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Fitness

Avoid injuries with the right athletic shoe

Running, hiking, and leisurely evening strolls around the neighborhood all require specific shoes to prevent injury and keep you active.

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Warmer weather and longer days increase outdoor activities. If you are participating in a single activity more than two times a week, consider purchasing a shoe designed for that activity. Running, hiking, and leisurely evening strolls around the neighborhood all require specific shoes to prevent injury and keep you active.

“When selecting a pair of athletic shoes, wait until the end of the day to try on shoes,” states orthopaedic foot and ankle surgeon and AAOS spokesperson Lew C. Schon, MD, FAAOS. “This is helpful because your feet swell throughout the day. This will ensure you better gage the right fit. Also, try on both the left and right shoe and tie the laces to ensure they both fit correctly.”

According to a 2018 study by the Journal of Foot and Ankle Research, only 28 to 37% of people are wearing proper fitting shoes of the right length and width.

The American Academy of Orthopaedic Surgeons (AAOS) suggests the following when selecting new footwear:

  • When possible, shop at a store that caters to the sport in which you participate. If this is not possible, do some research before shopping to find out what type of shoe is most appropriate for your favorite sport.
  • To ensure a proper fit, wear the same type of sock that you typically wear when you are participating in the sport for which you are buying the shoes.
  • Make sure the heel counter — the back of the shoe that holds the heel in place — adequately grips your heel to ensure stability.
  • The toe box — the front area of the shoe — should have ample room so that you can wiggle your toes. There should be at least a one-half inch space between your longest toe and the tip of your shoes.
  • When you try on shoes, walk around the store on different surfaces (carpet and tile, for example) to ensure that they are comfortable.
  • Make sure that the shoes have not been sitting on the shelf for an extended period. While the materials of an athletic shoe are designed to accommodate a lot of stress, the cushioning may become less effective over time, even without use.

“When it comes to athletic shoes, there’s more than meets the eye,” adds Dr. Schon. “Running shoes, court shoes, cleats and hiking shoes all have different features. If you plan on being active pursuing many different exercises throughout the week, a cross-training shoe may be the best choice.” When selecting a shoe for a specific sport, keep in mind the following tips:

  • Running shoes are grouped into three categories — cushioned or neutral, for runners with high arches; stability, for runners with arches that may collapse while running but need to be maintained; motion control, this shoe provides the most stability for runners who may have flat feet or a higher body weight. The best way to determine your arch is to have a professional evaluate your foot.
  • Trail shoes are designed for those who prefer to run off road. This shoe offers more stability than a normal running shoe.
  • Cross trainers easily take you from sport to sport no matter the impact or terrain. This shoe is not appropriate for someone who plans on running more than four to five miles a day.
  • Walking shoes provide stability through the arch, good shock absorption, and a smooth tread. Walking involves a heel-toe gait pattern, so you want to make sure that the shoe, and particularly the counter, is stable.
  • Court shoes include those designed for basketball, tennis, and volleyball. Court shoes have a solid tread and typically are made of soft leathers. They are designed to provide stability in all directions.
  • Cleats are designed with multiple protrusions or spikes made of steel or hard plastic that provide additional traction on grass or soft turf. These shoes are required for sports such as soccer, lacrosse, football and baseball.
  • Hiking shoes offer stability as you walk across uneven surfaces, as well as comfort and cushion in the insole to absorb the shock from various impacts. Hiking shoes also should have a good tread on the sole to keep your foot firmly planted on the surfaces that you encounter.

For more information on finding the right athletic shoe, visit OrthoInfo.org.

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Fitness

Postmenopausal women can dance their way to better health

After menopause, women are more likely to experience weight gain, overall/central body adiposity increases, and metabolic disturbances, such as increases in triglycerides and bad cholesterol. Together, these changes ultimately increase cardiovascular risk. Around this same time, women often are less physically active, which translates into reductions in lean mass and an increased risk of falls and fractures.

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Women often struggle with managing their weight and other health risk factors, such as high cholesterol, once they transition through menopause. A new study suggests that dancing may effectively lower cholesterol levels, improve fitness and body composition and in the process, improve self-esteem. Study results are published online today in Menopause, the journal of The North American Menopause Society (NAMS).

After menopause, women are more likely to experience weight gain, overall/central body adiposity increases, and metabolic disturbances, such as increases in triglycerides and bad cholesterol. Together, these changes ultimately increase cardiovascular risk. Around this same time, women often are less physically active, which translates into reductions in lean mass and an increased risk of falls and fractures. As a result of all these changes, postmenopausal women often suffer from decreased self-image and self-esteem, which are directly related to overall mental health.

Physical activity has been shown to minimize some of the many health problems associated with menopause. The effect of dancing, specifically, has already been investigated with regard to how it improves body composition and functional fitness. Few studies, however, have investigated the effects of dance on body image, self-esteem, and physical fitness together in postmenopausal women.

This new study was designed to analyze the effects of dance practice on body composition, metabolic profile, functional fitness, and self-image/self-esteem in postmenopausal women. Although the sample size was small, the study suggested some credible benefits of a three-times-weekly dance regimen in improving not only the lipid profile and functional fitness of postmenopausal women but also self-image and self-esteem.

Dance therapy is seen as an attractive option because it is a pleasant activity with low associated costs and low risk of injury for its practitioners. Additional confirmed benefits of regular dancing include improvement in balance, postural control, gait, strength, and overall physical performance. All of these benefits may contribute to a woman’s ability to maintain an independent, high-quality lifestyle throughout her lifespan.

Study results are published in the article “Dance practice modifies functional fitness, lipid profile, and self-image in postmenopausal women.”

“This study highlights the feasibility of a simple intervention, such as a dance class three times weekly, for improving not only fitness and metabolic profile but also self-image and self-esteem in postmenopausal women. In addition to these benefits, women also probably enjoyed a sense of camaraderie from the shared experience of learning something new,” says Dr. Stephanie Faubion, NAMS medical director.

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Fitness

Stair climbing offers significant cardiovascular, muscular benefits for heart patients

While it is widely known that exercise and lifestyle changes reduce the risk of secondary cardiovascular disease, statistics suggest less than a quarter of all cardiac patients adhere to fitness programs.

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A team of McMaster University researchers who studied heart patients found that stair-climbing routines, whether vigorous or moderate, provide significant cardiovascular and muscular benefits.

The findings, published in closely related studies in the journals Medicine & Science in Sports & Exercise and Frontiers, address the most frequently cited barriers to exercise: time, equipment and access to gym facilities.

“Brief, vigorous stair-climbing and traditional moderate intensity exercise both changed fitness, which is a key predictor of mortality after a cardiac event,” says Maureen MacDonald, one of the lead researchers on both studies and a professor in McMaster’s Department of Kinesiology.

“We’ve shown stair-climbing is a safe, efficient and feasible option for cardiac rehabilitation, which is particularly relevant during the pandemic when many people don’t have the option to exercise in a gym,” she says.

While it is widely known that exercise and lifestyle changes reduce the risk of secondary cardiovascular disease, statistics suggest less than a quarter of all cardiac patients adhere to fitness programs.

Researchers worked closely with the Cardiac Health and Rehabilitation Centre at the Hamilton General Hospital to develop an exercise protocol that did not require specialized equipment or monitoring and could be easily performed outside a laboratory.

Participants with coronary artery disease who had undergone a cardiac procedure were randomly assigned either to traditional moderate-intensity exercise or vigorous stair climbing: three rounds of six flights of 12 stairs, separated by recovery periods of walking, with participants selecting their own stepping pace.

Researchers compared the results and found that individuals who had done traditional exercise and those who had done stair-climbing both increased their cardiorespiratory fitness after four weeks of supervised training and maintained those levels for an additional eight weeks of unsupervised training.

They also reported substantial muscular improvement.

“These patients who had undergone a coronary bypass or stent procedure had muscle that was compromised, compared to age-matched healthy controls,” explained Stuart Phillips, a co-author of the studies and a professor in the Department of Kinesiology at McMaster who oversaw the analysis of muscle tissue taken during the study.

Previously, there had been very few studies of the impact of exercise on cardiac patients’ muscle specifically. This analysis shows heart patients can still repair and build lost muscle.

“Even in just a short period, whether it was moderate intensity, continuous training or high-intensity stair climbing, there were beneficial adaptations in muscles after a cardiac procedure,” Phillips says. “The improvements were clear.”

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Fitness

Returning to sports or exercise after recovering from COVID-19

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As COVID-19 affects everyone differently and the long-term effects are hard to predict, returning to exercise once recovered should be undertaken with great care, especially in the case of moderate to severe cases of COVID-19, says an expert from a top American hospital, Cleveland Clinic.

Sports medicine physician Marie Schaefer, MD, says: “The truth is, the disease can affect everyone differently. Anyone, including young athletes, could experience a severe case or have long-term damage, which is why it is so important to take this seriously.”

While experts know that in some people the virus can lead to damage of the heart, brain, lungs and kidneys, she says there is no way to pinpoint or predict who exactly these individuals will be. Some might also experience lingering symptoms, including shortness of breath, muscle aches, loss of stamina and exhaustion.

For many athletes and active people, Dr. Schaefer says, returning to activity will likely be a slow process and will require patience. Individuals should work with a physician to make sure they are progressing appropriately and to monitor their symptoms.

Timelines determined by severity of COVID-19

When an athlete or active individual is sick with COVID-19, they should not engage in any physical activity. During this time, they should focus on rest, good hydration, proper nutrition and following the advice of their physician or healthcare provider.

After this, the timeline of return to exercise or sport will be determined by how mild, moderate or severe the case was.

If an active individual or athlete only has a mild illness or tests positive without experiencing any symptoms, he or she can consider returning to activity after a 10-day isolation period. Once that window has passed, the athlete may consider a gradual return to physical activity, but must not have symptoms.

If an active individual or athlete had a moderate or a severe illness, or had to be hospitalized, he or she should be evaluated by a physician prior to restarting any type of exercise. Dr. Schaefer says these people may need to have additional tests, including ECGs, heart imaging or blood work before they are cleared to start a progression back into activity.

Myocarditis in athletes and active people

Dr. Schaefer points to the possibility of myocarditis, which is an inflammatory response of the heart due to a viral infection, such as COVID-19. It can cause swelling in the heart muscle making rigorous activity more difficult and sometimes, even deadly.

“Myocarditis is more likely to be found in people who had a moderate or severe case of the virus, but it can happen to anyone who was infected,” says Dr. Schaefer.

Given this increased potential risk for myocarditis, athletes or active people returning after COVID-19 infections need to be cleared by a healthcare provider who will determine if any additional testing is needed. Because of the risk of myocarditis, athletes and anyone who exercises should follow a graduated return to physical activity over the course of a week to monitor for signs and symptoms of this serious complication.

Advice for easing back into fitness

While serious athletes should follow a Return to Play (RTP) schedule supervised by a professional trainer or physician, Dr. Schaefer has three pieces of advice for anyone planning to reintroduce exercise into their routine.

1. Listen to your body. If someone is experiencing symptoms like chest pain or heart palpitations, they should stop exercising immediately and consult with a doctor. Exercise and movement are important for overall health, but for COVID-19, things can change overnight as we learn more about the virus, she says. People should keep monitoring themselves and if something feels more serious than just a consequence of being out of shape, they need to stop exercising and talk to a physician.

If individuals experience any of the follow red flag symptoms, they stop exercising immediately:

  • chest pain or heart palpitations
  • nausea
  • headache
  • high heart rate not proportional to exertion level or prolonged heart rate recovery.
  • feeling lightheaded or dizzy
  • shortness of breath, difficulty catching breath or abnormal, rapid breathing
  • excessive level of fatigue
  • swelling in the extremities
  • syncope (passing out)
  • experiencing tunnel vision or loss of vision.

2. Take it easy. Recovered patients should not try to “power through” as they did in the past. Athletes of all ages should follow a gradual progression to get back into exercise. They will need to build up the time and intensity of their workouts. Dr. Schaefer advises starting with a slow walk and if that feels alright, trying a brisk walk the next day. They will need to gradually increase the time they spend walking, building this up for about one to two weeks before returning to HIIT training or CrossFit, for example.

3. Be patient. Dr. Schaefer points out that even if someone the recovered patients were training for a marathon prior to becoming infected, they will likely discover that their body has changed a bit, which warrants extra caution. “Do not push too hard on a body that is still trying to recover,” she concludes.

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