Jan

12

For those of you with any kind of history of serious fitness training behind you, a dramatic shift has occurred in the world of fitness with the almost stratospheric rise in ”cross-fit” type workouts, likely because of the combination in time savings and the enormous gain in benefits from daily exercise, both of which occur with these new style workouts. Also coined HIIT, for High Intensity Interval Training, these workouts are super intense, with little to no break time between activities, and incorporating several muscle groups at one time. In the past, fitness regimens were largely bodybuilding based, including several sets of isolated muscle work, for lengthy sessions upwards around an hour. On odd days, the performance of long boring cardio sessions on the aerobic equipment. There are still many who train this way, either out of familiarity or simply because they are not privy to newer information. This premise of fitness, now seemingly antiquated, in spite of its acceptance and benefits, has several drawbacks, the single biggest of which is time commitments. While older protocols of sets and reps can create large muscles, they can also leave aspiring trainees with little athleticism or fitness diversity. If improperly performed, these programs can contribute to notable muscle imbalance, faulty kinetics, (motion patterns), and general dysfunction. In contrast, the cross-fitness movement promotes athleticism and athletic synchrony. By emphasizing compound exercises involving several muscle groups simultaneously, and diversity of routines, fitness “muscle confusion” is produced. By keeping the body physiologically confused, one never fully adapts to a “routine” and will continually improve in fitness and athleticism without plateaus, so common using older standards of training. The cardio benefits associated with HIIT type exercise have been demonstrated to be enormous, as you don’t just burn calories during the activity, you will actually burn calories at a higher rate for the remainder of the day. And most of the routines? About fifteen minutes in total. Thats it.

So whats the down side of these more modern fitness training protocols? Well, for one, most people are following videos on the internet, so there is inherent risk in using improper form which can lead to injury. Because of the intensity level of these new regimens, it is possible for beginners to experience a condition known as “exertional rhabdomyolysis”, or simply stated, overtraining. If you are new to fitness and are using HIIT type training, monitor your body and results carefully and consider starting on a 3 or 4 day per week routine initially. There are also considerable cardiac and respiratory demands associated with this style of working out as your heart rate will quickly elevate to extreme levels as will your breathing, so it is imperative that you know that your heart and lungs are capable of keeping up with you. As with any exercise regimen, you should consult with your family physician prior.

On a personal note, I am a past record holding competitive bodybuilder/powerlifter, and I have never felt as fit as I currently do. I have been doing variations of HIIT for about a year now.  For more information on fitness, refer to my Fitness page.

Nov

15

Over the years I have written several articles on headaches.  This is because there are so many types and causes of head pain that there is much to write about.  Headaches remain one of the top three reasons why people go to the doctor.  The most common types of headaches are tension headaches and migraine headaches.  Tension headaches are typically a constant squeezing-like pain around the head whereas a migraine headache has a throbbing or pulsating component.  Many people believe the term migraine headache is used simply to describe a very severe headache.  This is not the case.  Migraines are a specific group of headaches which have a vascular cause and thus have a throbbing component.  Compounding diagnosis, headaches of the same type can have many different causes.  In my office we address many migraine causes as well as tension headaches which are caused by brain based inabilities to perform appropriate eye movements.  This becomes confusing for many patients as once you mention the eyes as a cause of headaches you inherently think to see an optometrist.  In reality, optometrists are interested in the focusing ability of the eyes and in diseases of the eyes.  Movement of the eyes to targets however is brain based and not typically assessed by eye doctors.  This is an extremely overlooked cause of headaches as few practitioners have appropriate diagnostic equipment to evaluate brain based eye movements.  Additionally, many headaches are perpetuated through poor eating habits and deficient nutritional needs.  This can easily be addressed by changing poor dietary habits in favor of better eating habits and thus augmenting nutrition.  It is most unfortunate however that the vast majority of headaches are managed through inappropriate drug therapies, most all of which do not fix the underlying cause of headaches but rather are typically an opiate based drug prescribed to deal with symptoms.  Recent studies are uncovering more and more deficits associated with these-type drugs which can be extremely addictive and require increasing dosage to maintain any level of symptom control.  If you suffer from headaches you would be well served to contact my office to schedule an appointment for a complete neurologic examination.  For many, it is their last headache consult.

Nov

7

Each week I see patients who have recently been examined by their primary doctors and are told that have findings of high blood pressure, elevated blood sugar or both. They are ill advised to return for followup in 8 weeks for a second test. I am not suggesting that it is wrong to followup when you have such finings. It is however foolish to make no management recommendations and expect a different outcome on a subsequent visit. Often on the next visit medication will be prescribed as now there is a trend and not just a single visit finding which may have been just coincidence. It is necessary to show a trend vs. a single visit reading to prescribe drug therapies unless hypertension is severe. It is reasonable that if someone is found to have high blood pressure, or, blood work reflects elevation in blood glucose, that rather than simply recording such data for record keeping that lifestyle modifications would be immediately discussed and proposed as being not only appropriate but necessary. Again, it could be argued that simply having an elevation in blood glucose does not mean that you are diabetic. Currently the diagnosis of diabetes is based on a blood test called the Hemoglobin A1c. However, if your blood test is demonstrating elevation in glucose, you are currently in a prediabetic state that needs to be addressed, not just monitored until such point that you definitely have diabetes, as is the case with an enormous number of Americans. If you have either elevated blood glucose or high blood pressure there are definitive lifestyle changes that you need to be making, now, not later. These changes do not merely mean kicking back and awaiting a drug therapy. It is this combination of blood glucose elevation and hypertension that constitutes the metabolic syndrome, a leading cause of disabilities, stroke, heart disease and death in this country, and it is getting worse each year despite drug therapies. When I meet with my patients I routinely discuss all aspects of their health. Most patients come to see me for dizziness and balance problems as well as other brain based disorders, but this doesn’t mean that I can’t help them get their life back if they are dangerously hypertense or prediabetic. In fact, I believe it is my job.

Sep

19

Over the last few years it has become such that you cannot watch one television show without seeing at least a few commercials for drugs.  Not surprisingly, during the part where they list the adverse side affects attributed to the drugs, there is a very attractive young lady smiling and dancing and throwing rose pedals.  Drugs have become more accepted than breakfast in our “better living through chemistry” society.  Well, a recent study published in the archives of internal medicine, depicts a disturbing picture of our societies interpretation of these ads.  Of the thousands of individuals involved in the study, thirty-nine percent mistakenly believed that the FDA approves only “extremely effective” drugs; 25% mistakenly believed that the FDA approves only drugs without serious side effects.   In conclusion this study found that a substantial proportion of the public mistakenly believes that the FDA approves only extremely effective drugs and drugs lacking serious side effects.  This is hard to believe as the side effects are indeed mentioned at the end of each commercial.  It would seem that no one is paying attention for this part.

When I meet with new patients as part of my initial history taking process I ask each patient which drugs they are taking and why. I find that about 20% of my patients on initial consultation do not know why they are taking their drugs, and, many are taking more than six different drugs.   If you are taking prescription medication, you should be aware as to what you are taking and why you are taking it.  Learn the side affects of drugs which you may be taking as well, should you experience any of them. If you are on high blood pressure medication, buy a home blood pressure unit and check your own blood pressure daily.  It is not uncommon for me to meet with a new patient suffering with dizziness only to find out that they are on high blood pressure medication, have lost weight, and are still taking a high dose from before their weight loss and that this is causing there dizziness from low blood pressure.  Drug therapies are still drugs, and they should be used with diligence and with prudence.  Act responsibly and know all of your options before blindly going on drug therapies, as ultimately, you are the one taking the drug.

 

Jul

25

If you are new to exercise, I think you will find the following information extremely helpful.  Recent studies have demonstrated that the “negative” or “eccentric” movement of an exercise, offers the most beneficial changes to both the muscles being exercised and your overall blood chemistry.  Further, it has been suggested that even doing as little as one 30 minute session per week will make favorable changes in your overall health.

So what exactly is a “negative” or “eccentric” movement?  Any activity requires both a concentric and an eccentric component.  The concentric component is the phase whereby the muscle is shortening while performing the activity.  An example would be curling a dumbbell.  The eccentric phase of the movement would be the phase of movement whereby the muscle is lengthening while still under load.  Using the same example, this would be the lowering of the dumbbell after curling it.  So what does this mean and how can you exploit this information to improve your health?  Well, it means that something as simple as walking down steps, or down a hill, (yes, the easier half!) can be very beneficial with respect to changing your health.  If you are already exercising regularly, you can get more bang for the time expenditure by accentuating the eccentric phase of all of your exercise movements by performing the concentric phase over 1-2 seconds, the eccentric phase for 3-4 seconds.  For example if you are doing a pushup you should lower yourself to the floor slowly, 3-4 seconds.  Push up in 1-2 seconds.  This technique can be applied to most any workout routine.

Studies have shown that exercising in this way actually causes the most desirable changes on blood chemistry in reversing deleterious changes such as all of those associated with the metabolic syndrome, (obesity, hypertension, type II diabetes, etc.).

If you are not already exercising, try and formulate a 30 minute session once per week to perform eccentric activities such as walking down steps or any activity accentuating the eccentric phase.  Naturally it would be better to perform an exercise session at least three times per week, but if you are currently doing nothing, once per week is a major improvement and will evoke desirable changes in your overall health.  As your health improves you will find it easier to invest more time in additional exercise sessions.  There is no one who cannot find thirty minutes per week to exercise.