Barbell Squat vs. Dumbbell Squat Pros and Cons

Barbell squats or dumbbell squats: which is better? The barbell squat and dumbbell squat both have plenty to offer fitness enthusiasts. I'm a certified personal trainer, and whether the barbell squat is better than the dumbbell squat, or vice versa, depends upon your goals.
There are two ways to perform barbell squats: with a Smith machine type device, in which the barbell is on a tracked groove that eliminates the requirement of balance; and with a free barbell, in which it rests freely on your back, not part of any tracking device, and hence, requiring more balance. With either type of barbell squat, you can challenge your legs with very heavy weight.

Some people wish to build a lot of muscle mass/size in their upper legs and glutes. The ability to build a lot of muscle mass in the legs and buttocks is not possible with dumbbell squats, because with dumbbell squats, you are required to support the dumbbell weights with your hanging arms as you hold onto them.

This is a problem for people who can barbell squat a lot of weight. For instance, suppose you can barbell squat 225 pounds 10 times. To duplicate this resistance for your legs and butt, with dumbbell squats, you'd have to hold a 110 pound dumbbell IN EACH HAND while lowering into the squat position.

Your legs may be strong enough to support the weight with 110-pound dumbbell squats, but for many people, their upper body will not be able to hold onto those weights. Women, especially, will find it too much to hold a 100-pound dumbbell in each hand. If their wrists don't give out, their shoulders will, very early into the set.

In fact, I'd be willing to bet that very few women, who can barbell squat 200 pounds, can maintain holding onto 100-pound dumbbells in each hand for the duration of eight dumbbell squats.

And if all a man can barbell squat is 200 pounds, I can pretty much guarantee that his upper body strength isn't all that impressive, either, and hence, 100-pound dumbbell squats will be very difficult for his upper body to sustain. Though a 200-pound barbell squat is impressive for a woman, it's nothing to brag about for a man.

And then there are men who DO have impressive barbell squats, let's say 315 pounds. How could he duplicate this effort with dumbbell squats? First of all, there's no such thing as a 150-pound dumbbell. I've never seen one, anyways.

Secondly, the heavier the dumbbells, the more that the upper body must get involved, for these kind of squats. If the weight is heavy enough, dumbbell squats will simply become impractical.

But don't underestimate dumbbell squats for building fitness and durability in your legs. Obviously, they are not the choice for building maximum size, maximal muscle mass or maximum strength in the legs.
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But I'd like to see one of these men, who can barbell squat 400 pounds, do 30 repetitions of dumbbell squats on an air cushion, holding just 25-pound weights in each hand, reaching down to a full, 90-degree bend each time. I can tell you right now, such a beast with the barbell squats will be screaming in pain by the 20th rep -- if he even gets that far.

High rep dumbbell squats can be tweaked: Hold the down position for a 2-count and thrust quickly up to the upright position to recruit fast-twitch muscle fibers. Don't hang out at the top position; immediately drop down again and hold the 90-degree knee bend for 2 seconds. Do this 30 times with 20-pound weights on a flat surface. If you think that was nasty, do it on an air cushion or the flat side of a BOSU board. Good luck.

Does that Nasty Headache from Heavy Weight Lifting Mean You Might Have an Aneurysm

Sometimes heavy weight lifting (squats, deadlift, etc.) can cause a headache, and make you think this is an aneurysm. I'm a certified personal trainer, and I do know for certain that a headache, while doing heavy lifts, can be brought on by dehydration, even though you may not feel thirsty.
 To help rule out dehydration as the cause of a bad headache that occurs during or after deadlifting, squatting or some other heavy weight lifting routine, drink plenty of water prior to working out; a tall glass worth.

Fifteen minutes into your routine (including any warming up), guzzle some more water. Every 15 minutes drink water; not a tiny sip, but guzzle it at the fountain. Also make sure that you've been adequately nourished throughout the day with nutritious food.

If you nevertheless develop a headache during your weight lifting, or shortly after, this may be due to an increase in the venous pressure of the brain, according to Teresa Caulin-Glaser, MD, Executive Director at McConnell Heart Health Center/Riverside Methodist Hospital in Columbus, Ohio, and Clinical Associate Professor in the Department of Internal Medicine/Division of Cardiology at Ohio State University.

Dr. Glaser also mentions what is known as a primary thunderclap headache, which may be caused by heavy weight lifting (and we all know how heavy and wicked a good set of deadlifts or barbell squatting can be).

The primary thunderclap headache is related to the vasoconstriction of the blood vessels that feed the brain.

10 Reasons Never to Hold onto the Treadmill

Do you know the 10 reasons it's wrong to hold onto the treadmill while walking or jogging?

As a personal trainer, I have observed -- with a lot of interest -- how people use the most popular piece of gym equipment: the treadmill. And the vast majority of them use it wrong. What? Use a treadmill wrong? 
How can anyone use such a simple piece of equipment incorrectly? Well, believe it or not, it is used wrong all the time. And when you exercise with poor form, you put yourself at risk for repetitive stress injuries, and you'll get very little, if any, results.

Most treadmill walkers hold on. And not just older people. Even young people do this. It’s very wrong, especially from a fitness and weight loss standpoint. It burns far fewer calories (the calorie display is a computer that automatically shows numbers, based on the speed and incline only); and can wreck your posture.

Here are 10 reasons why you should not hold on.

1. Holding on burns 20 percent fewer calories than letting go at the same speed.

2. It can throw off your walking gait and posture.

3. It can cause repetitive stress injuries in the hips and shoulders. I once had a new client who complained of mysterious shoulder pain. I found out she always held onto the treadmill while walking. I told her to let go. After she began walking hands off, after a few days, the shoulder pain disappeared.

4. When you hold on, you are not really, truly walking, because in everyday walking, you're not holding onto anything for support. So if you hold onto the treadmill, your body is not being trained to do anything. In fact, it's being UN-trained.

5. It UN-teaches your body how to balance. Your balance will become worse if you hold on. When you hold on, the machine becomes an external support system to your body. This teaches your body to rely on an external agent for balance. So when you're outside somewhere, and you have to balance or walk on uneven surfaces, or step around things or go down stairs, etc., your body won't be efficient at handling the demands of self-support without that external agent to hold onto.

6. Holding on at fast speeds can raise blood pressure, because you are gripping at something. A tight grip, especially, will raise blood pressure.

7. You will be tricked into thinking you're far more fit than you actually are, because no matter how high you set the incline, even at a fast speed, if you hold on tightly enough, you can keep up with the tread without any challenge if you hold on. This will fake you out into thinking you can handle actual hills outdoors.

8. Holding on can aggravate a pre-existing back problem, or knee problem. When you hold on, the entire kinetic chain is disrupted.

9. Holding on creates a false sense of accomplishment. You're not really doing anything. Even the most frail person can use a treadmill if he or she grasps the machine.

10. It looks…well, quite silly. One of my clients even pointed that out to me and stated, “Some people call that walking! That isn’t walking!”

Why Old Men Have Skinny Arms & Legs but Big Bellies

It's Common to See Old Men with Thin Arms and Legs, but Fat Bellies

Ever notice how many old men have skinny legs and arms, but plenty of fat in their bellies? In fact, as they age, men typically lose mass in their legs and arms - they get thinner, while their belly just gets fatter and fatter.
I'm a certified personal trainer and there is a perfectly logical, and quite simple, explanation for why, as men get older, their bellies get bigger while their legs and arms get thinner or scrawnier. It has to do with the metabolic furnace.

This phenomenon happens to men who don't perform weight-bearing workouts on a consistent basis. To put it another way, the increasing stomach size and decreasing leg and arm size will happen to every man who doesn't exercise, as he gets older. The only exceptions are very underweight men, and it's rare to see an old man with scrawny arms and legs and a flat tummy.

The metabolic furnace is the body's muscle. For inactive men (and women), beginning at about age 30, the body begins losing muscle mass. As muscle mass decreases, metabolism slows down. A slower metabolism means that the rate at which you burn calories from food slows down.

A man, who wasn't into exercising, as he approaches middle age, continues to lose muscle, about five pounds' worth per decade. By age 50, this sedentary individual has lost around 10 pounds of muscle. This shows in thinner legs and arms; they've lost muscle mass. The butt sags. The thighs look, pardon my bluntness, pathetic.

So why does the belly in these men get fat? Because the muscle they used to have in their legs and arms, which is no longer there, is no longer there to burn some of the food they eat. Muscle burns more calories than any other body tissue; muscle is the body's metabolic furnace. The less muscle you have, the slower your metabolism (even though it may still be on the fast side, but relative to what you had when you had more muscle, it is slower nevertheless).

So food that used to get used by the muscle that was once in the legs and arms, is now getting stored as fat, and the first place men store fat is in the belly.

This phenomenon doesn't just happen to skinny men as they get older. A medium or even portly man will notice that as years go by, their belly just keeps getting bigger and bigger, while strangely, once thick legs are now smaller.
These men no longer have the muscle mass in their arms and legs to support their daily food intake, and thus, the non-used calories get stored in their belly as fat.

I might also mention that the muscle loss also occurs in their chest, back and shoulders. However, loss of muscle is most evident in the legs and buttocks. The fat belly in an otherwise "healthy" (free of disease) aging man is entirely preventable through strength training workouts. I see this all the time at the gym: old-timers with washboard abs, strong sturdy shoulders and backs, muscular arms and strong, toned legs.

Men over 30 who have noticed an ever-growing belly of fat can reverse this situation 100 percent in many cases (depending on variables including age; I wouldn't expect a 68-year-old who's never lifted a single weight in his life to achieve washboard abs and muscled arms and shoulders). The best way for men to lose the paunch is to hit the weights for their legs, back, chest and shoulders, and not camp out - yes, I said "not" - at the crunch machines.


Need Total Knee Replacement? How to Lose Weight via Exercise

Here is a guide on how to lose weight with exercise even if you can’t do aerobics or leg workouts and need a total knee replacement.

A person who needs a total knee replacement can still lose weight in time for the surgery by engaging in the right kind of strength training exercise. A report (Journal of Bone and Joint Surgery, Oct. 2012) points out that obese patients are at greater risk of complications following total knee replacement surgery, and that weight loss prior to the procedure is strongly advised.

I’m a certified personal trainer. The best way to lose weight is by lifting heavy weights. Now before you think, “I don’t want to bulk up; I don’t want to get bigger than I already am!” I have something to say:

Losing weight will reduce the risk of complications from total knee replacement surgery, and the best way for this kind of patient to lose excess fat is with heavy strength training. You will lose fat, gain muscle and GET SMALLER.

Not bigger. Smaller. Yes, you’ll gain muscle, but at the same time you will lose unhealthy weight that has certainly contributed to your need for total knee replacement.

To lose weight safely and be in the best shape possible prior to total knee replacement, follow this formula:

1) Use heavy resistance so that eight to 12 repetitions are extremely difficult.
2) Maintain good form throughout the set, though a bit of “loose form” for the last few reps is acceptable.
3) Avoid exercises that isolate the shoulders, triceps and biceps, as these will burn far less fat than compound exercises that work several muscle groups at once.
4) Do only compound exercises that hit the back, chest, shoulders, triceps and biceps.
5) Make an objective to keep lifting heavier and heavier over the course of time.
6) Perform these routines twice a week, e.g., Monday and Thursday, or Tuesday and Saturday.

Notice that leg exercises are excluded. I’ll play it safe and assume that the total knee replacement candidates reading this article are not able to perform even simple leg exercises like a leg press or hamstring curl. Though the inner/outer thigh machines won’t hurt your knee, avoid these anyways, as they will not cause weight loss.

Hopefully, you will have plenty of time to make a strength training approach work for you before your total knee replacement surgery. Follow my rules above.

Those isolation exercises to avoid include shoulder side and front raises with dumbbells/cables, triceps push-downs and kickbacks, and biceps curls. Your goal is weight loss, not shaping a biceps or shoulder muscle.

The fastest way to safe weight loss is to focus only on compound exercises that work multiple muscle groups, such as the bench press, lying dumbbell press, horizontal press, any kind of overhead press, and any kind of pulling motion such as a seated row with a straight bar.

Knee Pain Treatment by Pedaling Backward on Elliptical Trainer

If you have knee pain, try pedaling backwards on the elliptical machine and see if this doesn’t alleviate your joint discomfort.

Most people don’t pedal backwards on the elliptical trainer, but this may actually alleviate knee pain, according to a recent study. Most people don’t pedal backwards on the elliptical presumably because it taxes the quadriceps muscles of the thighs more, and also because most people do not think outside the box.

However, the leader of the study, Elmarie Terblanche, PhD, says that those who pedaled backwards experienced much greater gains in thigh and hamstring strength when compared to those who used the equipment going forward. The stronger the quadriceps, the more stable the knee joint. The study also showed that those who pedaled backwards on the elliptical had greater aerobic function than those who moved forward.

The study subjects represented numerous knee injuries and were randomly assigned to forwards or backwards pedaling on the elliptical for a series of supervised sessions. Terblanche urges “do it backward!” for those with knee pain.

I’m a certified personal trainer and always have my clients, knee pain or not, pedal backwards on the elliptical when this equipment is their preferred cardio mode. What people don’t realize is that only five minutes of backward pedaling are all it takes to produce a training effect and help alleviate knee pain, as well as strengthen knees in people without pain in this joint.

Next time you use the elliptical machine, toss in some backwards pedaling here and there for several minutes. Don’t clutch onto the rails and lurch forward. Keep your back vertical to force your core to be engaged. Try not to hold on. Move your arms in synch with your body and keep the back straight. By focusing on balance and good posture without holding on, you will burn significantly more calories.

For a deeper “burn” in the quadriceps, lower yourself to increase the bend in your legs. This isn’t necessarily recommended for those with knee pain, but just as a general way to modify the exercise. Remember to keep erect, straight posture and try not to hold onto the rails.

Fitter people should raise the pedal tension to increase the intensity of going backwards on the elliptical. Holding onto the rails will reduce pedal tension.



How to Prevent Weight Gain after Knee Replacement Surgery

Find out what you can do to prevent weight gain after your knee replacement surgery.

If you’re afraid of gaining weight after your knee replacement surgery, realize that fat gain does not have to happen to you. I’m a certified personal trainer, and my father has had three knee replacements (one a revision), and he never gained weight afterwards.

A new study shows that weight gain is a real threat for knee replacement patients, but this doesn’t mean it’s inevitable; you just have to know what measures to take to prevent adding on unwanted pounds.

How to Prevent Weight Gain Following Knee Replacement Surgery
The obvious thing that comes to mind is to cut back on calories. There is more room to do this if the patient, pre-operation, is a big eater. Simply cut back. However, this is easier said than done, especially for patients who aren’t eating all that much to begin with.

The biggest factor in preventing weight gain after knee replacement surgery is physical activity. However, I’m not talking about using the lower body here. Ask your surgeon how many weeks after the knee replacement you must wait before embarking on an upper-body strength training regimen.

While my father was still in the hospital after his third procedure, he was already lifting light dumbbells while propped up in bed.

Find out from your surgeon not only when you can begin weightlifting, but when you can begin using them with a lot of gusto.

If you’re new to weightlifting, you’ll need to start out with light resistance. But whether you’re new or experienced, this doesn’t change the formula for maximum prevention of weight gain:

#1) Focus on compound movements (several muscles at the same time), namely any kind of chest press (especially the bench press); any kind of pulling motion (namely the lat pull-down and seated row); and the shoulder press.

#2) Use a resistance load that makes eight to 15 repetitions difficult. If you can do 17 reps, the resistance is too light. (Beginners should aim for the higher rep range.)

#3) Take 60-90 seconds in between sets.

You’ll probably need to reduce the resistance for subsequent sets of the same exercise. If you don’t belong to a gym, consider joining one. You can also do strength training with tension tubing.

The study (from Virginia Commonwealth University) followed about 1,000 knee replacement patients over five years, and compared them to a control group who did not have this procedure. Thirty percent of the patients put on 5 percent or more of their bodyweight, while the weight gain figure for the control group was 20 percent.

Source: sciencedaily.com/releases/2013/01/130114153428.htm

How Important is Weight Loss Before Knee Replacement Surgery?

Find out the big difference losing weight prior to knee replacement surgery can make and why this should be of utmost importance.
If you have a total knee replacement surgery planned, you’d be doing yourself a huge favor by losing weight before having this procedure done. A report in the Journal of Bone and Joint Surgery (Oct. 2012) says that obese patients are at higher risk of complications following total knee replacement surgery.

These complications (including infections) are correlated to the need for revision surgery.

"Orthopaedic operations can technically be more difficult in obese people,” explains Gino M.M.J. Kerkhoffs, MD, an orthopedic surgeon at Academic Medical Center Amsterdam, University of Amsterdam. He led this latest study, and continues, “and it is important for us to know whether there is a higher complication rate in the obese, and if the long-term outcome is worse."

Weight loss prior to total knee replacement surgery will benefit the patient because, according to Dr. Kerkhoffs’ investigation, obese patients have a doubled rate of postoperative infection; obese people have a doubled rate of long-term surgical revision requirements.

The report also advises that obese people, who are scheduled for a total knee replacement, should make a plan to lose weight prior to the procedure. In fact, the paper goes one step further by pointing out that the orthopedic surgeons themselves should be prepared to recommend to their obese TKR patients, before surgery, professionals who can assist them with losing weight.

When an obese person with painful osteoarthritis in the knee hears that they should first lose weight to lower the risk of postoperative complications, the first thing that may come to mind is: “How do I lose weight if I can barely walk with this painful knee?!”

I’m a certified personal trainer. A re-evaluation of eating habits is in order, and even if the patient goes from 5,000 calories a day to 2,000 calories a day (a six pound per week weight loss), the variable of exercise should be put at the forefront – and this can be accomplished even if they have a painful knee!

What many obese people don’t know is that the best way to lose weight is through strength training, not aerobics! Upper body strength training can be done in a seated position, sparing pain in the knee!

The obese person will lose significantly more weight performing the bench press, dumbbell chest press, seated chest press, lat pull-down, seated row and shoulder presses than they will struggling through hours and hours and hours of pedaling, walking while hanging onto a treadmill, bouncing around in a swimming pool, and attending NIA, Zumba, belly dance and other dance aerobics classes – which can bring on pain in their knee.

Will Failed Knee Replacement Keep Worsening if not Revised?

Find out what likely will happen with your knee if you don’t have revision surgery for a failed total replacement.

You’ve had a total knee replacement and, over time, things have gotten worse, leading to a diagnosis of a failed implant. You’re told you’ll need “revision” surgery: a replacement of some or even all of the hardware.

Suppose you’re afraid to undergo revision surgery for a loosened knee replacement and are wondering if the situation will simply stabilize over time and be managed with painkillers, cold packs, gentle exercise, acupuncture, etc.

There’s bad news if you’ve been hoping that your failed total knee replacement will magically stop getting worse. 

For this article I asked a hip and knee replacement surgeon if a failed TKR will necessarily continue getting worse and worse, rather than stop declining and taper off to a standstill status.

“‘Yes; as time goes on, the loosened implants lead to more bone destruction around the joint, and lead to an increased risk of fracture around the joint replacement,” says Jeffrey A. Geller, MD, Associate Chief, Division of Hip & Knee Reconstruction; Director, Minimally Invasive Hip & Knee Replacements, Columbia University Medical Center, New York, NY.

“Pain worsens, but the bone around the replacement weakens, making likelihood of fracture higher as time goes on,” continues Dr. Geller. “Typically the pain worsens and walking becomes more difficult.”

If you’ve been diagnosed with loosened knee replacements, it’s not an issue of whether or not you should undergo the revision surgery; it’s an issue of when, unless you have concurrent medical conditions that contraindicate the revision surgery.

You have to decide if you can continue living in pain, or take that chance with the revision procedure. My father’s failed TKR generated so much pain that he had no problem deciding on the revision surgery, which so far, has been going well.

How successful is revision surgery?
Dr. Geller explains, “Patients feel much more stable and sturdy just about immediately. The recovery is similar to a regular total knee replacement, i.e., three months or so, but the difference is readily apparent. If a patient is quite aged, depends on medical comorbidities....better to fix it rather than subject patient to heavy-duty pain meds or risk of falling from pain and weakness in the knee. It is generally safer to try to intervene electively for the knee than do an urgent surgery for a fractured wrist or hip.”

Source: http://www.cumc.columbia.edu/

Cause of Increasing Knee Pain Soon After Revision Surgery

Is your knee pain worse after revision surgery even though at first it wasn’t so bad?

A knee revision surgery is when a failed or loosened implant is replaced in part or whole by new hardware, but what does it mean if soon after this procedure, the knee pain is a 9 or 10 out of a 10 pain scale?

Might this mean that the knee revision surgery failed? My father recently had a knee revision surgery. In the several days after the knee revision surgery, while he was still in the hospital, he reported that everything felt fine, other than the surgical pain, which is to be expected with these procedures.

He spent four days in the hospital. The fourth night after the knee revision surgery, he slept at his house, and next morning, reported that the knee felt good (there was pain, of course, but this was related to the procedure).

However, next day, he said it was hurting bad and became concerned. I noticed that he wasn’t walking as much (the doctor told him to use a walker for the next three weeks, then a cane for three weeks after that).

The next day it was still worse, and he couldn’t help but wonder if the knee revision surgery actually failed, even commenting that maybe something in there was loose.

Interestingly, his physical therapist, who came to the house, noted some oozing from the incision, and decided that this, in combination with the severe pain, might mean an infection. The PT contacted the surgeon’s office; he was told that my father should report to the emergency room.

I drove him there. The ER doctor said the knee didn’t appear to be infected. An X-ray was normal. A blood test also was normal. An orthopedic physician’s assistant then examined the incision, feeling the joint, and said everything was normal. So what was up with all the pain?

The P.A. explained that after knee revision surgery, the patient is up and walking within 24 hours. Each day after, the patient walks a little more, feeling “great.” Then come maybe the fifth or sixth day after knee revision surgery, the patient reports an increase in pain, sometimes dramatic.

This is because, said the P.A., the joint has become overworked. The patient typically cuts back on walking and becomes more inactive. This gives the joint a chance to recharge. When the pain diminishes, the patient eagerly begins walking again, and may again overdo it, bringing on a resurgence of the pain.

It’s an up and down cycle, said the P.A., that can persist for a few weeks, but over time, as the joint heals, it won’t respond so much with pain from all the walking.

My father had a follow-up visit a few days after with his primary care physician, who basically said the same thing. The joint looked perfectly normal, and that pain comes from walking too much (which doesn’t necessarily mean a marathon  --  remember, knee revision surgery is very traumatic to the joint, and what seems like normal walking about the house can easily qualify as “overdoing it”).

If you’ve recently had knee revision surgery and the pain has suddenly gotten worse, this might be due to “overdoing it,” but get a prompt follow-up with your primary care doctor to be sure.

Can Knee Pain Be Caused by Traditional Marriage Roles?

A study supports the idea that the traditional marriage can lead to the knee pain and disability of osteoarthritis.

If you’re a woman who waits on her husband hand and foot while he lives like a king in a chair every chance he gets, this dynamic may lead to disabling osteoarthritis in his knees later in life.
A study from Northwestern University Feinberg School of Medicine, led by Dorothy Dunlop, MD, shows a link between the quantity of light physical activity and subjective reports of disability and pain relating to knee osteoarthritis.

"Even among those [study participants] who did almost no moderate activity,” says Dr. Dunlop, “the more light activity they did, the less likely they were to develop disability."

In other words, this study looked at light physical activity, as opposed to moderate or intense. Light physical activity includes housework, which, in a traditional marriage, is done almost entirely, if not 100 percent entirely, by the wife.

My parents have always had a traditional marriage; my mother waited on my father hand and foot. Every chance he got, he remained in a recliner-type chair, while she’d get him things: a beverage, a snack, the TV guide, the newspaper, the mail, etc.

I remember one time when I was a child, he asked me to fetch for him a book, even though he could have gotten out of his chair to get it. He had to tell me where it was located. He could have gotten it faster.

The study points out that pushing a shopping cart or a vacuum cleaner constitutes “light” activity. My father never pushed a vacuum, and rarely handled a shopping cart. He’d leave used dishes and glasses on tables so that my mother could collect them.

Over decades, this marital dynamic would prove to catch up to my father. He eventually developed osteoarthritis in both knees (three total knee replacements). I don’t believe for a second this is coincidence. Meanwhile, my mother, 75-plus, has absolutely no sign of knee osteoarthritis and continues playing the role of the traditional wife.

Dr. Dunlop’s study appears in the April 29, 2014 British Medical Journal. The study involved about 1,700 people 45 to 79 who didn’t have disability, but had risk for disability due to knee osteoarthritis or some other risk factor for knee osteoarthritis.

Intensity and amount of physical activity, in the participants, was tracked with an accelerometer they wore during waking hours for a week. Two years after this data was collected, the people were surveyed.

Lower reports of disabilities were associated with more time spent with moderate or heavy activity.

But what about light activity?
The results showed an association between light activity and fewer disabilities.

Participants who engaged in more than four hours daily with light physical activity had over a 30 percent reduction for the risk of developing a disability, when compared to subjects spending three hours a day doing light activity.

The findings were adjusted for any time spent in moderate or intense physical activity, plus additional predictors of disability. Dr. Dunlop says that “simply moving your body, even at a light intensity, may reduce disability."

This study brings to mind two points, being that I’m a personal trainer. #1) Weekend activity won’t necessarily undo weekday king-like living. I’m not talking hiking 12 miles with an elevation gain of 3,000 feet on Saturday, then squatting heavy barbells and leg pressing heavy loads for two hours on Sunday.

I’m talking about mowing the lawn, using a power drill and circular saw to shape wood, putting up bookshelves, fixing a clogged drain, washing the family car, raking leaves and other typical weekend duties that “the man of the house” usually takes charge of.

And #2) The study shows an association between reduced disability from knee osteoarthritis and amount of physical activity. But cause-and-effect was not established. Is it possible that having no knee pain gives rise to more time spent being active? This is a fair question, but we can’t assume that this explains the association for every case, either.

After all, my father was waited on hand and foot due to a traditional marriage dynamic, not because he had knee pain or disability. In fact, decades before he began developing knee pain from osteoarthritis, he was waited on hand and foot, to the extent that he barely knew how to boil water and fold a towel.

Source: http://www.sciencedaily.com/releases/2014/04/140430121116.htm

The Link Between Walking Speed and Dementia

Slow walking is associated with a certain kind of cognitive impairment, which may signal future full-blown dementia.
If you’re a slow walker, even inside your house, you may have future dementia on your hands. A new study does not look promising for slow walkers. The study involved 93 participants age 70-plus and living alone, who welcomed the installation of infrared sensors in the ceilings of their homes, which detect walking motion in hallways. One-third of the participants had MCI: mild cognitive impairment.

After three years of the non-intrusive monitoring of walking speed, researchers determined that subjects with non-memory-related MCI were actually nine times more apt to be slow walkers. Fluctuation in walking speed was also correlated with MCI.

What can this mean? Does it mean that people with early dementia or mild cognitive impairment don’t like to walk fast or even at a moderate speed? Or does it mean that decades of slow walking cause faster aging of the brain, leading to dementia?

The study’s leader, Hiroko Dodge, PhD, thinks the findings are important enough to warrant more, and larger, studies, to see if walking speed can predict dementia and cognitive problems down the road.

Research has already shown that walking speed and duration are tied to physical health. For instance, the inability of an elderly person to walk one quarter mile is correlated to mortality and bad health, says a report in the May 2006 Journal of the American Medical Association.

Researchers at the University of Pittsburgh Graduate School of Public Health found that not being able to walk 400 meters was a powerful indicator of whether a person would be alive six years later, and how much illness they’d have in the interim. This study also analyzed speed of walk.

The elderly participants who had the slowest walks, even despite completing the course, had a 3-4 times higher death risk than the fastest walkers. How much more proof does one need that slow walking is bad for body and mind?

When I used to work at a traditional job, I hated when I got stuck behind slow walkers when it was time to exit the department for lunch. Every minute of my cherished lunch break counted, and the slow walkers’ workstations were closer to the narrow-hall exit than mine was—that’s why I’d be stuck behind them when it was time for lunch.

I’m sure these then 50- and early-60-something men thought I was rude as I squeezed ahead of them. That was years ago. I wonder how many of them are alive today.


Keep Brain Young, Avoid Cognitive Decline with Chocolate

Find out what kind of chocolate, and how much, can help keep the brain young and stave off mental decline in older adults.

Once again, the power of chocolate is revealed, this time in a study involving older people and their cognitive skills and brain health.
What kind of chocolate and how much?
The study is in the August 2013 online Neurology, and says two cups of hot chocolate daily can help older people keep a young brain.

How was the study conducted?
Sixty people, average age 73, none had dementia. They drank two cups of hot chocolate daily for 30 days, and did not eat any other type of chocolate during that time.

They were tested for thinking and memory, and had ultrasounds to measure amount of blood flow to the brain during their tests.

Blood flow is connected to thinking skills, says Farzaneh A. Sorond, MD, study author. "As different areas of the brain need more energy to complete their tasks,” says Dr. Sorond, “they also need greater blood flow.” This relationship is referred to as neurovascular coupling.

Eighteen of the 60 subjects had impaired cerebral blood flow at the beginning of the study. They had an 8.3 percent improvement in this blood flow to the brain come the end of the study. However, there was no improvement in the subjects who began the study with normal blood flow to their working areas of the brain.

The improved blood flow meant improved test times for the subjects who began with impaired blood flow.

Type of Hot Chocolate
This is the part that stuns me: Half the subjects drank hot chocolate that was rich in flavanol, an antioxidant; the other half drank hot chocolate that was poor in flavanol. Yet this did not affect the study results! So something else must be going on, then, with hot cocoa consumption.

More research is needed, says Paul B. Rosenberg, MD, who wrote an editorial that accompanied the study.  "But this is an important first step that could guide future studies."


Faster Maturity in Girls than Boys May Be Brain Cell Based

Can the myth that girls mature faster than boys be supported by a brain neuron study?

According to one research team, the myth that girls mature faster than boys can be supported by a study of the brain’s neurons. Newcastle University researchers point out that a process called “pruning” occurs to brains as we grow up and into adulthood. Pruning reduces brain connections.
Dr. Marcus Kaiser et al studied people up to age 40. The ability to integrate information remains preserved, while overall neural connections get reconfigured. Kaiser and his team found that this selective process occurs earlier in females.

But can this finding alone change the mythical status of girls maturing faster than boys to factual status?

Let’s first look at this study (the full report is in the journal Cerebral Cortex; December). The 121 study participants were between four and 40 years. MRI technology showed that pruning occurred during this age period.

Long-range connections, however, don’t happen the same way. Variation occurs based on type of connections. Shortcuts that quickly connect to different processing sections of the brain (such as sound and sight) get retained. These links enable fast transfer of information and efficient processing.

Kaiser and colleagues have revealed (for the first time in research) that when the brain loses white matter fibers between regions, this is a very selective undertaking. They call it preferential detachment.

The links between distant regions of the brain, between different processing modules and between hemispheres, all lose fewer nerve fibers during maturation of the brain than what was believed to occur. This allows for stable brain function, and occurs sooner in females than in males.

If this is too technical to understand, look at it this way, says the report: The reduction of connectivity during the brain’s development “can actually help improve brain function by reorganizing  the network more efficiently.”

The simple analogy is this: Which is more efficient? #1) talking to a bunch of people in a town at random about that town’s history, or, #2) speaking to only a few people who’ve lived in that town for 50 years?

Pruning in the brain, then, helps this organ focus more, or streamline more, on essential information.

It’s okay to question that this finding alone proves that girls mature faster than boys. Especially if you’ve ever attended an all-girls high school, like I did for grades 9 and 10.

It’s fair to wonder how many women, who went to an all-girls high school, believe that girls mature faster than boys. The concept of maturity needs to be defined.

The girls at my high school were vicious in spirit, though fistfights or other physical altercations were absent. The verbiage spewing from their mouths was as forceful as any punch thrown by a boy.

But it wasn’t just the “mean girls” thing. The level of childish behavior was astounding. For example, one day in English class, a bee flew into the room. Several of the girls were literally scrambling around the room shrieking as though being chased by someone with a knife. One even climbed up on a chair.

How many adults, and teenagers, can picture teen boys behaving this way? When I was in junior high, too, a bee flew into homeroom. All the girls (except me; no joke) fled in fear, congregating into the hallway, while the boys remained cool and calm as though a mere ant had entered the homeroom.

What really is a sign of maturity vs. immaturity? Is it the propensity to cry? Is it how one reacts to a bee or spider? Is it how viciously someone spreads gossip or treats a classmate?

Is it determined by how well a teenager babysits an infant, or whether or not a teen can fix a broken chain on a bicycle in the rain without having a meltdown? Whom would you rather be trapped in a burning elevator with: a teen boy or a teen girl? Assume physical strength isn’t required for escaping. Whom would it be?

The idea that girls mature faster than boys is a very subjective idea, at best. Some of the most mature people I’ve ever known were boys and young men, and I truly must admit, that the most childish, immature people I’ve ever met were girls and young women (college and beyond!).

So though the Kaiser study is compelling, let’s not allow “pruning” to propagate any reverse-chauvinistic statements.


Do Aging People with Down Syndrome Always Get Alzheimer’s?

Finally, there is hope for those with Down syndrome when it comes to the apparently inevitable Alzheimer’s disease.

Though the Cleveland Clinic web site states, “All people with Down syndrome develop Alzheimer’s disease,” this apparently isn’t the case according to Dr. Sharon J. Krinsky-McHale, a research scientist at the New York State Institute for Basic Research in Developmental Disabilities. She’s the leader of a study focusing on a 70-year-old man, “Mr. C,” who has Down syndrome – yet absolutely no sign of Alzheimer’s disease.

The Cleveland Clinic web site says that Alzheimer’s disease symptoms often begin showing when those with Down syndrome are in their mid-40s to early 50s. I might add that when I had a part-time job working with mentally retarded adults, one of the women had Down syndrome; she was in her early 50s and had absolutely no sign of Alzheimer’s disease.

The New York State Institute has been following Mr. C for 16 years. The average life expectancy for those with DS is the late 50s. The Institute says that for people with typical Down syndrome over age 65, Alzheimer’s disease is practically a guarantee.

The researchers have no idea why Mr. C has not developed dementia. "Mr. C paints an optimistic picture for people with Down syndrome who are aging, and says that an ordinary person with Down syndrome ought to be able to make it to 70, once you find 'Mr. C's secret," explains Dr. Krinsky-McHale.

What is “typical” Down syndrome? The patient has a third copy of chromosome 21 in every cell. However, in non-typical DS, also known as mosaic, this triplicate of chromosome 21 is not present in all the cells, but only in some of the cells. In people age 75-plus with the genetic disorder, usually they have this mosaic pattern.

Mr. C does not have this; he has typical DS. Because the triplicate is not present in every cell in the mosaic version, the patient is less affected healthwise. Mr. C’s case is the first ever to be recorded in science literature.

The researchers speculate that Mr. C may not have the typical overproduction of proteins that other typical DS patients have, but thus far, they have been unable to nail the mechanism of this mystery.



Best Treatment for Fighting off Alzheimer’s Disease

Here’s the latest discovery in a most effective treatment for warding off  Alzheimer’s disease in at-risk older adults.

The latest research shows what kind of treatment can go a long way in fighting against the development of Alzheimer’s disease in older adults who are at risk for this incurable disorder.

It’s exercise. This doesn’t surprise me, a personal trainer. More and more studies are piling up (e.g., Gow et al, Nigam et al) pointing to the indisputable benefits that different kinds of exercise have on the brain.

The latest research (led by Dr. J. Carson Smith) comes from the University of Maryland School of Public Health. The conclusion is that exercise has benefits to cognitive skills in older adults at risk for Alzheimer’s disease (and of course, to those apparently not at risk).

Some older people get MCI: mild cognitive impairment, which is more than just the typical memory loss associated with an aging brain. Those with MCI are at greater risk for Alzheimer’s.

In Dr. Smith’s study, exercise was shown (via functional neuroimaging) to improve memory recall and brain function in those with MCI.

The elderly subjects did moderate exercise (supervised by a personal trainer) for 12 weeks. “…Participants improved their neural efficiency,” says Dr. Smith, “basically they were using fewer neural resources to perform the same memory task."

Dr. Smith notes that no study has ever shown that a drug can beat out exercise at improving brain function.

Type of Exercise Done by the Elderly Participants
There were two groups of sedentary people 60 to 88. One group had MCI and the other had normal brain function. The exercise program involved treadmill walking.

Not surprisingly, cardiovascular health improved. However, both groups had improved memory skills and enhanced neural efficiency while performing memory tasks.

The exercise intensity was moderate, meaning, enough to elevate heart rate and induce a sweat, but comfortable enough to allow conversation.

Brain Scans Before and After the Exercise Course
Images and tests were taken before and after the 12-week exercise program and showed remarkable changes in brain activity during memory tasks.

In fact, the brain regions that experienced improved efficiency corresponded to the same regions involved in Alzheimer’s pathology. These include the temporal lobe, precuneus region and the parahippocampal gyrus.

"People with mild cognitive impairment are on a very sharp decline in their memory function,” explains Dr. Smith, “so being able to improve their recall is a very big step in the right direction.”

What’s next?
Dr. Smith plans on conducting a bigger study with more participants, including healthy people who have a genetic risk for Alzheimer’s disease.


Spinal Anesthesia: Prevent Lethal Complication with Magnets

Spinal anesthesia in general is safe, but a rare complication that affects the heart can be fatal.

The complication of high spinal block occurs in about 0.6 per 1,000 cases of patients under spinal anesthesia. This happens when the injected anesthetics migrate too high up the spinal cord, disrupting the cord’s fibers that control heart function. Heart rate and blood pressure drop sharply, placing the patient at risk for cardiac arrest.

Magnets can prevent high spinal block, says a report in Anesthesia & Analgesia (June 2012).
Preliminary studies were conducted by Dr. Robert H. Thiele of University of Virginia Health Sciences Center, Charlottesville.

Without the magnets, high spinal block can actually be prevented by managing the dose of anesthesia and by positioning patients to allow gravity to distribute the anesthetic to lower portions of the spinal cord.

"However, in certain instances, gravitational forces alone may not be sufficient to control block height," states the report.

The researchers used magnetized anesthetic fluid and a feeble magnetic field to control spread of the fluids. They created a simple spine model by using fluid-filled plastic tubing. Next they prepared a solution of local anesthetic with or without the addition of water-based ferrofluid to magnetize the fluid. This model permitted both fluids to run downward via gravity.

However, placing a magnet outside the tubing, below the level of the needle, halted the downward flow of the magnetized fluid. Moving the magnet resulted in the fluid moving “uphill,” against gravity.

Dr. Thiele and his colleagues believe that this technique can be carried over to the human body, using a magnetized local anesthetic solution with exterior magnets; this would help control spread of spinal anesthesia during surgery. This would be a simple yet effective safeguard against the high spinal block complication.

However, more research is warranted, including an investigation into how safe the magnetic fluid (ferrofluid) actually is. There are also other issues to consider, such as quality of the anesthesia, and how practical it is to apply a magnetic field in an operating room.

Source: http://www.sciencedaily.com/releases/2012/06/120601120510.htm

New Pain After Epidural Steroid Injection: Cause, Solution

Perhaps you’ve had an epidural steroid injection for a herniated disc which solved the sciatica pain, but now you have a new kind of discomfort.

Have you recently had an epidural steroid injection to relieve the pain of a herniated disc (lumbar), and even though the shot worked for the original discomfort, you now have a new kind of pain?

This happened to my mother. The doctor said that the new “soreness,” as my mother initially described it as, was the result of the injection itself and that it would be temporary. The original pain of her herniated disc was in her buttocks and the back of her upper leg (sciatic nerve).

After the epidural steroid injection, my mother reported that the sciatica problem was gone, but there was a new pain that had not been there prior to the procedure. The “soreness” didn’t seem to be going away as days went on, either.

It was bad enough to dampen her spirits, take painkillers and use cold packs. For almost two weeks this new pain persisted, and finally, my mother was prescribed gabapentin, also known as Neurontin, a drug for nerve pain.

However, her primary care doctor, as well as the doctor who had performed the epidural steroid injection, did not diagnose this new discomfort as being related to the sciatic or any other nerve.

The day of the epidural steroid injection, the doctor did mention that there’d be post-procedural discomfort caused by the volume of the injected medication within the confined space of my mother’s spinal canal.

As the medication “finds its way around,” explained the doctor, it would produce pain, and this would be normal, he added.

Well, how long was it supposed to take for the drug to find its way around and work its way through the region?

My mother was at first reluctant to try the Neurontin after finding out what the potential side effects were. On the other hand, every medication she’s ever been prescribed had a litany of potential side effects that were unnerving to read through.

Several days after getting the prescription, she decided to try the Neurontin, and it worked like a charm; the new pain vanished and she’s back to normal.

How Soon Epidural Steroid Injection Works in Elderly

This article is about how soon in an elderly patient an epidural steroid injection may take to work.

An epidural steroid injection is a common treatment for a lumbar herniated disc, says spine-health.com. My mother is elderly and was diagnosed with a low back herniated disc not too long ago (L5-S1).

After she had received the epidural steroid injection, I asked the doctor, “How long does this usually take to start working?”

He said that the time it takes for an epidural steroid shot to start working varies from patient to patient, and in some patients, it may start working very soon, while in others it may take “up to a few weeks.”

He didn’t make any distinction, however, in terms of elderly age vs. younger age in a patient. It’s also important to note that a herniated disc is not necessarily an “old person’s disease.” A relative of mine has had two epidural steroid shots thus far, and she’s only 22. I have another relative who had his first epidural steroid injection recently at the age of 56.

My elderly mother was in more pain after the epidural steroid injection than she was prior to the procedure. The doctor explained that this was because of the compressing effect of the drug in such a narrow space, that it was a matter of “volume.”

The amount of room for the medication was tight, limited, and so the drug was literally pressing against the tissue. This, he said, was temporary. My mother had walked into the procedure room without assistance, yet had to be wheeled out, all the way to the car where I was waiting.

In addition to pain from the medication filling up a limited amount of space in her spinal column, there was also some soreness from the actual injection. All day long my mother convalesced.

The next morning, the sciatica pain was gone. She was walking around as though nothing had ever been wrong, and reported that the only issue was soreness in her buttocks at the site of the injection.

So in my elderly mother’s case, an epidural steroid injection for a herniated disc took less than 24 hours to begin working.

Source: spine-health.com/treatment/injections/lumbar-epidural-steroid-injections-low-back-pain-and-sciatica