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Tennis is fun! Tennis is fitness! Tennis is social! Tennis is a great way to enjoy the summer, get in shape, compete, relax, or simply vent your frustrations and bat the ball around. Tennis is a great way to get in shape but to fully enjoy the game it helps to prepare yourself for the game. If you are in shape for the game you will be able to go for more balls, get to more balls, outlast your opponent, hit the ball harder and more accuratelly, and from the Jock Doc's point of view; avoid injuries. Tennis is a sport that requires a variety of physical attributes: speed, quickness, power, endurance, strength, and balance, as well as tennis specific skills. Tennis is mainly a series of short bursts of activity.

This is especially true in the pros where each point is very short(12-14 seconds). If you are not playing points or are playing on a slower surface there may be longer periods of continuous play. Therefore the major energy system used in tennis is the anaerobic system(sprints) which uses stored energy in the muscle. The other important system used in tennis is the aerobic system(long slow distance) which uses oxygen and provides energy at a lower level for a long period of time. This allows the player to recover between points and the endurance to last for the whole time you are playing. To play tennis you use the shoulder, arm, mid body and legs to get around the court and propel that small ball to the other side of the court.

Therefore it is important to strengthen these areas of the body to not only allow you to play better but to avoid pain during and after playing. You can use a good weight program or a program designed with surgical tubing. Needless to say the most common injuries are to the elbow, shoulder, back and knees. It is much easier to prevent injuries than to have to treat injuries. One of the most coomon problems I see is players delaying going to see a doctor once they do get an injury. ""I just thought it would go away"" is far to common a statement I hear on a daily basis.

The last component is flexibility. Again, flexibility will allow you to play better and to avoid injury. Stretching should be done before and after you play. It is important to warm up before you play. The worst thing you can do is drive up to the court and hop on the court. This is a sure way to pull a muscle. Go for a light jog for 10-15 minutes. When you are warmed up with a light sweat then stretch for a further 10-15 minutes. Each stretch should be held for 30 seconds and repeated 1-2 times. After playing stretch again for 10-15 minutes. The following stretches are a few of my favorite for tennis. So go out and get in the game. With a proper preparation you will play better, enjoy yourself more and avoid injury. Remember:Tennis is fun.

Healthy Weight Gain

While most of the world strugles with trying to lose weight, there are those that have the opposite problem. Most of these are athletes who are strive to gain weight to compete at their sport. In my office I see many youths who come for advice to gain weight, most of these playing a contact sport such as hockey or football where the extra weight can be an advantage. While youth go through puberty a great discrepancy arises where different people mature at different rates. Through this growth phase there can be over a 100 pound weight difference from kids competing in the same sport. This is when there is great incentive to try and gain weight. Gaining or losing weight is a simple equation of calories taken in and calories burned by activity. There are certain factors that will affect your ability to gain weight. The first is genetics. Certain people are born with the proper tools to gain muscle mass while others are not that way inclined.

Males can obviously gain weight easier than females. Muscle gains will be the greatest during puberty and although can not control the timing of puberty, gaining significant weight will have to wait until your body goes through this change and releases the hormones necessary to gain weight. The important thing is to do the proper type of exercise needed to gain weight. Certainly if you increase your food intake while not exercising you will gain unwanted fat. If you do aerobic exercise only you will become more fit and develop a healthy heart but you will not gain significant muscle mass. Therefore, it is important to do a structured weight training program to build muscle mass and the desired weight. It is important especially for young people to have proper supervision in the type of weight exercises to do as well as the proper technique to avoid injury.

The best place is a facility that specializes in training young athletes. It is also crucial to allow the proper rest and recovery between work outs. When you think about gaining weight you must think about the food your eat. Most of the young athletes that I see that want to gain weight are barely eating enough to sustain their activity let alone allow them to gain weight. They have a hard time fitting in all the food they must eat in their busy days. The first thing is advising them on the proper foods to eat. Choose high energy nutrient dense foods from a variety of food groups. Emphasize breads, cereals, fruits and vegetables. Carbohydrates help promote growth of muscle protein. Protein requirements are increased as you try to gain weight, but most of our diets have plenty of protein to meet our needs. You will require about 0.6 - 0.8 g. per pound per day of protein.

Therefore a 140 pound person will require about 100 grams of protein a day. A cup of milk or one egg has 8g. while an ounce of beef, chicken, or fish has about 7g. To gain weight you should eat five meals a day to get the required calories. Adding 500 calories a day to build a pound of muscle per week. It is important to eat all the required meals even if you have to eat them on the run. Quality snacking between meals can be an important way to get your calories. This may include bagels and peanut butter, trail mix, milk shakes, and pizza. Make sure you drink plenty of fluids such as juices and milkshakes. As fluids give a feeling of fullness try and drink your fluids between meals. Increase your portion sizes. Eat the high energy foods firs and salads and soup last. A lot of athletes ask me about protein supplements.

This is a multimillion dollar business. Supplements can be quite useful to increase your calorie and protein requirements. It may be easier to drink a supplement than eat another meal. Although this is okay it can be quite expensive. You can get a lot of calories and a lot of protein for a lot cheaper by making your own supplement with skim milk powder. Like weight loss, weight gain is a slow process. Pounds put on slowly are more likely to be healthy strong muscle as opposed to fat. Plan your meal and weight training program carefully and follow it closely over the time you want to gain the weight. Rarely will an athlete gain more than 10 pounds in a year. Therefore do not get discouraged, weight gain takes time but you will be well rewarded with an appropriate diet and training regimen.

Are Sports Contagious

Those of you who are regular readers of my column know that I believe sport and fitness should be an important part of everyone's life. Sport and fitness is probably the most important thing you can do in your life to prevent disease and add enjoyment and longevity to your life. But when is sport dangerous to your existence. Besides certain catastrophic injuries such as head and neck injuries there are certain other risks in playing sports. There are certain diseases that you can get while involved in your sport. The most common illness to reveal through athletes is a simple cold or flu. It is not uncommon for a whole team to pass a virus on to each other.

This may be a simple cold or a gastroenteritis. More significant than these are the influenza virus. While this most dramatically affects the elderly or sick it can significantly impact an athletes or teams ability to play let alone deal with this serious illness. These illness can be passed from person to person contact or contact with a object like a water bottle or towel that teammates might share. They can also be passed through the airborne route where even being in close proximity on a bench or dressing room will expose other members on the team to a virus that one person is carrying. There have been incidences of more severe illness travelling through teams such as measles or meningitis.

Although rare these can still occur. Disease can be spread through skin contact. The most common disease to spread i s herpes. This is spread obviously in sports that have a lot of skin contact such as wrestling. One wrestler with a herpetic vesicular rash spreads it to another wrestler who can become quite sick. There have been instances of total outbreaks spreading through a wrestling training camp or competition. Disease can also be spread through blood contact. The most publicized and most likely are HIV(AIDS) and Hepatitis. These can be transmitted through direct blood contact between athletes.

There has been one reported case of HIV transmission between soccer players involved in a blood filled fight where butting heads caused blood to be exchanged between the players one of which was HIV positive. There is no virus in your sweat but very small amounts in your tears and saliva. The risk of transmitting HIV in sport is there but extemelly low. Hepatitis is also spread through blood and is in fact easier to transmit than HIV(100 times). There have been cases reported in Japan in Sumo wrestling but no cases have been reported in North America. Although the risk is low it is prudent to take proper precautions.

Although it is impossible to prevent all illness from being transmitted between teams there are precautions that should be taken to prevent as much as possible.

1/ Players should have their own water bottle which should not be shared with other players.

2/ Players should not eat ice from a communal ice chest(ie. ice used for ice packs)

3/ Education of athletes on how viruses are transmitted

4/ Teams or individuals who compete at a high level during the winter months should consider a flu vaccine

5/ Players or officials who may have blood contact should have a hepatitis vaccine

6/ Players should know their own HIV and Hepatitis status

7/ Do not share razors, toothbrushes, needles

8/ Those exposed to blood or other bodily fluids should always wear gloves

9/ Wrap skin lesions well

10/ Athletes with vesicular lesions should not be involved in contact sport until it is healed.

11/ Cleanse and disinfect any equipment or surfaces exposed to blood

12/ Maintain proper diet, rest, and potential overtraining that may make the body more susceptible to infection With a few simple measures lot of illness can be diminished eliminated and allow that athlete or team to perform at the highest level possible.

Exercise For The Overweight

In order to further my quest to allow everyone to get fit and healthy this column will help those who for whatever reason find themselves overweight. An American study in 1991 found 33% of the population to be obese(greater than 20% overweight). This was increased 25% from a study done in 1980. Once someone has reached this state it sometimes becomes a onerous task to think about losing weight. The benefits of losing weight are well known to all of us. Not only will we feel a lot better on a daily basis we will have a lot more energy to do the things we want to do. This does not even consider the long term health benefits of not being overweight and by being fit. Numerous studies have shown that dieting alone rarely works. People may lose the weight on the diet but inevitably will gain it back sooner than later.

The best way to lose the weight and to maintain the weight loss is to make a significant change in your lifestyle. This includes both making healthy changes to your diet that are reasonable and will be able to maintain as well as a regular exercise program. Motivation is always the problem. Overweight people are not always used to exercise and therefore find it hard to maintain in their lifestyle. An important motivational factor is to work out with others. This provides the motivation to actually go do your exercise as well as to do the program once your are there. This can be with a friend or at a fitness facility. Often people who are overweight are intimidated at a fitness facility and may have to work out on their own until they develop the confidence to attend a fitness facility. The key is to start slowly and increase to the level you need to get to. While exercising a few times a week is excellent to maintain fitness levels it is important to exercise at least five times a week to lose weight.

 Weight bearing activities such as walking/jogging or aerobics may be hard on the overweight person. They may also be more prone to injury with the extra weight going through the joints. It may be easier to start with exercise that it not weight bearing such as cycling, recumbent biking, swimming or water aquabics. If you do not have access to a pool or other equipment than walking is the best activity. This can be done anytime and anywhere. The only cost is a pair of good walking shoes. Start exercising on alternate days to allow your body to adapt. Start with 15 to 20 minutes. Increase your time by a couple of minutes every other session. Ideally you should build up to 45-60 minutes and 5-7 days per week.

 As your program goes along you will find yourself increasing the pace of your walk. Some may start a walk/jog program progressing to a full jog. Other activities can be added to add variety, work on different muscles and help provide longevity to the commitment to the exercise program. The exercise has to become part of their life and very important to them. Lifestyle changes will also help your program. Walking to work or parking a block or two from work so you have to walk will all increase your calorie expenditure. Take stairs as apposed to elevators. You will be suprised how much more energy you can expend during the day if you make a concerted effort to do this. This is all about exercise for the overweight, but hopefully if you follow these simple principles you will not be overweight for long. You will be amazed how good you and others will feel about yourself.

Energy Systems

Where does all the energy come to allow us to do all the activities that we do? People are involved in all different kinds of activities and sports. They sprint, walk, jump, glide, lunge as part of the things they do. To do all these activities it requires energy. The body responds to what you ask it to do by using different energy systems. While certain activities at the ends of the spectrum use almost exclusively one energy system, most activities use a combination of energy systems. ANAEROBIC This is the energy system used for short duration explosive exercise. The chemical used to provide energy to the muscle is called ATP. There are two ways ATP is produced. For very short duration exercise like a 60 meter sprint or a high jump or javelin throw the muscle uses phosphocreatine. When it is broken down into phosphate and creatnine a large amount of energy is produced but lasts less than 10 seconds. After 10 seconds the second energy system kicks in.

In this system glucose which is stored in the muscle is broken down to produce ATP. This system does not require oxygen and is not very efficient. Not a lot of ATP is produced by this method of breaking down glucose. When glucose is broken down by this method lactic acid is released in the muscle. Once lactic acid builds up in the muscle the muscle will be painful and heavy and will not be able to perform. The body then sends a message to increase the breathing rate which through a complex method buffers the acid build up in the muscle. AEROBIC The main energy source the body uses is the aerobic system where the body uses the oxygen we breath to produce energy. This is used for any mid or long duration exercise. The body uses fat and glucose to provide the energy. Not only that but the lactic acid that was released by the anaerobic method is used as fuel. This system will only allow the body to expend energy at a certain rate.

This will vary on the individual and their condition. One of the main ways to measure fitness in a person is to measure the volume of oxygen that a person is able to consume while exercising(VO2 Max) The type of activity will determine the type of energy you will require. A marathoner will use almost only the aerobic system. Most sports we do such utilize a variety of energy systems. When you exercise you stress these energy systems and allow them to become more efficient. It is important in sports to train the appropriate energy system that your body will require. When you stress the aerobic system there will be increased stores of glycogen in the liver and muscle. Your lungs learn to bring in more oxygen and the muscle becomes more efficient in using that oxygen to produce energy. The more you train the more your body will allow you to do to perform at a higher pace with the same effort. When you train the anaerobic system the muscles become more used to the build of lactic acid and can tolerate a bigger build up before decreasing their ability to function. Now that you know where the body gets its energy you can go out and train your energy systems that are most appropriate for you. Everybody is born with different capabilities to utilize and develop either energy system. Athletes tend to develop in the sport that uses an energy system that their body has a better opportunity to develop.

Healthy Weight Loss
A 13 year old gymnast who looks very thin to most of the world is told by her coach to lose weight. A 16 year old wrestler who appears to not have much body fat wants to lose weight to wrestle in a lower weight division. While so many of us struggle to lose weight it is hard to understand these scenarios where these athletes want to lose weight when they certainly do not appear to need to. There are only certain sports that athletes are overly concerned with their weight. Some sports have divisions based on weight such as wrestling, boxing or rowing. Other sports require a thin look as they are being judged on appearance such as gymnastics, skating, and dancer. While there are situations where it might be reasonable for these athletes to lose weight we must be careful especially with our female athletes. We have all read reports where female athletes have developed anorexia nervosa in these situations that have even lead to severe dysfunction and even death. An athlete that wants to lose weight should only do so under the guidance of the coach, parent and doctor. Then and only then is a program set out if it is deemed reasonable. Goals must be set and monitored closely. The following factors have listed to consider by the Sport Nutrition Advisory Committee of Canada: 1/ The desirable weight loss means fat loss only 2/ The fat loss is desirable only if it leads to improved athletic performance while maintaining good health 3/ Many athletes already at their optimal weight believe they are too fat and thus sacrifice muscle, strength, and health and performance in a futile attempt to reach unattainable levels of body fat reduction 4/ The rapid weight loss by dehydration, and or restricting fluid intake is water loss and can reduce strength, endurance and overall athletic performance 5 That a qualified professional can best assess body composition and determine if fat loss is necessary 6/That if you must lose fat you should consult a qualified sport nutritionist Once that it is decide that fat loss is necessary a formal plan must be put into place. You must allow sufficient time to lose the desired weight. You can expect to lose 1% of your body weight per week. You want to lose only fat and not muscle. You must always eat enough to provide the energy you require for your continued training. Combine a diet with your activity. As with any weight loss it is a combination of diet and exercise that provides the most efficient way to lose weight. Aerobic exercise is the best exercise for losing fat. Chose a balanced diet that is low in fat and sugar and high in complex carbohydrates. Drink plenty of fluids to avoid dehydration. The Sport Nutrition group provides these helpful hints: 1/ Eat small, frequent meals to help control hunger and to avoid over eating 2/ Plan your food intake for the day. Prepare and pack appropriate foods rather than relying on fast food 3/ Eat most of your food early in the day. Don't skip breakfast. If you are hungry at bedtime, snack on low calorie food such as vegetables, dry popcorn, dry toast, skim milk or fruit 4/ Eat meals slowly, chewing your food slowly and enjoying your food. 5/ Learn to eat to only the point of satisfaction and not to your stuffed. 6/ Drink plenty of water. Do not dehydrate your body to lose weight 7/ Prepare and stick to a shopping list. Do not shop when you are hungry Yes some of the above scenarios MAY be appropriate for the athlete to lose weight, but it has to be done sensibly under close supervision. 

Acne In The Athlete
While acne is common on the general population, it also affects athletes. In fact there are certain factors that make an athlete more prone to developing or worsening an acne condition. The general treatment for acne i s the same as anyone with this problem but athletes have can do a few extra things to help control their condition. From my point of view this is extremely important for my high profile athletes who are under the public view live, on television or in the print media. Other athletes who have a large amount of skin exposed like swimmers and wrestlers may decide not to participate from the embarrassment of having acne. The treatment of acne consists of both topical and oral measures. It is important to think of not only the short term cure of the problem but the potential of scarring and long term disfigurement.

Therefore the key is to be aggressive in your treatment. The first thing is to eliminate the factors in your life that may be making the acne worse. The long held theory that certain foods can cause acne does not seem to be true. No studies have shown that consuming greasy fatty foods or chocolate will cause acne. If in fact you think certain foods may be causing your acne it is best to stop eating it for a while and see what happens. If things improve then slowly reintroduce it to your diet and see if in fact it gets worse again. Frequent cleansing is important to remove the harmful oils from your skin. Sweating a lot can make acne worse especially under equipment. Keep your body as dry as possible by changing the layer next to your body as much as possible and showering immediately after activity.

Hormones in your body affect acne which is why it is so common in adolescence. While we can not do much about the hormonal change that accompany the monthly menstrual cycle acne can be a serious problem from those athletes taking anabolic steroids. The first treatment for acne is topical medications. While these can be very effective they rarely cure the problem completely. The most tried and true medication is benzyl peroxide. This can be purchased over the counter or by a doctors prescription. Tretonin is also a very effective drying agent. Topical antibiotics are often prescribed. This may be all you need to do in a mild case or this is used as an adjunct to further therapy in more severe cases. The next step is topical antibiotics. These are well tolerated and very effective. The most common used are tetracycline. It can take up to five months to reach full effectiveness.

There are a couple of other antibiotics that can be used if tetracycline is not effective or is not tolerated. These can be tried on successively. If the above does not clear the acne there is a new drug which came on the market several years ago called acutane. This drug can be very effective but has certain risks and side effects. This is used for 20 weeks and must be prescribed by a physician who has experience with this drug. It makes your skin and eyes very dry and may cause nose bleeds. The other serious side effect for athletes is muscle aches. Therefore it should not be used for athletes while in their competitive season. It also can produce birth defects and women must use birth control while on this medication. The advantage is that this medication can actually cure acne for at least two years. While acne will not directly affect athletic performance it can be very distressing for the individual, but with a good program it can almost always effectively controlled and the athlete will not be afraid or embarrassed by their condition.


One of the most talked about medical problems in the 90's is Osteoporosis. as `our population ages this problem has become more to the public and medias attention. One in four women over 50 years of age and one in eight men over fifty are believed to have osteoporosis. This amounts to over 1.4 million Canadians.While having osteoporosis is in itself not a painful or disabling condition the results of this problem can be devastating. Osteoporosis is a thinning of the bones. The consequences of this is that the bones become increasingly more susceptible to fracture. Bones can then fracture when exposed to normal trauma that a person would normally expect to withstand.

The most common areas to be affected are the hip, back, and wrist. Not only are these injuries painful and disabling for the individual they can often lead to a severe compromise in the quality of life and even death. The cost to the health care system and community is staggering into billions of dollars. The key feature is aging bone mass as you get older. You develop bone mass to a certain age in your adolescence and this must be maintained the rest of your life. This is especially important to young females. Females involved in sports or dance who force themselves to maintain thinness may not develop the necessary bone mass to carry them through life.

In the extreme case people who have anorexia have the highest risk of developing osteoporosis. It is very hard or even impossible to reach the level of bone mass you will require if you do not obtain it in your developing years. There are certain risk factors in developing osteoporosis. They are

1/ Early menopause or premature menopause

 2/ Young woman who do not menstruate due to ovarian hormone deficiency from either anorexia or a medical problem

3/ Women who do not receive hormone replacement therapy within five years after menopause

4/ Family history of osteoporosis

5/ Other medical problems Once you have been diagnosed with osteoporosis there are certain things we can do to help maintain or even increase bone mass. The first thing is to document the amount of bone loss. This is most commonly done with bone mineral densitometry.

This will determine the bone density and compare it to what you should be for your age. You will be diagnosed with osteoporosis if your bone density is a certain level below the norm. The following is the treatment protocol:

1/ Education to avoid falls. An elderly person is assessed as to their risk of falling and appropriate advice is given. Both indoor and outdoor hazards are minimized.

2/ Regular physical activity is one of the best things to do to maintain bone mass. Regular weight bearing exercise such as walking positively affects bone mass. It also increases strength in the legs and reduces the risk of falling.

3/`Postural retraining may be necessary in those that have sustained vertebral fractures.

4/ The most basic and simplest nutritional measures is to maintain adequate levels of calcium and Vitamin D. The recommendations is that premenopausal woman have at least 1000 mg of calcium combined in their diet and if necessary a supplement. This should be increased to 1500 mg. a day after menopause. Vitamin D increases absorption of calcium. Usually you get sufficient Vitamin D from being outside but those that need extra should take 200IU per day. This increases to 800 IU in people over 65.

5/ Although controversial, ovarian hormone replacement therapy started within five years after menopause helps greatly to maintain bone mass. The therapy should be continued for a minimum of 10 years for maximum bone protection.

6/In the past year several new drugs have come on to the market which have dramatically changed the way we treat osteoporosis. These can be used as an alternative or an adjunct to hormone therapy. They can also be used in males. These drugs can actually increase bone mass between5 and 9%. This therapy is used for 5-7 years while the bone density is monitored. While osteoporosis can be a devastating problem if we start to think about it at a young age there are many things we can do to prevent bone density loss and the major catastrophic problems that it can lead to.

Winter Baseball

As I watch the baseball playoffs, I am amazed again how much these athletes push themselves when it comes down to the crunch. This especially applies to the pitchers. They pitch on three days rest and then go on to the next game in relief, pushing their bodies and especially their arms to the limit. No longer are they limited to pitch counts, but they throw excessively in their quest for the final win. They know that after these few outings, they have a long winter to recover. They gladly risk injury and pain for that one win that might bring a World Series. Unfortunately, this philosophy also applies to our little leagues. Although there is no big money and fame at the end, the youth push themselves through their playoffs. They too are counting on a long winter to recover. Minor injuries are ignored in the post season that would more likely be taken care of during the regular season. The usual criteria for number of innings pitched is often exceeded. While most of these situations do in fact work out okay, there are others that do not. The two most common problems I see in the young throwers are in the shoulder and in the elbow.

These two joints undergo tremendous stress in the throwing motion. As a player grows and starts to throw harder, the stress is greatly increased. In the shoulder, we often hear about rotator cuff tendinitis. This is definitely the most common problem in the throwing athlete. In the adolescent we often see problems in the growth plate in the upper arm. Although this is the part of the body that is actually causing the pain, it is other factors that lead to the actual problem. Commonly the athlete may have a loose shoulder joint, weak muscles around the shoulder, or postural dysfunctions especially with the scapula. In the elbow, the most common problems are in the tendons or the growth plate on the inside of the elbow. This is commonly called little league elbow. This is again caused by muscle imbalances and just plain overuse. Both shoulder and elbow problems can be affected by the thrower's biomechanics. A poor throwing motion puts added stress on these joints. Most of these athletes who develop pain in the fall will assume that resting the arm in the winter will cure these problems. The pain quickly goes away when they do not throw.

They assume that the problem is cured. Out of site, out of mind. I can not tell you how many throwers I see in the spring who are surprised that the pain that went away in the winter with rest comes immediately back in the spring when they start to throw again. I can not tell you how many times I wish that they had come to see me in the fall immediately after the season to cure their problems and work on it all winter. Then they would be throwing not only pain free, but more efficiently and harder. Now, they have to take time off in the spring to correct their problems and the best case scenario is that they are throwing by mid summer and are half a season behind their competition. The athlete may also have a more serious problem in their joint that has to be dealt with to preserve the injured joint not only in the short term, but for the rest of their life. The key is to use the off season to correct all biomechanical problems, muscle imbalances and technique problems. Once a professional who understands a throwers injuries makes an analysis of what needs to be done, it is up to the athlete to work on these imbalances over the winter. The off season is also the time to work on high performance training to improve speed, strength and power. This is the best time to improve your performance. Do not make me upset when you come to see me in the spring and I have to say ""Why didn't you come to see me in the fall."" Take care of your injuries now and make sure your raring to go in the best shape of your life in the spring

Exercising When Sick

Countless times in the next few months I will get asked by people if they can still exercise when they are sick. Everyone is looking for the cure for the common cold. Research has shown that exercise is affected by having a cold or flu,but the key question is if in fact it is safe to exercise without risking your health. As we are now into the winter season, it is also the cold and influenza season. The cold winds seem to make us more vulnerable to illness. Colds are the greatest cause of absenteeism in North America. It is said that Canadians alone lose more than 60 million working days a year. The common cold is indeed common where the average person will have 2.5 colds per year. Most of these fall into the nuisance category. The cause of the common cold is a virus. We have now isolated more than 200 of these viruses which cause the symptoms of the cold. Although we often visit a doctor for these colds there is really nothing that can be done but the usual symptomatic treatment that you can buy yourself at the drug store. Antibiotics will not do anything to help these viral infections.

 If the cold is relatively minor, there is very little reason to limit exercise. I am often surprised by some of the individual Toronto Maple Leaf performances have when they are quite sick. Exercise does not seem to prolong these minor illness. In fact people will tell you that they actually feel better immediately after exercise when they have a cold. The theory is that when you raise your body temperature you are creating a fever like effect which may help your body combat the infection by increasing the white blood cells which fight the infection. This post exercise feeling is usually short lived. Exercising also releases adrenaline which acts as natural decongestant. You will notice that when you exercise with a cold, that after you clear the initial mucous your nose remains relatively clear while you are exercising. Research has shown that acute febrile viral infections decrease muscle strength and reduce endurance performance. If you are going to exercise, take it easy and do not go as hard as you might normally go. Monitor how you feel more carefully. If after you start you do not feel too bad, then continue. If on the other hand you start to feel worse with your heart or head pounding, call it quits and take the needed rest.

 On the other hand if you have a more serious illness it is advised that you do not exercise. There have been reported deaths from people who have exerted themselves when they were sick. The cause of death is Myocarditis where the infection spreads into the heart muscles. This occurs when the body is suffering a more severe infection such as influenza. Therefore if you have a more severe infection where you have muscle aches, diarrhea, high fever, or a hacking cough you should not exercise. A rule of thumb is that if the illness is above the neck such as only a runny nose then it is okay to exercise but if you have symptoms below the neck such as those mentioned above then you should wait until you feel better. The other question about illness I often get asked about is if regular exercise will reduce their immunity and make them more prone to colds or other infections. A recent study of people training for a marathon showed that they had more colds than other people. It was reported that runners that trained more than 60 miles per week had twice as many colds as those that averaged only 20 miles perweek.

Also those that actually completed the marathon were six times more likely to be sick the week following the marathon than those that trained and registered but did not run the marathon. Other studies have found other results. One study claimed that those runners who averaged more than 30 miles per week were less likely to ""catch the flu"". Therefore the answer to this question is not as clear and may be related to other individual factors such as stress. In summary it is wise to follow these common-sense tips.

1/ Avoid other people who have colds.

2/ Avoid getting chilled.

3/ Stress has been proven to lower your immunity-Avoid or reduce stress

4/ Vitamin C may play some role in preventing and treating colds.

5/ Maintain good health and nutrition

6/ Children, elderly, pregnancy and other medical illness need special care and should be advised by their individual doctor.

7/ Use disposable tissues as opposed to a handkerchief which can harbor the virus

8/ Do not share water bottles. 9/ Wash your hands regularly. Hands come in contact with a virus which you can spread to yourself by touching your mouth.

9/ Follow the neck check and exercise appropriately to your condition.

10/ Drink sport drinks when you are exercising for a long time. There is a theory that lowered blood sugar during exercise reduces your immunity. The immune system seems to be preserved if you drink a sports drink during exercise.

11/` A`flu shot may be advisable depending on your condition.

12/ Avoid places that have poor circulation and recirculate air. Airplanes are particularly bad.

13/ You do not need to see your doctor for the common cold but if the symptoms become worse or are persistent then seek your physicians advice. So, are you going to play this weekend? I hope this column has helped you answer the question for yourself

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