Causes of injury while doing physical exercises (Part 1)

Injuries take place when they are least expected! It seems that they are part of life, even if most can be avoided if one has the necessary knowledge to avoid them!An injury could be physical exercise related, or not! It could be due to the following:

Poor flexibility and overstretching

If the muscles are tight, brought about by lack of stretching, they are more prone to be injured. For this reason, before engaging in any form of exercise, you need to pay more attention to improving the flexibility of muscles at the lower back, the calf and hamstring muscle, Achilles tendon and the iliotibial band (Glover, 2009).

Stretching has to be done properly; otherwise, injuries could take place. If a particular muscle, or set of muscles, is (are) injured, don’t stretch it (them)! If you stretch an injured muscle, you will exacerbate the pain and delay the disappearance of any inflammation! Leave an injured muscle alone and give time for the tenderness and swelling to go away. When it is no longer painful, then you can start improving on its flexibility! If you experience recurrent back pain, don’t do any exercise(s) that will aggravate it (Glover, 2009)! You may need to see a medical doctor if you experience recurrent back pain!

Incorrect warm-up and cool-down                                         

Doing warm-up and cool-down exercisesare as important as doing the main work out regimen. To most gym enthusiasts, they look down on the warming up and cooling exercises and consider them as mere antics and ceremonial rites!However, they are very important in maintaining and inducing the flexibility of the muscles. Without properly doing them, such as devoting lesser time than required, injuries could take place during the gym session.

Old injuries

It is common to most gym enthusiasts that they have previous injuries. In most instances, these previous injuries have not really returned to their normal functioning; but since it has been long that the accident took place, it has been forgotten and has been stored in the memory as a totally healed injury. In truth and in fact, however, old injuries, in most occasions, are potential weaknesses in the human anatomy. They should be remembered! When a person engages in a physical exercise, without considering and factoring in his previous injury, this old crack may eventually give way, producing injury.

Improper injury rehabilitation

The rehabilitation of an injury takes time. Depending on its severity, it will require a particular length of time; the more severe it is, the longer time it will take. Most gym enthusiasts, however, have the wrong notion that the injury will heal faster if given, and exposed to, some degree of physical exercise! That’s not true! The dictum is this: if not totally healed, don’t engage in any form of exercise! Give all the necessary time for the injury to heal—completely!

Errors in form

Every sport requires a particular technique and form of playing it.Tennis requires one; running requires another; and boxing requires still another! It is very important that upon starting a particular sport, learn the right form of playing it. Don’t start with the wrong form; otherwise, you will keep on using it, and you will injure yourself! If you have been using the wrong form, it is very hard to stop you! It will be very hard for you, and for the trainer, to change your wrong form—your bad habits! The root cause of your problem was that, at the very start of your sport, unconsciously, you had adapted a particular form—and it happened to be   wrong—because it was easier for you to do it! You were not aware that it was the wrong form! That’s the disadvantage of starting a new sport without the supervision of an expert! You tend to do it in your own way! If the wrong forms are not corrected at the earliest time possible, you might injure yourself!


Glover, Bob, Shepherd, Jack, and Glover, Shelly-lynn Florence. “The Runner’s Handbook”. New York: Penguin Books USA Inc. 1996.

Practical management of sprained ankle caused by physical exercise(s)

Definition of Sprain

Stedman’s Medical Dictionary defines sprain as “an injury to a joint, with possible rupture of some of the ligaments or tendons, but without dislocation or fracture”. Sprained ankle is one of the most common injuries among gym enthusiasts and to those who play some sports. Being very common, each one should be prepared and equipped to institute a simple and right management.


With the use of drugs

The initial approach in the management of ankle sprain is to give analgesic—a drug which will eliminate the pain being experienced by the patient. Drugs that can be used are: (1) paracetamol, (2) mefenamic acid, and (3) ibuprofen. The advantage of ibuprofen over the other two drugs is that, aside from its analgesic effect, it could also relax the involved muscle(s)—thereby palliating pain in a shorter time. The standard dose of paracetamol and mefenamic acid for adults is 500 mg every 6 hours, while ibuprofen can be given at 400 mg every 4-6 hours.

These drugs can be given as initial treatment. If the pain is not relieved, or if it recurs after stopping the intake of one of theaforestated drugs, see your medical doctor without delay. The medical consultation is necessary to firmly establish your diagnosis and to possibly prescribe you with more potent drug(s). Always remember that pain managing doctors follow the “Stepladder Approach” to treating pain. They start with the simpler drug(s), and then resort to   more potent ones if the situation will require it.

With the use of other means outside of drugs

In addition to the use of drugs, there are other means of relieving the inflammation and the accompanying pain. These are encapsulated in the word RICE.


An injuredankle needs rest in order to recuperate. As experienced by most, trauma in the ankle—as in other physical injuries—will lead to inflammation, which will in turn lead to having pain, swelling, and hot sensation over the affected area. It is necessary to temporarily deprive the injured part of any movement and action in order to hasten the recovery. It is recommended by some experts, however, that the injured part be moved and used as soon as possible to return the normal functioning of the soft tissues involved in the injury and to promote blood flow in the affected area.


In the first 48 to 72 hours after injury, the inflammation could be reduced by placing plastic bag with ice over the ankle for 15 to 20 minutes. This can be done 3 to 5 times in a day for the first 3 days.


The use of elastic rubber bandage is very important and indispensable. It comes in different length and widths. You can select the size which fits you, or the size prescribed by your medical doctor. You can wrap it around the injured part in order to exert some degree of compression over the affected area. When this is done, swelling in the area can be prevented and the injured part will be largely immobilized, providing it with the necessary rest.

As the name implies, elastic rubber bandage is stretchable; therefore, you can stretch it as you wrap around the ankle, and it will effect a firm hold over the area. The bandage is provided with a metal hook which could anchor it and prevent disengagement.


While sleeping or resting, the injured leg needs to be elevated so as to reduce swelling. However, as soon as possible, while your leg is elevated, use your foot in spelling out the alphabet! Do it as often as you can.

Reference Websites:

“The best way to treat a sprained ankle”, by Dr. Ben Kim.

“3 ways to treat ankle sprain”

The five S that should be avoided to stay healthy: the role of physical exercises to negate the adverse effects


It has been emphasized in several articles of Powertec that being sedentary is bad for the health. If a person has been deprived of periodic physical exercises and muscular exertions for a long time, he will be prone to develop cardiovascular diseases, such as ischemic heart diseases and/or hypertension. The lungs, heart, muscles and bones need to be jarred from time to time—by way of intense physical exercises—so that their functional competence will not deteriorate. This advice needs to be taken seriously especially when an individual has elevated fasting blood sugar, or triglycerides, or cholesterol, or different combinations of the three!


Certain amount of salt is needed in the human blood and different tissues because it is involved in the different biochemical processes that take place in the bodily systems. If its concentration is below the normal value, an individual will feel weak and sleepy; if very much increased, his blood pressure may increase, depending on his age.

When a person is still young, his/her kidneys are very much capable of eliminating extra salt that has been taken in. However, as he/she grows older, the kidneys become less and less competent to eliminate the unneeded salt. With increased concentration of salt in the blood, much water is retained in the piping system of the human body—the so-called intravascular volume—leading to elevation of blood pressure.

One of the ways of reducing salt in one’s body is for one to perspire; this can be achieved by having periodic and regular gym exercises!


For as long as one lives in this world, stress of different forms will always be there! To some extent, it is needed for one to fully develop his/her personality—emotionally and intellectually. However, when it comes in high level of intensity and frequency in most of the times, then said stress will surely have adverse effects on the health of an individual. In most of the times, stress arises when one does not know how to manage his/her time! It arises when one does not know how to manage his/her finances and relationships—and when one aspires for an ambition that is beyond his/her means! The basic solution to an stressful life is to simplify the needs of life itself! It is a matter of having the right attitude to pursue simple life in this world!

When one is under stress, one of the ways of relieving it is to have gym sessions and other forms of physical exercises.


Sugar, or glucose, is the principal source of energy of every human being. Actually, it is the preferential source of energy of every person! Thus, even if there is much protein and fat in the bodily systems, for as long as glucose is available, it will be used as source of energy ahead of fat and protein. When one is suffering from diabetes mellitus (DM), however, the glucose in the blood is not used properly; in fact, it is not burned by the body because it is not taken up from the bloodstream! The only way to use the glucose which is admixed in the blood is for one to take medication(s) for DM. In addition to taking the appropriate medication(s), the concerned individual needs to control his/her intake of sugar-rich foods! In fact, even the quantity of rice—which is rich in glucose—to be taken in every meal will be limited and measured! As a general precaution, even if one is not suffering from DM, if he/she has a family history of the disease, he/she needs to control his/her intake of sugar! More strictly, even if one does not have a family history of DM, he/she needs to abstain from taking in too much simple sugars for he/she could be the first one to have DM in the family!

Physical exercises have been proven to increase the competence of insulin—the hormone responsible for the burning of glucose! With competent insulin, elevation of blood sugar could be prevented.


The adverse effects of cigarette smoking on health have been supported by thousands and thousands of medical literatures! There is no doubt that it could cause lung cancer, hypertension, and ischemic heart disease. The only way to avoid contracting these diseases is to refrain—and stop—from smoking! If one is preoccupied with other activities, such as regular physical exercises, smoking could be avoided!


What are trans fats? Part 1


There are two broad types of trans fats—otherwise known as trans fatty acids—in  foods: (1) the naturally-occurring, and (2) the artificial trans fats. Naturally-occurring trans fats are produced in the gut of some animals, and foods prepared from these animals, such as milk and meat products, may contain small quantities of these fats.  Artificial trans fats, on the other hand, are manufactured in an industrial processes wherein hydrogen is added to the liquid vegetable oils to make them more solid. When you use the hydrogenated oil in preparing your foods, such as cookies, doughnuts, frozen pizza, stick margarines, pie crusts, crackers, pastries and fried foods, it will inevitably follow that you take in trans fatty acids when you take these foods! Thus, unknowingly, your  main source of trans fatty acids  is from your diet [1].

Some companies prefer to use trans fats because they are easy to use, less expensive to produce and have longer shelf life.   They, at the same time, provide foods with a desirable taste and texture. In some countries, however, the use of trans fats is restricted because of its ill effects on health [1].

Adverse effects on health

There are two types of cholesterol in your body: (1) high-density lipoprotein  cholesterol, otherwise known as HDL-cholesterol, and (2)  the low-density lipoprotein cholesterol, also known as LDL-cholesterol. The HDL-cholesterol has been proven to be  “good” while the LDL-cholesterol has been found to be “bad”. The reason for this is that HDL-cholesterol has been established by scientific study that it promotes the so-called “reverse cholesterol transport” wherein cholesterol is eliminated from your body, whereas the LDL-cholesterol promotes the deposition of cholesterol in the different tissues of your body, causing the blockage of both the small and large  arteries. Worse and very fatal, the development of obstruction in the small arteries  could  take place in your heart, which could lead to heart attack—medically known as myocardial infarction. When this takes place, you may die!

When you take a lot of foods rich in trans fats, your “good” cholesterol (HDL)  decreases while your “bad” cholesterol  (LDL)  increases. This will  mean that the rate of deposition of cholesterol in your tissues will be faster than its elimination. When this happens, you are prone to develop diseases of the heart and the blood vessels—otherwise known as cardiovascular diseases. Examples of cardiovascular diseases are hypertension, atherosclerosis (hardening and narrowing of the large arteries), and  arteriolosclerosis (hardening and narrowing  of the small  arteries).  Stroke (bleeding in the brain) and diabetes mellitus could also develop because of high intake of trans fats [1].

Preventing the intake of trans fats 

To find out if the food that you are about to take in contains trans fats, look at the “Nutrition Facts” of the product. You can also look at the “list of ingredients”. If “partially hydrogenated oil” is listed as one of the ingredients, then the food product contains trans fats [1].

Ways of lowering the intake of  trans fats and saturated fatty acids

As mentioned in the preceding paragraph, high level of  LDL in your systems is bad for your health, and  all means must be resorted to lower it. In line with this, the American Heart Association recommends that adults need to lower their intake of trans fat and limit their consumption of saturated fat to 5 to 6% of their total daily caloric intake [1].  This recommendation can be achieved through the following ways:

  • Eat a lot of  fruits, vegetables, whole grains, low-fat dairy products, poultry, fish and nuts. In addition,  limit your intake of  red meat and sugary foods and beverages [1].

(To be continued)



General guidelines on how to lose weight (Part 1)

Compute for your ideal body weight

There is an ideal body weight (IBW) for every person, and it is computed in the following manner:

Height in centimeters – 100 = Ideal weight in kilograms (kg)

Thus, if your height  is 5 feet and 4 inches, its equivalence in centimeters is  64 inches x 2.54 = 162.56 centimeters. Ideal body weight will be:  162.56 centimeters – 100 = 62.56 kg. If you are an Asian or a woman, you can afford to deduct 5-10 percent from 62.56 kilograms, and your IBW will be:  62.56 – 6.25 = 56.31 kg or 124 lbs.  Your IBW is the most appropriate weight for your sex, age and degree of activity.

Compute for your total daily caloric need  

Your total daily caloric requirement (TDCR) is the number of calories that you need to take daily to maintain your IBW. If you take more than your TDCR, you will gain weight; if less, you will lose weight. If you will use your IBW in pounds, you need to multiply 15 if you are moderately active and multiply 20 if you are very active to compute for your TDCR (Roth, 2007).  This does not discriminate whether you are a male or a female; hence,  ball park  figures are used here.

Thus, if your IBW is 124 lbs, and you are moderately active, your TDCR will be  124 x 15 = 1,860 calories. If you are very active, your TDCR will be 124 x 20 = 2,480 calories. Initially, if it is too hard for you to use the lower value, you can take the average of 1,860 and 2,480, which is 2,170, as your starting TDCR. At the very start of your weight reduction program, you can afford to exercise some degree of flexibility because then you are still adjusting.

Compute for the total daily calories that you have been taking

Before the start of your weight reduction program, you have been taking a certain number of calories per day which is called    your  total daily caloric intake (TDCI).  Surely, if you are overweight now, your TDCI has been more than your TDCR!  TDCI can be roughly computed by adding the number of calories derived from a certain size of food. In the  food exchange lists, you will see, for instance, that one slice of bread provides the body with certain number of calories; a cup of rice weighing 150 grams, for another example, could provide certain number of calories. Adding all the number of calories coming from the different foods that you take each day will give you the TDCI.

If you have a  friend who is a nutritionist–dietitian, s/he could provide you with the  food exchange lists that would help and guide you  add up the total calories that you derived from the foods that you take each day. Searching the internet could be another  option of consulting  different food exchange lists. Of course, this process does not require very exacting computation! All you have to do is to approximate the TDCI.

Compute for the discrepancy between the TDCN and TDCI

If you are overweight now, your TDCI has been more than your TDCR! The difference between your TDCI and your TDCR is the excess energy that you have been taking and has been causing your being overweight! To normalize your body weight, and for you to achieve your IBW, you need to stop taking the excess energy.

Reduce the number of calories that you take each day

The physiological rate of reducing weight is to lose 1-2 pounds per week. To achieve this, you need to reduce your total  caloric intake by 3,500 -7,000 calories per week, or by 500 – 1,000 calories per day (Roth, 2007). One way of facilitating your weight reduction is to examine closely your intake of fats. Remember that for every gram of fats that you take in, you consume 9 calories! The caloric content of a gram of fats is the highest among the three food groups! Thus, it would be logical—and of prime importance—to  target its reduction because then it could significantly  facilitate your weight reduction.

Further discussion of this topic, particularly the method of reducing fat intake,  will be continued in the second part.


Roth, Ruth A. Nutrition and Diet Therapy. Singapore: Delmar Learning, 2007.

Obesity as a risk factor for chronic diseases

Obesity is one of the most common disorders in medical practice. In the United States about 60 million people are now obese (more than 30%) and 68% of population is overweight.  It is alarming that overweight rates among children have doubled and among adolescents even tripled, increasing the number of years they are exposed to the health risks of obesity. Obesity is defined as an excess of body fat. The best way to classify obesity is to use body mass index (BMI). It closely correlates with excess fat tissue, and it’s calculated by dividing measured body weight in kilograms by the height in meters squared.  A normal BMI is defined as 18.5 – 24.9. Overweight is defined as BMI 25-29, 9 and obesity is BMI over 30. Class I obesity is 30-34.9, class II obesity 35-39, 9 and extreme obesity, or class III is over 40. Obesity is a risk factor for developing type 2 diabetes, cardiovascular diseases, especially coronary disease, hypertension, obstructive sleep apnea , knee osteoarthritis, hyperlipidemia (high blood cholesterol levels) and even cancer.  It is also an important risk factor for stroke, abdominal angina, obesity hypoventilation syndrome (Pickwickian syndrome) and deep vein thrombosis (which is a risk factor for developing pulmonary embolism).  For example, except the fact that diabetes is the risk factor for developing coronary disease it is also the leading cause of amputation of the lower limbs throughout the world.

The main cause of obesity in the most of cases is sedentary life and chronic ingestion of excess calories. But, nowadays, it has been discovered that genetic influences are very important, to even 40-70 %. Most probably is that obesity develops from the interactions of multiple genes, environmental factors and behavior. Since there is a rapid increase in obesity in the last 30 years it is obvious that environmental factors have the most important role in the development of this disease. Upper body obesity (excess fat around waist and flank) is much more dangerous than lower body obesity (fat in the thighs and buttocks) and it is a greater risk for developing diabetes mellitus, stroke, coronary artery disease and early death. Of course, it is important to know  that obesity itself leads to hyperlipidemia, which leads to atherosclerosis, and that’s the most important risk factor for developing cardiovascular and cerebrovascular disease, and they are the leading cause of death in the Western World. Of course atherosclerosis will develop even if people have low cholesterol levels and if they are slim, but the process will be slower and the stenosis of the arteries probably won’t be significant.  Also, some studies have shown that being only 10 pounds overweight increases the force on the knee by 30-60 pounds with each step. Overweight women have nearly 4 times the risk of knee osteoarthritis; for overweight men the risk is 5 times greater. For a woman of normal height, for every 11 lb weight loss (approximately 2 BMI units), the risk of knee osteoarthritis dropped > 50%. Conversely, a comparable weight gain was associated with an increased risk of later developing knee OA. It is obvious that obesity plays an important role in the development of the most important chronic diseases today and by controlling our weight we can significantly decrease the risk of sudden and early death as well as the disability caused by stroke, heart attack, osteoarthritis or diabetes.


1. Role of Body Weight in osteoarthritis,

2. Maxine A.Papadakis, Current Medical Diagnosis and Treatment 2014, Visceral Artery Insufficiency (Intestinal Angina), p 453-454

3. Diabetes and Amputation,

4. Kumar and Clark, Clinical Medicine, 2005, 6th edition, Obesity p.252-257

5.Robert B.Baron, MD, MS, Nutritional Disorders, Obesity, , Current Medical Diagnosis and Treatment 2014, 53rd edition p.1213-1215

6. Robert F.Kushner, Evaluation and Management of Obesity, Harrison’s Principles of Internal Medicine (18th edition), p 629-634

Precautionary measures for diabetics before working out

Have your fasting blood sugar checked

The major problem among diabetic   patients is that their blood sugar is high, but it is low in the different tissues of different organs. For example, it is low in the muscles which are used in doing physical exercises. Hence, it is very dangerous to engage in any form of physical exercises because the muscles are deprived of the sugar very much needed for muscular contractions. With family history of diabetes mellitus, or with established diagnosis of diabetes mellitus, you need to submit yourself to a periodic fasting blood sugar examination so that you will know if your blood sugar is  low, normal  or high. If high, you need to have medicine(s) needed to have your blood sugar absorbed and used by your different bodily systems.

Take your medicines regularly   

If you have been prescribed with medicine(s), take them regularly as scheduled. Do not reduce or increase the dosage(s) of your  medicine(s) without the approval of your medical doctor. Always remember that the anti-diabetic drugs you have been taking are active drugs which could drastically affect the level of your blood sugar. If you reduce them, your blood sugar will increase; if you increase them, they could drastically reduce your blood sugar, and you will experience the clinical manifestations of hypoglycemia, such as sweating,  dizziness, shaking of the extremities, increased heart rate, anxiety, hunger, dizziness, headache, blurring of vision, confusion, abnormal behavior and loss of consciousness.

Avoid physical exercise(s) if the dosages of your medicines are being calibrated   

If you  are a newly diagnosed diabetic patient, the first set of medicine(s) that your medical doctor has prescribed to you is still under observation. After two or four weeks of using the said medicine(s), your fasting blood sugar will be checked to find out if  your blood sugar has been controlled—that is, your fasting blood sugar falls within the normal range! If controlled, then the dosages of your medicines will be continued. If not controlled, your dosages will be increased, or another class of anti-diabetic drug will be added. If your sugar is very much lower than the normal range, then your set of medicine(s) may be so high for you that your medical doctor needs to lower your dosages. During this period of observation and calibration, it is very precarious to engage in physical exercise(s)—especially the intense ones—because you are still unsure of the effect(s) of your present medicine(s). If your blood sugar has turned out to be low, and you engaged in intense physical exercises, you could experience the various clinical manifestations of  hypoglycemia as described above, and you will suffer!  The safest attitude is to wait for the right dosage(s) of your medicines before you engage in physical exercises.

Take your meals regularly and as scheduled

If you are taking anti-diabetic drug(s), it is presumed that you are taking your meals as scheduled. If you are taking your medicines regularly but delaying your meals, you might suffer from hypoglycemia! As mentioned in the preceding, your anti-diabetic drugs are active! Hence, they will effect the absorption and usage of your blood sugar! They will not wait for you to take your meals before they will act! Their actions are very independent from taking your meals. Once you have taken them by mouth, they will start to take effect, regardless of whether you took your meals or not! Hence, your blood sugar will lower considerably if you took your anti-diabetic  medicines but not your meals!

Have regular physical exercises once the right dosages of your medicines have been determined

The blood sugar of a diabetic individual is high because the insulin which is responsible for the uptake and use of blood sugar is either low in quantity or poor in quality. A  person may have the right quantity of insulin; but if they are of poor quality, he may contract, or experience, diabetes mellitus in his lifetime! There are reports in various literatures, however, that regular physical exercises will improve the competence of the insulin! Hence, by doing regular physical exercises, a diabetic person may require lesser drugs compared to someone who remains sedentary.

Precautionary measures for hypertensives before working out

Take your medicines

If you are hypertensive and have previously consulted a medical doctor, for sure, you were prescribed with medicine(s) to control your high blood pressure. To be effective, you need to take them regularly, and—if possible—at the same time of the day. Thus, if you will work out after breakfast, be sure to take your medicine(s) scheduled to be taken after breakfast! Go on with your work out; no one is preventing you from doing so; however,  take all  your medicine(s) as scheduled at a certain time of the day.

Measure your blood pressure

Before you start your work out, measure your blood pressure by using the sphygmomanometer. In most gyms, this instrument is available and is usually placed in the most conspicuous place of the gym so that would-be users would be reminded to use it, if needed. If you do not know how to take your blood pressure—as most gym enthusiasts do—you can request a gym staff who has been assigned and trained to do so. The uppermost reading of normal blood pressure is 140/90; hence, if your blood pressure is higher than the said figures—be it one or two figures—you cannot start your work out!

If you failed to take your medicines, then take them as soon as possible. Once your blood pressure is lower than the upper limit, then you can start your work out. However, if, in spite of taking your medicine(s), your blood pressure remains elevated, you need to forego your gym work, and you might need to consult your medical doctor soonest. It is possible that you might need additional medicines, or need to change some of them. Do not insist to work out if your blood pressure is 140/90 or greater!

Pay attention to warning signals

As a hypertensive, there are several warning signals that you need to pay attention to. Foremost are headache and dizziness. If you have headache, most probably your blood pressure is elevated; if you have dizziness, it is possible that your blood pressure is elevated or decreased considerably. Hence, if you experience any one of the above, or both, have your blood pressure checked before working out.

Ensure to have solid and adequate sleep

Do not  insist to work out if you failed to have solid sleep the night before! Most hypertensive patients tend to have elevated blood pressure when they lack sleep! In addition, to some of them, their heart rhythm is disturbed, such that they manifest escaped beats, or cardiac arrhythmia. If you have cardiac arrhythmia, in some instances,  the amount of blood that will go to your brain and other organs may decrease, leading to dizziness or syncope (loss of consciousness). As such, if you are doing a threadmill exercise, you might suddenly fall from the equipment!

Watch your previous and immediate diets

Your last three diets prior to your work out are very important.  Take note of what you took in the immediate diets! Were they rich in animal fats? Were they rich in salt based on what you tasted? If so, watch out for possible elevation of your blood pressure! Hence, take your blood pressure before starting to work out; if elevated, forego your work out if it will not be controlled in the next hour or two.

Consult your medical doctor regularly

If you have not consulted your medical doctor for some time, six months or more, you need to see him so that he could examine you and request for the necessary laboratory and blood examinations and for the electrocardiogram (ECG). If your blood chemistry examination reveals that there is elevation of your blood cholesterol, triglycerides, and fasting blood sugar, then appropriate medications will be prescribed for you; otherwise, it will be harder to control your blood pressure.

If you have not had ECG in your entire life, or had it more than 5 years ago, you need to have one soonest. ECG results are very important in assessing the competence of your heart in handling extra load, such as intense physical exercise(s).



Guidelines in doing physical exercises for arthritis (Part 2)

Listen to your body signals

In doing physical exercises, do not push yourself to the limit if your bodily systems cannot afford to do so. Depending on your level of fitness, you can only do so much! You cannot hurry up the development of your fitness! You can gradually build it up! As you physically exercise, you need to listen to your body signals which tell you if you are pushing yourself to the hilt, and it is very dangerous!

What are these body signals? Firstly, if suddenly you feel irregularity in your heart beats, it is possible that you are going beyond your limit! Slow down! Secondly,  if you experience dizziness while working out, slow down, then have your blood pressure checked! Thirdly,  if you experience muscular cramps, then you might as well need to slow down,  or stop for some time! Other body signals that should be watched out are chest pain, difficulty in breathing, headache, and blurring of vision. These are warnings that should not be disregarded!

Avoid exercise if the joint feels hot

If the joint feels hot, it means that there is inflammation going on; since there is inflammation, there is some degree of pain in those areas. Thus, physical exercises should be avoided, lest you will aggravate the inflammation.

Alternate rest with activity

Some gym enthusiasts, or arthritic patients in particular, hold the belief that more frequent physical exercises will significantly  improve their condition. While properly paced frequency of doing physical exercises  will prevent occurrences of joint pain, overdoing it may cause and trigger painful joints. Thus, alternate working out with rest. The human body, specifically the muscles,  needs some time to replenish what it needs—such as oxygen, electrolytes, and glucose. It also needs adequate time to throw out toxic substances, such as carbon dioxide and other metabolites. By having  rest, this processes of replenishment and cleaning up in the different  bodily systems could properly and effectively take place.

Control your weight

If you are suffering from arthritis, control your weight and strive to have your ideal body weight (IBW). As defined in previous article by Powertec, IBW is the normal and allowable weight that you need to have based on your height and nature of your daily activities. If your weight is greater than your IBW, then you are overweight! Since the joints are very sensitive to the jarring effects of physical exercises, if you are overweight and do physical exercises, such as threadmill and weight lifting, your joints will take the brunt, and it could lead to severe joint pain.

Set realistic and achievable goals

As mentioned in the preceding, do not overdo physical exercises! As such, set realistic and achievable goals. If you set your goals too high, you might suffer from exhaustion, or experience bodily and joint pain afterwards! If you set it too low, then it may not lead to improvement in your physical fitness. Strike at a rational balance!

Have regular  blood examination for your uric acid

For gym enthusiasts with gouty arthritis, you need to have regular blood examination for your uric acid level. If it is not checked, and it rises to a high level, uric acid crystals  will be formed and deposited in the joints. This will cause excruciating pain! To prevent this, have your uric acid level controlled by taking in  medically prescribed drugs, such as allopurinol. In addition, avoid taking too much of the following: nuts and seeds, such as peanuts and cashew nuts, internal organs and alcohol.

Have smooth, steady rhythm

If you drive your car with varying speed—and the variation is so great—you will consume more gas, and it will shorten the service span time of your vehicle. The same holds true in doing physical exercises: see to it that you have smooth and steady rhythm in doing it. If ever you want to increase the intensity, do it gradually.

Exercise and bronchoconstriction

Exercise is a common trigger of bronchoconstriction and asthma, especially in children. It is linked to hyperventilation, which results in increased osmolality in airway lining fluid and triggers mast cell mediator release, resulting in bronchocontriction (narrowing of the airways). Exercise induced bronchoconstriction usually begins after exercise had ended and recovers spontaneusly within about 30 minutes. It’s worse  in cold, dry climates than in hot, humid conditions. It is more common in sports such as cross-country running in cold weather, overland skiing , ice skating and ice hockey than in swimming. It can occur not only n in recreational but in professional  athletes as well. Is occurs in asthma but it can also occur in people without any pulmonary diseases. About 10-15% of the general population has exercise-induced bronchoconstriction, and the only time that they have any kind of breathing issues is during exercise. People with asthma have symptoms at many other times – when they are exposed to allergens, during upper respiratory infections, and so forth.  Common symptoms include coughing, wheezing, and chest tightness with exercise. These symptoms usually occur during strenuous exercise and peak about five to 10 minutes after exercise. However, many athletes will present with nonspecific symptoms, such as fatigue, feeling out of shape and abdominal discomfort.  Certain factors can trigger exercise induced bronchoconstriction. The most common are cold, dry air, air pollution (smoke, smog), and some chemicals, like chlorine in swimming pools, previous respiratory infection, high pollen counts and other allergens.  Few tests are necessary to diagnose this disorder and to rule out asthma. The most important is spirometry (it should be normal), exercise challenge test (to see how exercise affects your airways) combined with spirometry (before and after exercise) is the best. Exercise is usually done for six to eight minutes on a treadmill or other stationary workout machine. For competitive athletes, exercise challenge tests are sometimes done in the sporting environment.  Allergy skin tests can be done as well, to see whether you have allergic reaction to other things, such as animal dander, mold, dust mites, latex etc.  The main goal of treatment is to allow patients to exercise safely and help competitive athletes to maximize performance.  The recommended therapy includes a short-acting bronchodilator, such as albuterol — usually 2 puffs 15-20 minutes before exercise. If a person really has EIB, that will be sufficient to control the symptoms of EIB in about 80% of the cases. If the person continues to be symptomatic despite using the albuterol properly, that may indicate that he or she has underlying asthma that is inadequately controlled.  Prevention is very important, and it can be done by avoiding exercising outside when there is a lot of pollen or air pollution or on cold, dry weather. If you are outside cover your mouth with a mask or scarf. It’s recommended to get in good physical shape gradually before trying vigorous types of exercise and always allow at least ten minutes of warm-up time before exercise. Person should cool down gradually at the end of the workout and wait at least two hours between bouts of exercising.


1. Peter J.Barnes, Chapter 254, Asthma, Harrison’s Principles of Internal Medicine (18th edition), p 2108                   2. What is Exercise-Induced Bronchospasm,                                      3. Exercise-Induced Bronchoconstriction, Diagnosis and Management,                                                                                                                                4. Exercise-Induced Bronchoconstriction: The New Guidelines,