and American College of Sports Medicine consider this level optimal for long term weight loss. 2.  Don't Do Just Cardio - Aerobic exercise is great for burning calories while you're doing them and for a short time later. Strength training has the added advantage of building lean muscle - which means your metabolism increases and you burn more calories ALL DAY LONG! Ideally, do a combination of both for best results. 3.  Skip the Small Muscle Exercises - The larger the muscle, the more calories it will burn when you exercise. Legs, Back and Chest exercises give you the most bang for the buck, while small muscles like shoulders, arms and calves burn very few calories. Multi-joint exercises like those shown on the chart below give you the biggest bang for the buck, and can hit smaller muscles in the process. Skip These Small Muscle Exercises Emphasize Big Muscles/Multi-Joint Exercises Biceps, Triceps, Shoulder Press, Shoulder Lateral and Front Raises, Calf Raises Squats, Lunges, Pushups, Pullups, Chest Press, Rows,   Lat Pulldowns, Hamstring Curls 4.  Cut the Down Time- Organize your strength workout into circuits so that you get more training volume and keep your heart rate up by reducing idle time between sets. Examples of circuits include lunge/pushup/pullup with no rest in between and chest press/row/squat. I've got some circuit training programs on my website at programs.caryraffle.com.   5.  Don't Go in Without a Plan - It is proven that having a plan and schedule lead to better results. Where, when, how often will you exercise and what will you do in every exercise session? Base your plan on goals that are Specific, Measurable, Attainable, Realistic and Timely. 6.  Don't Get Hurt - Overtraining, inappropriate exercise selection, and poor setup technique can lead to an injury that derails your program - or worse. Give each muscle group a day off between strength training sessions. Identify problem exercises for you with the mini-self assessment on my website trainercary.com/fitness-assessment. Be careful with technique in getting in setting up weights or getting in and out of machines. It is easy to get hurt grabbing for a weight in the wrong way or squirming in and out of a machine without adjusting it properly.  If you've had a long break or are new to exercise, check with your doctor first. If you need help getting a safe, appropriate, efficient and effective program off the ground, I can usually get someone on routine in as few as five sessions.

Get the Results YOU Want

Whether you're new to the gym, returning after a break, or resolved to bust through a plateau and take your fitness to a new level in 2013, this newsletter has you covered.  In this issue,  the tools you need including  help Setting Goals, Assessing Your Current Fitness, Scheduling and Commitment, Program Design and Measurement, and sample programs that you can adopt or adapt.

Effective Fitness Goals are measurable, achievable, yet challenging.  Break big goals up into smaller goals so that you can track progress and be motivated by little successes along the way.  Choose the right measurements of success:  Some goals like strength and athletic performance and weight loss are easily measured in pounds, or with a ruler or stopwatch. For toning, body measurements, clothes size and subjective assessments of how you look and feel and move are often a better indication of change in body composition.  Ensure success by incorporating the following into your plan: ·          ·     Burn 3500 calories (or eat 3500 fewer) to lose a pound of fat. ·      Exercise at least 150 minutes per week to maintain health and body composition, and 300 minutes weekly significantly improve body composition according to the American College of Sports Medicine. ·       To ensure safe, effective long term weight loss, make lifestyle changes that lead you to drop 1-2 pounds per week, according to ACSM and the American Dieticians Association.  ·        It takes about 16 exercise sessions over several weeks to increase the size of muscle according to the National Strength and Conditioning Association.  ·       You cannot spot reduce, according to the American Council on Exercise. Combine aerobic and strength training to burn calories so that the body draws on stored fat from all areas.  Once you've established your goals, assess your posture, movement and any problem areas using this mini-self-assessment.  Incorporate exercises that improve your posture and movement. Common problems like rounded and elevated shoulders, knock knees, out-turned feet and hips that are tilted can lead to injury, prevent you from working muscles at the optimum angle, and interfere with balance and force production. You'll perform better when working out or in sports and reduce risk of finding yourself on the disabled list.

Custom-tailor your program to focus on your goals, condition and abilities.   You probably can't wear a new suit off the rack without having it tailored to you, the same idea applies to "one-size-fits-all" exercises program, or borrowing exercises that suit another person or purpose.  If your goal is weight loss, focus on aerobic exercise, strength training large muscles (legs back chest), circuit-style training with limited rest, and multi-joint exercises to maximize calories burned.   For other goals, select the number of sets, repetitions and rest interval using the chart below. Goal Sets Repetitions Weight/ % 1 Rep Max Rest Lean/Tone (Endurance) 1 - 3  12 - 20 Moderate / 60-70% 0 - :90 Increase Size (Hypertrophy) 3 - 5  8 - 12 Moderate-High / 70-85% 0 - :60 Maximum Strength 3 - 6  1 - 12 High / 70-100% :45 - 5:00 Power (and Plyometrics) 3 - 6  1 - 10 Low / 30-45% or 10& body weight 3:00 - 5:00       Consistency/showing up takes commitment.  Schedule your workout appointments like any other important meeting. Put it right into your calendar!  Attend scheduled classes, meet a reliable friend, have an appointment with a trainer, or create your own "incentive reward" program - reward yourself for achieving a fitness goal or just for showing up. My clients often tell me that without our scheduled appointment they would find a reason to skip the gym.  I even found myself skipping my aerobic workouts or cutting them short - so I changed my schedule to alternate days of total body strength training and aerobic exercise because it made my aerobics more consistent.

500 Crunches a Day Won't Get You a Six Pack Abdominal exercises may be the most over-hyped, overdone and possibly least effective exercises.  Your abdominal muscles are covered with fat.  To see the muscles, lose the fat.  Abdominal exercises do not burn a significant amount of fat.  You cannot spot reduce.  So what's the secret?  Diet, aerobic exercises, and working the big muscle groups.

Exercise progression means continually overloading the body's system by changing the exercise stimulus. Increasing weight and/or repetitions is one way to progress, but shouldn't be the only way. Your body adapts to exercises within 4-6 weeks, you'll experience diminished return from your program as you continue doing similar exercises and a similar range of sets, repetitions, time under tension and stability.  Or in the case of aerobics, if you continue training in a steady state. You also expose yourself to the same kind of repetitive stress injuries as factory workers when you continually do the same exact movements and work at the same intensity.  Periodization is changing your exercise program at regular planned intervals.  For best results, most people should Periodize their training and cycle between 2-3 different phases of training on a 4-6 week basis. If you've been focused on stable training such as machines, lying on benches and/or sitting through your workout, try standing.  It increases core activation and targets a greater cross section of muscle fibers. Once you've mastered standing, progress to exercises on a single leg, or with balance boards and balls. Then come back to a more intensive stable strength training routine. Or try plyometrics to increase power.   I've got some examples of progressions here.  Another option is to include different types of training within each week.  Instead of splitting between muscle groups, try alternating workouts between strength, stability and power. Visit  trainercary.com/programs for a progression of programs for any fitness level.

Running the Marathon in 2013 is a realistic goal if you've been running at least 2-3 hours a week for a about a year.  Running your best time may also be possible for those who've run before, or maybe you want to get back into the marathon because an injury sidelined you?   Or run shorter distance races.  Interval training can help improve your aerobic capacity and speed, read more in this article, The Best Interval Training Technique for You. The biggest mistake people make is to assume that because they're running they don't need to do leg exercises.   In fact, a custom-tailored corrective strength and flexibility program can help prevent injury and improve athletic performance.  The steps are almost identical to those outlined above for strength training.  Assess your posture and movement, and follow the programs outlined on my website.  Has your running program been sidelined by recurring injury or pain?  It may be possible to overcome these problems with the right program.   I recently began training a new client who stopped running years ago because it hurt his knees.  After 2 weeks on a corrective program, he was able to start running without pain. My niece is one of the top divers on her Division 1 college team, but  hamstring pain and tightness has affected her ability to jump off the diving board.  She's about to begin a program to overcome this problem.  Basketball players, soccer players and other recreational and competitive athletes can often benefit from corrective programs.

Choosing the right measurement tool can be an important part of your success.  Many people want a hard objective measurement but softer measurements such as how you feel and how your clothes fit are also important.  People often rely too much on a specific measurement, or choose one that lacks positive reinforcement or accuracy.  Body fat measurements, for example, are imprecise tools, and for someone interested in losing a large number of pounds, potentially discouraging.  Changes in waist or clothing size might be a more appropriate and motivating measurement.