What if you used to be really fit and now you're not? What if, as the years have gone by, you've added a couple of pounds here and there, and you suddenly notice you're 30 pounds heavier than you were at your 10th high school reunion? Or, what if you've never enjoyed the idea of exercising, exercise was never part of your world-view, but you're not feeling as good as you'd like to feel and think that exercise might help improve your overall health and sense of well-being?

Many people want to get fit or want to regain a former level of fitness for a variety of considerations, including the above scenarios.^1,2 But most of us need guidance in the process of getting fit. We need information and even instruction on what to do and how to do it. For example, it would be a serious mistake for someone older than 50, and even older than 40, to simply go out and try to run 4 miles if he had never run before. Muscle strains, shin splints, or even a stress fracture of one of the bones in the foot would be a likely and unwanted result. Similarly, going to the gym and trying to "work heavy" would assuredly create various problems for an out-of-shape person who wanted to "get fit" as quickly as possible. The injured tendons and sprained ligaments resulting from trying to rush would set back your hoped-for progress by at least four to six weeks, further delaying achievement of improved health.

The best way to get fit or return to fitness after a long period of inactivity is to start slowly, progress in small increments, and gain an authentic, long-lasting level of fitness over months and years. Being a smart exerciser means not doing too much too soon, in other words, respecting your body's capabilities. Also, smart exercise involves engaging in a blend of activities, usually on alternating days. Persons who only bike or run and persons who only lift weights will never be as healthy and fit as those who do both aerobic activity and strength training.³ Developing a two-week schedule will provide a thorough, balanced fitness program. In week A you do aerobic exercise (walking, running, biking, swimming laps) on Monday, Wednesday, and Friday. You do strength training on Tuesday and Thursday. In week B you reverse activities, doing strength training Monday, Wednesday, and Friday and aerobic exercise on Tuesday and Thursday. This alternating pattern ensures you are getting the full benefit of your valuable time spent exercising.

It is important to remember that what works for you, works for you. Each of us needs to find his or her best way forward. Some methods of exercise will be experienced as intuitive and enjoyable. Others will be experienced as the opposite. You probably won't want to continue any of the latter. For example, the exercise program suggested by your friend may not be effective for your physical makeup and may even be harmful. Your chiropractor is an expert in healthy exercise and will be able to recommend fitness activities that will be right for you.

¹Johanssen NM, et al: Categorical analysis of the impact of aerobic and resistance exercise training, alone and in combination, on cardiorespiratory fitness levels in patients with type 2 diabetes mellitus: results from the HART-D study. Diabetes Care 2013 July 22 [Epub ahead of print]

²Stanton R, el al: Is cardiovascular or resistance exercise better to treat patients with depression? A narrative review. Issues Ment Health Nurs 34(7):531-538, 2013

³Lorenz D, Reiman M: The role and implementation of eccentric training in athletic rehabilitation: tendinopathy, hamstring strains, and acl reconstruction. Int J Sports Phys Ther 6(1):27-44, 2011

Bob Barker, beloved host of The Price Is Right, recently made headlines by announcing his retirement after 35 years. "Barker irreplaceable!" blared the entertainment tabloids. And yet, Mr. Barker celebrated his 82nd birthday a few months ago.

Eighty-two! Who really are the "seniors" among us? And what does "senior" mean in today's world? Certainly, America's population is aging by the minute. Baby boomers are rapidly closing in on their 60th birthdays. But most of those in this huge group (more than 76 million)¹ are resisting the concept of "getting older" and searching for ways to stay healthy and fit and well.

Fitness programs provide a major answer to these challenges. Yet, there are many questions. What to do? How to get started? What if I have health issues - can I still get fit?

Before we dive in, some special concerns need attention. Baby boomers and those even older must address decreased flexibility and possibly - temporarily - decreased stamina. Medical issues, including osteoporosis², high blood pressure³, and diabetes, as well as overweight/obesity, must be considered when beginning a new fitness plan.

The bottom line - have a complete physical exam with your chiropractic physician and/or family physician, and make sure you're good to go. Start slowly and easily, making gradual progress, and adding intensity and duration over the first several months.

Begin a walking-for-fitness program. Walking is fantastic exercise! Do 10 minutes at an easy pace the first day, build up to walking around the block, gradually building up over a 12-week period to a brisk 30-minute walk.

Also, begin lifting weights. Many helpful books are available, or ask a friend who knows what they're doing to show you the ropes. Start slowly, carefully, gradually. Train your upper body and lower body on separate days. Make sure you're focusing, paying attention, and working within yourself!

Nutrition is just as important as exercise in regaining the level of fitness we need to live healthy, long lives. Eating right requires some mental toughness, and it may take a while to build new habits. The payoff comes quickly, though, and is tremendously empowering.

We want to be fit for the rest of our lives. How to keep it all going? Here are a few tips from the fitness front lines -
• Writing down a weekly plan. This keeps your workout and nutritional goals fresh. They're right there, on your desk or refrigerator, where you see them every day.
• Vary your routines. Change your workouts every few weeks. Ride a bike if you've been walking. Use dumbbells instead of machines. Vary your fruits and vegetables, and vary your sources of protein.
• Set up a buddy system or join a fitness club. The support of a group of friends who share your lifestyle goals, can make a big difference.

And, most importantly, have fun!

¹MetLife Mature Market Institute Analysis, U.S. Census Bureau, 2000.
²Carter ND, et al: Community-based exercise program reduces risk factors for falls in 65- to 75-year-old women with osteoporosis: randomized controlled trial. Canadian Medical Association Journal 67(9): 997-1004, 2002.
³Staessen JA et al: Life style as a blood pressure determinant. Journal of the Royal Society of Medicine 89(9): 484-489, 1996.

The average age of Americans is increasing year-by-year. Approximately 77 million babies were born in the United States during the boom years of 1946 to 1964. In 2011, the oldest will turn 65, and on average can expect to live to 83. Many will continue well into their 90s. Most people continue to retain the habits they developed as children and teenagers. For many Americans, these habits included lack of regular exercise, sedentary activities, and poor nutrition.

As adults we no longer possess the free pass we had when we were kids. If we continue to eat high-fat and high-carbohydrate foods, we'll gain more and more weight. If we persist in viewing regular exercise as an unnecessary indulgence, we'll continue to experience high blood pressure, heart disease, and weakened immune systems. Older adults who resist the importance of good nutrition and regular exercise are also missing the thrill and sheer joy of having a vibrantly healthy, high-efficiency body. In contrast, older adults can achieve high levels of fitness, or even satisfactory levels, and feel much more youthful than they have in years.


Young adults who are the children of older adults can set a good example for fitness. Of course, this strategy is the reverse of what we're used to - our parents setting the example for us. But good examples work both ways, and smart parents may be willing to take a tip from their kids.

The first good example is regular exercise. The U.S. Department of Health and Human Services recommends 30 minutes of exercise five times per week. Most Americans do no exercise at all. Get your parents into the routine by inviting them to go for a walk or bringing them to the gym and showing them a few basic exercises. For our parents, the key is to get them started. Keep encouraging them - not as something they "should" do, but rather as something they could bring into their lives as a "choice". No one wants to do what they "should". Make it an invitation - make it fun.

Also, begin to set a good example with nutrition. Take your parents out to dinner at a healthy place - talk to them about eating smaller portions, avoiding fried and processed foods, and food combining. Food combining means eating a portion of protein and a portion of carbohydrate at every small meal. For most people, altering their food habits-of-a-lifetime is pretty radical. Help your parents learn how to take small steps in the direction of healthy nutrition, rather than attempting to change everything at once. Again, help them have fun with it. Good nutrition is a choice.

For all of us, it's important to walk the talk. Our kids - and even our parents sometimes - will mimic what we do. We want our own lifestyle choices to be healthy and life-promoting, so our kids and our parents have a good example to follow. Your chiropractor is an expert in using exercise and nutrition as a means of helping patients restore good health. She will be glad to provide valuable information on both of these topics for you and your whole family.

¹MetLife Demographic Profile. MetLife Mature Market Institute, New York, NY, 2006
²Howard RA, et al:Physical activity and breast cancer risk among pre- and postmenopausal women in the U.S. Radiologic Technologists cohort. Cancer Causes Control October 21, 2008
³Leitzmann MF, et al: Physical activity recommendations and decreased risk of mortality. Arch Intern Med 167(22):2435-2460, 2007

You're pregnant! Congratulations! Your body's changing-wondrously, marvelously. One unexpected and unwelcome change may be lower back pain. Recent studies suggest that two-thirds of pregnant women experience lower back pain.¹

These statistics seem reasonable. The weight of the growing baby, plus the weight of the placenta and amniotic fluid, create an unbalanced load in front of the lower back. The result is irritation of spinal ligaments, muscles, and tendons, causing pain, muscle spasm, and loss of mobility.

Of course, some cases of pregnancy-related back pain have specific medical causes. Uncommon conditions such as pregnancy-associated osteoporosis, septic arthritis, and inflammatory arthritis may need to be considered.²

That said, the vast majority of cases of back pain in pregnancy are mechanical in origin.

Your doctor of chiropractic will perform a complete examination and determine the correct course of treatment, if appropriate. Once you're feeling better, you can begin

stretching and doing safe, gentle exercises that will help prevent recurrences of lower back pain. The goal is to strengthen your lower back and minimize the mechanical effects of pregnancy.

The best method of preventing back pain in the first place is being fit. This includes healthy nutrition, gaining a moderate amount of weight, and regular exercise. Your obstetrician will likely recommend vitamin and iron supplements and will monitor your weight. The average healthy woman gains between 25 and 35 pounds during the course of her pregnancy.³

Let's fast forward a few years. Your newborn is now a toddler. Parents know that if you have kids, stuff happens. You bend over to place a bulky car seat in your car. Then you place your child in it. And then, you bend over to remove the car seat from your car. If you've gone to the mall, kids want Daddy or Mommy to carry them. Pick them up, cart them around, put them down again.

What's a parent to do? It's not like you can avoid any of these activities. Your kids are kids - it's up to you to do stuff for them. The answer lies in regular exercise. "But how will I find time to exercise, when there already isn't enough time to do the things I need to do?"

That's a tough question, but if you recognize the benefits, you'll make the effort to make the time. Forty-five minutes or an hour per workout, three or four times a week, will be plenty. And, once you're in the habit of exercising, you'll notice it's easier to lift your kids, easier to bend over, easier to carry them. It's easier because you're

fitter and stronger. And healthier. And, surprisingly, you're having more fun.

¹Pennick VE, Young G: Interventions for preventing and treating pelvic and back pain in pregnancy. Cochrane Database Syst Rev 18(2):CD001139, 2007.
²Sax TW, Rosenbaum RB: Neuromuscular disorders in pregnancy. Muscle Nerve 34(5):559-571, 2006.
³Jain NJ, et al: Maternal obesity: can pregnancy weight gain modify risk of selected adverse pregnancy outcomes? Am J Perinatol 24(5):291-298, 2007.

Windows and Mac users actually do have one thing in common - computer ergonomics issues, namely, pain.^1,2 Beyond the usual hardware and software gotchas we deal with on a daily basis, the real bottom-line question is, "how to play nice with my computer".

Doing computer work is a funny kind of work, a type of activity we're still getting used to. It's not physical work in the sense that there's no heavy lifting going on, no truck-driving, no emergency services heart-pounding decision-making.

But computer work is still an intensely physical activity, although the work is pretty subtle. In computer work it's the small muscles that are getting the workout, not the big muscles we're used to thinking about.

Wrist muscles, tendons, and ligaments. Finger muscles, tendons, and ligaments. Shoulder muscles, Neck muscles. All of these are involved in ongoing repetitive tasks when you sit at a computer and one hour turns into two, two hours turns into three, and suddenly half the day is gone and you notice you've got a killer stiff neck.

Or, one day the tendons on the back of your hand begin to hurt, feeling irritated and inflamed. Or your shoulders and upper back are tight and painful.

Your hands or shoulders feel better by the time you go to sleep. But the next day, as soon as you start to type they act up again.

This is all very uncomfortable, because you've got to do your work.

What's going on?

These various pain patterns in your hands, wrists, shoulders, and neck can be grouped together as a repetitive stress syndrome. Repetitive activities, done over a long period of time, can irritate and inflame the muscles, tendons, and ligaments that are involved in doing the work.

But computer work involves repetitive tasks. How can you avoid these painful problems?

The best approach is to prevent them in the first place.³ If such a syndrome does develop, relative rest is indicated. Reduced computer activity, in smaller intervals, is a good solution. A very useful work-around for right- or left-arm pain is to teach your non-dominant hand to use the mouse or touchpad. This training may take a few weeks - the valuable result is the ability to switch hands whenever you like, distributing the workload between the two sides. Much better.

The most important aspect of prevention is to take a quick, refreshing break once an hour. This is a critical habit to develop. Get out of your chair, walk around, get some fresh air if possible. Change your environment for a few minutes - talk to a co-worker for a moment, get a drink from the water-cooler down the hall, seek out a picture, wall-covering, or landscape you've never seen before.

These activities refresh your body AND your brain, and you're ready to do another hour of productive, creative, healthy work. You'll feel much better, you'll be avoiding repetitive injuries, and your workday will be more enjoyable.

¹Keyserling WM, Chaffin DB: Occupational ergonomics - methods to evaluate physical stress on the job. Annu Rev Public Health 7:77-104, 1986.
²Computer Workstation Ergonomics. Centers for Disease Control and Prevention, 2000. http://www.cdc.gov/od/ohs/Ergonomics/compergo.htm
³Robertson MM, et al: Effects of a participatory ergonomics intervention computer workshop for university students. Work 18(3):305-314, 2002.

Kids get hurt all the time. They're running, they're jumping, they're crashing into things. Kids want to have fun, and when they play, they play full-out.

So, when kids play real sports, stuff happens.1,2 Whether your kid plays soccer, baseball, football, or studies karate, a broken bone, sprained ankle, or twisted knee is just the natural fallout of learning new skills and having a good time.

The treatment for most childhood sports injuries is straightforward and standard.3 For strains and sprains that involve only mild to moderate swelling and pain, the time-honored RICE protocol is followed - rest, ice, compression, and elevation.

Pediatric orthopedists get involved when the injury is more severe or when an arm or leg bone is broken.

But there are other issues, and every parent needs to be aware of these possibilities. In one of the unusual chains of circumstances that make the practice of medicine and the practice of chiropractic so interesting, a physical trauma (like a sports injury) can reveal an underlying serious problem.

In other words, various disorders of bone may not show themselves in terms of symptoms until a physical trauma makes them apparent. Such problems include metabolic disorders, growth and development problems, and even benign and malignant tumors.

What would make a parent suspect such an issue? First, if the child's pain seems out-of-proportion to the degree of injury. A mild knee sprain - for example, caused by tripping over second base while trying to stretch a double into a triple - should not be causing significant pain.

Also, mild-to-moderate injuries should not be warm to the touch. A parent can evaluate this. And, a child should not be running a fever after an activity-related injury.

It would also be suspicious if the pain did not improve daily. For the majority of injuries, pain that lingers beyond several days suggests an underlying problem. Children are resilient. Healthy kids heal quickly. They want to shrug off an injury, forget it happened, and get back to playing.

If your child isn't getting better in a few days, seems lethargic, or feels ill following an injury, warning bells should go off.

Your family chiropractor is familiar with all such conditions and scenarios. He or she is always alert to unusual situations and will recommend the appropriate steps to take, including a complete physical and x-ray examination. If necessary, your chiropractor will be able to recommend appropriate specialists for follow-up, including hematologists, endocrinologists, and pediatric orthopedists.

These more serious problems are uncommon. And, of course, well-informed parents help their kids grow up healthy and strong.

¹Caine D, et al: Incidence and distribution of pediatric sports-related injuries. Clin J Sport Med 16(6):500-513, 2006
²Emery CA: Risk factors for injury in child and adolescent sport: a systematic review of the literature. Clin J Sport Med 13(4):256-268, 2003
³Demorest RA, Landry GL: Prevention of pediatric sports injuries. Curr Sports Med Rep 2(6):337-343, 2003

Kids can get checked, too. Do kids need regular blood pressure check-ups or regular tests of their blood glucose levels? Probably not - these simple procedures can be done during a child's annual physical. But kids are very active and more frequent chiropractic check-ups are usually a good idea. Most of us were introduced to chiropractic care when we were adults - and we had to play catch-up for however long a period of time before we really began to feel healthy again. If we began chiropractic care as a younger adult, it probably didn't take too long to restore good health. If we were older - well, the process probably took more time.

If chiropractic care is valuable for you, imagine how valuable it is for your children. Kids are natural explorers - they run, jump, climb things, fall down, and bounce around. And, kids are resilient - this ability to recover quickly is one of the great benefits of being very young. Occasionally, one of these activity-related injuries impacts a child's spine. Nothing obvious has happened and nothing hurts. But there may be subtle injuries to spinal muscles and spinal ligaments that have a long-term effect on spinal nerve function.

Spinal nerve function depends on mechanical integrity of the spine itself. If spinal muscles and ligaments are inflamed or irritated, spinal nerve function is compromised to a greater or lesser extent. In a child, the short- and long-term results may include muscle pain and stiffness, loss of full range of motion in the neck or lower back, frequent colds, headaches, gastrointestinal problems, allergies, and asthma. Of course, when it comes to good health for you and your family, preventing a problem is much easier than treating a problem. In the long run, prevention also costs much less. We all want our kids to be healthy and well. We want them to play full-out, to engage in all kinds of sports, and to have a lot of fun. In order for children to continue to enjoy optimal health, regular spinal check-ups are as important as an annual physical exam. Your local chiropractor is the spinal health expert in your community. She will be glad to help you ensure your child's continued good health.

¹Barkley JE, et al: Reinforcing value of interval and continuous physical activities in children. Physiol Behav April 16, 2009
²Fecteau D, et al: The effect of concentrating periods of physical activity on the risk of injury in organized sports in a pediatric population. Clin J Sport Med 18(5):410-414, 2008
³Spinks AB, McClure RJ: Quantifying the risk of sports injury: a systematic review of activity-specific rates for children under 16 years of age. Br J Sports Med 41(9):548-557, 2007

American kids are under tremendous pressure to perform well in school. Every year they're required to take more and more standardized tests, and every year they fall further behind children around the world, particularly in science and mathematics.More is required to do well in school beyond sitting in the classroom and managing to stay awake throughout the day.

Kids by nature want to learn, but somehow this love of new knowledge and new experiences is sucked out of them early on. Many teachers no longer teach to broaden the skills and abilities of their students. Instead they teach to the standardized tests. There's no longer much room for exploring new territory, and kids get bored easily and stay bored if they're not challenged.

How can we help our children when the educational system does not provide the formula to engage many kids? Making sure our kids are healthy and well is a very good start. One of the most interesting developments in cognitive science (how people learn) in the last ten years is the importance of physical activity in relation to human performance. The results are in - research proves that physical activity is highly correlated to learning and academic achievement. Active kids are explorers. Active kids are alert and interested in what's going on around them. Active kids have an instinctive desire to grow and develop.

What kinds of exercise should our kids be doing? The great news is that the specific type of exercise doesn't matter. It's all good, whether a kid is playing soccer, running track, or riding around the neighborhood on her bike. It's the amount of exercise that counts, not the format of the exercise. Federal agencies recommend that every child get an hour of physical activity each day. This hour can be broken up into small segments or done all at once. What matters is the amount and consistency of the exercise.

Chiropractic care can play a big role in a child's development. Periodic chiropractic treatment can improve the functioning of a child's musculoskeletal system, and thus help improve their physical performance. And, chiropractic care can help a child recover quickly from activity- and sports-related injuries.

By helping a child continue with fun, enjoyable, and rewarding physical activities, chiropractic care is also helping them improve their academic performance. The result is a much more well-rounded young person, one whose interests may extend from the ball field to the science lab to the music room.

¹Hillman CH, et al: The effect of acute treadmill walking on cognitive control and academic achievement in preadolescent chiildren. Neuroscience 159(3):1044-1054, 2009
²Ploughman M: Exercise is brain food. The effects of physical activity on cognitive function. Dev Neurorehabil 11(3):236-240, 2008
³Davis CL, et al: Effects of aerobic exercise on overweight children's cognitive functioning. Res Q Exerc Sport 78(5):510-519, 2007