Our coaches, trainers and gym teachers have long instructed us to touch our toes before we touch the court. Most of us almost intuitively stretch before working out, running, or exercising. But what does stretching really do? Does it increase flexibility? Enhance performance? Prevent injury? Turns out, too much stretching may be a bad thing. It all depends on how much you move while you’re stretching.

All stretches involve postures that move your body to its outer limits of motion. Stretches are classified as dynamic or static, depending on whether you are moving – like doing high knees – or standing still – like doing long quad stretches. We often think of those long, static stretches as the standard – you elongate a muscle group and then maintain that elongation for 30 seconds or so. But stretching dynamically, while you move, is gaining popularity because it engages the muscles in a similar way to the workout itself. When you do a dynamic stretch, you propel your muscle through its maximum range of motion, and you stay in motion. Dynamic stretching prepares your muscles for the kind of performance they must give during your workout, and it warms you up at the same time.

New evidence suggests that static stretching, in particular, may be a warm-up tradition based in superstition. A University of Nevada, Las Vegas study found that static stretching tends to weaken the muscles involved in a workout, thus decreasing strength and ultimately performance over time. This appears to be caused by the neuromuscular inhibitory response that takes place in muscles with static stretching. Long stretches make a muscle less responsive to brain signals, which effectively weakens the muscle just as it’s about to perform. But don’t roll away the yoga mat just yet. Static stretching has other proven benefits like increasing flexibility, decreasing elevated blood flow and even restoring calm. Many experts believe that static stretching should play a key role in a cool down after the workout is through, but almost everyone agrees on the benefits of dynamic stretching before a workout.

Studies show that dynamic stretching causes no neuromuscular inhibitory response, it increases flexibility over time, and it helps to prevent injury. Stretching the muscles in ways that mimic a workout is a great way to reduce the likelihood of ligament and muscle tears. So next time you hit the gym, trade your static stretches for dynamic stretches so you can have a safer and more effective workout.

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Osteoarthritis, being a debilitating and painful disease, can turn athletes into couch potatoes. We all understand that exercise is important to stay healthy and live longer, but it’s tough for those with osteoarthritis to do the bare minimum of exercise. The catch 22 of osteoarthritis is that exercise is an important way to reduce pain in the joints and prevent the pain from getting worse in the future. EverydayHealth.com showcases a few low impact exercises that allow patients with osteoarthritis to maintain their health and keep their joint pain from worsening:

1. Tai Chi

2. Yoga

3. Qigong

4. Water Aerobics

While movement with osteoarthritis can be arduous, it actually can be a great way to relieve pain when done right. Some of the keys to look for in a good approach to exercise is a focus on low impact movement and, not surprisingly, fun. In a recent piece for EverydayHealth, I discuss how activities such as tai chi and water aerobics can improve your quality of life. By both strengthening your body and alleviating stress, these 5 activities can make life both more comfortable and enjoyable. Give them a try!

1. Tai Chi
2. Yoga
3. Qigong
4. Water Aerobics
5. Belly Dancing

Chronic pain has the ability to strip individuals of their productivity, happiness, and well-being. ABC News wrote this great piece about Tiiu Leek and her pain in the workplace, describing how women feel more pain than men do. The article references a relatively new study from The Journal of Pain that showed women generally feel more pain than men. However, this study wasn’t thorough since it didn’t account for confounding factors such as emotional effects or an additional painful disease. Women tend to be better at analyzing and describing their pain to doctors which give the illusion they feel more pain. As a culture, men are expected to complain about pain less as well as talk about their emotions. One’s mental well-being has a huge effect on physical pain, thus conclusive studies are hard to produce.  Nevertheless, the findings reflect what I see as a chronic pain specialist. Here is a telling excerpt from the ABC News article:

Meyer saw 13 doctors before she got a proper diagnosis and the majority were men. “It’s very uncomfortable for them to see real emotion: ‘Tell me the facts, m’am, just the facts.’ I see them tune out.”

Now, she consciously spares the doctor the emotional talk. “I can literally be in so much pain I am crying when the staff is in there, but I pull it together when the doctor is in the room and have no tears at all. And it’s not easy to have to do that.”

She said doctors need to listen more to their female patients – “feelings are a part of the equation … Patients shouldn’t have to shut things down.”

Both Meyer and Leek sit on the leadership circle at For Grace, an advocacy organization that educates, supports and empowers women in pain through annual conferences and legislative outreach.

For Grace’s “Fail First” bill recently got through the California State Assembly’s appropriations committee on a 12-5 vote. If signed by the governor, it will allow women in pain much better access to pain medications, bypassing insurance companies.

As for Leek, she has seen marked improvement in her pelvic pain thought exercise and homeopathic approaches. She also tries to surround herself with positive people.

“My career was lost, but not my optimism,” she said. “I continue to live well. I once read that if you can get through your 60s unscathed, you can have a pretty good life.”

Read this article on ABCnews.com 

KTVU's John Fowler interviews Dr. Moshe Lewis on the negative aspects of normal stretching. What kind of stretches lead to less injuries and allow you to perform 11% better? Watch to find out.

Watch this video on YouTube.

Do winter blues have you down? Here are some simple, inexpensive ideas to rejuvenate your body and improve your mood throughout the winter season.

1. Treat yourself to some spa time.

Even if going to a spa is out of the budget, get yourself a handheld massager to use in the comfort of your own living room. And when it’s cold out, the next best thing to a massage is a hot bubble bath with some soothing music. You get the added benefit of increased blood flow to muscles, helping you relax. Music itself can be a relaxing way of helping you take your mind off your worries as it is the universal language of emotions. From timeless classics to contemporary jazz, indie, and fusion, the secret is to turn the volume down so low that it is almost imperceptible. This little trick allows you to focus on listening and helps silence racing thoughts.

2. Unwind with a relaxing walk.

Chronic stress can produce too much cortisol, a hormone that can ramp up appetite and lead to overeating. A simple exercise like walking just 30 minutes a day helps facilitate weight management and stress reduction all in one.

3. Treat yourself to a little R&R.

Nap time. Sleep loss causes slowed metabolism and increased appetite, putting us at risk for overeating, unhealthy food choices, and inactivity. Most of us don’t make enough time for rest. Curling up with a good book and some hot cider or tea before lying down can help us fall asleep faster during stressful times.

4. Keep finances in check.

Cutting your expenses is a good idea any time of the year. Studies show that financial stress is one of the main reasons adults worry. This concern can be transmitted to your kids. While most kids don’t bear the financial responsibility of their parents, they can often sense something is wrong. Save money by drinking water instead of coffee and sugary beverages. Don’t plan to make any large purchases on credit until you are out of debt. Lastly, pay yourself first, even if it’s only a dollar a week.

5. Go Zen.

Take up mood-boosting yoga, tai chi or meditation! These mind-body strategies incorporate improving posture, relaxing, and stretching to improve balance and coordination while simultaneously decreasing stress. Take time to breathe deeply and say a prayer, or just sit down in a quiet place and simply meditate with relative peace and quiet.

6. Release inner tension.

Never underestimate the power of a good, healthy sex life and reconnecting with your significant other. Enough said.

7. Take time to laugh.

Comedy is good for the soul, and there are clear health benefits of laughter. Whether you rent movies, download comedy sketches, or even go to improv or karaoke, a good laugh goes a long way. Consider taking your kids or young family members skating, skiing, or snow boarding, where everyone is engaged in lighthearted physical activity. Laughter lowers stress hormones and improves blood flow, which increases your energy levels. The more energy you have, the less likely it is you’ll be overwhelmed by depression that sometimes comes with the winter season.

This article was featured on SutterHealth's "MyLifeStages".

In this interview with Dr. Michael A. Lenoir on KPFA Radio's About Health, we touched on acute vs. chronic pain, Michael Jackson and dietary considerations. We answered many listener questions regarding increased sensitivity to pain, acupuncture, avoiding surgery, chiropractors, arthritis, the stress caused by pain, and more.

Listen to this interview on KPFA Radio's website

Creating a weight loss lifestyle in 2012 doesn’t have to seem like an insurmountable goal. Break down your goals into smaller, more attainable pieces that will have you creating healthy eating habits, rather than shedding pounds using crash dieting methods that won’t last.

Weight loss is an excellent resolution to have in spite of how difficult it may seem. Although there are many diets and fads that come and go, even a 10-pound weight loss can improve your health and your risk for diseases associated with obesity, like type 2 diabetes, hypertension and heart disease.

Here are ten easy steps to jumpstart your weight management program

1. Accept that weight management is an achievable goal

   If you approach weight management with the frame of mind that small steps will make a big difference over time, then the idea of losing weight will not seem so complex.



2. Make a plan to succeed

   Identify 10 food items that you currently purchase that you know are bad for you and that you can live without. Make a consistent plan to start eliminating two of these items each week from your grocery list.



3. Contact a nutritionist and make an appointment

   Every individual should have a customized plan tailored to their age, weight, height, metabolism and activity level. This plan is best created with a professional who will dedicate time to working with you one on one.



4. Schedule regular exercise

   Make it a goal to double the distance that you walk each day until you are walking at least 30 minutes each day.



5. Set realistic goals

   Rapid weight loss that can’t be sustained only results in frustration. The goal should be to lose approximately 1-2 pounds every week. Depending on how much you choose to lose, over the course of a year this would result in a substantial amount of weight loss.



6. Develop a support system

   It is important to join a support group and to develop a network of individuals who are committed to your success. Some of the most accessible groups exist at Weight Watchers, Ediets.com and faith-based organizations. Check your health plan for resources that also may be able to help you maintain your goals.It is important to check your weight regularly. Every week you should check your weight in the morning before you get dressed, on the same scale.



7. Positive reinforcement

   Feel good about the success that you are making and provide a small reward for yourself each week that is not food related. Some excellent suggestions include a manicure, a massage, taking a scenic walk, purchasing a new CD or new clothing item.



8. Congratulate yourself

   Weight loss is similar to a marathon that is not always won by leaps and bounds. The goal is to stay focused on your goal even if there are small setbacks from time to time.



9. Love yourself

   While absolute weight loss is a goal, it is important to love yourself no matter what your size may be.

Stretching, warming up, building endurance, taking care of your nutrition and feet, and mainly having fun are great ways to be healthier!

If you’ve been using your weekends to their athletic maximum to make up for sedentary time during the week, congratulations, Weekend Warrior! Weekend sports and outdoor adventures like team sports, hikes, swimming and skiing are good for both the mind and the body. Your well-earned weekend recreation has the added benefits of boosting your mood, reducing stress, increasing muscle and cardiovascular health, and providing a great social outlet.

But using physical recreation as a weekends-only reward comes with its own set of risks. Intermittent exercise quickly increases the risk of a muscle strain or ligament tear. Joints can easily be injured without the proper warm-up during the week. Repetitive stress injuries like plantar fasciitis or shin splints can put you in a walking boot for weeks. Skimping on weekday workouts leaves muscles stiff and poorly conditioned for weekend performance, so you’re far more likely to get injured in the pursuit of weekend excellence.

Luckily, a little bit of preparation goes a long way. You can start immediately to optimize your weekday routines in order to excel at your weekend sports activities. Here are six simple tips that can make your weekend performance better, safer and more fun.

1. Reach for the Sky

Stretching should always be the first step in a warm-up routine. Basic stretching allows you to prepare the muscles for the work they are going to do, preventing muscle strain injuries. More advanced stretching exercises like yoga and Pilates also improve your balance, core strength, back strength, and conditioning for the spine. You can reap the benefits of stretching even if you are unable to take a dedicated weekday class—just devote fifteen minutes to stretching a few days every week. Stretch before any strenuous athletic activity, on the weekend too. For a bit of variety, try an online yoga routine. You’ll feel better during your weekend activities, as well as the rest of your week.

2. Pump Iron, Or Soup

Strength training is an essential way to build endurance for the Weekend Warrior. Muscles need resistance training to function at their full capacity. Utilize lighter weights with multiple reps to improve tone initially—even doing curls with a soup can will help to tone your muscles for endurance-based activities like hiking or distance running. If you’d like to build strength and bulk, gradually move to higher weights with fewer reps. When using heavier weights, don’t forget to rest and pace yourself.

3. Know The Condition

Many of us are weekend warriors by necessity, not choice—our routine simply does not permit a lot of time to train during the week. But if you can find the time for even a little bit of simple aerobic conditioning, you’ll see a huge change in both your weekend performance and your everyday energy level. Activities like light jogging, hiking, aqua-therapy, tai-chi, yoga and rowing are easy, low impact ways to optimize cardiovascular health, limit damage to the cartilage and joint while having our body burn calories, thereby mobilizing muscles in a very natural way. For the athlete who prefers structured activity, a class or a second sport is an ideal way to train for weekend events. Aerobic fitness classes, dance classes, golfing, tennis and cross country skiing can all help you to step up your game while providing good cross training of multiple muscle groups simultaneously. Sometimes even tried-and-true exercises like running can cause knee pain, so don’t hesitate to decrease impact by using the elliptical or hopping in the pool every other day instead.

4. Did You Say Supplements?

From Omega 3′s to glucosamine to antioxidants to vitamin D, the right nutrition and dietary supplements can make a big difference in your sports performance and your general wellbeing. Always consult your doctor, who can support your good health through the appropriate supplements. Remember, a healthy diet, including adequate fluid intake, are essential to all athletes, professionals and weekend warriors alike.

5. Happy Feet Are Healthy Feet

Good ergonomics, posture and even the wear of your shoes can make or break your technique. Take a page from professional athletes, who optimize the mechanics of their technique with custom orthotics, proper shoes, and correct body mechanics. Consider taking a few lessons from a professional trainer in your sport of choice. Also, consider seeing a podiatrist for advice on inserts and shoe wear, especially if you have foot pain. An investment in proper foot support is an investment in your long-term orthopedic health.

6. The Fun Factor

Most importantly, realize that exercise should be fun! This certainly goes for your weekend recreational events, but the fun doesn’t have to end on Sunday night. It’s far easier to keep up on your regular conditioning if you genuinely enjoy it and look forward to it. If you’ve been having trouble jogging to prepare for your weekend pursuits, why not substitute rigorous swing dancing? Swimming? Dog frisbee? Or even aerobic gardening? Any weekday physical activity is better than none, and regular light activity will help your body to be acclimated for weekly hard activity. If you can keep moving, stretching, and having fun during the week, you’ll reach new levels of excellence in your weekend pursuits in no time.

Resources:

1. http://www.ncbi.nlm.nih.gov/pubmed/19761960

2. Rehab Manag. 2011 Apr;24(3):18-9. An ounce of prevention: physical activity plan can help weekend athletes allay overuse injuries. Berliner M.

3. N J Med. 1991 Sep;88(9):639-40. Recreational sports and the weekend athlete. White KM, McInerney VK, Hirsch PJ.

Many students, celebrities, soldiers, and even company owners are turning to meditation to help them with their daily activities. ABC News has written a great article on the benefits of meditation. The article even includes tips and opinions on meditation from the Dalai Lama himself.

A quiet explosion of new research indicating that meditation can physically change the brain in astonishing ways has started to push into mainstream.

Several studies suggest that these changes through meditation can make you happier, less stressed – even nicer to other people. It can help you control your eating habits and even reduce chronic pain, all the while without taking prescription medication.

Read on ABC News: Re-Wiring Your Brain for Happiness: Research Shows How Meditation Can Physically Change the Brain
More reading: Meditation 101: Tips for Beginners

USAweekend.com recently released an article title “Important tips to manage your chronic pain: 4 sure-fire strategies for feeling better”. The article includes important information on how to practice mindful meditation, supplements, and how to accept your pain (in order to move forward in life). It’s a great read:

Move a little everyday

Chronic pain can be debilitating, all-consuming and even frustrating — especially when you’ve taken every test and tried every medication and you still hurt. You start to think maybe it’s all in your head (it’s not) and there’s nothing else you can do (not true). Research shows the best way to control chronic pain is to tackle it from all fronts; in fact, a published review found that comprehensive pain programs — ones that address biological, psychological and social aspects of pain — are most effective at improving quality of life. For many conditions, medications help; to better manage pain, try these strategies, too

Read the rest of this article on USAweekend.com/

Gymnastics is one of those sports that encompass agility, balance, precision and strength all in one. Although injuries are prevalent in all sports, gymnasts should take extra caution because any little injury that has gone untreated may turn into a chronic problem later in life.

1. Before any routine, no matter what age or gender, you MUST warm-up –Spend at least 20-30 minutes to warm-up all the major muscle groups and stretch out your wrists and ankles since these are the joints that are most susceptible to injury.
2. Wear appropriate attire – Wear fitted clothing as loose clothing can get caught in equipment and can also prevent the athlete from doing aerial movements. In addition, hair should always be pulled back out of the athlete’s face, dangly jewelry and body piercings should not be worn as it can also get caught in equipment and pose harm to other surrounding athletes.
3. Have a qualified spotter – Spotters play a very important role in assisting athletes attempting new and/or difficult skills.
4. Have emergency contact information handy – Because injuries are inevitable, it is crucial to have an emergency plan to minimize/ease any discomfort an injured gymnast may feel.
5. Stop performing at the first sign of pain – If you think you have hurt or injured any part of the body, no matter how minor the pain may be, stop gymnastics activity until you have been checked out by a coach or doctor.
6. Wear additional safety gear when appropriate – some apparatuses require athletes to wear grips.
7. Eat a well balanced diet when in training – at any stage of gymnastics training, it is important to maintain a well balanced diet in order to perform at your best.
8. Do not attempt skills that have not been practiced – a gymnast should be confident and know how to perform a skill before attempting it for the first time.
9. Talk to your coach(es) – coaches are there to explain to gymnasts how to safely execute skills, how to improve those skills and can discuss with the gymnast any other worries or insecurities he/she may have.
10. Know and understand your body – Not only is gymnastics a physically demanding sport but also requires the athlete to be psychologically and emotionally inclined. Being attuned to your body will allow the athlete to block out distractions and concentrate more on his/her training.

Relatively clear evidence emerged to suggest that t'ai chi is effective for fall prevention and improving psychological health and was associated with general health benefits for older people. t'ai chi is a practice that combines deep breathing and relaxation with slow and gentle movements and is based on the Confucian and Buddhist belief that health is controlled by 2 opposing life forces, yin and yang. This is based on a recent extensive review of the literature by Myeong Soo Lee as reported in the May 16th British Journal of Sports Medicine.

However, t'ai chi seems to be ineffective for the symptomatic treatment of cancer and Rheumatoid Arthritis. Interestingly, a separate paper that was presented at the Royal College of Nursing’s research conference within the same week has found that T’ai Chi sessions may “help those with rheumatoid arthritis to gain increased self-efficacy and confidence through greater control over their mobility and condition within a supportive environment.”

It is also important to note that Tai Chi is only one form of Qi Gong. The various aspects of Qi Gong exercises can be even more beneficial for your health. T’ai Chi was developed hundreds of years ago in China as a series of graceful physical movements combined with deep breathing, and is now thought to be practiced by at least 2.5 million people around the world.

My colleague and friend Dr Perry is offering is stress reduction classes again at the Palo Alto Medical Foundation. It's an intensive 8-week course that helps people cope with physical and mental stress, and to reduce suffering from the conditions arising from stress. Read his statement below:

I am again offering a Mindfulness-Based Stress Reduction (MBSR) class at Rainbow Medical in Palo Alto.

Curious? Maybe interested? Come to a free introductory class at my office on Saturday morning, February 5, 2011 from 9:30 until noon.

The class will begin the following Saturday, February 12, 2011, and will meet for 8 Saturdays from 9:30 until noon until April 9, 2011 (no class on March 12, 2011). The fee of $300 includes all materials (2 CD’s and a book).

Jon Kabat-Zinn, Ph.D. developed MBSR in the 1980’s as a way to introduce the mindfulness concept, practices designed to cultivate mindfulness, and applications of mindfulness in reducing suffering. In his 1994 book, Wherever You Go There You Are, he gave a simple definition: “Mindfulness means paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally.”

Since then, the teaching of MBSR has spread world wide, and hundreds if not thousands of research reports have revealed the power of these practices in relieving the suffering of those of us with all kinds of stress, including in particular chronic pain, anxiety, depression, autoimmune diseases, etc. Does anyone out there not have stress?

After studying with Renee Burgard, MFT and Bob Stahl, Ph.D., I began offering MBSR classes in my office several years ago. Our classes have been small, and the participants have been enthusiastic in describing the benefits.

(Read more at the Palo Alto Medical Foundation website)