Exercise Smarter, Not Harder!

We all want to get the most out of the time we spend exercising, and it's natural to think that exercising harder is going to provide a bigger, faster payoff. But exercising harder without adequate preparation often leads to injury. Then there's recovery time, possibly the need for rehabilitation, and ultimately you're back at the beginning in terms of fitness, strength, and endurance. Injuries are to be avoided, if at all possible. The best way to avoid injury is to exercise smarter. Exercising smarter is also the best way to achieve continual, progressive gains in fitness, health, and well-being.

Exercising smarter means doing what you're capable of doing, and then doing a little bit more. For example, if you're a runner and typically run three miles a day, three times a week, it wouldn't be smart to do an eight-mile run the next time you go out. The likely outcome would be a strained muscle, shin splints, or worse. If you lift weights and typically bench press 100 pounds, it wouldn't be smart to find out what it feels like to bench press 150 pounds. What it could feel like is a back, neck, or shoulder injury. In either scenario, the price paid for attempting to train "harder" is at least two weeks of down time, possibly much longer, while you recover from your injury. Of course, we've all made mistakes and sometimes training injuries just happen, but tempting fate by doing too much is not, in fact, "smart."

The goal with any type of exercise is to progress gradually over time.¹ For example, if you're 60 years old and haven't exercised for many years, a walking program is a good way to begin. On your first day, walk at a comfortable, steady pace for 10 minutes. That may not feel like much, but you will be increasing your total time over the next four to six weeks. The next day, add a couple of minutes. As long as you're continuing to feel good, add a couple of minutes on every second day or so, building up consistently to a total of 30 minutes per day. At this point, you're walking 30 minutes per day, five times per week. Next, every second day or so, increase your pace by a bit.

Don't increase your pace if you feel uncomfortable or feel as if you're working too hard. Be in tune with what you're doing. After four to six weeks of gradually increasing your pace, you'll probably be able to walk 30 minutes per day, five days a week, at a nice brisk pace.² You may also notice that you've lost some weight,³ you feel more flexible, you're standing more upright, your skin has a nice, healthy glow, and you're sleeping more soundly and more restfully.

Use the same gradual approach with strength training. Start with lighter weights, not heavier weights, than you think you can use. With lighter weights, you can build up your strength over time. With weights that are too heavy, there's always the danger of incurring an injury that will set you back and interfere with your training. Exercising smarter leads to consistent gains in strength, muscle mass, ability to do physical work, and overall health.

It's natural to want to exercise harder. But exercising smarter is the way to go for long-term benefit without the danger of time-wasting injuries. Exercising smarter is the effective way to maximize the value of our investment in physical fitness.

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¹Braham R, et al: Can we teach moderate intensity activity? Adult perception of moderate intensity walking. J Sci Med Sport 15(4):322-326, 2012

²Centers for Disease Control and Prevention: Vital signs: walking among adults - United States, 2005 and 2010. MMWR Morbid Mortal Wkly Rep 61:595-601, 2012

³Exercise training and impaired glucose tolerance in obese humans. McNeilly AM, et al: J Sports Sci 30(8):725-732, 2012

Do I Have Carpal Tunnel Syndrome?

Many people believe they have carpal tunnel syndrome (CTS). The majority have been told by their medical doctor that they have CTS. Others have mistakenly concluded that because they have some numbness and tingling in their wrist or hand, they must have this neurological disorder. Still others have ongoing forearm, wrist, or hand pain (possibly localized to the thumb and/or index finger), and are led by articles they've read on the Internet to diagnose themselves with CTS. Almost all of this is in error.^1,2

Why are so many diagnoses of this condition mistaken? The primary culprit is lazy clinical decision-making, compounded by a failure to understand correctly the workings of the musculoskeletal system. Carpal tunnel syndrome is a specific diagnosis which involves mechanical pressure on the median nerve as it passes through a small tunnel in the wrist created by tiny adjoining bones. There's not much room in this carpal tunnel and its dimensions can be narrowed further by inflammatory conditions such as osteoarthritis or rheumatoid arthritis. Pregnancy can lead to CTS owing to increased fluid retention. Repetitive stress may lead to inflammation of tendons that cross the wrist. Such inflammation may lead to soft tissue swelling which compresses the carpal tunnel, causing CTS. Various other disorders should also be considered when CTS is suspected.

Importantly, CTS is not a catchall diagnosis to be used when a person has forearm, wrist, and/or hand pain. If a person really has CTS, he or she will have specific symptoms. The person will awaken at night owing to pain and/or numbness and tingling. Symptoms will be precisely located to the thumb and index finger (possibly involving the middle finger). Wrist pain may or may not be present. Also, the person will demonstrate a weakness of pinch grip involving the thumb and index finger. If these signs and symptoms are not present, the person does not have carpal tunnel syndrome. Usually, the diagnosis is clearcut and does not require special tests such as electromyography.

Remarkably, most physicians, regardless of specialty, are unaware of these important criteria. If the patient has pain and/or numbness in the hand, the patient has CTS. Case closed. This lack of sophistication leads to real harm done to the patient, such as unnecessary tests which waste time, cost a lot of money, and may result in damaging surgery which is not curative as it was directed at a problem that really wasn't there.

In marked contrast, chiropractors are highly trained in accurate analysis of musculoskeletal problems involving the shoulder, arm, and hand.³ When patients have symptoms mimicking those of carpal tunnel syndrome, chiropractors use their broad knowledge and experience to correctly evaluate the situation. For example, spinal dysfunction, muscle spasm, and trigger points can all cause symptoms which appear to be those of CTS. Chiropractors are able to see through this masquerade and effectively address the real underlying problems.

 

 Many musculoskeletal problems, including symptoms masquerading as carpal tunnel syndrome, are effectively managed by chiropractic care. The key, as always, lies in accurate evaluation of the cause of the patient's pain patterns.

To a very large extent, physical pain involving the spine, arms, and legs is related to mechanical joint dysfunction. There are exceptions, of course, including pain caused by a severe acute injury or an inflammatory condition such as ankylosing spondylitis. But in most cases, chiropractic care will provide a solution to a person's musculoskeletal pain, resulting in a reduction or even a resolution of the problem.
It's important to remember that most painful symptoms don't just happen on their own. Your chiropractor will do more than address the problem at hand. He or she may also help you design an effective exercise program and a healthful nutrition plan to optimize your health and well-being over the long-term.

¹Ibrahim I, et al: Carpal tunnel syndrome. Review of the recent literature. Open Orthop J 6:69-75, 2012

²Uchiyama S, et al: Current concepts of carpal tunnel syndrome: pathophysiology, treatment, and evaluation. J Orthop Sci 15(1):1-13, 2010

³Bialosky JE, et al: Heightened pain sensitivity in individuals with signs and symptoms of carpal tunnel syndrome and the relationship to clinical outcomes following a manual therapy intervention. Man Ther 16(6):602-608, 2011