Athletes
Sports Spine Specialist Chiropractic Team: Athletes strive to achieve their body’s maximum performance by participating in numerous training regimens consisting of strenuous exercises and physical activity and ensuring they meet all of their body’s nutritional requirements. Through proper fitness and nutrition, many individuals can condition themselves to excel in their specific sport. Our training programs are designed for athletes that look to gain a competitive edge in their sport.
We provide sport-specific services to help increase an athlete’s performance through mobility, strength, and endurance. Occasionally, however, the excess workouts can lead many to suffer injuries or develop underlying conditions. Dr. Alex Jimenez’s chronicle of articles for athletes displays in detail the many forms of complications affecting these professionals while focusing on the possible solutions and treatments to follow to achieve overall well-being.
by Dr Alex Jimenez | Fitness, Seniors
Older, obese adults need to shed weight, but dieting can worsen their frailty. A new study addresses this conundrum, suggesting seniors take up both aerobic and resistance exercise while slimming down.
Engaging in aerobic and resistance exercise while losing weight enabled study participants to maintain more muscle mass and bone density compared to folks who did just one type of exercise or none at all, the researchers found.
Elderly and Obese, Here is What to Do
“The best way to improve functional status and reverse frailty in older adults with obesity is by means of diet and regular exercise using a combination of resistance and aerobic exercise training,” said study leader Dr. Dennis Villareal. He’s a professor of medicine at Baylor College of Medicine in Houston.
More than one-third of people age 65 and older in the United States are obese, according to the study authors. Obesity worsens the typical age-related decline in physical functioning and causes frailty, while weight loss can lead to harmful declines in muscle mass and bone density.
The researchers wanted to see what combination of exercise, along with dieting for weight loss, might be best. They randomly assigned 160 obese and sedentary adults, age 65 or older, to one of four groups: weight loss and aerobic training; weight loss and resistance training; or weight loss and a combination of both types of exercise. The fourth group served as controls and didn’t exercise or try to lose weight.
After six months, physical performance test scores increased by 21 percent in the combination exercise group, but just 14 percent among those who only did aerobic exercise or resistance exercise, Villareal’s team said.
The researchers also found that lean body mass and bone density declined less in the combination and resistance groups than in the aerobic group.
One strength of the study is its evaluation of several regimens, said Miriam Nelson, director of the Sustainability Institute at the University of New Hampshire.
Such research is critical, as ”the majority of [older] people are either overweight or obese,” said Nelson, who wasn’t involved in the study.
It’s About Health NOT Weight
While many studies of obese or overweight older adults focus only on exercise and weight loss, “this is really looking at health,” she said.
“Health in aging is really [about] functioning,” Nelson said. Maintaining muscle strength and bone density is essential to remain mobile and functional, she pointed out.
“All these multiple factors are what dictate to a large extent somebody’s ability to be independent, healthy and to live life to its fullest as they age,” Nelson added.
At the outset of the study, participants were mildly to moderately frail, according to the authors.
The researchers assessed the seniors’ physical performance, muscle mass and bone health over the 26-week study.
The overall winners, the combination group, exercised three times a week, from 75 to 90 minutes each session.
Aerobic exercises included treadmill walking, stationary cycling and stair climbing. Resistance training involved upper-body and lower-body exercises on weight-lifting machines. All groups also did flexibility and balance exercises.
The study showed a clear inverse relationship between weight loss�and lower back pain. �The greater the weight loss in the studied clients, the less lower back and knee pain was clearly presented
The study was published May 17 in the New England Journal of Medicine.
SOURCES: Dennis T. Villareal, M.D., professor, medicine, Baylor College of Medicine, and staff physician, Michael E. DeBakey VA Medical Center, Houston; Miriam Nelson, director, Sustainability Institute, University of New Hampshire, Durham; May 17, 2017, New England Journal of Medicine
News stories are written and provided by HealthDay and do not reflect federal policy, the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, or the U.S. Department of Health and Human Services.
by Dr Alex Jimenez | Diets, Fitness
With summer officially just weeks away, many of us are dreading bathing suit season because we’ve packed on pounds — especially around the mid-section. But you won’t get those washboard abs by doing sit-ups, say experts. Abs are made in the kitchen, not in the gym, as the saying goes.
In other words: It’s what you put into your gut that helps banish belly fat.
“Visceral fat, or what we commonly call belly fat, is more than the fat you see on your body and can pinch between your fingers,” notes Tara Gidus Collingwood, the team dietitian for the Orlando Magic basketball team.
“It’s the layer of fat deep inside the body that forms between your organs. And even though you can’t see it, if you have an increased amount of subcutaneous fat, the fat you CAN see and pinch, it’s likely that that you also have a large amount of visceral fat.
Collingwood, co- author of the “Flat Belly Cookbook for Dummies,” tells Newsmax Health the more belly fat you have, the more dangerous it is to your health.
“Visceral fat is so toxic that research has linked it to everything from an increased risk of heart disease, to metabolic syndrome, Type 2 diabetes, gallstones, certain cancers, and even dementia,” notes.
Now for the good news: Gidus says that science has uncovered foods that actually help blast away belly fat. Here are her top 10 choices:
Salmon. Inflammation caused by an imbalance in your gut which can turn on your fat genes, leading you to gain weight around your belly. Salmon is a super anti-inflammatory food and also contains omega-3 fatty acids which have been shown to reduce belly fat storage. It also helps to control the hormone levels like cortisol, a common culprit of increased fat storage in the midsection.
Apples. These summer and fall favorites are great belly-fat fighters because they are high in fiber. This allows foods to be slowly digested, which controls the response of insulin and helps stabilize blood sugar — giving an added boost to the fight against fat.
Almonds. Not all fats are created equal, and some are actually helpful in reducing belly fat. Stock up on almonds for snacking because they are high in monounsaturated fat which reduces the accumulation of fat around the belly.
Popcorn. Here’s another handy snack food that is a great belly-flattening treat and you can eat a lot of it. Purchase loose corn kernels or low-fat and low- sodium microwave popcorn to help reduce your sodium intake and keep calories in check for a flat belly all season long.
Green tea. This powerhouse beverage contains the flavonoid quercetin which not only boosts the immune system and promotes heart health but also helps fight belly fat. It works by blocking fat cells from maturing and inhibits the rate of new fat cell formation.
Eggs. One of the best ways to protect yourself against visceral fat is to strengthen and protect your muscles. Muscle burns energy on a regular basis, so it steals energy away from fat cells — especially belly fat cells — to sustain itself. For under 80 calories, an egg provides six grams of muscle-building protein.
Spinach. This leafy green contains a unique long-chain sugar molecule called sulfoquinovose (SQ). According to a study in the journal Natural Chemical Biology, SQ feeds the good or beneficial bacteria, which in turn promotes their growth in the gut. When these bacteria are strong, they provide a protective barrier in the gut preventing the growth of bad bacteria which can cause inflammation and increase belly fat.
Greek yogurt. The Society for Endocrinology presented a study by researchers who found that when protein is digested and broken down into amino acids in your body, one of those amino acids called phenylalanine, triggers hormones that help reduce appetite, which ultimately leads to fat burn and weight loss.
Bananas. When you are sleep deprived, the levels of ghrelin called the “hungry hormone” skyrocket while the levels of leptin, the hormone that signals satiety, plummet. As a result, studies show you are more likely to eat more the next day and the foods you choose are the ones that typically increase belly fat. So if you are having trouble falling asleep, eat a banana which is an excellent source of the muscle relaxing ingredients magnesium and potassium. This handy fruit also contains tryptophan, a chemical which can help summon the Sandman.
Cayenne pepper. This popular spice doesn’t only burn your tongue, it helps burn away belly fat. Daily consumption of one of the compounds found in pepper seeds, called capsaicin, speeds up abdominal loss by boosting the body’s ability to convert food into energy, according to a study published in the American Journal of Clinical Nutrition.
by Dr Alex Jimenez | Fitness, Health, Wellness
You’re probably already incorporating strength moves such as squats, planks, and burpees, into your workout routine. But there are a few additional moves you’re likely missing. These�strength exercises below target commonly overlooked muscle groups, says Karen Litzy, a spokesperson for the American Physical Therapy Association. Adding them to your regular workout routine will not only improve your strength in your lower body and core�but also help keep injuries away.
Stability Ball Hamstring Curl
Lie faceup with lower legs and heels on a stability ball, knees straight. Lift hips off the floor (A). Slowly bend knees to pull the ball toward hips (B), then slowly return to the starting position. Do 3 sets of 15.
Fire Hydrant
This exercise targets the gluteus medius (a.k.a. the upper part of your butt), says Litzy, which helps support your pelvis. “Any weakness there can cause hip strain that leads to pain.” Start on all fours (A). Raise left thigh to the side, keeping knee in line with foot (B). Hold for 30 to 60 seconds. Repeat on other side.
RELATED: This Next-Level Burpee Tones Your Abs Like Crazy
Bird Dog
For good posture, it’s important to tone the erector spinae muscles along the back of your spine. From all fours (A), simultaneously extend left leg at hip height and right arm at shoulder level (B). Hold for 5 to 10 seconds. Repeat the move with right leg and left arm. That’s 1 rep. Do 10 reps.
by Dr Alex Jimenez | Fitness, Health, Wellness
Targeted workouts are great for when you want to hit a tough-to-tone spot, but we think feeling fatigued all over is especially rewarding. And when it only takes 20 minutes of work to feel sore the next day? Well, that’s even better.
This routine from the Brave Body Project does just that. Founded by trainers Lindsey Clayton and Amber Rees, the Brave Body Project is an “online community and fitness membership program for people who share a passion for feeling strong, being bold, and finding the brave within.” Put another way, these ladies know how to help you get fit—and feel great about it.
That’s precisely why we asked Lindsey and Amber to share their favorite exercises for head-to-toe strengthening. They brought 10 moves that deliver a serious “full-body beatdown.” Sound intimidating? Yes. But is it an amazing sweat session? Double yes.
WATCH THE VIDEO: This Full-Body Workout from Emily Skye Torches Calories and Builds Strength Fast
In this video, the energetic duo will lead you through a workout that targets the arms, legs, core, and glutes. Here’s how it goes: Each move is done for 50 seconds, and followed by 10 seconds of recovery. Once you complete all 10 moves, you get 30 seconds of rest, and then do it all over again.
The best part about these moves is that they sculpt and stretch different body parts simultaneously. For example, a walkout tricep push-up with a hip opener not only targets the upper arms, but also creates space in the hips. Similarly, a side lunge with a lateral raise works the muscles in the thighs and challenges balance too.
Want to break a sweat in just 20 minutes? Watch this video for a full-body workout you can do at home. Press play, get strong, repeat.
by Dr Alex Jimenez | Athletes, Health
With the competitive season looming, chiropractor Dr. Alexander Jimenez�gives insights & examines the current best thinking on vaccination for athletes, and makes recommendations for sports clinicians.
Without doubt, vaccination is one of the greatest triumphs of modern medicine. Many serious diseases that used to routinely maim or kill large numbers of people are no longer a threat. More than that, vaccination can prevent outbreaks of less serious illness, which although not life threatening, are still unpleasant, leading to missed time from work and school.
Anyone with young children or who has travelled extensively abroad will (hopefully) understand that a programme of vaccination is either required or recommended. When it comes to the travelling athlete however, the situation is rather more complex. While the basic vaccinations (eg typhoid, hepatitis etc when travelling to certain regions of the tropics) are of course still required, clinicians will also want to ensure that their athletes stay as well as possible to compete at their full potential. A mild illness that is an inconvenience to a tourist may be a disaster for an athlete focusing on the peak of his/her season!
Sports clinicians may therefore wish to consider extra vaccinations to minimise the risk of more minor conditions. However, this approach raises a whole new set of issues. For example, which additional vaccinations may be use for athletes who regularly travel abroad? What are the possible side effects of these extra vaccinations and how should vaccines be timed to maximise immunity during the competition, while minimising disruption to training in the run up to competition?
Athletes Are Different
There exists some uncertainty about the most appropriate vaccination regimens in athletes among team doctors and other physicians because general public health vaccination guidelines cannot be easily transferred to elite athletes. Complicating factors include the typical circumstances of athletes� daily life, such as frequent travelling to foreign countries or close contact with teammates and opponents, which might indicate the need for a modification of recommended vaccination schedules. In addition, intense physical activity of training and competition with its possible effects on the immune function can affect decisions about execution and timing of vaccination.
Other complicating factors are that vaccination recommendations are formulated around a public health policy rather than for specific individuals and are likely to change over time(1-3). Also, there�s the issue of cost effectiveness; the majority of vaccines that are not generally recommended are not recommended because the medical benefit is not regarded sufficiently balanced with the costs if implemented across the whole population. This is despite the fact that they may be potentially beneficial in specific individuals(4,5). It�s also important to understand that generalised recommendations take no account of the implications of the effects of illness in athletes, which can be far more profound and far reaching than in the general public (see Box 1).
Further reasons as to why athletes are different when it comes to vaccination include the following:
- Athletes are often in close contact with opponents and teammates, which increases the risk of transmission of many diseases, particularly respiratory- transmitted diseases(9,10). Typically, a contact of less than 1-2 metres distance is necessary to transmit diseases such as influenza or other respiratory- transmissible agents such as varicella(11,12).
- For blood-borne diseases, the transmission risk due to sport is less pronounced but athletes are still at higher risk than the general population(13,14).
- Even healthy non-vaccinated athletes being exposed to an infectious agent (eg contact with a diseased individual) may have to be excluded from training and competition for medical reasons. Usually, such an exclusion has to last for the complete incubation period of a disease, which may be up to three weeks.
Putting all these factors together, the recommendation is that elite, competitive athletes should be vaccinated more aggressively than the general public(15).
Which Vaccinations?
The decision as to which vaccinations are given prior to foreign travel will depend on a number of factors, including the travel�destination(s), the nature of the sport and the health/vaccination history of the individual involved. Regardless of these factors however, it is recommended that ALL adult athletes are routinely vaccinated against the following:
1. Tetanus
2. Diphtheria
3. Pertussis (whooping cough)
4. Influenza
5. Hepatitis A and B
6. Measles, mumps and varicella (if immunity is not already proven by a natural infection)
Of these, numbers 1-5 should be given as inactivated vaccines while measles, mumps and varicella (chickenpox) should be given as live vaccines(15). A full discussion on the detailed considerations regarding each and every possible vaccination is beyond the scope of this article (readers are directed to a full and recent review of this topic by Luke and D�Hemecourt(15)). However, Table 1 summarises most of the key recommendations.
Vaccination Timing
Timing of vaccinations should be chosen in order to minimise interference with training and competition, and to ensure the immune reaction is not temporarily impaired. Inactivated vaccines generally cause side effects within two days following vaccination. This is in contrast to live vaccinations where the peak of side effects is most likely to occur after 10-14 days when replication of the vaccines is at a maximum. Unless a vaccination needs to be administered urgently, the best time therefore for vaccination is at the onset of resting periods � for example at the beginning of the winter off season.
When a vaccination has to be carried out within a training and/or competition period (eg influenza), there is no major medical problem with training undertaken shortly before or after vaccination. However, it is recommended to vaccinate shortly after a competition in order to make the period of time to the next competition as long as possible. Many vaccinations given via injection can cause local pain and inflammation at the injection site. Clinicians may therefore wish to time vaccine administration so as to not coincide with delayed onset muscle soreness (DOMS) following strenuous exercise.
Vaccination Techniques
Dependent on the injection site, some sport- specific impairments may result (for example buttock pain in runners following a gluteal injection). Obviously, it is advisable to use the non-dominant side for injections in unilateral disciplines such as racquet sports. For vaccines that can be administered using either the intramuscular or the subcutaneous route, the intramuscular option seems to be preferable as it yields higher titer rate (more antibody production) and a lower risk of granuloma.
Injection into the deltoid muscle is preferred if possible, although other muscle sites are possible. Regardless, it is important that the athlete is sitting or lying, and the muscle is completely relaxed. Studies indicate that the use of longer needles (25 mm) and a fast speed of injection/ withdrawal of the needle (1-2 seconds) are associated with less pain(37). Also, an angle of injection of 90 degrees may also help reduce pain in intramuscular injections.
Syncopes or collapses following vaccination are uncommon but may occur; some studies on influenza vaccination suggest the frequency of syncope in younger athletes to be around 1%(38). However, the syncope itself may be less important than secondary injuries caused by the collapse such as skull fracture and cerebral haemorrhage. Given that the majority of syncopes (80 %) occur within 15 min of vaccine administration, it is recommended that athletes are observed for a period of 15-30 minutes following vaccination. This recommendation may be particularly important for endurance athletes because there are indications that, in these athletes, vasovagally-induced syncopes are more frequent(39).
Vaccination Schedule
The recommended vaccination schedules for disease prevention will be dependent on the previous vaccination record and disease history of the athlete in question. Also, some schedules are dependent of the type/brand of vaccines used and recommendations may also differ according to public health policy in each country. Readers are directed to the summary given by Luke and D�Hemecour(15); there are also some excellent downloadable resources on the US Centre for Disease Control and Prevention (CDC) � www.cdc.gov/vaccines/ schedules/hcp/adult.html.
Summary
The vaccination requirements for elite athletes are not the same as that for the general public. Not only are these athletes�potentially exposed to more disease pathogens as a result of international travel, even the mildest episode of illness that would be barely noticeable to most of us can be devastating for elite athletic performance. For these reasons, sports clinicians and doctors should take a much more aggressive approach to vaccination of their athletes. Together with steps to reduce exposure and the correct vaccination techniques and timing, clinicians can maximise the potential of their athletes to perform at all times of year across all regions of the globe.
References
1. World Health Organization. WHO vaccinepreventable
diseases: monitoring system. 2012
global summary 2013. www.who.int/
immunization_monitoring/data/data_subject/
en/index.html accessed 5th Feb 2017
2. Sta�ndige Impfkommission (STIKO).
Empfehlungen der Sta�ndigen Impfkommission
(STIKO) am Robert Koch-Institut. Epi Bull.
2012;283�10
3. Centers for Disease Control and Prevention.
General recommendations on immunization�
recommendations of the Advisory Committee
on Immunization Practices (ACIP). MMWR
Recomm Rep. 2011;60:1�64
4. Vaccine. 2013;31:6046�9
5. Pharmacoeconomics. 2005;23:855�74
6. J Exp Med. 1970;131:1121�36
7. Am Heart J. 1989;117:1298�302
8. Eur J Epidemiol. 1989;5:348�50
9. Clin J Sport Med. 2011;21:67�70
10. Sports Med. 1997;24:1�7
11. J Infect Dis. 2013;207:1037�46
12. Lancet. 1990;336:1315
13. Br J Sports Med. 2004;38:678�84
14. Clin Sports Med. 2007;26:425�31.
15. Sports Med 2014; 44:1361�1376
16. Vector Borne Zoonotic Dis 2004;4(1):61�70
17. www.nhs.uk/Conditions/Lymedisease/Pages/Introduction.aspx#symptoms accessed Feb 2017
18. J Infect Dis 1999;180(3):900�3
19. Ann N Y Acad Sci 2003;990: 295�30
20. J Infect Dis 1984;150(4):480�8
21. N Engl J Med 2001;345(2):79�84
22. Pediatrics. 2013;131:e1716�22.
23. Euro Surveill. 2005;10(6):E050609.2
24. Euro Surveill. 2013;18(7):20467
25. Centers for Disease Control and
Prevention. Epidemiology and prevention of
vaccine-preventable diseases. The pink
book:course textbook. 12th ed.; 2012.
26. World Health Organisation. Poliomyelitis;
2014. www.who.int/topics/poliomyelitis/en/
27. Clin Exp Rheumatol. 2001;19:724�6
28. JAMA. 1997;278:551�6
29. Clin Infect Dis. 2004;38:771�9
30. Travel Med. 1998;5:14�7
31. Cochrane Database Syst Rev.
2014;1:CD001261
32. Curr Opin Infect Dis. 2012;25:489�99
33. Drugs. 2013;73:1147�55
34. Hum Vaccin Immunother. 2014;10:995�1007
35. Popul Health Metr. 2013;11:17.
36. Vaccine. 2009;27(Suppl 2):B51�63
37. Arch Dis Child. 2007;92:1105�8
38. Vaccine. 2013;31:6107�12
39. Prog Cardiovasc Dis. 2012;54:438�44
by Dr Alex Jimenez | Diets, Fitness
A new UK study has found that obesity in childhood has long-term health implications that could last well into adulthood.
Carried out by a team from the University of Surrey, the researchers collected data from 18 studies which included over 300,000 children in total with an average age of 10.
The team looked at the measurements of the children’s body mass index (BMI), waist circumference and skin fold thickness, and compared them to results from the same participants 25 years later as adults.
They found that participants who were obese as children were predisposed to ‘pre-diabetes’ — a condition in which the body cannot adequately metabolize glucose and which can lead to diabetes — and thickening of arteries in adulthood.
An increase in the thickening of these arteries also increases an individual’s risk of experiencing a cardiovascular condition such as heart disease in later life.
The children’s BMI was also found to be a good predictor of high blood pressure in adulthood, and could also help predict other illnesses later in life that are associated with obesity.
However, due to the limited data available the team were unable to determine if waist circumference and skin fold thickness were also indicators of future health conditions.
Commenting on the findings lead author Dr Martin Whyte said, “It is worrying that obesity is becoming endemic in our society.”
“The adverse effects of adult obesity are well known but what we have found is that obesity in childhood can cause lasting arterial damage which could potentially lead to life threatening illness. This is something that we need to address to protect adult health and reduce pressure on the NHS.”
Childhood obesity is on the increase in the UK, with figures from the NHS National Child Measurement Programme indicating that 19.8 percent of 10-11 year olds were classed as obese in 2015/16, a rise of 0.7 percent on the previous year.
The findings can be found online published in the journal Obesity Reviews.
by Dr Alex Jimenez | Diets, Fitness
Still taking sleeping pills to get a good night’s rest? New research suggests there’s a better way: Hit the gym.
Rush University clinical psychologist Kelly Glazer Baron tells CNN a growing body of evidence over the past decade has confirmed that regular exercise helps people sleep better than medication.
“In one study we did, for example, older women suffering from insomnia said their sleep improved from poor to good when they exercised. They had more energy and were less depressed,” he said.
Most sleep studies have confirmed sleep quality is enhanced in people who get the recommended amount of exercise — 2½ hours a week of moderate-intensity aerobic exercise, along with strength or resistance training.
Brisk walking, light biking, and using a treadmill or elliptical machine all increase heart rate and cardiovascular fitness, which aids sleep quality.
Experts also recommend not exercising within six hours of bedtime, which can hinder sleep.
