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Benefits of Exercise(2)

5/15/2018

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This is a follow up to the first post on benefits of exercise, which can be found here.
So you’ve heard exercise is good for you, and you’re like “yeah it’s probably good, but I’m fine, it can’t be as good as just having the evening off to chill at home” which is more like something I have said and I’m projecting it onto you. If you are also like me, then you also need sufficient evidence before you’re going to make any lifestyle changes. So here we go...
 
Today’s post is the meat-and-potatoes of 'why' exercise is good for you, but maybe more importantly 'how' it is good for you. In most cases, a “trust me, this works” is not really sufficient for us to really understand how something works, and we have a much deeper respect when we see the -why and how- it works.
 
Ok, exercise is a little good for me.
No, hold up. It’s actually got some amazing nuances to how it changes your mind and body. The Academy of Medical Royal Colleges released a report going so far as to call it the closest thing to a “miracle cure”. (http://www.aomrc.org.uk/publications/reports-guidance/exercise-the-miracle-cure-0215/)  This report was not just based on a few case studies, but many randomized controlled trials and meta-analyses. Ok maybe not total-miracle-cure-for-everything, (https://www.bmj.com/content/350/bmj.h1416) but we have a LOT more evidence for the benefits of exercise compare to, say, some supplements that seem to come in fad cycles. And the best thing is that I’m not trying SELL you anything, this is literally something you just go out and DO. (On the other hand, I really promote the use of a personal trainer on occasion to check up on your form and muscle engagement, as well as the "do as much as you are able" mentality for your particular circumstance.)
 
Inactivity is a natural result of convenience. But being inactive has become such a problem that many big research groups have given it the pleasant term “Sedentary death syndrome”.  (https://www.ncbi.nlm.nih.gov/pubmed/15317985) The phrase is to give you an eerie feeling for a reason: It describes “major public health burden due to its causing multiple chronic diseases and millions of premature deaths each year”. Meaning not just one or two diseases, but like, a BUNCH of them. Even for diseases that don’t necessarily have a direct link to being sedentary, research is pointing more to the likelihood of a sedentary lifestyle making matters much worse. 
  • The following is just a research dump. Of course this is nowhere near an exhaustive list. It is mostly a list I am compiling for reference for future grad school studies that I've dumped into an excel file, and will continue to add to the list of references. But hey, feel free to take a glance at some of them, you'll do a better job of convincing yourself than I could! 

The problems with NOT exercising:
May be traced to ‘the cause’ of many chronic diseases
(20- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4241367/)

The benefits of exercising:
  • Reduced anxiety and depression
 (1- https://www.sciencedirect.com/science/article/pii/S1044743107002606)
(2- http://www.ingentaconnect.com/content/ben/cnsnddt/2014/00000013/00000006/art00012)
(3-  https://rd.springer.com/article/10.2165/00007256-199111030-00002)
(6- https://link.springer.com/article/10.1007/s00702-008-0092-x)
(7- http://journals.sagepub.com/doi/abs/10.1177/1073858410397054)
(8- http://journals.sagepub.com/doi/abs/10.2466/pms.1992.74.1.79)
(9- http://journals.sagepub.com/doi/abs/10.2466/pms.1995.80.2.523)
(10- https://insights.ovid.com/british-psychiatry/bjps/2002/05/000/effects-exercise-depressive-symptoms-older-adults/8/00002405)
(25- https://www.ncbi.nlm.nih.gov/pubmed/11273973)
(26- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC474733/)
  • Spatial learning improvement
(1- https://www.sciencedirect.com/science/article/pii/S1044743107002606)
(34- https://www.ncbi.nlm.nih.gov/pubmed/21282661)
(35- https://www.ncbi.nlm.nih.gov/pubmed/24205142)
Memory improvement
(4-https://medicalxpress.com/news/2018-02-brain-counteract-negative-effect-stress.html)
(5- ://www.sciencedirect.com/science/article/pii/S1074742718300042?via%3Dihub)
(7- http://journals.sagepub.com/doi/abs/10.1177/1073858410397054)
(34- https://www.ncbi.nlm.nih.gov/pubmed/21282661)
(35- https://www.ncbi.nlm.nih.gov/pubmed/24205142)
Stress reduction
(4-https://medicalxpress.com/news/2018-02-brain-counteract-negative-effect-stress.html)
(5-https://www.sciencedirect.com/science/article/pii/S1074742718300042?via%3Dihub)
Enhanced self-concept
(8- http://journals.sagepub.com/doi/abs/10.2466/pms.1992.74.1.79)
Reduction of chronic inflammation
(11- https://www.ncbi.nlm.nih.gov/pubmed/20188719)
(13- https://www.ncbi.nlm.nih.gov/pubmed/15851714)
(14- https://www.ncbi.nlm.nih.gov/pubmed/12445534)
(15- https://www.ncbi.nlm.nih.gov/pubmed/15983180)
(16- https://www.ncbi.nlm.nih.gov/pubmed/12684358)
(17- https://www.ncbi.nlm.nih.gov/pubmed/15209647)
(19- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2759573/)
Reduced risk of chronic disease
(11- https://www.ncbi.nlm.nih.gov/pubmed/20188719)
(12- https://www.physiology.org/doi/full/10.1152/japplphysiol.00587.2015)
(20- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4241367/)
(27- http://www.onlinejacc.org/content/64/5/472)
(29- https://bmcobes.biomedcentral.com/articles/10.1186/s40608-018-0183-7)
Reduced risk of cardiovascular disease
(18- https://www.ncbi.nlm.nih.gov/pubmed/15735210)
(27- http://www.onlinejacc.org/content/64/5/472)
Lower mortality risk
(21- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3410432/)
(27- http://www.onlinejacc.org/content/64/5/472)  
Improved cognitive function/prevent decline of cognition with age
(22- http://bjsm.bmj.com/content/early/2017/03/30/bjsports-2016-096587)
(23- http://bjsm.bmj.com/content/early/2017/03/30/bjsports-2016-096587)
(24- https://www.ncbi.nlm.nih.gov/pubmed/28304298)
(33- https://www.ncbi.nlm.nih.gov/pubmed/21722657)
Improve functional capacity
(28- https://link.springer.com/article/10.1007/s11932-002-0017-7)
Relieve some types of pain
(28- https://link.springer.com/article/10.1007/s11932-002-0017-7)
Improve glucose tolerance and insulin sensitivity
(28- https://link.springer.com/article/10.1007/s11932-002-0017-7)
Improved immune function
(30- https://onlinelibrary.wiley.com/doi/full/10.1111/acel.12750)
(12- https://www.physiology.org/doi/full/10.1152/japplphysiol.00587.2015)
(32- https://www.physiology.org/doi/full/10.1152/japplphysiol.00587.2015)
Delays aging
(31-https://medicalxpress.com/news/2017-03-exerciseinterval-particularhelps-mitochondria-stave-age.html#nRlv)
(32- https://www.physiology.org/doi/full/10.1152/japplphysiol.00587.2015) 
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Benefits of Exercise(1)

4/26/2018

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It's not all about cosmetics, it's truly about health. Your body changes in response to exercise in ways that improve anxiety/depression, balance hormones, increase brain function and memory, reduce inflammation, keep you from getting sick, and also the extra benefit of being able to keep doing stuff when you get older. Like not falling over. Additionally, these effects of exercising regularly are still there even if you are overweight. (Yes, really.)  Today's post is on the many amazing benefits of that thing that most of us totally hate... Exercise! 

Fundamentals of Health: Sleep, Exercise, Diet
The first post will attempt to persuade you to the idea that exercise is a fundamental part of the puzzle of health and well-being. The second post will go into a small sample of the vast amount of research and data-driven analysis on the many ways that exercise benefits us.
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As a massage therapist, I encounter all sorts of imbalances in a persons body. As much as we want to blame it on having bones out of place, blame it on genetics, or posture, or just blame it on atmospheric pressure... many minor imbalances can be corrected with exercise. As much as I love my clients coming to me for repeat treatment for problems that pop up over and over again, I really do want people to be healthy and have the tools to take care of themselves. 

There are two main points I want to make in this post. 
  • Exercise probably doesn't take as much time as you think it will.
  • There are several ways to exercise- do the one that you enjoy. But do it in a quality way. 
It doesn't take that much time? 
About 3 times a week for 30 minutes is all that many of us need for many of the benefits associated with exercise. After that much time, the benefits start to plateau, so unless you are looking to compete in a sport, your general maintenance can be done in as little as 30 minutes 3 times a week if you are able to do a vigorous workout for 30 minutes, or 5 times a week for moderate intensity. (1) The benefits do continue as you add more time exercising (up to a point) but this number (3x30) is a really good starting goal, especially for those with a sedentary lifestyle. 

Types of exercise

As for the different types of exercise, there are some simple categories: endurance training, strength training, and stretching. Endurance training helps your heart health, immune system, and brain function, strength training (when done correctly) helps keep you upright and balanced, strong, and is good for your immune system and your brain/memory too. Endurance refers to high repetition (doing the same movement over and over again), and your muscles adapt by using oxygen more efficiently. Strength training refers to lower repetitions with higher weight (8 to 10 repetitions). This can be done by lifting weights, using a resistance band, or your own body weight. Each type give different benefits, so it is recommended to include some of each in a weekly routine (2). 

Invest in your health
"I can exercise on my own, why would I need to employ someone to help me exercise?" To learn the things you don't know that you don't know. In other words, to help become well balanced, invest in a few training sessions with someone who can help customize a well-balanced routine for your specific body type. For example, you may not know that "the rhomboids retracts the scapula and rotates it to depress the glenoid cavity, functions to stabilize the scapula against the thoracic wall, is antagonized by the serratus anerior, and can be effectively targeted to help upper-crossed syndrome and neck pain" but you don't have to know what all that means if you have a trainer who instead says "Ok we're going to pull  your arm backward for this exercise and it's going to help your back and neck". Let someone else do all the research and then boil it down for you. Invest in the person who is willing to do that, because it's saving you a ton of time and will leave you more well-rounded as a result. 
Maybe you are clued into the idea of "buy local" ... it helps support your local vendors, you can feel all warm and fuzzy about buying from a local source and helping your home town economy. You can do this by finding a local personal trainer as well. Just like any other business, there will be good and bad representatives of the field. My best recommendation is to actively look for a class you can take (such as yoga, pilates, zumba) for the community exercise aspect (especially if you are very introverted) and a 1-on-1 trainer such as a personal trainer, who has proper certification, and expertise in working with people like yourself. 
Things to look for: You want your trainer to be knowledgeable, especially if you have any chronic conditions that need to be taken into account. A good trainer will know that you need to be pushed in order to grow, but will know how to do it in a way that will avoid injury. The risk of injury can be minimized, but not completely avoided. The second part of the equation is that you need to communicate with your trainer. 
You don't have to see your trainer 3 days a week for 30 minutes, you could see them once a week, or twice a week. Or see them once a month for a 'check up' depending on whether you are a self-motivated person. My recommendation would be to see someone twice a week for a month, then scale back to check-ups. I feel like this is a great way to get comfortable with their routine, see the progress you get in a month, then evaluate. Just remember, if your goal is muscle growth, you need to expect several months to see real progress. For those who have a sedentary lifestyle, you will see a lot of progress in your first couple months, though. 

The second post (Coming Soon™) will start getting into the hard-hitting research on things like the benefits of exercise on chronic inflammation, depression, anxiety, oxygen usage in tissues, immune function, memory and brain function, adaptations to bones, muscles, nerves, hormones, and all the other stuff that you just can't wait to hear about!  So stay tuned! 

​​
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Stretching

4/1/2018

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Muscle Pain- 2. Delayed Onset Muscle Soreness

2/12/2018

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Why do my muscles hurt after exertion? Is that normal?
This post is here to tell you that yes, muscle soreness is totally normal after exercise. It usually peaks a day or two after exercise, and then fades off after about 72 hours. There are a lot of ideas about why it happens, and what you can do about it. Not everything you may have heard is accurate, though. But let’s go over the basics here.
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Delayed Onset Muscle Soreness (DOMS) (1) is generally a painful response to new activity. Whether lifting something heavier than normal, using muscles you haven't used in a long time, or doing more repetitions than normal, the pain comes from micro-trauma, or small tears that occur in the muscle during normal exercise. These micro-tears are necessary for the muscle to grow(2). 
It's not just the micro-damage, but there is also a response in the nerve signals to repair the muscle stronger than it was before (3), but also to grow new nerves (4). The combination is most likely to result in pain. One very interesting study found that pain occurred even in a muscle group that was not exercised, which suggests a neural component of the pain associated with DOMS (5). 

The way muscle gets damages is mainly by eccentric contraction, which is the lengthening of the muscle while under stress (6),(7). 
It was once thought that lactic acid buildup in the muscle was the cause of the pain after exercise, but this has been demonstrated to be false (8), (9). Your lactate actually clears out of your system pretty quickly compared to how long you are sore. 

The good news is that as you adapt to the new movement or exercise, your body actually builds support in the area you are exercising! (10) That's kind of amazing if you think about it... You have tiny little workers running around reinforcing the areas of your body that you are using, and conserving resources in areas you aren't using. 
Is there any way to avoid the muscle soreness that accompanies exercise? Well, the first thing I always say is that if it works for you, then do it. But as far as the studies tell us, there's really no significant way to avoid it. You'll be sore, but you will adapt, and you will become stronger and more stable, with lasting benefits for years to come. 

In terms of research, stretching before and after did not significantly reduce muscle soreness (11). While you do want to stay hydrated, it may not be accurate to say that increasing your water intake will lead to less cramping or pain (12). In sprinters, the delayed onset of pain did not respond to anti-inflammatory drugs (13) and anyway it doesn't appear that inflammation is a necessary component to the adaptations that occur in muscles after exercise (14).
Interestingly enough, it seems that there is a way to temporarily reduce the pain that occurs after exercise: to exercise some more (15), (16), so long as it is intense enough.
Massage therapy was found to be effective for some people in reducing some of the symptoms of muscle damage (16).  
Other treatment ideas may have lower success in studies, but if it makes you feel better then by all means, do it! You could try heating, icing, or a combination of the two! 

There are many factors that could lead to a slower recovery from exercise, and some people may experience more pain than others. For example, low Vitamin D levels are related to widespread pain (17), (18), (19), (20), and even muscle weakness (21). 

There is still a lot to learn about how pain works, and how we can deal with it. I hope this gives you a little introduction to what's happening in the muscles, and maybe leaves you with in awe at how fascinating the body is! 
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    New Things

    What's going on with me, research articles, interesting little blurbs. This blog is an attempt to consolidate research into an easily digestible format. 

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    Alex Moon has been a Licensed Massage Therapist since 2012, did his undergraduate studies at Utah State, and is currently working on his Doctorate in Physical Therapy. 

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