Heart Rate Training Levels in Women

Individuals in the health industry as well as those who are just into their fitness know a long-standing formula for calculating maximum and target heart rates (HR).  We have generally thought of maximum heart rate as 220 minus the person’s age.  Based on this maximum heart rate, the target heart rate would be calculated as 65-85% of that value.  For example, a 30-year-old person’s maximum heart rate would be 190 beats per minute (bpm) and his target heart rate during training would be between 123.5 and 161.5 beats per minute.  This has stood as common knowledge for some time now but researchers at Northwestern Medicine in Chicago have found that this is not always the case. 

These researches have conducted a study of over 5,000 women to determine maximum and target heart rates.  Their results demonstrated that if women use this formula they may be calculating heart rates that are too high which could place them at risk, exercising over a safe threshold.  As trends of wearing HR monitors to constantly monitor target values increase, it is important that we have the correct targets in place. 

The researchers at Northwestern Medicine have found a new (not easy) formula for women to find their maximum heart rates.  The formula is 206 minus 88% of the woman’s age.  According to this new calculation, if that 30-year-old person mentioned before was a woman, she would have a maximum heart rate of 179.6 bpm not 190 bpm.  Based on this new maximum HR her target heart rate would be between 116.7 and 152.6 beats per minute.

It is important to point out that “there’s nothing wrong with achieving a higher heart rate with exercise, and if you can maintain that, it’s fine,” said Dr. Martha Gulati, a cardiologist and assistant professor of medicine and preventive medicine at Northwestern, who led the study. “But it might be that some women are getting tired and need to stop or slow down because they’re not able to maintain their heart rate at the higher level. But they’ve been using the wrong numbers.”1

If you are one of those women who has noticed difficulty staying in your target range during exercise consider using the new formula mentioned.

1.       The New York Times.  Recalibrated Formula Eases Women’s Workouts. July, 5, 2010. http://well.blogs.nytimes.com/2010/07/05/recalibrated-formula-eases-womens-workouts/

Backpack Safety

Believe it or not the summer is coming to a close and children are returning to school in the next few weeks.  This is a great time of year when kids of all ages get to see their friends and begin a new chapter in their lives.  However, this new time can bring aches and pains to many children and adults.  Due to weak muscles and heavy backpacks, children often walk around with stooped posture.  This can lead to shoulder, neck, and back pain along with numbness and tingling in the arms and hands. 

When I was attending school regularly there were many “backpack fads” that came and went.  First, it was cool to wear your backpack over one shoulder; then it was only cool to “sag” your backpack and have it hang as low as it could.  Both activities can cause multiple musculoskeletal problems.

Follow these easy tips to help your child prevent pain and risk of injury:

-- Lighten the Load – A full backpack should not be more than 10-15% of one’s weight.  Make sure not to carry items that will not be used that day.  When placing heavy items in a backpack, organize them so that the heaviest items are closest to the body.

--Wear Both Shoulder Straps – If you only use one shoulder strap you place a large amount of the stress on one side of the body causing muscles to be overloaded.  It is important to wear both shoulder straps so that the weight is distributed evenly.  Although most children find it “un-cool” it is also a good idea to wear support straps across the chest or hips.

--Position the Backpack Correctly – The backpack should be over the middle of the back where the muscles are the strongest.  In this position the low back does not have to overwork to carry the load.

Good luck with your new beginnings and if you or your child have shoulder, neck, or back pain make sure to see your physical therapist at Hayashida and Associates Physical Therapy.

Reference: www.APTA.org

Posture for New Parents

The birds and the bees have come and gone; spring is over and we are in the heart of summer, the time of the year when the most births take place (at least in America).  This means that there will be a lot of new mothers and fathers out there playing with their children.  Having children can lead to a large amount of added tasks for new parents.  These caregivers will need to lift their children from the floor or bed, carry them for prolonged periods of time, and bend over repetitively to pick up toys or food from the ground.  We all know the old adages: When lifting a box bend the knees, keep the load close, do not use your back to lift.  However, when there is a child involved we all too often throw out these rules of correct body mechanics.  Here are some simple pointers to keep you out of pain with your new activities.

Lifting Your Child

When lifting your child from the floor you should come down to one knee with the one foot slightly forward of the other while keeping your back flat.  You should try to keep your child close to you, using two hands to grasp him or her.  Before attempting to lift you should tighten the core musculature (stomach muscles) in order to keep the back straight.  You should lift with the muscles of the legs to safely return to a standing position.

 

Carrying Your Child

Often we see mothers and fathers hold their children in one arm with the child resting on their hip.  This can put a lot of stain on the low back since the weighted object (your child) is all to one side.  Instead you should hold your child balanced in the center of your body, holding them closely. 

Picking up Objects from the Floor

There will be many times when you need to bend over and grab toys or fallen food from the floor.  If this repetitive motion is done incorrectly you can cause yourself back pain relatively quickly.  In order to avoid back pain you should keep your back straight with your head in line with your back.  The bending action should take place at your hips, extending one leg straight behind you as a counter balance.  By reaching to the floor in the manner you maintain the low back in a neutral position decreasing any abnormal stresses to your back. 

If you do find yourself with back pain be sure to see a Physical Therapist at Hayashida & Associates for a thorough evaluation and quick recovery. 

“Please be aware that even if your state requires a physician’s referral before you can see a physical therapist, you always have the right to see the physical therapist of your choice.” -APTA

Resource:  www.apta.org

Fat Busting Shoes?

As we have been looking at the advantages and disadvantages of barefoot running I thought it would be appropriate to look at the new revolution of oddly shaped shoes.  These shoes such as “Shape-ups” by Skechers and “EasyTone” by Reebok tout huge fitness results but, the question is, do these shoes produce their advertised results? And, more importantly, do they have the ability to cause injury?  First, an overview….

Reebok’s shoes describes a revolutionary technology where they have pads of moving air on the sole of the shoe which mimic walking or running on an unstable surface.  They explain that this makes your muscles work harder throughout the day, causing increased activation of the gluteus maximus (bottom), hamstrings, and calves.

Skechers “Shape-ups” also describes a ground-breaking technology where they have a dynamic rolling bottom on the sole.  According to Skechers this makes you feel like your heal is sinking into sand as you walk forcing you to activate your muscles more to get towards your next step.  The advertised benefits include more toned legs, back, and abdominal muscles, reduced body fat, improved circulation, and improved posture.

But, if my last two blogs show how we should be decreasing the amount of shoe wear that we put on our feet, is it really good to have these shoes which further alter our gait mechanics?  While Reebok does not actually show us any of their research articles, Skechers reports many clinical case studies that back their findings.  Their articles show an increased amount of weight loss, an increase in hamstring and calf muscle activation, and improvement in low back endurance.

So, do you buy them or not?  First, I must emphasize that under each clinical case study for Skechers there is a statement: “These independent case studies where commissioned by SKECHERS.  Results may vary from person to person”¹    This breaks rule number one in “research 101.”  You must gain your research based knowledge from peer-reviewed articles that are not endorsed by the company that is selling the product.  There is no way to tell if the money that Sketchers paid the researchers persuaded their outcomes. Second, according to Matt Powell of SportsOneSource, a sneaker analyst, the sales of these shoes “represent the fastest-growing segment of the $17 billion-a-year athletic footwear industry. It's a market driven by a customer base that is 90% women.”²  Anytime we see such a sharp increase in a product we must ask ourselves if this is due to a truly innovative product or fads and good advertising.

Without ever putting a pair of these shoes on I have some problems with their design.  Destabilizing the foot during walking, especially in a deconditioned person, will lead to problems of the knee (knee cap tracking problems causing pain), the Achilles tendon (increased stresses causing pain and possible tears), the plantar fascia (causing arch pain) or even falls causing serious injuries.  I have heard stories of people developing fractures from wearing these shoes after stepping awkwardly and “rolling their ankles.”

Wendy Shore of Johns Hopkins, says “consumers would get the supposed health benefits of toning shoes and save money if they skipped buying the shoes, then bought one less bagel a day — and walked an extra block."²

As a physical therapist I cannot say that I support the use of these sorts of shoes at this time.  Yes, my opinion may change as more peer-reviewed research articles are presented in respectable medical journals but without the evidence of true health benefits along with the high risk of injury these risks of these shoes outweigh their benefits. 

And as mom always told me, if it sounds too good to be true, it probably is.

References:

1.       http://www.skechers.com/info/shape_ups_clinical_case_study

2.       http://www.usatoday.com/sports/2010-06-30-toning-shoes_N.htm?csp=usat.me

Barefoot Running: Part II

In our last installment we introduced the concept of barefoot running and some advantages that it has over our current trend of running with footwear that controls heel strike, supination/pronation, and gait mechanics of the lower limb. Today I plan to discuss how you can begin a proper barefoot running program.

DISCLAIMER: Before I even get started on this subject in no way am I telling anyone to go out and run barefoot tomorrow.  There is still extensive research that is being conducted in this area and before we fully understand the biomechanics of running without shoes; any use of the technique should be used with extreme caution.  YOU SHOULD VISIT YOUR PRIMARY PHYSICIAN AND/OR PHYSICAL THERAPIST FOR A COMPLETE GAIT ANALYSIS AND GET ANY MEDICAL CONDITIONS CLEARED BEFORE ATTEMPTING A NEW EXERCISE TECHNIQUE. 

First I must cover some disadvantages to running without shoes in our modern urban environment.  If you have been running for a long time with running shoes you have slowly been trained to hit with your heel first before rolling onto the midfoot and then forefoot.  I bet you can imagine that if you went out and “hit the pavement” for a nice run with a strong heel strike that you would be in a lot of pain (especially in the heel).  When transitioning into running without footwear we must retrain our bodies to run striking first on the midfoot or forefoot (middle or balls of the feet respectively).  Other problems also will arise including stepping on sharp objects such as rocks, sticks, or glass.

So how do you get started?

First you MUST see your physician or physical therapist to make sure you are healthy and strong enough to begin a new training technique

Secondly, you need to know how to land on your midfoot or forefoot.  When running in this style you should land on the ball of your foot softly while gradually letting your heal come to the ground.  This is harder than it seems and should be attempted at slow speeds to start.  This form of foot strike will likely make you use muscles in your feet and lower leg that have not been used sufficiently so following the tips below will help you get started.

1.       Start your new program while progressing slowly.  Remember these muscles are going to be used in a different way causing fatigue and possible strain. This can be reduced by first beginning to walk around barefoot.  When beginning running you should start with a very short distance at slow speeds and “increase your distance by no more than 10% per week.”¹ If you find that your feet are sore you should take a few days off for full recovery.

2.       Land gently on your foot; there should be no pounding.

3.       Take small strides.  Do not over step while running.

4.       Stretch you leg muscles!  Barefoot running will make you use your gastrocnemius (calf muscle) and hamstring more causing tightness and fatigue.    

5.       Stop if it hurts!  This should not be a painful process.  If you notice any pain in any part of your foot or in your calf you should stop your training and talk to your physical therapist.

Good Luck!

1.  http://www.barefootrunning.fas.harvard.edu/5BarefootRunning&TrainingTips.html

Barefoot Running: Part 1

Ever since the release of the book Born to Run: A Hidden Tribe, Superathletes, and the Greatest Race the World Has Never Seen, I am asked more and more by my patients if barefoot running would benefit their current orthopedic complaints.  This book by Christopher McDougall explains the running style and philosophy of the Tarahumara Indians of Mexico’s Copper Canyons. So why should we run barefoot? 

DISCLAIMER: Before I even get started on this subject in no way am I telling anyone to go out and run barefoot tomorrow.  There is still extensive research that is being conducted in this area and before we fully understand the biomechanics of running without shoes; any use of the technique should be used with extreme caution.  YOU SHOULD VISIT YOUR PRIMARY PHYSICIAN AND/OR PHYSICAL THERAPIST FOR A COMPLETE GAIT ANALYSIS AND GET ANY MEDICAL CONDITIONS CLEARED BEFORE ATTEMPTING A NEW EXERCISE TECHNIQUE. 

The main focus of barefoot running is that we as humans have been running since the beginning of time; whether it was away from danger, towards a moving target for food consumption, or for fitness alone.   Before the 1960’s running was completed with minimal to no footwear.  Our current data is slim but we do know that approximately 30% of all runners get hurt each year—an astonishing number.¹  Current and further research is in the works to compare running with and without footwear. 

In the days before running shoes humans would run with a “Midfoot strike” where their whole foot would essentially hit the ground at one point with the ball of the foot often striking the ground before the heel.  Modern shoe wear has conditioned us to land on the heel first while constricting normal foot movements such as supination and pronation.  We can understand where shoe makers are coming from; they have added a nice big cushioned heel and have given us support throughout the foot.  Both of these additions to shoes help distribute forces throughout the foot.  It allows landing on the heel to be a comfortable experience and limits excessive pronation or flattening of the foot.  These modern additions to shoe wear lead the athlete to “prefer” to land on the heel secondary to the cushioned feeling.  The problem is that there is some anecdotal evidence that this constant heel strike causes increased ground reaction forces leading to common running injuries such as ankle sprains, shin splints, and patellofemoral (knee cap) pain.

Since modern shoe wear might be contributing to common overuse injuries and since humans have been running for 1000s of years without shoes, current research is investigating the use of barefoot running as a common training protocol.

Be sure to come back and check out the next installment as we will introduce some ways the common runner can begin a barefoot running regimen.  Until then keep those shoes on….

1. http://www.barefootrunning.fas.harvard.edu/1WhyConsiderFootStrike.html

Live a Healthy Life with Prevention

American’s today are beginning to throw the word “prevention” around a little more when it comes to their health.  As we discussed in our last blog, taking minor steps in the correct direction can decrease our chances of heart disease and dementia.  So besides getting an annual physical exam and teeth cleaning what can you do to stay healthy?

EXERCISE – This is the easy one.  Exercising, especially in low impact sports such as swimming, bicycling, yoga, or tai chi can help with increasing you cardiovascular endurance while maintaining both strength and flexibility.  The more your body is prepared for the unexpected, whether it is a simple fall or the need to run from a tiger in the safari, the less of a chance you will be injured during the process. 

WEIGHT CONTROL – In physical therapy when a patient cannot perform weight bearing activities because of joint pain or recent surgery physical therapists often put the patients in some sort of off-weighted environment such as a pool.  This is because increased weight on joints leads to breakdown of cartilage, ultimately causing osteoarthritis and pain.  If a person already has osteoarthritis the added weight of a couple pounds can significantly increase pain and disability levels.  Studies show that losing just 10 pounds can reduce the risk for osteoarthritis by 50%.¹

AVOID INJURY – I know what a lot of you are thinking here.  “Of course, we all try to avoid injury so that we do not need to visit health care practitioners.”  But there is more to this.  I would say that about 50-60% of all Achilles tear injuries that I see in the office are people who are “weekend warriors.”   If you are stuck at a desk 5 days a week for 9 months and then decide to partake in a full contact basketball tournament on Thanksgiving  day your are probably a “weekend warrior”.  Your chance of injuring yourself is tremendous; if you are not prepared for sports you will be injured.  Make sure to prepare for your upcoming sporting events by exercising regularly in order to increase your cardiovascular endurance, strength, and flexibility.

Take care of yourself today.  It can save you from pain in the future.  The pain is not just physical but can also be financial.  Protecting your body, especially your joints can save you thousands.  If you don’t exercise, are overweight, or partake in high impact sports you are at risk of wearing down the cartilage in your joints, creating pain, an ultimately causing you to spend up to $50,000 for a joint replacement, not including time away from work. 

If you are currently not maintaining this level of exercise or you need guidance on how to perform exercises correctly Hayashida and Associates offers many options such as Pilates, and both  one-on-one personal training and group fitness classes.  Prevent injury and live a healthy life.  The choice is yours!

1. Fingertips. http://massage.largeheartedboy.com/