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4A Daily News ��� Tuesday, February 26, 2013 Vitality health & fitness How to work out after sickness, surgery or injury DALLAS (MCT) ��� Megan O'Laughlin works hard to maintain her weight loss and fitness level. She's diligent about portion control. She runs regularly and takes aerobics and weighttraining classes at Cooper Aerobics Center. So when she fell while running December's Rock 'n' Roll half marathon in Las Vegas and broke her elbow, she had a big question for her doctor: "How soon can I start running again?" "I used to be morbidly obese," said the Dallas attorney, who ran the last nine miles of the race without knowing the extent of her injury. "I lost more than half my body weight. When you go through that, one fear is gaining weight back." Another was losing the level of fitness she'd worked so hard to attain. The injury was, she said, "like having the rug pulled out from under me. For someone who is addicted to exercise as mental therapy, it's really hard to be sidelined." Luckily, avid exercisers can find ways to ease back into a routine during recovery from injury or illness _ if they're careful about it. Meanwhile, being injured, getting sick or having surgery can send diehard exercisers' spirits into a sedentary tailspin. "For people who exercise regularly, exercise becomes part of them," said Bill Borowski, director for athletic training services at Baylor Institute for Rehabilitation in Texas. "It's part of their social network, stress relief, everything else." O'Laughlin has spent almost every Tuesday, Thursday and Saturday for the last six years running with groups from Luke's Locker. She misses the camaraderie, she said. But she knows if she doesn't do what she's supposed to do ��� including three hours of physical therapy every day ��� her recovery will be longer. The line between taking it too easy and rushing recovery is a narrow one, said Dr. Damond Blueitt, a sports medicine physician on the medical staff of Texas Health Fort Worth. "With prolonged bed rest, you lose muscle mass, Choose your own potential with exercise, healthy eating By James Fell Chicago Tribune (MCT) Courtesy photo Megan O'Laughlin works out despite having just broken her elbow two weeks ago, in the "Total Body" aerobics class at Cooper Aerobics Center. you lose strength," he said. "Prolonged bed rest can decrease bone calcium." It can also increase the risk of blood clots because the blood is static, he said. But trying to speed your recovery can be dangerous, too. "Say you had a surgery where you were repairing something," he said. "You have a lot of blood vessels in that area. The tissue gets altered. Any time you do an exercise where you get your heart rate up, more blood is going to that area. One of the consequences is that it may produce more swelling, more scarring." Just as frightening is the potential for infection if you're sweating and the wound gets dirty, he said. "If someone has surgery and stitches, don't get your heart rate up high for four or five days," he says. "Let the tissue heal some." Most important, ask your doctor, and listen to the answer. "You have to be specific," he says. "If the doctor says, 'I want you to rest for two weeks,' ask what that means. 'Does that mean I can't go for a slow walk? Does it mean I can't go light on the exercise bike or do light resistance training?'" A stationary bike is often a go-to recommendation for Borowski, who tailors clients' workouts based on what their doctors advise. 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"You're still using quads and hamstrings. It's just a little different." Pilates instructor Marilyn Levitt will work with injured clients only after they have a doctor's release. Often, they come to her to learn how to modify their workouts while they heal. "Engaging in different types of exercise is so important," said Levitt, owner of Core Pilates Dallas. "It's tough being told you can't run for a while. But that time could be used to strengthen other areas of the body. "You can always do something else," she said. "People who want to will find something they can do." Advised Blueitt: "There's usually always something you can do to get your blood flowing and your heart rate up so you don't have such a tough time recovering. You get better results after surgery if you can get that person moving again, but you want to make sure they're not doing things to affect the area that needs rest." What he, Levitt and Borowski stress is the neck rule: If your illness is from the neck up, you're probably OK to work out. "When I really won't work with a client," Levitt said, "is when they are sick with a fever or something in the chest." "Once you get a chest problem, be careful," Blueitt said. For people like O'Laughlin who work out regularly and worry about dropping their fitness level or gaining weight, he has encouraging words. First, if you're in fairly good shape, "it will take a while to lose a substantial amount" of fitness and will be easier to get it back. As far as weight, Bluieitt said, yes, you may gain some. Once you start moving again, you'll drop it. Besides, he said, "Your body is working in overload to heal. So usually the caloric intake you don't have to watch as much because you need those extra calories to help the body heal." O'Laughlin has been relieved to find that she didn't gain weight. In fact, her post-surgery experience has had the opposite effect. "It's crazy because my first fear was that I'd start gaining weight," she said. "Without even trying, I've lost about 3 pounds. I think even if I'm not getting my heart rate up with a cardio workout, I'm being so active with physical therapy that I'm burning more calories. "I wouldn't think sitting on my butt and moving my arm would burn calories, but apparently it does." IS IT SAFE? How to know whether it's OK to resume your workout: Listen to your body."It's telling you something, no matter what it is," said Bill Borowski of the Baylor Institute for Rehabilitation. If your foot hurts, stop working out for a little while. Otherwise, it could get worse and you could end up having to stay off your feet for much longer. "I know a lot of people who won't stop and slow down," he said. "Then instead of a little tendonitis, they're dealing with stress fractures and have to sit out for eight weeks." Let your neck be your guide.If your illness is from the neck up, like a head cold, and you feel like working out, go ahead. But, cautioned sports medicine physician Dr. Damond Blueitt, "once you have a chest problem, be careful." Said Borowski: "Once it's into your lungs, you're taking an already irritated organ because of inflammation or mucus ��� something inflamed ��� and making it work harder by increasing the heart rate." Ease back into your routine.It's going to take some time to get back to where you were before you eased off on your workouts. So be patient. If you get tired walking to the end of the block, back off a little the next day. Announcing Practice Closure Michele Martin, DPM Office Closing February 28, 2013 527-2523 Medical Records Request P.O. Box 609 Cottonwood Ca 96022 Long ago I had one of those "choose-your-own adventure" books based on a James Bond movie, and I made bad choices; the poor British spy kept getting consumed in a vat of molten lava, impaled on a bunch of spiky things or became an appetizer for saltwater crocodiles. But when it comes to the exercise-then-chooseyour-food adventure that that I've lived my whole life, however, I have a far better track record. Do you know the three mealtime words that can cripple weight loss? "Because I exercised," said Dr. Yoni Freedhoff, an obesity researcher in Ottawa, Ontario. Burning off 300 calories on an elliptical trainer then rewarding your efforts with a 500-calorie piece of cheesecake is just bad math. That's the choice that leads to spiky, overweight crocodiles in lava. The other choice is realizing that burning calories is the least important thing exercise does. This choice takes advantage of the cognitive-boosting effects of physical activity to resist food rewards and make healthier choices that fuel performance. Obesity researcher Dr. Sue Pedersen, a specialist in endocrinology and metabolism in Calgary, Alberta, explained, "The bottom line is that weight loss is 90 percent about diet." You cannot out-exercise a bad diet. So go ahead, choose your own adventure. ___ Adventure 1: "I exercise, so I earned this treat." So we're a few months into this New Year, and you've resolved to get in shape and lose weight. You're going to the gym ��� walking, jogging, swimming, cycling or whatever. After a good workout, you think, "I'm exercising now. I deserve this treat." This adventure is called the "reward mentality." Because you exercised, as Freedhoff explained, you believe you have leeway in terms of dietary choices. You can have seconds, drink extra booze, care less about what you consume. The problem, professor Eric Ravussin, of the Pennington Biomedical Research Center in Louisiana, explained to me, is that most obese people are incapable ��� both physiologically and psychologically ��� of the type of activity required to burn the calories required to achieve significant weight loss. They tend to overestimate just how many calories they burn via exercise then overcompensate with food reward. It's bad math, but it happens all the time. The downside to choosing this adventure is numerous studies showing exercise alone doesn't lead to weight loss. ___ Adventure 2: "I exercise, so I need healthy fuel." Because weight loss is simple caloric restriction, it can be done easily by eating less, but in an environment with 24/7 McDonald's, rapid pizza delivery and doughnuts at meetings, it's hard to resist the constant call of the cookie, cream puff or cheeseburger. "Exercise is a critical component of weight loss and weight maintenance," Dr. Miguel Alonso-Alonso, a Harvard neurologist and specialist in how exercise affects the brain, told me. "We know that. It's a fact." First off, stress eating is common, but exercise is one of the most powerful tools available for reducing stress. Beyond that, Alonso-Alonso says, it boosts your ability to stick to a plan. "Physical activity and eating behavior are connected in the brain at the cognitive level. It's the same mental processes." Alonso-Alonso explained we use goal-oriented systems in our brains to suppress those immediate impulses to eat junk food. "The resources for goal-oriented eating behavior are greatly enhanced via physical activity," he said. "Exercise improves eating behavior through brain and cognitive changes." Healthy eating involves sticking to a plan. Exercise makes you better at sticking to a plan by enhancing "executive function" and decision-making ability. Every time you eat, good decisions plus higher executive function equals better decisions. Oh, and according to Brian Wansink, a professor of consumer behavior and nutritional sciences at Cornell University, we make more than 200 decisions about food every day. "There is a dose-response effect," Alonso-Alonso said. "A fitter person is going to have greater improvements in executive function and therefore better control of what they eat." Exercise also has the ability to help at the subconscious level. Although you may feel like you're inhaling fire ants after a hard run, the reality is that physical activity has a rewarding effect on your brain. It elicits the same reward sensation as things like drugs, alcohol, gambling, and even junk food. A 2012 study of 30 people by researchers at California Polytechnic State University determined that exercise suppresses desire to eat by giving your brain an alternate, healthier fix. But when it comes to appetite, not all exercises are created equal. Another study from last year, this one by researchers at the University of Western Australia, used 33 sedentary people and found that those in the aerobic training group had increased satiety, but those in the resistance training group (such as weightlifting), did not. redbluff.mercy.org www.redbluff.mercy.org Community Diabetes Support Group 6:30pm-8pm 3/4 1st Monday Columba 527-5290 Auxiliary Sole Love Alegria Shoe Sale 10am-3pm 3/6 Wednesday Main hall of hospital 736-1326 Grief Support Group 3pm-5pm 3/7 Thursdays Coyne Center 528-4207 Community Basic Life Support 6pm-10pm 3/12 2nd Tuesday Columba 529-8026 Diabetes Education 1pm-3pm 3/20 Wednesday Columba 529-8026 Diabetes Education 1pm-3pm 3/27 Wednesday Columba 529-8026 5:30pm-9:30pm 3/13 Wednesday Columba 529-8026 Waterbirth Class Weekend Childbirth Class 5pm-10pm 3/15 Friday Columba 529-8026 8am-4pm 3/16 Saturday Columba 529-8026 Sees Easter Candy Sales 10am-3pm 3/27 Wednesday Main hall of hospital 736-1326 St. Elizabeth Community Hospital introduces relief from vein pain and varicose veins, our new outpatient procedure. Call our Community Relations Department to learn more as the seminar will launch the last week of March. 529-8038 or email ContactSECH@dignityhealth.org www.redbluff.mercy.org