Carone Chiropractic Center

Since 1969, when Gatorade officially hit the U.S. market, the sports drink industry has been soaring. Stop by any field or gym on any given day and you’ll undoubtedly see participants in various sports using these products. But are sports drinks your best option when it comes to recovery during and following intense exercise?

Not necessarily, suggests a study in the European Journal of Clinical Nutrition. The review study analyzed the results of 12 previous studies in which researchers compared how chocolate milk – yes, chocolate milk – influenced exercise recovery compared to a sports drink or a placebo drink (one without any recovery benefits). In the studies reviewed, participants (athletes) performed exercise tests such as running or cycling, and researchers evaluated various markers to determine how each of the beverages impacted recovery.

Overall, chocolate milk appeared to lengthen the time it took athletes to reach exhaustion and improved other exercise recovery markers equal to sports drinks, and in some cases, proved superior to sports drinks. In fact, while the researchers caution more studies are necessary, they conclude: “[Chocolate milk] provides either similar or superior results when compared to placebo or other recovery drinks.”

So, what could account for chocolate milk’s recovery potential? Simple: It contains carbohydrates, protein and fat, plus water and electrolytes – all of which are required during exercise, particularly prolonged and/or intense exercise, to maintain energy, prevent dehydration and help muscles recover. Look for a chocolate milk brand that minimizes added sugars – after all, a chocolate milk shake probably won’t help athletic performance or recovery nearly as well! Talk to your doctor to learn more.

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How to Avoid Surgery and Stay in the Game

The growth of organized amateur sports over the past 30 years has spawned an unexpected and unwanted increase in sports-related injuries. Many young athletes suffer sports-related injuries that can turn into lifelong problems. Here are some basic facts about knee injuries and how they are handled in the world of modern medicine. I am not passing judgment – just pointing out some facts.

The American Academy of Orthopedic Surgeons reported that in 2003, 9.5 million people visited orthopedic surgeons because of knee problems. By now, this staggering number is probably even higher, considering a greater number of children and adults are participating in athletics every year. The most common recommendation regarding knee injuries is to avoid the activities that take place when the knee is injured, such as activities that require stopping and starting or quickly changing directions. It is thought that these extreme forces on the knee can result in torn ligaments; however, they don’t result in torn ligaments in everyone, which means there could be some pre-existing contributing factors.

To learn why our knees are injured so frequently, it’s important to know how the knee works. The knee joint is composed of four bones: the femur, the tibia, the fibula and the patella (see image on facing page). Cartilage covers the joint and provides a smooth, lubricated gliding surface so the knee can move. The shape of the knee joint is stable, but to function properly, the ligaments have to be in good shape, too! Those ligaments include the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the medial collateral ligament (MCL) and the lateral collateral ligament (LCL).

While the ACL works as the main stabilizer when the knee is bent, the PCL works as the main stabilizer when the knee is extended. The collateral ligaments are used when you move side to side. The medial and lateral menisci are located within the joint and act as “shock absorbers” and also influence knee stability. The most commonly injured parts of the knee are the ACL and the medial meniscus. Tears of the meniscus usually take place during twisting, pivoting, or decelerating movements, or as a result of direct impact.

When you look for information regarding treatment of knee injuries, you will see two basic categories of medical care: surgical and nonsurgical. Surgical intervention has certainly improved over the past 20 years and typically involves arthroscopic surgery for severely sprained or ruptured ligaments or torn cartilage. The new procedures are far less invasive than techniques used many years ago, resulting in less scar tissue and faster recovery time. Nonsurgical intervention typically involves improving the stability of the knee joint with rehabilitative exercises, focusing on the quadriceps (thigh) muscles and the hamstrings. Bracing is also a common practice to enhance stability by limiting motion in the knee joint.

To summarize, the way knee injuries are handled in today’s world is to stop doing things that tear ligaments, like running, jumping, twisting and stopping quickly. If you do want to continue doing those things, the common recommendation is to get surgery or do rehab and put on a brace to limit motion in the joint. The resulting lack of motion will likely cause degenerative arthritis over the next 20-40 years, which will result in the need for a knee joint replacement.

OK, so where’s the good news? Simply put, a chiropractor has the ability to do a better job than that! Their knowledge of the foot, knee, hip and spine connection, combined with practical experience, affords an alternative to the “shoot the dice and hope for the best” theory. The first thing to understand is that healthy knee function is not possible without healthy foot function. The medical model of health care does not take that into consideration because the foot rarely presents itself as being painful. Even if the foot does hurt, treatment only takes care of the symptom and does not address abnormal joint function.

A vast majority of people, young and old, excessively pronate. This means that when the foot hits the ground, it flattens out or unlocks, rolling inward and creating a twisting stress up the leg and into the knee. These twisting stresses do three things to the knees: stretch the ACL, stretch and twist the medial meniscus, and inhibit contraction of the quadriceps muscle.

Every time we take a step, jump, pivot, stop quickly and run, those three things take place. A torn knee ligament is not a one-injury event; it is a multiple micro-injury event. These abnormal forces take place perhaps thousands of times, creating microtrauma to the support structures of the lower leg until the ligament fails catastrophically.

If thigh muscle weakness is one of the results of excessive pronation, doesn’t it make sense that the muscle loses its tone to a point that it can no longer stabilize the joint efficiently? Remember, muscle is the primary stabilizer; ligaments are secondary. If you weaken the muscle and traumatize the ligament a few thousand times, you have all the ingredients for the classic knee injury.

Common sense tells us to prevent the excessive damaging motions by supporting the foundational structures (your feet) so they function within the functional range of motion.  Many chiropractors now evaluate the quality of the arches of the feet. If the arches aren’t supporting the legs and pelvis sufficiently, it can create stresses that lead to injury or joint wear and tear. It’s just like the foundation of your house; if it settles too much, it creates stress in other parts of the structure. 

Take a proactive step to avoiding injuries and preserving the health of your knees, hips and spine. After all, you know what they say about “an ounce of prevention.” Ask your doctor for a thorough foot evaluation, particularly if you’re experiencing knee pain or participate in activities that put you at risk for a knee injury.

By Brian Jensen, DC

While nonsteroidal anti-inflammatory medications (NSAIDs) have been widely and successfully used to ease back and joint pain and injuries, it is important to be aware of potential drawbacks, including greater risks of serious cardiovascular, gastrointestinal and kidney problems.

Some estimates suggest that each year, more than 100,000 patients are hospitalized for NSAID-related GI complications alone and 16,500 people die annually from these complications.¹

NSAID use is also associated with costly adverse events impacting the CV and renal systems. For example, NSAID use has been associated with increased risk for hospitalization due to myocardial infarction and heart failure. Likewise, acute renal failure, also associated with NSAID use, can ultimately lead to expensive dialysis treatment.¹ Studies have also shown ibuprofen alters human testicular physiology to produce a state of compensated hypogonadism² and low testosterone, one of the leading causes of male erectile dysfunction.

Risks and complications are typically greater for those taking the medications for a long period. The FDA recommends that people taking an NSAID for more than 10 days see a doctor, and that NSAIDs be used in the smallest effective dose for the shortest possible time.³

As many people are not aware of the downside of NSAIDS, and abuse is so common, it is important to be informed of the multiple risks and dangers, as well as the multiple natural alternatives, a few of which are briefly presented below. Be sure to talk to your doctor for more information.

Optimal EPA / DHA Status

Perhaps the most familiar supplemental approach to reducing a generalized pro-inflammatory state is to cut hydrogenated “fake fats” from the diet, limiting overconsumption of omega-6 fats and increasing omega-3 fatty acid intake, especially EPA and DHA from fish. EPA and DHA are converted by the body into powerful anti-inflammatory chemicals called resolvins which block inflammatory cytokines and prostaglandins.

Fish oil provides a variety of benefits when supplemented, particularly when the ratio of omega-3 and omega-6 fatty acids in the body is almost equal (1:1). The average diet (red meat, eggs, salad oils, chips and baked goods) is high in omega-6 fatty acids, which is why fish oil is recommended (to balance the ratio).

Fish oil supplements at normal doses are safe, but more than 3,000 mg (3 grams of EPA / DHA combined) a day increases bleeding risk. Also avoid taking with blood thinners such as warfarin (Coumadin). However, doses up to 6 grams a day are used in chronic inflammatory conditions or short term to rapidly garner a one-to-one (1:1) ratio in cell membranes and subsequent clinical response.⁴

It should be noted that some people will have difficulty digesting such large doses of fish oil. (In my practice, this is usually related to liver / gallbladder problems.) Emulsified fish oils allow for easy digestion. (Indeed, for patients without a gallbladder, I always use an emulsified, good-tasting, naturally flavored omega-3 oil.) Many people also find swallowing many large pills daily difficult, which is naturally associated with poor compliance.

Astaxanthin (ASTX)

Another nutrient found in some omega-3 rich fatty, deep cold-water fish like salmon is pertinent to this discussion. It is the phytonutrient salmon ingest in their diet that makes salmon pink: astaxanthin (ASTX), a marine algae. Astaxanthin has been shown in humans to significantly lower important inflammatory and metabolic disease measures. A multitude of published ASTX studies suggest it is also effective in the treatment of OA.⁵

Tumeric Curcumioids

Of course, there are plant-based phytonutrients that also have powerful anti-inflammatory effects. Perhaps the most popular right now is turmeric.

Tumeric is a spice that comes from the root Curcuma longa, a member of the ginger family, Zingaberaceae. In Ayurveda (Indian traditional medicine), tumeric has been used for its medicinal properties for various indications and through different routes of administration, including topically, orally and by inhalation.

Curcuminoids are the most active components of tumeric; according to PubMed, curcumin has been demonstrated to be safe in six human trials and has demonstrated anti-inflammatory activity. It may exert its anti-inflammatory activity by inhibition of a number of different molecules that play a role in inflammation.⁶ Dosages from 1,250 to 2,500 mg a day were deemed safe.⁶

Tumeric is fat soluble and poorly absorbed. However, there are products that provide solutions to improve increased bioavailability. It is best taken with a meal with fat. (In my clinic, I have patients take turmeric containing products with an emulsified fish oil if I have recommended both.)

Ginger Rhizome

Ginger, the “root” or rhizome of the plant Zingiber officinale, has been a popular spice and herbal medicine for thousands of years. It has a long history of use in Asian, Indian, and Arabic herbal traditions. According to the University of Maryland Medical Center website, traditional medicine has used ginger for centuries to reduce inflammation.⁷

They cite evidence that ginger may help reduce pain from osteoarthritis (OA). In a study of 261 people with OA of the knee, those who took a ginger extract twice daily had less pain and needed fewer pain-killing medications than those who received placebo.⁸

Boswellia Serrata Extract (BSE)

The resin of the Boswellia species has been used as incense in religious and cultural ceremonies, and in medicines since time immemorial. Gum-resin extracts of Boswellia serrata have been traditionally used in folk medicine for centuries to treat various chronic inflammatory diseases.⁹

In a study of the potential effectiveness of BSE on rheumatoid arthritis (RA), researchers concluded that BSE was effective in bringing significant changes on all the (enzymatic) parameters studied.¹⁰

Oral administration of BSE resulted in significantly reduced levels of inflammatory mediators.¹⁰ The protective effects of BSE against RA were also evident from the decrease in arthritis scoring and bone histology. “The abilities to inhibit proinflammatory cytokines and modulation of antioxidant status suggest … the protective effect of Boswellia serrata extract on arthritis,”¹⁰

Key Points to Discuss With Your Doctor

The above research suggests a combination of large, adequate dosages of EPA / DHA along with oral ingestion and/or topical cream application of these herbs, combined with the “hands-on” care provided by your chiropractor, may offer relief equal to or greater than oft-abused NSAIDs – without nearly the potential for serious side effects, not to mention the many other significant health benefits these nutrients and phytonutrients provide beyond the scope of this article.

By John Maher, DC, DCBCN, BCIM

Gravity-(noun) the force of attraction by which terrestrial bodies tend to fall toward the center of the earth.

This textbook dictionary definition eloquently explains what falling means. Gravity is constantly pulling us towards the ground with profound effect on posture and overall health. Throw the likelihood of traumatic falls and you have unlimited potential to cause bodily harm. It’s safe to assume that each of us will experience some type of fall in our lifetime. Every fall impacts body function, movement, mechanics, and efficiency. Even a minimal fall transfers energy from the ground through the body potentially causing severe injury. Energy is never lost or gained, it is simply transferred. If a body’s ability to absorb that energy is compromised dysfunction, pain, and injury will occur.

Different types of falls injure the body in distinct ways. Once you understand the mechanism behind a fall you can predict what areas of the body will typically be prone to pain. Forward falls onto an outstretched hand can cause injury to your wrist, elbow, and shoulder. However, the impact force travels up the arm and exits in the cervical spine (neck) and thoracic spine (upper back) similar to a whiplash type injury. Residual delayed symptoms may appear, which include headaches, neck pain, muscle spasm, tingling or numbness in the arm, and pain between the shoulder blades. Backward falls on the buttocks cause trauma to the spine, pelvis, hips, and head. Concussions are extremely common in backward types of falls due to the sudden whipping motion of the head. The tailbone portion of the spine is often bruised or fractured from impact velocity of the backwards fall. The energy transfer through the spine exits at the top of the head leading many people to complain of severe headaches and neck pain. Severe symptoms might not appear for several days or weeks following the fall. Falls from a height landing on the feet may injure the ankles, knees, hips, pelvis, and spine. Hairline fractures are often a side effect of foot landing falls, particularly in the shin bone and pelvis. Lower back pain is the most common spinal complaint after a foot landing fall due to the compressive forces of the impact.

All falls cause mechanical and functional damage to the body leading to inefficient movement and compensations. These neurological compensations are part of your nervous systems hardwired survival mechanism to avoid pain at all cost by taking the path of least resistance. This mechanism involves adaptation of muscles, connective tissue (fascia), bones, joints, ligaments, and nerves. Postural changes are ingrained in your movement patterns to protect and guard you from future injury. Common chronic side effects from traumatic falls include; arthritis, muscle spasm and tightness, soreness, spinal disc degeneration, disc herniations, and visual postural distortions. You may notice one shoulder becomes higher than another, rounded shoulders, neck far out over the shoulders, hips become tight and you walk with a foot flare. These dysfunctional movement patterns manifest into pain and injury years after the trauma. Everything in your health history contributes to the possibility of future injury. Even that fall you had off the swing on the playground when you were a kid. Everything is connected and everything matters.

So what can and should you do after a fall to help minimize injury? First and foremost is to determine the seriousness of the injury. If severe headaches, dizziness, nausea, slurred speech or sleepiness are present immediately seek emergency medical attention for these are common sign of a concussion (impact injury to the brain). Anticipate the onset of symptoms in the next several days following a fall. For swelling, inflammation, and muscle spasm apply ice for the first 72 hours. Heat is best used for chronic injuries and over muscles. Ice tends to be a more effective alternative for joint related pain to reduce swelling. A warm sitz bath is a very effective conservative treatment for post fall related soreness. Consult your primary care health provider if symptoms do not show improvement or worsen after 72-hours. Pain is the warning signal from your body that something is wrong. Do not ignore the pain message and hope things resolve without professional intervention. It is essential to visit a skilled clinician in manual therapy such as a chiropractor to ensure proper alignment of the spine and joint systems of the body. A doctor of chiropractic is an expert in assessment and treatment of acute and chronic musculoskeletal injuries with programs of preventive medicine. They will do a complete evaluation including x-rays to rule out severe trauma to the body and diagnose any underlying problems that may manifest in the future. Chiropractors will work in conjunction with your primary healthcare provider to ensure you receive the most effective care program for your type of injury. Once pain symptoms have improved your chiropractor will put you on a corrective exercise program involving strengthening and stretching for balance. This will train your body with proprioception (balance) to help improve your chances of catching yourself before falling in the future.

Never underestimate the long term deleterious effects of any fall. Every fall leaves its mark on your body. Play it safe and assume the fall had a negative impact on your health. Be proactive and take steps to ensure you have the maximum chance of full recovery. Little things mean a lot when it comes to your health. Make sure to speak to your chiropractor about effective ways to deal with falls that may occur.

By Perry Nickelston, DC, FMS, SFMA

We’re thick in an era of sports specialization, and it’s working its way all the way down to the grade-school level. Increasingly, children are specializing in single sports, with parents doing everything in their power to ensure Little Johnny becomes the next Lebron James, Peyton Manning or Landon Donovan.

But at what cost? In terms of their chances of reaching the elite level, research suggests focusing on only one sport too early may not lead to success.

A U.S. Olympic Committee (USOC) report based on a survey of nearly 2,000 Olympic athletes reveals that “multi-sport athleticism” is important, valuable not only to coaches, but also a common characteristic of most Olympians surveyed. In fact, according to the survey, most Olympians did not specialize in their sport until their teens, with many continuing to play multiple sports even after focusing on one sport as the priority.

It’s also important to understand that anyone, be it a child or an adult, has a higher risk of burnout / disenchantment with a sport if that’s the only thing they’re doing – every day, every week, all year round. Pushing too hard toward a single sport, especially too soon, could push your children away, rather than grow their love of the game. The USOC survey supports this premise, with love of the sport listed frequently by athletes.

You may want your child to be the next great soccer player, but as this survey suggests, they might have a better chance if soccer’s not the all-consuming, be-all, end-all of your child’s existence. So teach them to love being active and to dedicate themselves to excellence; those are the traits that will bring them success in whichever sport they eventually choose.

For those of us who are always on the run, finding time to exercise can be a challenge. While work, school and day-to-day stresses are a part of life, it can be tough to climb out of bed early and hit the gym; or prioritize an evening yoga class after a long day.

I often hear patients in my integrative medicine clinic complain about being too tired to work out or unable to squeeze gym time into their hectic schedules.

I always remind my patients that exercise doesn’t just happen in a gym, nor does it require the “right” workout clothes or shoes. Exercise can take place at any time of the day, as long as you’re open to changing up your regular routine and getting creative with it. Even a few extra minutes of movement per day promotes blood flow and will affect your energy levels and mood. Here are five tips on incorporating daily movement into your life in ways that are both practical and enjoyable.

1. Shake It Out: The next time you’re watching TV, challenge yourself to do jumping jacks during a commercial break. Mute your TV and put on your favorite music, do as many push-ups or sit-ups as you can, dance around, or even just jump in place. Worry less about doing the moves wrong and more on enjoying yourself. There is no wrong way to move!

2. Count Your Steps: Try taking the stairs instead of riding the elevator when you get the chance, especially if you’re only going up or down a few floors. If you work in a building with many floors, hop off the elevator a few floors before your own and walk the rest of the way up/down.

3. Stop and Smell the Roses: Instead of driving somewhere to grab lunch, go green and walk to a nearby café or restaurant. If you bring your lunch with you, don’t settle for sitting inside a cafeteria – briskly walk to the nearest park or green space and enjoy your lunch outdoors. Not only will you get your daily requirement of vitamin D, but you’ll also have the energy to power through the rest of your workday.

4. Change Your Pace: If you’re the type who circles around the shopping mall looking for the closest parking spot, switch up your routine and get in the habit of parking far away. Not only will you find a spot with ease, but you’ll also get a workout, particularly if you’re toting shopping bags.

5. Back to Basics: If getting to the gym is deterring you from working out, remember exercise is literally around the corner. Whether you live in the middle of the city or out in the suburbs, taking a stroll around the block only requires you to put shoes on and walk out the door. Put on your favorite playlist or podcast and set a timer if you’re short on time, and remember: You can be active anywhere as long as you prioritize it in your daily schedule.

By Julie T. Chen, MD

An important collection of papers published in research journal The Lancet highlight the global impact of low back pain, the ineffectiveness of current medical treatments, and the value of spinal manipulation and other nondrug options before turning to medication is receiving substantial media attention.

One of the brightest spotlights: a “Health Alert” segment on a recent episode of “Good Morning America” titled “New Research on Lower Back Pain: Are Millions of People Getting Ineffective Treatment?”

“GMA” anchor Robin Roberts opened the segment with this statement to the show’s estimated 4.5 million viewers regarding lower back pain: “As many as 540 million people suffer from it. According to new research, many treatments, [including surgery and pain medication] … could be all wrong.”

She then introduced Dr. Jennifer Ashton, chief health and medical editor for the show. Dr. Ashton, who described the papers as the “magnum opus on low back pain” and The Lancet as “very reputable,” said the material “[draws] attention to the massive gap between evidence-based medicine and what’s really going on” when it comes to the treatment of back pain.

According to Dr. Ashton, reporting on the papers, back pain is a “massive global public health burden.” First-line treatments include staying active (“the worst thing you can do is get in bed”) and education: learning “what works and doesn’t from reputable sources.” Second-line treatment options (Dr. Ashton urged viewers, “This is really what I want people to pay attention to”) include superficial heat, spinal manipulation, massage and acupuncture. [Italics ours]

Dr. Ashton added that NSAID medication (nonsteroidal anti-inflammatory drugs, commonly available as over-the-counter pain meds such as Advil, Aleve, etc.) is also considered a second-line treatment according to The Lancet papers, but should be utilized “only if the other things are not working.”

The Lancet content on lower back pain, published online on March 21, features two “series” papers, a “viewpoint” and a “comment,” all of which are available in full-text format free of charge on the journal’s website:

• “What Low Back Pain Is and Why We Need to Pay Attention” (Series 1) (Hartvigsen J., et al.)
• “Prevention and Treatment of Low Back Pain: Evidence, Challenges and Promising Directions” (Series 2) (Foster N.E., et al.)
• “Low Back Pain: A Call for Action” (Viewpoint) (Buchbinder R., et al.)
• “Low Back Pain: A Major Global Challenge” (Comment) (Clark S., et al.)

Contrary to what you may read in your Facebook feed or junk email box, there’s no “magic pill” when it comes to fitness. Instead, following these simple, basic principles can help you reach and maintain your fitness goals.

1. Eat Food. Skip the bars, meal-replacement shakes, sugar substitutes and low-fat peanut butter – REAL food, which comes from the trees, the soil, the farm and the sea, and hasn’t been messed with in a lab, is all your body needs to reach and maintain a healthy size. Opt for meals and snacks with a good balance of vegetables, protein, fat and complex carbohydrates, and let others get stuck in the dieting loop.

2. Move Every Day. Our bodies do best with consistency, so moving (even a little) every day is more beneficial than 1-2 big workout sessions a week. Walk on your lunch break, clean your own house, bike to dinner, do yoga in the living room, hire a trainer, plant a garden. It only takes 15 minutes to alter your brain for the better and improve your circulation, so get moving!

3. Stretch. Stretching is essential because it not only affects our ability to get stronger, it also improves circulation and decreases pain and injury. Think of it as the reward after a full day at work, a tough workout, or a long car ride. Plus, it’s a good time to take deep, replenishing breaths, which help energize and de-stress you.

4. Play. It’s no secret that stress wreaks havoc on our health, and recreation is an excellent way to combat the effects. Take the kids to the park and toss a ball around, go dancing, learn how to surf or ski, strap on some roller skates! Do something that gives you joy, and you’ll not only release essential endorphins in your blood stream, but you’ll feel so much better that you’ll be more likely to do it again and again. (see #2)

5. Un-plug. Living in a world of smart phones and tablets can be convenient and entertaining, but your brain and body need to un-plug. Regularly trading in your electronics and television for outdoor activities can significantly improve your mood and make you more inclined to embrace habits that benefit your health. Simply put, when we feel better, we are less likely to turn to the “comfort” foods and inactivity that keep us from reaching our fitness goals.

By Emily Duval Ledger

Are you coming up with reasons not to exercise? The number-one reason I hear from people for why they don’t exercise is, “I don’t have time.” Really! I know everyone is busy, but all it takes is being flexible and having a bit of determination. Studies show that a little bit of exercise every day – even 10 minutes – helps. I ask my clients for 30 minutes a day, but if that seems too daunting to begin with, start with less. Don’t get stuck feeling that you must take the “all or nothing” approach. Aim to exercise two to three times a week, and add more sessions as you find ways to fit them in.

I consistently exercise in the morning, but I understand that for many people, mornings are hectic and trying to squeeze a workout in is impossible. Research actually shows there are benefits to working out at any time of the day, even if it’s half an hour before bedtime.

Key Principles

I love putting together a series of exercises into a workout known as circuit training. Circuit training is doing a number of exercises back to back (short exercise bursts with intensity), including a short recovery or break between exercises. I can add in cardio exercise such as running in place, jumping rope, or using equipment such as a treadmill, elliptical or stair-stepper.

I am going to teach you how to put together a combination of exercises in a circuit format. It’s a great technique to focus on strength and cardiovascular training and sculpt your own body. You can experiment with a large variety of exercises and equipment at whatever intensity you choose. You compete only with yourself, and you don’t have to be in sync with others.

Circuits can include exercise with one or both feet on the ground, your own body weight, stability balls, rocker boards, and various resistance devices like bands, free weights, kettlebells, machines or cables. You can isolate muscles or perform multi-joint / multi-muscle exercises that involve the whole body; and all the while the circuit is cardio-inspired because of the moves. A well-rounded exercise program should include flexibility training, strength training, endurance training, balance training, trunk (core) stabilization exercises and speed training. You should easily be able to modify the intensity and complexity of the circuit.

A cardio-resistance class is probably offered at your gym or fitness center. They put together a multi-station circuit for about 5-25+ people. Usually the total amount of circuit time can be 50-60 minutes, which allows participants to complete the circuit three times.

Design Your Own Program

If you don’t have access to a gym or don’t have time to go to the gym, I want you to create your own circuit at home. All you’ll need is an exercise mat, a pair of free weights or a kettlebell, a step platform (a chair or bench works, too), a stability ball, a medicine ball (2-5 pounds) and a pull-up bar. There are even online circuit clocks that act like an instructor, letting you know when to start and finish each exercise station. Put on your favorite music and start working out.

I usually allow 30 seconds for each exercise, and I choreograph my program ahead of time. It is important to start your circuit with a full-body, dynamic-movement warm-up. This prepares the muscles and joints for the forces and mechanics of the exercises ahead. Give yourself a full 10-minute warm-up and if that is all the time you have to exercise that day, that’s OK! If you can keep going, anywhere from 25-50 minutes after warming up, you’ll get a fantastic workout.

Here’s the basic concept:

• Perform a designated exercise for a predetermined time (usually 30 seconds) and, when prompted by the clock, move to the next exercise.
• Give yourself 15-30 seconds to set up for the next exercise.
• Pick about 10-12 exercises ahead of time, alternating between strength and cardio. For all strength exercises, you should be able to complete a minimum of 12 repetitions, but since the stations are time-based, keep going until signaled to end. For cardio exercises, keep moving for the allotted time. You can change the length at each exercise station and make it last anywhere from 30 seconds to one-and-a-half minutes; just keep the prep and recovery time the same (about 30 seconds).

A Sample 10-Station Circuit

Station 1: Strength. Equipment: balance trainer (ball) or balance pad (several varieties are available). Position: on all fours, right knee on ball, left knee and both hands on floor. Exercise Description: Lift and extend the right arm and left leg. Perform flexion and extension for 12 reps or until prompted by the clock to change sides. Repeat entire sequence on opposite side. (This exercise is good for the back.)

Station 2: Cardio. Equipment: step platform. Position: standing, facing the platform. Exercise Description: Squat-jump onto platform, then step down (alternate lead leg down; modify squat-jump as needed). Let arms assist by moving upward during jump.

Station 3: Strength. Equipment: stability ball. Position: kneeling, hands and forearms on stability ball. Exercise Description: Perform a forward roll-out, engaging the torso and lowering buttocks to create plank position from shoulders to knees. Roll back to start; perform 12 reps or until time is up. (Good exercise for the abdominals.)

Station 4: Cardio. Equipment: jump rope (if you don’t have a rope, imagine you are using one). Position: standing. Exercise Description: Perform movements with legs and arms.

Station 5: Strength. Equipment: chin-up bar. Position: hanging from the bar. Exercise Description: Perform pull-ups. This exercise taxes your entire upper body, and performing them correctly (pulling your chest up to the bar, retracting your shoulder blades and contracting the muscles in your upper back) leads to improvements in strength and appearance. And if you can’t do pull-ups, then use a small step or foot stool to help you start in the “up” position and slowly lower yourself down. Assist yourself up with the step or stool.

Station 6: Cardio. Equipment: a kettlebell. Position: standing. Exercise Description: Place the kettlebell arms distance in front of you between your feet. Stand a little more than shoulder-width apart. Do not stand too wide. The wider you stand, the less hip drive you will have. Push back with your butt and bend your knees to get into the starting position. Make sure your back is flat and look straight ahead. Swing the kettlebell between your thighs forcefully.

Quickly reverse the direction and drive through with your hips, taking the kettlebell straight out to chest level. Let the kettlebell swing back between your thighs and repeat until you reach the time limit.

The swing is one of the best ballistic exercises that you can do with kettlebells. It takes tremendous hip drive and hamstring power to drive against the kettlebell and to project it to chest level. In addition to building powerful, rapid hip action, the swing is an excellent hamstring exercise that carries over well to other exercises such as the barbell deadlift. The swing is also a tremendous core exercise, as you really have to brace yourself as the kettlebell swings between your legs.

Station 7: Strength. Equipment: your own body-weight. Position: push-up. Exercise Description: Push-ups are another great upper-body builder for your chest, shoulders, back and arms. But mix it up by putting a medicine ball under your hands, do them with your hands around free weights, do them with different hand positions, wear a weighted vest, or try them inverted. The push-up is a great “basic” movement that can be modified for all levels.

Station 8: Cardio. Equipment: body-weight. Position: mountain climber (start in a push-up position). Exercise Description: Assume a push-up position with your arms completely straight. Your body should form a straight line from your head to your ankles. Without allowing your lower-back posture to change, lift your right foot off the floor and slowly move your right knee toward your chest. Return to the starting position and repeat with your left leg. Alternate back and forth for the duration of the set.

Station 9: Strength. Equipment: body-weight. Position: standing (lunge). Exercises Description: Lunges. I love lunges because they target the entire lower body. And when you are looking to get the most bang for your buck, focus on training the big muscles like the glutes and quads. Again, you can diversify the types of lunges you do: straight, angled, reverse, side, cross-behind. Have fun with it, but they’ll surely work your entire lower body.

Station 10: Cardio. Equipment: body-weight. Position: standing split jump. Exercise Description: Stand in a staggered stance with your feet 2 to 3 feet apart, your right foot in front of your left. Keeping your torso upright, bend your legs and lower your body into a lunge. Now jump with enough force to propel both feet off the floor. While you’re in the air, scissor-kick your legs so you land with your left leg forward. Repeat, alternating your forward leg for the duration of the set time.

A new year’s right around the corner; make it your healthiest year ever by following these exercise principles and engaging your entire body. Remember, if you say you don’t have the time, you’re just making excuses! Get started today and see how much better you look and feel. Talk to your doctor if you have questions about how to perform any of these exercises or if a health condition may limit your ability to perform any of the above.

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Circuit Training Tips

• Create stations that challenge you and don’t require a considerable amount of set-up time.
• Try to increase the number of repetitions you can perform in the same amount of time each week. Use the “one more rep” mentality.
• Make sure you maintain good body alignment and core engagement throughout.
• Warm up before the circuit and cool down after it.
• Don’t forget the fun factor!

By Dr. Jeffrey Tucker

The socialization process in grade school is interesting, to say the least. Too often, kids get labeled, stigmatized and categorized according to their primary area of performance. Good athletes become “jocks.” Good students become “brainiacs.” But we need to teach children that they can be both; in fact, it’s high time to hail the student-athlete! Here’s why.

According to a recent study of 9-11-year-olds, muscle fitness, determined by 30-second repetitions of a battery of upper-body, lower-body and core exercises (lunges, push-ups, shoulder presses, etc.) using either body weight or a medicine ball, correlated with performance on memory, math, reading and writing tests. Kids who performed better (more repetitions) on the muscular fitness tests also did better on the memory and academic tests than their less-fit peers, according to the study.

Parents all want their children to succeed in all areas of life, but too often, they make a choice between academics and athletics. Here’s a great reason to prioritize both! Talk to your doctor to learn more about the importance of muscular fitness and how to get your kids started on the path to fitness. To learn about safe exercise strategies for adolescents and teens, read Dr. Perry Nickelston’s article from the May 2009 issue of To Your Health.

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