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Transcript

Moving Crew: Fitness Aches and Pains

With Calvin Poston
Athletic Trainer at Metro Orthopedics & Sports Therapy
Thursday, October 14, 2004; 11:00 AM

You need to get moving.

Let's face it, we all do -- not to claim boasting rights in the gym or look good in a Speedo (you don't) -- but to boost our chances of staying healthy and energetic, regardless of age and athletic ability.

The Moving Crew is not aimed at health faddists, body builders or extreme athletes. But if you're a harried deskjockey trying to find creative ways to squeeze in exercise, a senior looking to stay active or a workout enthusiast whose routine's gone flat, you might find the answers here.


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Each week the Crew will explore some facet of fitness from the inevitable new trends to the latest research and offer ways to overcome the excuses that keep so many of us desk- and sofa-bound.

A transcript follows.

Editor's Note: Washingtonpost.com moderators retain editorial control over Live Online discussions and choose the most relevant questions for guests and hosts; guests and hosts can decline to answer questions.

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John Briley: Top of the Morning, Loyal Crew -

Today's chat topic is 'aches and pains' and, ever conscious of the need for timely reporting, I am nursing a severe blister from a 3-day backpacking trip last weekend. Turns out I committed rookie stupidity: Setting out with very new hiking boots without applying preventive adhesives in
likely blister spots (seasoned trail trompers use mole skin or even duct tape to ensure that new boots don't abrade their feet).

Lucky for me - and you - we have a guest expert today to address a range of sports and fitness injury topics:

Calvin Poston, an athletic trainer with MOST (Metro Orthopedics & Sports Therapy, Silver Spring, Md.), helps people at all ages and athletic abilities, from (ahem) rookie backpackers to elite athletes, recover from minor and more serious maladies. Poston is also an assistant trainer for the Washington Freedom women's soccer team and the University of Maryland football team, and a strengthening and conditioning specialist.

We're taking questions on your (hopefully minor) aches and pains, plus the usual array of fitness topics. Feel free to quiz Calvin on his areas of expertise.

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Richmond, VA: I want to pass along to the Crew a video series that I recently obtain from Borders. I got "Simply Ball" and "Simply Tai Chi". There are several others in the series. They ideal for beginners because, unlike so many books/videos, they are simple and to the point with out giving you the history of physical activity since the beginning of civilization and without complicated workouts which most of us would spend all our wakening hours. The manuals are excellent and to the point. At Borders they were $8-$9.
John

Craig Stoltz: Hey Richmond, thanks for the tips. I haven't seen these, but I'll check them out. Anybody know this "Simply" series, or have other good tapes/books/programs to share with Crewsters?

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Alexandria, VA: I just started a video yoga program, and I love it. When I'm in the stretches, it feels wonderful, and for a while after, I feel great. A few hours later, or the next day, I'm kind of sore, but when I go back to my video the next evening, it feels good again in the same cycle. Is this just ordinary, not-used-to-stretching pain or is it a fatigue - and thus a warning to slow down a little?

John Briley: Hi Alexandria - Sounds like just normal soreness from the workout. But a key question: Does 'kind of sore' include any sharp, recurring pain? That would be a warning to ease off the intensity or take the occasional night off from yoga.

Also, it would be good if you're mixing up the routines night-to-night - i.e., not doing the exact same poses every day. Some - like sun salutations - are OK to do daily, but we are all susceptible to over-training in any activity and the body likes to rest muscles, usually for 48 hours at least, between workouts.

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trappe, md.: I have a weight set (dumbells and the bench-press bar-?]) but no weight bench because my apartment is too small. What are some exercises I can do with them without a bench? Hoping to build up my chest.

Craig Stoltz: Hey, Trappe-r,

As a big fan of stability balls, I can tell you that replacing the bench with the ball has lots of benefits.

First, how to do it: For bench press or flyes, sit on the ball and walk your feet out until the ball is under your mid-back. Your thighs should be parallel to the ground, your lower legs perpendicular. Keep your back straight and your hips up, so it's just like you're on a bench but you have to hold yourself in the position. That's the key.

Now do your chest flyes or bench presses. Use low, low weights until you learn how to control the position and sustain your balance. (I'm serious. 5 lbs., 10 lbs. to start. I've been doing these a long time, weigh 170 lbs and just progressed from 15 to 20 pound dumbbells.

Good luck, be careful and most of all, enjoy. . .
For military presses, curls and tricep curls, simply sit on the ball and do the exercise, keeping your back straight.

The beauty of all this is that it turns each of these exercises into a core workout that helps develop your deep-in-the-gut muscles that keep you stable as you move through the world. It also helps improve your balance.

It's true these exercises take a bit of emphasis off the specific muscle being trained--pecs/shoulders for benches, flyes--but the added benefits outweigh that small loss. Unless you're into bodybuilding or maximizing muscle size, using a ball instead of a bench pays off many ways. Cheaper, too.

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Washington, DC: Does the Moving Crew have an archive of chats online? I looked, but couldn't find one.
But I'll ask you the questions I was looking for: Can you please recommend a good exercise bra? I've never found one I'm comfortable with, at 34C, but I know it must be out there.
Thanks!;

Craig Stoltz: Thanks, D.C. Read below and all will be explained.

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washingtonpost.com: Missed a chat or a column? No problem, check in and read past columns or past chats. Craig Stoltz: here ya go. . .

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More Sports Bra Advice: One more recommendation on bras for big (and even medium) ones: a specialized bra is MUCH better than layering multiple ones, which can cause pinching and chafing and flatten you out uncomfortably and unattractively. The brand "Moving Comfort" has several good options including the Maia model for large sizes--it's supportive and jiggle-free even for high-impact activities. You can find them and other great workout wear for women online at www.activasports.com or www.rei.com. Locally, REI has a good selection. I don't work for any of these companies--I've just tried a lot of bras that didn't do the 38DDs any favors and would like to spare others the discomfort.

Craig Stoltz: Thanks for this, MSBA. . . .

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washington, dc: Good Morning,
I recently dropped several dress sizes thanks to better eating habits and Curves. I bought a stability ball to work on my abs and am looking for a class without incurring the additional expense of joining another "gym." Any suggestions? I'm also thinking about purchasing one of the Denise Austin tapes that focuses on exercises using the ball.
Thanks for your time and consideration.

Calvin Poston: via comcast cable company, they have fit TV ondemand where you cna find yoga to weight training at a touch of a button. There are websites out there that at as cyber personal trainers as well.

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Jessup MD: Recently read your column stating that a 200 lb person uses 200 calories per mile walked regardless of time elapsed. Do you have a study to this effect?

Also, is there any correlation between weight, time spent exercising and heart rate to determine calories expended?

Great work folks!;!;!;!;

John Briley: Hi Jessup - I got the 1 calorie-per-mile-per-pound of body weight - which applies to WALKING on flat ground - from a U of Kentucky expert and I do not have a study citation at the ready. We had an expert on this chat a couple weeks back who said that formula is an OK but general rule, meaning it will be different for every exerciser.

There is a formula for determining cals burned based on body weight, heart rate and time, but I don't have that either. I can give you this, and perhaps you can do some backwards math to deduce the formula: A 130-pound woman exercising at 80-85% of max heart rate will burn about 410 calories per hour. The same woman working out at 65% of max heart rate will expend around 290 calories per hour.

Hope this helps. I will research these formulas for the next chat.

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Arlington, Va.: First year mom here... I have lost all my "baby weight" but the last four pounds and am having a hard time losing those last four pounds. I have been running three times a week and following a challenging weight-lifting routine twice a week. I eat fairly well, so its hard to know what to cut out. I would appreciate any advice.

Craig Stoltz: Hey Mom, congrats on losing so much of that weight! You da gal!

You really worried about those last four lbs? You're pretty tough on yourself.

Lots of reasons for hitting plateaus: Your body may have habituated to your exercise regmine--bodies are damnably good at that. They find ways to do what you ask of them without expending as much energy as you used to. The answer there: Change your workout--different weight exercises, different cardio, add intervals to a cardio workout or run. Don't just do more of the same!

Another reason: People have "calorie leaks" into their diet they are not aware of. That handful of peanuts gives you good fats, but lots of calories. Maybe that afternoon cookie has 250 calories, not the 120 you thought. Maybe what you call one serving of pasta is really 1.7. And so on.

Advice for that: For one week, record everything you eat, without mercy or compromise, and find out its calories. Measure everything (this isn't for life, it's just a one week experiment). You may find that you're simply eating more calories than you need.

Caloriesperhour.com is a good, free site that has some good information about this. The Lean Plate Club, by sometimes-Crewster Sally Squires, has a page on washingtonpost.com that's full of tools to help you do this.

Good luck, and let us know how it goes.

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Gaithersburg, MD: I have no problem with working out. I love it, actually. It's the looks I get at the gym when I work out. This country amuses me. They say that "fat" people need to move and lose weight, but when "fat" people do, they get made fun of...WHAT A CROCK!; I love to ride my bike, go hiking, go swimming, take spinning classes, but the roll of the eyes and the giggles when I'm wearing a bthing suit or breathing hard are hurtful. How do I ignore these and continue on my mission to good health and a kick butt body??

Susan Morse: Hi Gaithersburg,
There are some in every crowd. From what you say, it's clear: you have the healthy attitude. The "jokers" have the problem. The answer, I think, is to continue what you're already doing: engaging in fitness activities you enjoy and that are good for your health, and never mind what a few rude and obviously misguided people might say. (I think I've met some of these same losers on the road. whew) Congratulations on your persistence and your goal. You're on the right route.

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Washington, DC: How long should an ache last before I should be concerned? I was working out with dumbbells a couple of weeks ago (admittedly, probably with more weight than I should have), and the next day, I felt some pain in the crook of my elbow, especially when I would rotate my arm. The pain's lessened considerably, but it's still there.

Calvin Poston: The inflammatory period lasts about three days. And the subsequent healing can take a couple of weeks. But during that time there should be a gradual decrease in pain. At the start of an injury RICE should be used (Rest Ice Compression and Elevation. If that does not work and a decline in function is present it is time to see a doctor.

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Washington D.C.: So which is it? Stretch before or after you workout? I always have found my joints are a little more responsive during activity when I stretch before activities, yet, I keep reading to stretch after a small amount of activity...any help would be appreciated.

John Briley: WDC - The advice to stretch after warming up is to prevent minor muscle pulls from stretching cold. These are more of problem as we age and for people who are relatively inactive all day (e.g., desk jockeys) who then try to stretch hard before exercising.

If you move around quite a bit during the day, especially right before your workout - for example, walking to the gym from the Metro station - you may be warm enough for some light stretching. Otherwise, the wisdom holds: Get some blood flowing and heat up the bod (for example, with 5 to 10 minutes of light cardio) then do your stretches.

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richmond, VA: Enjoyed the column on balance as I am old, overweight, arthritic, and various other ailments which I won't mention in mix company. I have found the ball excercises and weight-lifting routines really help with balance. You do have to overcome reducing your weights from the normal bench but it accomplishes the same objectives. I like the "Arnold Schwardzeiger" lift on the ball.

Susan Morse: Hi Richmond,
Glad to have you with us and--ahem--so on the ball. (Okay, I'm sorry.) For all of us folks who are getting older day by day (as they say, it beats the alternative), strength and balance exercises are really important to help maintain function and prevent the risk of falls. Glad you've found a solution that works for you. Thanks for chatting.

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New York: First let me say I like Sally's new picture.

My question: I work out a couple of times a week with a trainer. We often begin with about 15-20 minutes of stretching and then some more light exercises before getting to the real stuff. I am finding it frustrating though to spend 30 minutes of a one-hour workout warming up and starts to sap my enthusiasm so that by the time we get to the harder exercises I have less energy. My trainer says he knows I want to rush things, but he's not going to let me hurt myself.

Your thoughts?

Thanks

Craig Stoltz: Hey, New York. Sally's new picture has made the rest of us want to get glamour shots too. I'll bet Briley would clean up real good for the camera.

On the trainer: He works for you, not you for him. You should feel free to tell him you want no more than 10 minutes of stretching in a workout. If he says no, find another trainer. Injury prevention is excellent, admirable. Devoting half a workout to preventing injury in the rest of it is an unusual recommendation and may be unncessary.

As for the value/proportion of stretching: Be aware what he has you doing, while no doubt valuable, is not standard practice. And that opinions are mixed on whether stretching prevents injury, and if it does how much of it is required.M

Most trainers I know, and have worked with, and read (though, to be clear: I'm not a trainer), say to start a workout with 2 to 5 minutes of *warm-up* (as distinct from stretching). Warm up can be walking, light jogging, any cardio machine, even doing arm circles. Anything to get the joints lubed and the blood flowing.

After that, stretching can be done before strength work, between strength exercises or after them. Opinions differ. For what it's worth, the workout I've been doing for the last year or so has me do related stretches between exercises (tricep stretch between tricep curls, quad stretch between sets of lunges, etc.). It saves time and keeps me loose between exercises and sets. Works for me. I haven't been hurt.

If you want a great education on stretching, try Bob Anderson's Stretching, a book considered the bible on the practice.

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Aldie, VA: Hi, I've been going to the GYM 3-4 times a week. I do cardio for about 30 minutes then do the ball exercieses and some weights. I have lost all my pregnancy weight and want to tone up now. I have the baby belly that i'm mainly concerned about. How can I change my routine to achiece the goal?

TIA

John Briley: Hi Aldie - Great work getting back to fitness after pregnancy. As we state often, you cannot spot-reduce fat areas, but you can spot-tone by working certain muscles, in this case your abs. HOWEVER, I wouldn't focus too much on that because many people get obsessed about their tummies and get into imbalanced exercise routines.

Do your crunches, yes, and make them harder if you want by holding a 5-pound medicine ball while you do them. But also do back extensions to balance the front-side workout, as well as exercises for your core (e.g., some of the balance exercises we detailed in this week's print column: www.washingtonpost.com/wp-dyn/articles/A25608-2004Oct11.html). Keep up the cardio - that is the most efficient way to burn fat and, if you have the time, your other weight work.

To get more muscle tone from weights, increase the amount of weight and lower the number of reps, but make sure you can do at least 8 reps in good form.

Does that help?

Keep up the good work!

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Washington DC: I am a certified personal trainer and group fitness instructor who teaches stability ball classes. To the person interested in good stability ball videos, please check out www.resistaball.com -- Resist - A -Ball is the industry leader in stability ball education, and they have links to SPRI, a fitness retailer and wholesaler that has many great videos. I think "New Moves on the Ball with Gin Miller" is a terrific video for those looking for a total body workout, and there are other great videos at SPRI. If the chatter has a change of heart, please check out some local gyms -- there are a lot of great instructors out there ready to help you!;

John Briley: Thanks for the advice, DC PT! Nice to know the fitness pro community is surfing the chat.

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Craig Stoltz: Nobody asked, but since we're talking aches and pains, let me share the following.

For the past few years, my knees and back have been making me feel, how you say, like an old man (I'm 47). Old runner's knee injury, and an off-and-on sore back that gets spasmey in reponse to stuff like carrying mulch bags, weeding, golf swings, sleeping funny, sleeping serious, etc.

The past three months or so, after joining a new gym, I've been working out pretty consistently four or five times a week. Lots of core, flexibility and light weights. (This change in my behavior scares my co-workers.)

(And my wife.)

But by doing a lot of ab exercises, and core work, my back pain has virtually disappeared. (Except for the mulch-bag kind. That still makes me spasmy and tight the next day.)

Even my knees, which I'd given up on long ago, are doing much better thanks to a lot of quad and calf exercises (lunges, step-ups, half-squats with stability ball between back and wall).

The point is, pains I'd ascribed to Inevitable Aging Degeneration have been reduced, and even disappeared, by good workouts. My back pain was due to weak abs, I think. My knee pain to weak quads and hamstrings.

Put another way: A consistent, reasonable exercise program may be able to alleviate those aches and pains--without Vioxx, Motrin, knee braces, items purchased at The Back Store, etc. Sure, it's a lot of work. But it's a huge relief.

Just make sure you see a doctor to rule out serious stuff first. Especially with back pain.

Thank you for indulging me. Back to the questions.

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Washington, DC: I live in a 3-level townhouse, and afted a day in which I have to go up and down the stairs several times, I have minor pain in my right knee. I have been diagnosed with osteo arthritis in my right thumb. Is this the beginning of arthritis in my knee? I walk for exercise and do 3 miles 4 days a week on the treadmill. I've also lost about 17 pounds in an effort to keep the arthritis at bay. Is there anything else I can do?

Susan Morse: Hi Washington,
First a caveat: This is not a medical opinion. For that, you'll have to see your doctor, which might be a good idea, particularly if you've been bothered by this symptom for some time. He'll want to examine your knee for any possible swelling or mis-alignment--to rule out other possible causes of pain--and ask you about your age and medical history. If it is arthritis, you're right: You're already doing one very important thing to help prevent its aggravation: You're losing weight. That's terrific. While walking is good exercise, if your knee is bothering you, you might consider alternating with some non-weight-bearing activity, like swimming or bicycling, to see if that helps. Some orthopedists advise arthritis patients to take a supplement called glucosamine-chondroitin. Some early research suggests this can be helpful, but the evidence in humans is not yet conclusive.
Taking a mild OTC painkiller like Tylenol can help with the pain so you can keep moving. The keeping moving part is critical. And exercises that strengthen your quads (such as squats) are also recommended to take some of the pressure off your knees. In doing squats, make sure when you bend, your knee doesn't come forward past your toes.
Lots of luck to you.

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Washington, DC: This responds to the inquiry from the overweight person who does not like some of the glances, attitudes, etc. from her fellow exercisers. I am a very overweight woman who has begun exercising with some frequency (in old, sloppy clothes no less!;) and I have, much to my surprise, found that the most supportive people have been men that I know who are in terrific shape. I was definitely not expecting this, but am delighted when they encourage me. Maybe some of those who she thinks are negative a insecure (or just jerks . . .).

John Briley: Good points and encouragement, DC. Like so much of life, the best advice (admittedly hard to follow sometimes) is to forge ahead without worrying about the spectators. Continued good luck to you.

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Cortlandt Manor, NY: I do 200 pushups in sets of 80, 60, 30 and 30. I have recently stopped lifting weights. Do you think that this will help me to continue muscle growth, or is it not enough?

Calvin Poston: By using higher reps(15 and above)one is more "toning" than gaining hypertrophy. Weight training invovling lower reps, no more than 12 will cause muscle growth and increased strength.

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Washington, DC: Hi. I have a question on knee pain. I started running at least 4 days a week (2.5 miles) a couple weeks ago. I have no problems while I run but afterwards the muscles around my knees start aching. I get the same problem if I try to lunges as well. The symptoms don't seem to match runner's knee since I don't have pains while I run or a cracking sound. Any ideas?

Calvin Poston: It could be tendonitist. Tendonitist is an overuse injury that comes from doing too much activity too fast. Tendons take awile to remodel and become strong enough to endure the stress that is placed upon them. A gradual increase in activity is needed to allow proper growth and strengthening of tendons. To aid in the healing process of tendonitist, stretching and ice should be used after running. A good warm up is needed as well before exercise (5-10min). After warming up stretching of the major muscle groups must be done to ready the body for activity.

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DC: So how to decide if you've injured yourself enough to see a doctor? I went hiking on Saturday and pulled/twisted something badly enough that I could barely walk Saturday night/Sunday morning, but was much better by Sunday night.

Susan Morse: Hi DC,
Sounds like a sprained ankle. And yes, I know from experience, those can swell up pretty badly and temporarily keep you off your feet. But if you rest it and it's much improved in 24 hours, so that you can walk on it and it's not causing you any real pain, it's not likely it was anything more serious. Of course, if you have any further problem with it, then it deserves medical attention.

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Arlington, VA: Ok, I need help. I'm literally falling apart. About 12 and 15 years ago I had both of my ACLs reconstructed due to two blow outs playing soccer. Up until about 2 years ago I had no problems with my knees but now I can feel them slipping, even when I walk. I used to be so active until then and now I'm afraid to do most exercises because I don't want to finish them off again. What kinds of exercises would be good to start without putting so much pressure on my poor knees? I'm not even 30!;

Calvin Poston: Before starting to exercise it is advisable to consult with an orthropedic who is experienced with athletes. Once getting cleared to exercise, start with the basics. Using lite resistance and avoiding leg extensions. Leg extensions can place high compressive forces on the knee. Pay close attention to strengthening the hamstrings to minimize the forward translation of the tibia. And strengthen the VMO of the quads; thats the tear drop shaped muscle closest to the knee. If all else fails rehab maybe the best course.

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Anonymous: hello, i injured a (normally weak) ankle about a month and a half ago while running. i now know that at least part of the problem ere sneakers that needed to be replaced due to loss of padding. my question is, how long does an injury like that normally take to heal? i have had no problems walking since the injury and had stopped running for a while, but when i recently start running again (very easily), after 20 minutes or so, i can feel the ache in my ankle again, and i'm surprised that after taking a month off, it's not almost 100% better. i can definitely take more time off of running and will continue to do lower impact exercise - but how long can ankle injuries take to heal? is the ankle a spot on the body that needs a long recovery time?

thanks!;

John Briley: Hi Anonymous - You're talking to someone who has blasted both ankles repeatedly playing basketball (you'd think I'd learn, right?) and here's my counsel:

Physical therapy is key to recovering full range of motion. It's a tedious process - combination of boring exercises like pulling one of those balloon-material bands around your foot and doing reps of foot-out-to-the-right, then a set out to the left, then pointing down. Ice it after you work it, whenever there is pain.

Bad injuries create energy blocks in the body and if you don't work at healing it fully, your energy will naturally detour round the injured area meaning some residue of the injury will remain.

I am glad you say 'ache' and not 'sharp pain' because the latter might indicate a bone chip or stress fracture - or a still-torn ligament.

Calvin: Anything to add here?

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Stability ball: I bought a Gaiam-brand ball a few months ago and it seems to leak a lot... consequently I've had to pump it up periodically (every week or two) and now the tip to the cheezy pump has broken off, rendering it useless!; Do I have to (or should I) buy a whole new ball, or can I just replace the pump?

John Briley: You should contact the company for a replacement or refund on the original ball and pump. If that fails, buy a new ball: They're cheap enough and you shouldn't have to deal with the hassle every week or so.

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Falls Church: When I walk on the treadmill, I often get pain in my calf muscles as I increase the speed. Lowering the speed reduces the pain, but I don't get as good a workout since my heart rate is lower. I'm talking about 120-5 versus 130-5 for a 53 year old male, 230 lb.

Is there anything I can do about this?

Craig Stoltz: Hey, FC: I get pain on the *front* of my lower leg--my shin--when I walk too fast. Not quite the same, but you may try the solution of mixing a light jog into your walk, even for 15- or 30-second "bursts." Then resume your walk until your heartbeat stabilizes. Then jog lightly for another brief period. This is a form of interval training and has great cardiovascular benefits and will get your heartrate deeper into your training zone. More to the point here, it will keep you moving but likely relieve your calf of the repetitive motion that may be causing the pain.

Another option, if you're in a health club: use a different machines: bike, rower, stair climber, elliptical. People get habituated to a machine, and that slows their progress--and increases risk for repetitive-motion injury.

Good luck!

Of course, if you can't jog at all, don't try.

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DC: I remember being told to rest a day in between weight training, but that core exercises could be done daily, is that right?

Susan Morse: Hi DC,
It's generally not advised to do more than two successive days of weight training, because the miniscule muscle tears caused by the exercise need time to be repaired. It's the cycle of tearing and rebuilding of tissue that makes the muscle stronger. Core exercises can be done more frequently--though there, too, if your muscles feel sore, switch off to something else for a day and give them a rest.

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Washington, DC: What, exactly, causes the normal aches and pains you get from exercising? I understand that there is a way to minimize the aches and pains in how you exercise and I would like to know more about that. I think it has something to do with how you use resistance in working the muscle. For example, in doing a biceps curl, you lift and you lower...if you lifted only, you would have more pain.

Also, to the woman with weights and no weight bench, I had the same problem and used the exercises in the book "Strong Women Stay Young" by Miriam Nelson, Ph.D. This is a research-based approach to weight resistance training for women that can be done in the home, no weight bench needed. The study results were published in JAMA, so you KNOW if you do what she recommends, it will work (and it did for me).

Thanks!;

Craig Stoltz: Hey, Wash: We're almost out of time, and I'd love it if Calvin could handle your Q, but he's tied up. I wanted to post this for the second part, about Miriam Nelson's book and program. You're right--it's unusually well documented for an exercise program.

As for the pain: The way you build muscle is by actually doing small damage to muscle fibers by taxing the muscle beyond its current capability. The pain you feel for a day or three is from torn tissue. When the body repairs the tissue, the muscle gets bigger and stronger.

That's how the process works, so if you *don't* feel the pain--we're talking that minor muscular pain that reminds you you worked out, but doesn't disable you--you're not growing your muscles. If it's worse than minor, and really inhibits your motion, see a doctor. You may have done more serious damage.

You can reduce pain by doing more reps with less weight, but that won't grow and build your strength as well. It will also increase risk of overuse injuries. Try to use a weight you can do between 8 and 12 reps with; you should "fail" on the last rep or two. That's when you know your workout is helping you. That and that slight pain for a day or two. Trust the (minor) pain. It's your friend!

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Washington, DC: I overtrained for the Army 10-miler and ended up with a stress fracture in my foot!; I've been to the doctor but was wondering how I should start running again once I'm healed. I also heard that biking and swimming are good, low-impact alternatives while I'm recovering. Any advice or insight is greatly appreciated!; thanks for these chats!;

John Briley: First, DC, good effort on the race. The over training shows high enthusiasm and dedication. Of course - as your foot is telling you - that's not all good. Now, to the recovery:

Start back slow. Make sure you can walk on it pain free before even attempting running and - as my sports doc tells me - normalize your gait. Any limp or unnatural adjustment of the foot to reduce pain means you are not fully healed.

Regarding swimming and other non-impact sports are good for you, but will not test how your foot feels under pressure. Try an elliptical machine: Those are low impact but force you to bear weight on your feet - and offer a range of motion - so you can get a sense of how it feels.

Drop back next time and tell us how it's going.

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Fractured Clavicle: I suffered a minor fracture to my non-dominant side clavicle this past Monday. Any tips to speed recovery?

Calvin Poston: Nothing can really speed the healing of an injury. Everybody heals at their own rate. Yet it is possible to create an opitimal healing situation. Ice can be used to curb active bleeding and infalmmation. Antiinvicflamatory medications can be used to reduce gaurding and muscle spams. And increase the intake of water and vitiamin C which aid in healing. There are clavicle splints available that places the shoulders into a millitary posture, and of course a sling to take pressure off the arm.

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John Briley: Well, we're way out of time today, folks. Yet another active chat. Thanks for participating and we sincerely hope those aches, pains and injuries heal fast.

Join us again in two weeks for more fitness discussion. Questions in the meantime? Email us at move@washpost.com.

Over and out,

The Crew

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Viewpoint: Paid Programming