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New Years 1999

SPORTSMANSHIP- "" Taking defeat without complaint and victory without gloating. This is the last year into the millennium. I reflect on to the last 100 years and especially the last year as I look in to the upcoming year. The new year presents a great opportunity to think about the past and what one wants to accomplish in the new year. Resolutions are made , but it is the implementation of the ideas that what is truly important. People in the world today are intent on winning. Winning at all costs becomes the modus operandi. I have never believed that winning is not important. The big question is what does winning really mean. I am a sport medicine physician and exposed to many athletes and teams at all levels. There are many lessons to learn in sport. It is often said that sport is a mirror of society, and sometimes I think it is the opposite.

With all that is happening in sport today and all the negative stories this may in fact be scary, but as I look into the past year there are some great stories that provide some great lessons. The Toronto Maple Leafs of the 1998 season. Here is a team that did poorly last year and is now near the top of the league in points and goals. I can not tell you exactly what has caused the difference. What I can tell you is the difference in the players that I am in close contact with on a daily basis. Here now is a team that believes not only in themselves but in each other. Here is a team that shows respect and confidence in each other. Here is a team that enjoys playing the game believing that every day that they can go out and do their best and be competitive against any team they face. Here is a team that is enjoying a higher quality of life then they were 365 days ago.

Here is a team that plays with the confidence that they can control their own destiny. These are all important factors in being successful in life. The Phoenix Coyotes of the 1998 season. Here is a team that for many years that has been laden with talent and always under performed. The rumor on the street is that there are several individuals on the team that can be selfish and place their own personal agenda above those of the team. I believe strongly in setting personal goals but personal goals have to be made in consideration with the people you are living and working with. The team, work or family can not be sacrificed for the individual. People in the know feel that the Phoenix players have matured and now believe in the bigger greater picture. I have seen athletes win individual awards, but I can tell you that winning the big team award(The Stanley Cup) provides much greater satisfaction. An individual award provides some short term happiness, but the satisfaction of being part of a team effort and victory is not only much greater but endless.

The NBA this year. Everyone becomes a loser when two side become fixed on issues that they can not resolve. There are many people involved that are wasting a valuable part of their productive life. It is important to look at the big picture and ""not sweat the small stuff."" People often become overly concerned about issues that can waste a lot of needless energy and unproductive time. I can not believe there will be any winners in the NBA dispute. Michael Jordan says it all ""Very few guys come into the NBA with the idea of doing all the thankless tasks necessary for a team to win. They usually are focussed on scoring points and playing enough minutes to pad their stats"" Patrick Rafter does a lot for professional tennis. With so many big name male and female players needlessly berating officials, tanking matches that do not fit their schedule and other antics that denigrate tennis, Patrick Rafter and others simply play hard and derive the inner satisfaction of winning while maintaining the dignity of themselves and the sport. Here is an athlete playing an individual sport but still doing all he can for the ""team"" of professional tennis.

The Sports Medicine and High Performance Specialists this year. I am very proud of my staff. We have now grown to a staff of over 45. Our goal and mission is to be the undisputed leader in sport medicine and high performance. I feel we have achieved that goal but we never stop trying to get better. We have an unbelievably strong and talented team, but the reason we are so successful is that everyone believes in the plan. It is crucial that everyone trusts and respects each others skills. It is only then that each individual that is treated at the clinic is given the opportunity to benefit from the eclectic skills offered by the various individuals. We would be a failure if any of our individuals believed they were greater than the team and placed their own agenda ahead of the benefit of our clients. It works because we are a team and we all believe in each other as part of the team. The concept of winning and losing all aspects of life. In this millennium year believe in sportsmanship, believe in the team, believe in your family, believe in your co workers and you will find that they will believe in you.


New Years Column

As a creature of habit and not one of those who like to break tradition, I am writing my annual New Years column. Although this comes a week late due to the timing of this bi-monthly column I hope that it will be helpful. ""Common Sense"" seems to be the what we should be considering for our lives. Well, if it is good enough for the government, it must be good enough for ourselves individually. It is easy for one to pontificate on how the best way to live our lives is. The key is to determine what is best for oneself and have the courage and dedication to make it happen. Life presents many challenges and chances. We must step up to these challenges to make things happen.

In sport, people often say others were successful because they had luck. Everyone involved in sport knows that you make your own lick, and those that succeed and win are the ones that have worked the hardest at the goals that they had set for themselves. And yes luck does play some roll in any championship, but it its only those that are ready to capitalize on their luck by the hard work and preparation that will be able to capitalize on those chances. Many articles have been written on what makes people successful and happy, and many who have achieved these goals have written on their secrets of success. Ultimately it boils down to having control of the two major components of living.

That is the physical and psychological aspects of oneself. It is no wonder that at the Olympic games the coach and physical trainer of the athlete work closely with the psychologist in preparing these athletes for the ultimate competition. The successful person is one that balances and achieves both aspects of their life. This is not easy to do and involves thought and diligence to achieve. There are always times in our lives that one aspect becomes somewhat more important than the other. It is important to realize this and pay particular attention to either the physical ar psychological part whichever requires the most attention at the time. This is the reason people make resolutions. The new year is a time to reflect on the past and plan for the future. It is a time to determine what you have achieved or failed on in the past. It is a time to reflect on these successes and failures and plan accordingly for the future. It is never too late to make changes.

Last year I made a long detailed list to help meet your physical and psychological resolutions. There were hints to help live your life in a more healthy state. As a Sport Medicine Physician I strongly believe in taking care of your body. There is excellent scientific evidence that if you follow a healthy lifestyle, you will not only live longer, but also live a more productive and functional life. There are many things you can consciously do to achieve those goals. It is important to dream, but none of us can predict the future. It is impossible to for see what will happen tomorrow. The secret is here in the present. If you pay attention to the present, you can improve upon it. The present is with us every day. We must daily think about and do things to make ourselves better. If you improve upon the present, what comes later in the future will also be better. Here's to a happy and healthy and fit new year. I hope you can help yourself make your dreams become reality.


Focus On The Millenium

I always enjoy my New Years column the best as it gives me time to reflect on the year and think about the upcoming year. This year I want to FOCUS on the millenium. Whether it be your family life, friends, leisure, or your work it is crucial to have a positive outlook to enjoy your life. People who enjoy all aspects of their life are the true winners. Many of the corporate motivational speakers are coaches, GM?s, or players from the sports field. They are all consistent in what they say makes a winner. They say it is a team that plays as a team and respects every member as an integral part of the team. Everyone ?Buys into the system.? Everyone pulls together as a team. The great players are the ones that make everyone else perform at a higher level. It is not based on individual play.

We can all think of very talented players who we do not think of as great players because of their attitude or the way they play selfishly only concerned with their own personal glory or goals. They market themselves as individuals apart from the team. The great players like Gretzky realize that he himself is a greater person and player and much more gratified when he in fact makes the other players on the team better and the team succeeds because of his influence. We have all heard Gretzky say that he is not a goal scorer. We all know that this is ridiculous as he was one of the best natural scorers of all time, but he wanted to be known more as a player who was known for his assists and his commitment to the team. He is truly the great one because he made every single player on the same team a better player and made every one feel they were an integral part of the team. It is important to be a team player and show no elitism.

Is the player who scores the winning goal more important than the player who prevented the other team from scoring minutes before? We have to accept responsibility for all our individual actions whether good or bad. Somehow negative energy pervades stronger. We must always be positive and supportive. You create your future by your actions AND your non actions. Sometimes your non actions have even more of an effect. Several years ago, Stew Gavin, a successful individual both in his NHL career and post NHL career told me a very interesting story of how one player destroyed a whole team. He was playing with the Minnesota North Stars at the time. This was not an overly talented team but a team that gelled and everyone bought into the system. They had progressed into the finals and were playing a close game in game three of the series. Game three is often considered the crucial game. One of the players took a very bad selfish retaliatory penalty in the middle of the game.

The other team scored and at that moment Stew said you could feel the whole team deflate. This one payer had broken the bubble by ignoring the team and pursuing his own selfish vendetta. They were defeated as soon as the individual became more important than the team. There are many different ways to be successful. It is important to understand that they are all very important. Understand that not only your way is the best way. The best results are obtained with a healthy combination of attitude, personality and skill. One of the most successful players in the NHL is Brian Skrudland. Brian has three Stanley Cup rings and coming down the stretch he is sought after diligently by the teams who think they have a good chance of winning the Cup. Brian Skrudland was a third line centre in junior and if he was drafted at all he was drafted very low. He is a winner and sought after because he understands the skill that he posses and utilizes it to the best of his ability to the benefit of the team.

He is the consummate team player who makes everyone better with his attitude, personality and skill. When players buy into the plan and improves their game, everyone wins. Many who have languished in mediocrity become stars and household names when their performance is elevated by a positive attitude. Other peoples focused positive energy gave them a chance. They became famous, confident and successful(and rich). Suddenly all those players whom we have never heard have become good or great players. They have become better with the support and confidence, but will only maintain that level if they stay within the system. Avoid negative energy and do not put up with mediocrity. I recently read a book by Rick Pitino, the coach of the Boston Celtics. The title of the book is ?Success is a Choice.? Constantly remind yourselves of this fact. All day long we make choices as well which affect our ability to be the best at what we do. Be aware of these choices.

There are many extrinsic factors which can affect our choices. Remember we still have a choice on how we react to each individual situation, and who we respond affects yourself and everyone around you. Make the choice to be positive and supportive. It is always easier and you might be surprised and how good it can make you feel even when you may have felt stressed before hand. If you give someone attitude they will usually respond negatively towards you and make you feel even worse than before. There is little to gain by vindication. On the other hand a positive warm response will allow the other people to respond warmly to you. Remember you can ALWAYS choose a good mood over a bad mood. If you are choosing to be in a good mood you will be amazed how happy you and everyone around you will be and how much more you will enjoy your day. Your family, friends, and co-workers will all benefit. Looking into the millennium remember to always keep your FOCUS F-Find what your talents are. O-Observe your mentors and be eclectic C-Challenge yourself to always be positive-set goals U-Use your resources and above all..... S-Strive to make a difference. FOCUS on always being the best, being a team player, and on constant improvement in the millenium.


Taking Time To Peak

There are times in your sporting career when you want to be at the very top of your game. This may be a specific competition, a race, a tournament, or an event where you will be scouted. All good coaches know that an athlete can not perform at their maximal level all the time. This is impossible from a physical and psychological point of view. So, what do you do when you have a specific event you want to peak for. No matter what your sport you can only peak at your best performance several times a year. We gear our Olympic athletes to gear up to top level only three times per year. This is somewhat sport specific as certain events are harder on your body than others. A marathoner would be the extreme case where it is perhaps the hardest sport on your body from a peaking point of view. You simply can not maintain your top level all year round and therefore have to work on cycles.

To obtain your peak performance, it requires both a sound body and a sound mind. You must be prepared to enter an intense training period in a totally healthy state. Physically you must be injury free. It is crucial that any injury you have had is FULLY rehabilitated. The injured area must be pain free and then the affected body parts brought back to full strength and flexibility. Objective testing will ensure that this is accomplished. It is important to seek the help of a qualified sports medicine physician. You can not set goals of future competition while you are still recovering from an injury. It is also important that you enter an intense training period with your body well rested from the last time you peaked. Without this rest period the body will soon reject the training and breakdown or simply not perform. Psychologically, your mind must be focussed on the task at hand.

You must be prepared to train and be committed to the program in order to succeed. Personal problems can affect your training and must be dealt with appropriately. The next step is to examine the last season or performance. Both positive and negative features are examined. A game plan is then devised to correct and improve on the past experiences. The first part of the game plan is to look at the building blocks for your particular sport. Each sport will have it's own particular needs. What energy systems are employed by the sport is the key to designing your program. Most sports use a combination of aerobic and anaerobic energy sources. Both of these energy sources are trainable, but what proportion you dedicate to each will depend on your sport. Strength training will also depend on your sport. The training must not only be specific to what muscles you train, but how you work them. Never forget the importance of a good stretching program.

Nutrition is of paramount importance both during your training and as you approach your peak performance. Food and drink are your energy sources and provide the building blocks to build muscle. As you are building your energy systems you have to start honing your skills. If you are a racquet sport player it is time to go on to the court and work on your shots. Spend a particular amount of time on the shots that give you the most problems. It is also important to spend some time on your footwork. As you progress in the season you must do more and more sport orientated training. Your energy systems and strength can be maintained with twice a week workouts. Now is the time to get that game experience. A runner may start to enter races. As you get closer to the time you are peaking for you must start putting it all together. Your performance must be fine tuned. This is where the big commitment is. You must now increase your training time to orchestrate your body into a finely tuned machine. You must dig down deep to bring together all parts of your training. Finally, you are ready to take on all comers. You can visualize the club championship, you can smell a Personal Best time, you can taste the victory. But most of all you have become the best you can be!! NO GUTS-NO GLORY!!!


Muscle Cramps

There are not many of us that have not ever experienced a muscle cramp. These very painful sudden occurrences come when we least expect them. Just when we are feeling good, we are felled by these cramps which are often referred to as the common cold of Sports Medicine. Not only are these cramps experienced by athletes they can often occur at night and are extremely common to pregnant females. Although these cramps have no long term consequences they can be quite a nuisance to the athlete when they are trying to exercise. We do not really know what causes these cramps but we know of certain factors that can bring them on.

1/DEHYDRATION As we get into the warmer weather we experience problems with adapting to the heat. This is even more so immediately after the winter when our bodies have not adapted to the heat.

2/ELECTROLYTE IMBALANCE When muscles contract and relax they are passing electrolytes back and forth. These electrolytes like sodium and potassium carry an electric charge enabling the muscle to both contract and relax. an electrolyte imbalance may cause the cramp where once the muscle is contracted it is not able to relax which is what a cramp essentially is.

3/MEDICAL PROBLEMS Certain medical diseases such as diabetes and atherosclerosis(hardening of the arteries) may predispose the athlete to cramping.

4/FATIGUE Cramping occurs more commonly in endurance events. This is combi- nation of the above factors and the fatigue factor. There is an even greater chance of cramping when changing events such as in Triathlon. You will notice triathletes will routinely stretch their calves on the last portion of their cycle stage to prevent a cramp as they start to run. The next question is what to do with the cramp once it has occurred.

The following are things you can do to alleviate the cramp. 1/STRETCH This is the easiest an most reliable way to relieve the cramp. You should stretch the muscle to ease the cramp. For example, if you had a calf cramp you should pull your toes toward you to lengthen the calf.

2/MASSAGE This increases blood flow to the cramped muscle to increase circulation and to possibly remove waste products which may be causing the cramp.

3/ICE My marathon medical experience has proven to me that ice is a good way to relieve a cramp.

4/ACUPUNCTURE For the believers, compressing your upper lip will relieve the cramp.

5/FLUIDS With fluid and electrolyte losses being the most common cause of cramps, it makes sense that you should use electrolyte drinks to both treat and prevent cramps.

6/CLOTHING Wear proper clothing to prevent overheating or temperature changes. You will always see a baseball pitcher wearing a jacket to keep their arm warm. Avoid tight fitting clothes which might caught off circulation.

7/STRETCHING A regular good stretching program combined with stretching before and after exercise may be the most important thing you can do to prevent cramps.

8/ELECTROLYTES AND MINERALS If you have a problem with recurrent cramping I always to increase your intake of potassium(bananas,raisins),sodium(salt, sport drinks), magnesium(nuts, apricots), and calcium(milk, salmon, dark green leafy vegetables).

9/CONDITIONING A fit athlete is much less prone to cramps than one who attempts events which they are not prepared for.

10/PHYSICIAN If you still have a problem with cramps after following the above advice then see your doctor to look for any underlying problems.


The Day After I Can Barely Walk Muscle Pain!!!

Muscle soreness is very common. This occurs the day after exercise and can last for several days after. How often have we gone out to play a sport or exercise at something we have not done in a while or at a harder level than usual,and although we felt pretty good during the activity the next day we could barely walk. It usuaslly kicks in about 24 hours after the activity. What causes this extreme pain? This has perplexed many scientists. As athletes we always complained of lactic acid in our muscles. Lactic acid is a by product of exercise. The muscles convert different enzymes in the body to produce energy and allow the muscles to contract. The waste product of this chemical reaction is lactic acid. Lactic acid is thought to be irritating to the body, so if exercise at a higher level than normal too much lactic acid is hanging around and your muscles will become sore. Other people have thought that the pain was from an increase in muscle spasms in the muscle.

These are not thought to cause this pain. The most popular theory is muscle damage to the muscle. Blood tests and muscle biopsies taken after exercise prove this theory to be correct. It seems that unaccustomed exercise produces an initial insult to the muscle and this sets off a chain of events leading to further damage. The sensation of pain in the muscle is picked up by the high number of nerve endings found in muscles and tendons. They are particularly sensitive to chemical stimulation. The damage to the muscles in exercise allows chemicals to be released which are at a peak about the 24 hours after exercise when you feel the most pain. Does all types of exercise lead to delayed onset muscle soreness? The answer is no. Certain types of exercise cause more damage than others. In movement a muscle can contract concentrically or eccentrically.

These are big words but are easy to understand. When you lift an object your biceps muscle is shortening while it is contracting. This is called concentric exercise. When you slowly lower the object the muscle is still exerting force to support the weight but the muscle is now lengthening. This is harder on the muscle and is called eccentric exercise. If you are doing a lot of eccentric exercise which you are not accustomed to then you have a much greater chance of developing this delayed onset muscle soreness. Running like most activities consist of a combination of concentric and eccentric contractions. It is the downhill portion which utilizes the eccentric force as you break down the hill. Therefore even if you were a very trained runner but not used to running downhill you would experience muscle pain if you ran on a course which had a lot of downhill portions. Squash players often talk about the ""squash bum"" they get if they have not played in a while.

Again it is the braking of the bum muscles in the quick game of squash that causes these muscles to contract eccentrically and lead to the pain the next day. Research has also shown that the damage to the muscle may not totally heal for up to twelve weeks following the exercise. Therefore not only will your exercise capacity and ability be limited for the next week after developing the pain the effects may actually last for a few months. What can we learn from the above information? 1/ To avoid the muscle pain we must start the exercise program or sport at an easy level for a limited amount of time. 2/ We must train the ""eccentric"" component if we are going to compete or participate in that kind of exercise. ie. downhill running or downhill hiking and climbing. 3/ Once we develop the pain of delayed onset muscle soreness we must allow our bodies sufficient time to recover from the damage to the muscles before we push ourselves through a similar type of activity.


Home Fitness

You have had a long day, and your family is waiting for you for dinner. You feel like a nice work out to ease away the days tension and maintain that fitness that has become so important to you. All that you have read is that the best thing you can do to improve your quality of life and prevent heart disease is regular exercise, BUT that time thing is making it hard. That trip to the health club just will not fit into your daily routine. Well, congratulations you have just made the decision to join the home fitness brigade. I, for one, thought that home fitness would be a passing fad. Thousands of dollars would be wasted on fancy machines collecting dust in peoples basement. The fact is that home fitness is growing in leaps and bounds. Home fitness sales have grown 67% since 1987 and that was well before the myriad of infomercials.

Home fitness does not necessarily mean quit the health club. A lot of fitness enthusiasts still maintain their health club membership to utilize all they have to offer and use their small home gym to supplement their club activities. Others do not have the time or inclination to join a club and will use their home gym exclusively. Now, that you have decided to start a home gym, what do you put in it? The first thing to do is identify a space that you want to dedicate to exercise. This may be a spare bedroom or a place in your basement. If you do not have the room to dedicate then pick a space in another room to put a piece of equipment. Make the area bright and cheery so it will attract you to it. Paint the area in bright colours and use mirrors to make the space appear bigger and so that you can examine your form while exercising.

Entertainment is key to help your motivation. A good sound system and a TV/VCR will make your exercise area complete. Other small extras such as a magazine rack, towel rack and a motivational bulletin board will all add to the environment. The obvious most important question is what equipment you should buy for your home gym. There is no right piece of equipment to buy, I am often asked what the best form of exercise is? The answer is one in which you enjoy and will continue to use on a long term basis. No matter how good a piece of equipment is, it is totally ineffective if not used. Home fitness comes in two basic categories. That is cardiovascular and strength equipment. The easiest and most common thing to buy for the home is a good piece of cardiovascular equipment. This includes things like stationary bicycles, steppers, treadmills, and ski machines. The most popular are the stationary bikes especially now with the introduction of the very comfortable recumbent models.

Try to but quality equipment that will not only last longer but will be much easier and smoother to use. Avoid buying equipment from television or mail order. It is always better to see and try the equipment you are dedicating your self to. The other category is strength equipment. This can be as simple as resistance bands or free weights to a sophisticated multistation gym. It is important to mix cardiovascular exercise with strengthening and flexibilities. If you are on a tight budget, remember you can have a home gym with a small investment of a step bench, skipping rope, or slide with the corresponding video and away you go. On the other hand, if you are really serious a personal trainer who comes to your home is the ultimate in motivation. As our lives get increasingly busy, home fitness provides the answer to many individuals. So, what are you waiting for? Run out and buy that machine that you always wanted and start exercising


Psychology Of The Injured Athlete

Johnny excelled in his hockey career all the way through bantam, midget, and junior. He was now leading his college team to a national title. He always played and exuded enthusiasm and confidence in himself and his teammates. Suddenly in the semi-final game he injured his knee. He is told that he requires surgery on his knee. He is devastated. The first time in his life he is faced with dealing with adversity. As health care workers, coaches, and parents it is very easy to deal with the physical part of a injury. It generally is straight forward of what the injury is and how we are going to treat the injury. The intangible is how the athlete will deal with the injury. A lot depends on the individual situation. While a star player may be extremely depressed or angry about the injury, another player may feel relief in that they have been under performing or not wanting to feel the stress of performing under pressure.

An athlete on a losing team has a different approach to their injury than an athlete on a winning team. It is crucial that we play close attention to the athletes mental state in treating the injury. The athlete and those working with him must understand realistic goals and expectations. Some athletes who want to delay their recovery will need to be pushed while others are so keen to get back to playing that they are ignoring the natural biology of healing and have to be held back. Therefore it is very important to have a lot of communication with the athlete and have a very clearly defined program to heal the injury and return to sport. Often, especially early in the injury an athlete will forget or deny the initial advise. This is a normal response and we must be patient through these difficult times for the individual that is injured. It is said that a person goes through five stages when faced with devastating news.

They are Denial, Anger, Bargaining, Depression, and Acceptance. Now while this is usually applies to situations where someone is dying an injury to the athlete whose sport is so much a part of their life may go through these same five stages of response to what is happening to their body. There are some that will use an injury to get out of participating in a sport. I recall a very sad scene in my office where a young gymnast was signalling to me from behind her coach and mother that she did not want to go back to the gym while the coach was pushing me to get her back in time for the next competition. There was no way that her back pain was ever going to get better unless we dealt with the psychological problem between the athlete and her parents and coach. Another athlete may delay the recovery to avoid an event that they are afraid of under performing in. Fortunately these kinds of situations are not common.

The majority of time, the main psychological approach to the injured athlete is to keep them motivated. The healing of the tissues is helped by a positive attitude. Others even believe that we can help heal tissues by the actual visualization of the healing process. The athlete must feel confident that those treating him have the ability and knowledge to get him back playing as close to his previous competence as possible. It is important to keep the athlete in environment that is therapeutic to their healing. An athlete should be undergoing their rehabilitation centre that caters to athletes with the same attitude. It is not an ideal situation to have that athlete in a center where those around him may not have the same motivation to return such as a those on workers compensation. If they are around athletes, they can see other athletes recovering from injuries which help motivate them in their rehabilitation.

They can see how other athletes have come back from their injuries and are close to returning to their sport. As they progress in their rehabilitation, they can function as a role model to those that have just been injured and need the support from some one who has gone through that rehabilitation process. All this makes the athlete feel part of a ""team"" which is such an important part of their life. This progression from student to tutor helps prepare them psychologically to return to their sport with the confidence they need. It s important to have the athlete feel as much a part of the team as possible in their injury recovery. The athlete should be cross training to maintain their fitness while the injured area heals. They should remain as much a part of the team as possible by attending all games, social functions and even going on road trips if possible. Johnny did have a serious injury that did require major surgery to repair. He had a long recovery and did not play until a year later. In the right environment Johnny worked hard and came back to play stronger that when he left. He had the full support and confidence on his coach, team mates, parents, doctor, and therapist to help and motivate him to recover from his injury and return to be an integral part of the team.


Fitness For Health

It used to be that we had to convince people of the benefits of exercise based on only an impression of those of us that were committed to a regular regimen of fitness. People would often look at us as crazy and obsessed. Maybe we were, but it is now that we actually have hard research to prove the benefit's of regular exercise. Previous columns have shown evidence of the benefits of exercise. The most comon talked about benefit is the reduced risk of cardiovascular disease. A reduced risk of heart attack and stroke. We are now seeing that the benefits of regular exercise has been shown to reduce the risk of various cancers. Believe it or not we now believe that the lack of regular exercise is more significant a risk factor than smoking cigarettes. It is now easy to jump on the bandwagon of regular exercise. It is easy and makes sense. It not only improves longevity but the quality of life. Several years ago they started to build homes for the elderly with all the conveniences so they would not have to strain as they got older.

They lived in beautifully manicured teraces, plowed and shovelled driveways and walks and elevators to take them to their residences. What happened to this sedentary roup of individuals is that they became depressed, out of shape and had an increased death rate compared to others their same age. The question now is how much to advise people to exercise. The standard equation for cardiovascular health is to exercise three times per week. Exercise should be cardiovascular in nature using large muscle groups such as the legs or arms in a repetitive motion. The ideal exercise is walking, jogging, cycling or swimming to name a few. Your heart rate must be raised to a level of 60-85% of your maximal heart rate. Your maximal heart rate is approximately 220 minus your age. This should be maintained for thirty minutes. The above has been the standard party line for many years. While it is an excellent guideline, it has not been without some controversy. There is a group of doctors that believe that these guidelines are too resrtrictive.

People should be encouraged to simply become more active in activities such as walking an extra block to work or gardening and these several short blocks of activity will have the same effect as a committed block of time walking or joggong or whatever. There was a trend to thinking that we were being too restrictive on the amount of physical activity needed to be efective for health. At the same time scientific research has shown that health benefits are increased by not only the duration of exercise but also the intensity of exercise. People who exercised on a regular basis for a longer period of time reaped the benfits of improved longevity. Someone who is running 40 miles a week has a risk that is 30% lower than someone running 10 miles per week. So, what does the Jock Doc recommend? There is no doubt that being physically active is beneficial. I like the origional guidelines as it sets a goal for the individual to follow which is important to help people remain on their fitness track. These are sensible easy guidelines that should be easy to comply with. It is also important for people who can not seem to follow a regular routine to increase various things in their life that may be in short bursts throughout the day such as walking up the stairs instead of the elavatoror parking several blocks from work and walking the rest. For those that are keen like me ""GO LONG AND GO HARD""


Bike Safety

Spring has come very early this year and the streets are full of people getting active again. The main thing we see is more wheels. While in-line skating has became more popular, bikes are still the most popular leisure activity on wheels. This is great from a fitness and health point of view and I want to see everyone maintain their ability to enjoy this great activity without getting hurt. My first bone of contention is still the multitude of riders who do not wear helmets. While it is now the law that riders under age 18 must don a hard shell lid, most of those over this age some how think that once you reach that magic age that the brain is no longer vulnerable to injury. Most of those riders that I see on the road are not wearing helmets. The worst case scenario are those smart parents who put a helmet on their children in their infant seat behind them while they themselves are not wearing any protection. Not only are they at an increased risk for falling with the uneven weight distribution, but when they do fall they are probably more concerned with their child?s safety than their own.

To keep you informed the statstistics are quite overwhelming to protect that brain of yours. Studies have shown that head injuries are45% more common in cyclists who do not wear a helmet. Of those that die while cycling 75% of those are due to head injury, and wearing a helmet reduces your risk by 85%. In children and hopefully this will change with it now mandatory to wear helmets, cycling related head injuries is the most common cause of serious head injuries. While head injuries are the more serious side of cycling injuries there are also other injuries that can occur with cycling. The majority of cycling injuries are caused by two main factors which makes them very easy to treat. the first main cause is improper bike fit. There are three main types of bikes. They are the traditional road/racing, the now most popular mountain all-terrain bike, and the hybrid. It is important that you buy a bike that best suits your needs. A knowledgeable experienced sales person will make sure that the bike is the proper size for you and it is fit to your body.

The key features of a good fit includes handlebar placement, seat placement(3 adjustments) and pedal height. The next most common cause of injuries is cycling technique. If you are going to cycle a lot then proper technique is important to not only avoid injuries but for increased efficiency. Most people think that the power in cycling comes from the down stroke on pushing down on the pedal. While this provides the majority of the power there is also the other 60-65% of the stroke that can provide power. At the bottom the foot can pull the pedal back, if wearing toe clips or a cleated system the foot can pull the foot up and finally push the pedal across the top to propel the bike forward. Ultimately the best cyclists are pedaling in a circular motion to provide power all the way around. This disperses the force and in particular makes it easier on the knees.

Another common mistake is to drop your heel down to the bottom of the stroke. In the Tour de France you will never see the heel drop below the toes. Again this is most efficient and less stress on the Achilles. Cycling gloves will make the ride more comfortable, prevent nerve compression in the wrist and protect the hands if you ever fall. Drink plenty of fluids if on an extended ride and with a water bottle holder on every bike, there is never an excuse not to keep well hydrated. It is important to follow the rules of the roads and paths. Always cycle as if you are invisible. Although you may have the right of way , the battle with a motorized vehicle is rarely one. Always assume that the driver can not and has not seen you. Not obeying the rules of the road will make you more vulnerable to injuries or a steep fine. There has been a large increase in the number of injuries on the paths with not only other cyclists but with in-line skaters who may not have the same control as you. Drive in control and slow down around corners



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