Please note that this month's MAF FITNESS NEWSLETTER is for the November/December time span. The editorial staff is contemplating a change to the publication schedule, and is more-or-less in disarray over the issue at the moment. Subject matter has become more scarce, and at-the-same-time submission of topics of interest by readers has fallen off, making it necessary to change from the current monthly publication schedule to a new schedule not yet determined, but which will likely be either every-other-month, or possibly quarterly.
A new accidental discovery of a migraine relief drug may have been made. Women who were given injections of the botulism toxin (botulinum) to smooth wrinkles on their foreheads reported a fortuitous side-effect -- no more migraines.
Botulism has long been a villain that causes food poisoning, and is part of any self-respecting country's biological warfare arsenal.
It (botulinum) attacks the nervous system and has a paralyzing effect. It was once used by some members of the medical profession, in very small doses, to paralyze small muscles to stop tremors and spasms. Then the wrinkle-smoothing effect was noted, and finally the anti-migraine effect. That is quite a string of unexpected benefits from a toxic substance.
The plastic surgeon, William J. Binder of UCLA, who did the wrinkle-smoothing by injecting botulinum, subsequently got the reports of no more migraines by some of the participants, and ran a study to verify what he had been told.
The study results found that 76 of 96 patients either had no more migraines, or they had fewer or less severe migraines since the introduction of botulinum into their systems. In 1994, Binder requested three other physicians to try his discovery, and they found results consistent with his.
This gives migraine sufferers one more subject to discuss with their physicians.
Adapted from a story in the September 29, 1999 San Jose Mercury News -- Final Edition.
Vitamin E is kind of a hot topic, so lets look at it a little bit. One question we frequently hear about vitamins is which is better "natural" or "synthetic?" The answer, generally, is that it doesn't matter, and "natural" is more expensive. But for vitamin E, that advice doesn't seem to hold. Studies have shown that more natural vitamin E is absorbed, and retained in the body than is true of synthetic E. So, while you may take a 100 IU dose of either natural or synthetic, more finds its way into your blood from the natural E.
The bottom line is; however, that since 200-800 IU (see note 1) is recommended (at least by the editors of the University of California, Berkeley Wellness Letter); you will get enough from either source -- natural or synthetic. But they still recommend that, if you can afford it, buy vitamin E that says "natural" or "d-alpha tocopherol."
Vitamin E has been recognized as a friend of the cardiovascular system, but there are different forms of E, with different benefits.
There are eight related compounds called "vitamin E". Four are called tocopherols, the best known of which is alpha-tocopherol, the substance is contained in the body and used in supplements.
The other four compounds are called tocotrienols, and are being marketed as supplements (EvolvE is one), and it is being claimed that they can lower cholesterol and provide heart and artery protection. In some animal studies, they have lowered blood cholesterol. Note that tocotrienols are naturally contained in cereal brans.
Tocopherols don't lower cholesterol, but are heart healthy as anti-oxidants -- they prevent oxidation of LDL cholesterol, thereby reducing fatty plaque buildup in arteries. And both forms of vitamin E seem to reduce blood clotting.
Human studies are still in short supply, and with conflicting results, but there is no recommendation to cease taking regular vitamin E capsules. And don't forget that a normal diet which includes wheat bran, wheat germ, barley, oat bran, and rice bran provides tocotrienols and other healthy substances. Add vitamin E supplements and you are doing good things for your health.
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note 1 - The U.S. RDA has been 30 IU, but more recent research has led to much higher recommendations, like the above mentioned 200-800 IU.
Goldenseal is a yellow flower that serves as a very old form of herbal medicine. And, unlike many herbal medicines, its active ingredients have actually been identified -- hydrastine and berberine, Berberine has been found to have anti-diarrheal effects. Goldenseal is also used as a cold remedy, and as a mild antiseptic -- often used as a mouthwash for minor mouth irritations, as well as for lip and eye irritations, although there is no scientific evidence to support the effectiveness of such use.
Anti-diarrheal effects are effective against diarrhea caused by infections like E. coli, vibrio, and giardia, but there are other drugs that work as well; and most doctors are reluctant to recommend it because of possible side-effects and its unpredictable action.
For those who choose to use goldenseal anyway, the recently published reference book "Herbal Medicines" (by three British herb experts) cautions against excessive use because of potential side-effects, including stomach upset, symptoms of nervousness, depression, and in extreme cases (with large doses) death from respiratory failure. Pregnant women or nursing mothers, children, and anyone with heart disease or high blood pressure, epilepsy, or blood clotting problems should avoid use of goldenseal.
This information is adapted from an article in the October 1999 issue of the UC Berkeley Wellness Letter.
Low back pain (LBP) is a common problem in the U.S., and is the subject of the following article; but before we get started, let's define LBP. It is acute lower back pain that lasts less than three months, may be accompanied by sciatica or other low back symptoms, sometimes with no obvious cause; but excludes serious back pain conditions from, for example, spinal fractures. LBP may have relatively disabling effects, but is likely to cure itself, given enough rest; unlike more serious lower back pain caused by spinal or nerve damage.
CAUSES OF LBP
There are a number of factors contributing to LBP; including:
There was a time when your physician might have told you to rest, and maybe take pain killers and/or muscle relaxants. Now, however, you are more likely to be told to exercise. And you would be much better off by starting an exercise program NOW, rather than waiting for LBP to strike. Prevention, not treatment.
EXERCISE GOALS
Very generally speaking, we want to improve aerobic fitness, muscle strength and endurance, and flexibility to avoid inactivity resulting from LBP, which increases both the frequency and discomfort of the condition. We are really looking at long-term management (or avoidance) of LBP. We want to improve exercise tolerance, and to regain previous optimum levels of activity (even if you were never at an optimum level).
General Exercise Guidelines
When you begin an exercise program for LBP, keep performance consistently on schedule. That is, avoid sporadic training.
It is important to maintain a neutral spine position during the exercises. That is: when in a supine position, contract your abdominal muscles, and simultaneously do a pelvic tilt (object: to keep your lower back in contact with the floor). When standing, contract your abdominal muscles and do a pelvic tilt, keep shoulders back, and your head up so that your ears are directly over your shoulders. [That is excellent general posture advice, follow it!]
Aerobic Exercise Guidelines
Low stress aerobic exercise, like walking (on a flat surface), swimming, indoor recumbent bicycling, or elliptical cross-trainers, can begin within the first two weeks of LBP symptoms for many victims. To be avoided are running, all high-impact aerobic classes, rowing, and hill walking or incline treadmill walking.
Activities should be selected based on pain/discomfort tolerance, and ability to maintain a neutral spine and proper form.
Resistance Exercise Guidelines
Generally speaking, increasing the intensity of exercises should consist of increasing reps, not weight.
Avoid exercises that load the spine from above (i,e,. that cause compression of the intervertebral discs, like bar-on-the-shoulders squats, Military presses, lying leg presses, or a heel raise that requires pushing with the shoulders against a pad, to name a few.
Remember that while it is important to exercise lower back and abdominal muscles, it is also important to exercise your total body to maintain overall balance of strength and flexibility, including the middle and upper back, chest, shoulders, and legs.
Flexibility Exercise Guidelines
Flexibility training for the spine should be focused on improving mobility, rather than range of motion (ROM), as is typical for other body parts.
Toward that goal you should hold each stretch for at least 30 seconds. As you become comfortable with a stretch, you might find it fruitful to take some deep breaths and ease into another, slightly deeper stretch and hold it for another 30 seconds.
Breathe throughout each stretch, and don't bounce. There are appropriate situations for dynamic stretching, but for LBP, stick to static stretching. And you should feel a mild tightness, but NEVER pain. And always keep your spine in a neutral position, as previously mentioned.
Abdominal Muscles -- Their Importance
LBP is frequently accompanied by a restricted range-of-motion in the pelvis and trunk. The abdominal muscles (rectus femoris -- bending and twisting, internal and external obliques -- aids bending and twisting, and the transverse abdominis -- compresses the abdomen to support internal organs), along with supporting trunk muscles (erector spinae -- backward lean, hip flexors, and quadratus lumborum -- side bends) are all part of the LBP management equation.
Before getting into the actual exercises, let's reiterate some crucial points:
Abdominal crunches - In a supine position with knees bent so heels are close to buttocks, hands behind head with elbows out wide, and chin off your chest; raise your shoulders off the floor as high as you can without your lower back losing contact with the floor. Hold for one second and slowly return to the starting position. Note that hands may be positioned at the sides of the head, and to maximize intensity don't completely relax on the return -- keep some tension on the abs throughout the set.
Dynamic pelvic tilts - In a supine position with knees bent, contract your gluteal and abdominal muscles to curl your pelvis off the floor -- your lower back remains in contact with the floor.
Reverse crunches - From a supine position, raise your knees until your thighs are vertical, cross your ankles; then, using your lower abdominal muscle, do what is called a pelvic tilt. Your knees will move toward your head as your pelvis curls up, but it is important to concentrate on the ab muscles. They are responsible for the movement, not your hip flexors. Return to the thighs -- vertical position. And the range-of-motion is very limited, but don't worry about it. The wider the range, the greater the hip flexor muscles are involved.
Double crunches - From a supine position, with thighs vertical and hands behind your neck; simultaneously raise your shoulders off the floor, and tilt your pelvis using your lower abdominal muscles. [Yes, this is simply combining a crunch with a reverse crunch.]
Diagonal crunches - From a supine position with knees bent, and hands behind your head with elbows out to the sides; move one shoulder toward your opposite knee, and keep your elbow pointed out to the side. During this movement your lower back remains pressed to the floor. Do all reps planned for your set on one side, before switching to the other side. Also, for all variations of crunches maintain the space between your chin and chest.
Reverse Twists - On your back with knees bent, and feet and knees together; rotate your knees toward the floor. Then back to vertical and over to the other side. Keep both shoulders pressed to the floor. If you keep your arms straight out from your shoulders, you won't tend to topple over (especially with the more advanced version of this exercise where you start with knees extended and thighs vertical). As you rotate your feet or knees toward the floor, only go as far as is comfortable, and don't touch the floor.
Opposite arm/leg lifts - In a prone position, with your face or cheek on a towel, and both arms extended past your head; lift one arm from your shoulder, and the opposite leg from your hip. Both limbs should be lifted about 4-6 inches, each at an equal height. Hold for one second, and exhale at the same time. Repeat this action 8-15 times on each side. Progress to doing this exercise on all fours. Keep your neck in-line-with-your-spine. Don't allow your lower back to sag. In the hands-and-knees position, raise your limbs until they are level with your trunk.
Modified Cat stretch - On all fours, round your back up vertebrae-by-vertebrae so it is arched toward the ceiling; hold for 10 seconds, while breathing normally; then unroll it until it is flat (initial position) -- your lower back does not arch during this stretch.
Some General Notes on Flexibility and Its Relationship to LBP
Decreased flexibility (shortened range-of-motion, or ROM) can increase risk of injury. For the lower back, the muscles involved are primarily those which attach to the pelvic girdle -- hamstrings, quadriceps, hip flexors, gluteals, piriformis, quadratus lumborum, abdominals, and erector spinae.
Inactivity leads to adaptive shortening of muscles and connective tissue, which shortens ROM. To combat the problem, static stretches of about 30 seconds are most effective, but only if the tissues involved are warmed-up.
(Q) I have been making my own ice bags by just putting some ice cubes in a zip lock bag, but they seem to always start leaking. Any suggestions on how I might improve them?
A.J., Auckland, NZ
(A) One way is to make a gel pack by partially filling a heavy-duty plastic freezer bag with a mixture made of 1/4 rubbing alcohol and 3/4 water. Seal the bag inside of a second bag. then freeze it. The gel will remain soft, so it is gentler on injuries, and the double-bag arrangement is less likely to leak.
(Q) I am having a circulation problem in my legs, and my doctor says to keep up my walking program, as exercise can improve vascularization. Do you know of any way that I might augment exercise to further help my condition?
L.F., Roseburg, OR
(A) This is no sure thing, but maybe worth a try, if your doctor approves. There are reports that ginkgo biloba may improve blood circulation, especially in the extremities; but there is currently no proof that it works, or that it doesn't work. It is; however, prescribed in Germany and France for circulatory disorders, and it shows some promise of being effective against claudication (leg pain caused by blood flow ob struction from, for example, atherosclerosis). But it is essential that you talk to your doctor before treating yourself.
(Q) My mom used to tell me that "an apple a day kept the doctor away." Is there any credence to that old homily?
D.F., Eugene, OR
(A) Close, apples are not as nutritionally poor as has often been charged. They may not be vitamin/mineral powerhouses, but they have other redeeming value.
Apples are an excellent source of antioxidants, which counteract free radicals (those critters that damage cells and can cause cancer or heart disease. Apple juice, pulp, skin, or whole apples all contain antioxidants, especially the skin.
Apples are a good source of an antioxidant called flavonoids, which seem to help fight infections and reduce inflammation.
Apples are also a good source of fiber, which seems to reduce risk of heart disease. So, chomp away.
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Send questions or comments to Michael Fenner: e-mail to Mike Fenner
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