Promoting an active lifestyle in health and illness has found a prominent place in many professional medical journals. Among others, since 2006, at the invitation of the Editorial Board of the Medical Tribune, a popular biweekly of health care, I have the pleasure in the professional part. From the doctors for doctors to run the Department of Sports Medicine.
The articles presented in the above section – prepared by recognized specialists in sports medicine, medical rehabilitation, physical culture and health promotion – have an important practical aspect and are mainly intended for family doctors. MT editors rightly assume that due to their comprehensive impact on a large number of patients, family doctors may be the best promoters and promoters of a healthy and active lifestyle.
I would like to present to the readers of the Leader selected materials in the field of sports medicine (my own introductions to the aforementioned articles), which concerned recommendations and contraindications regarding the selection of physical activity in different groups of patients and those who consider themselves healthy.
Physical activity of children and adolescents
Along with the first post-school bell there are problems related to sports and recreation activities of children and adolescents. Movement activity is one of the most important stimulators of psychophysical development of young people. However, improperly applied motor stimuli can lead to aggravation of malformations, fatigue syndrome or discourage sports. Also, too many children still have eye defects, allergic disorders, overweight and obesity, and various types of static-dynamic disorders of the musculoskeletal system. Hence, pressure from parents on sports and family doctors for issuing long-term exemptions from physical education classes. And the lack of movement disturbs the child’s natural and functional development, depriving him of the opportunity to learn new games and sports skills, and impoverishes his social relations. Practicing many sports requires proper medical examinations. It is them, and not the ambitions of parents, coaches or mentors, that decide on the right choice of competitive sport.
Movement for the heart
Today no one has any doubts that metabolic disorders are the basis for the development of atherosclerosis and ischemic heart disease (IHD). This group of disorders includes disorders of lipid metabolism, obesity and type 2 diabetes. Their development is determined by genetic and environmental factors. The latter include, among others way of feeding, smoking, alcohol consumption and the level of physical activity. Recently, it is believed that the dominant role in modulating the expression of genes responsible for pathophysiological processes may be played by some diet components. Also, more and more studies point to the importance of systematic physical activity in maintaining positive health indicators.
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A lively walk
In 1968, the doctor of the American Air Force, Dr. Kenneth Cooper, the creator of aerobic training and a well-known 12-minute test, assessing performance, offered military pilots the use of marching training to shape and maintain the general condition at a favorable level. The author included the alternative use of running training with walking and gradually increasing the intensity of the effort (tempo, distance), adjusted to the level of physical efficiency (low, medium, good). The adaptive training included in the marching program lasted from 6 to 12 weeks and depended on the level of fitness.
After this period, pilots could cultivate any of the selected aerobic-recreational sports. In Poland in the 1980s and 1990s, these principles were adapted to the needs of our population Henryk Kuński and Józef Drabik. They assumed that training should be characterized by high flexibility, taking into account the volume and intensity of walking training, depending on the well-being, weather conditions and physical fitness level of the exercisers. The recommended initial training lasted up to 16 weeks. If after this time the trainee was able to march fast for 10 minutes, he met the criteria for conducting a physical fitness test and conducting more intense forms of aerobic exercise.
The optimal form of health training
Health-related physical activity in the opinion of specialists consists in the use of strictly defined physical exercises aimed at obtaining beneficial physical and mental effects, improving health and increasing the adaptability of the body. Thus, through beneficial physiological effects, health training prevents or slows down the rate of development of civilization diseases, affecting our biological age. Of the many exercises used in health training (mainly oxygen), exercises performed in water proved to be very effective. The more so because it could be used by many people who could hardly exercise on land (high overweight, injuries, degenerative joint changes, etc.). Hence the idea of using various forms of aquafitness (aerobics), which consist in conducting varied exercises, mainly in a vertical position – to the rhythm of the music. There are different water depths and temperatures, special gear (increasing buoyancy and resistance) and no swimming skills required. Adaptive training is conducted before the actual exercises. Such exercises have a comprehensive impact on the body through specific conditions of the aquatic environment, targeted physical exercises and rhythm and music. As a rule, exercises take place in warmer water than during normal swimming classes to ensure optimal thermoregulation of the system. Existing fears that long-term relief exercises may favor osteoporosis have not been confirmed in experimental studies. A number of such studies were carried out at AWF Warsaw, showing significant health and psychological benefits in systematically exercising women, especially in the perimenopausal age. Of course aquafitness (in a more intense form) is also practiced by men, constituting an essential complement to training in various sports.
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Sticks on the road
There is no doubt that the best forms of health training are natural forms of movement, engaging the cardiovascular and respiratory systems in the small or medium level, and skeletal muscles that give the right pressure on the bones. Many studies show that endurance exercises supplemented with strength and flexibility exercises are such endeavors. Taking into consideration the sedentary lifestyle of a modern man, the best forms of recreation are certainly the activities conducted in the open air and throughout the whole year. In our geographical area, this year-long physical activity concerns only a few sports and recreation disciplines. Of these, Nordic Walking (NW) seems to be optimal for health with walking sticks. The sticks with hand grips used in a normal walk allow for the involvement of more muscle mass, relieving the joints, improving balance and stability while moving on different surfaces. In addition, the sticks can be used as gymnastic equipment for flexibility and general shaping exercises. Of course, NW is not just a march with sticks. It requires the use of proper technique of support and repulsion from the ground. Therefore, the first classes should be held with a recreation instructor, for example due to the recommended intensity of effort and attractive forms of gymnastics. Contraindications do not differ from those used during walking or jogging training.
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Plants grow and efficiency
Activity is a very popular form of spending free time in contact with nature and elements of satisfying gardening and gardening. It is also a form of lively social contacts (grilling), family and passive recreation. Due to systematic physical activity, it is considered a form of health training, and being in the open air also has a hardening effect on the body.
The Polish Association of Allotment Holders states that approximately four million Poles benefit from this form of activity, yet there are many more non-members. Of all the allotments, pensioners and pensioners prevail (around 47%). High prevalence and fairly diverse age and sex of allotment holders instruct family physicians to pay attention to some of the risks resulting from this form of active rest. When working on a plot, we often lift, move, drag and push various heavy objects that constitute a significant burden on the spine. Added to this are gardening works in forced positions of stato-dynamic motion system, which also affect the circulatory system (HR, RR) and the organ of sight (headaches, Valsalva test). Other health risks include work in the ground (tetanus threat in abrasions and scratches of the skin, imprints), adverse weather conditions (high and low temperature, humidity, high insolation), insect bites, allergies (hay fever, photodermatitis, etc.). Of course, these are matters that should be reported, but which should not interfere with such a valuable and health-oriented form of recreation. And what is important, the action also fulfills important social, integration and ecological functions.
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Performance from the saddle
Cycling is a very popular form of endurance exercise (aerobic), which is recommended for people with low performance or with specific diseases that prevent, for example, running training. Riding a bike on a flat terrain with speed close to running, we use half the amount of energy. Sports practitioners believe that health or general-fitness training leads to strengthening of the heart, lowering blood pressure, increasing the possibility of energy expenditure, increasing the condition and improving exercise tolerance (eg in coronary disease), increasing tolerance to work in a hot environment, consumption of excess tissue fatty tissue, eliminating stress and emotional tensions, shaping the muscles and contours (sculptures) of the hips, buttocks and thighs. Two / three training sessions are recommended, each week not exceeding 40-50 minutes. driving (in the ninth week, a distance of 10-18 km is recommended, with 70-80% HRmax). Sports traumatologists recommend using the bike also in the pains of the cross, juvenile kyphosis, knee instability, diseases of the shin, ankles and feet. However, the height of the saddle and the steering wheel must be adjusted accordingly. In Scheuermann’s illness, for example, the saddle is set low and the steering wheel is high. Contraindications to cycling include major eye defects, advanced pregnancy, cardiovascular instability, balance disturbances and large degenerative-distorting joints.
Chronic cardiovascular diseases
The sedentary lifestyle and the associated low level of physical fitness are important risk factors for chronic cardiovascular disease and metabolic hypertension, ischemic heart disease, and overweight and obesity with accompanying carbohydrate and lipid metabolism disorders. Therefore, the biologically effective use of physical activity in the prevention and alleviation of these diseases involves the need to determine the optimal dose and type of exercise. Only the POZ doctor has the ability to continuously influence the lifestyle and attitudes of their patients and to recommend them effective physical activity, determine the health status and risk factors of chronic disease in a given person, determine its current level of fitness and capacity, tolerance of exercise load and indicate optimal forms of training.
The applied doses of physical activity should be acceptable for the exercisers, safe and effective in function, taking into account their full individuality. Before undertaking more intense sports activities, it is absolutely necessary to conduct medical qualification tests of resting and exercise ECG, echocardiogram, field physical fitness tests (Cooper’s test), paying special attention to exercise cardiovascular tolerance. We should also clearly specify contraindications or their absence and take into account co-morbidities or post-traumatic conditions.
Let him move and speak
Obesity should be treated as a chronic and degenerative disease, negatively affecting many vital functions, limiting physical fitness and efficiency. If the first degree obesity (BMI = 30.0 – 34.9 kg / m2) is moderate, it poses a risk of complications and limits the physical fitness to a low degree, the second and third degree obesity (BMI = 35.0-39.9; 40,0 kg / m`) are a big problem for physicians and physiotherapists, in the effective selection of proper movement exercises and the limitation of the possibility of side effects. In people with significant obesity, we can expect such disorders as dyslipidemia, type 2 diabetes, arterial hypertension, ischemic heart disease, gout, degeneration of the osteoarticular system, etc. The above disorders narrow the range of recreational exercises and force them to lower their intensity. Many studies point to the pathological style of eating and lowering the physical activity of obese people. Therefore, in the comprehensive treatment of obesity, we must take into account changes in eating habits and the need to increase physical efforts. At the same time, it should be taken into account that physical exercise has a limited effect on the significant consumption of fat stores. However, systematic physical activity plays an important role in shaping favorable adaptive system reactions (metabolic, neurohormonal, physiological) and improving health potential. Even if we do not achieve weight reduction, improvements in physical fitness and cardiovascular and respiratory functions are reflected in the improvement of mental mood and quality of life. To minimize the undesirable effects of physical exercise, we recommend performing an exercise ECG test along with an assessment of the pressure response to exercise.
Selection of running shoes
Running, which is a natural form of movement, regardless of age and gender, is commonly used in various forms of health training – for example for pleasure (jogging) or increasingly fashionable marathons. Thanks to special training clothes and sports footwear you can run practically any time of the year and almost in all terrain conditions. Against the expectations of runners also come reputable sports companies, producing more and more perfect and having a lot of utility and health footwear. Of course, people with overweight or obesity should start training with walking and jogging, but in this case, the selection of appropriate sports footwear is equally important. During the run, our feet must accept loads equal to three times the mass of our body. Systematic running also requires footwear adapted to the anatomical structure of our feet. Good sports shoes are characterized by adequate elasticity and flexibility, facilitating the running step thanks to smooth rolling from heels to toes. Other important features include foot stabilization, shock absorption and active foot movement control.
Regardless of this, shoes should take away excess heat (including the large role of appropriate socks) and sweat, and at the same time be resistant to soaking. Carefully selected and maintained sports shoes should be so vital that running comfort is ensured for 500 to 800 km.Posted on: January 18, 2019