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For January 19, 2017

  • Tendons, Ligaments And Bones
    Tendons, Ligaments And Bones
    At both ends of every muscle, the fascia covering the muscle tapers to form a strong, rope-like length of connective tissue called a tendon, which is connected directly to one of your bones. One end, which connects to a relatively unmoving skeletal part, is the origin of the muscle. The point where it's attached to a moving bone is the insertion of the muscle. (The bicep's insertion is in the forearm, near the elbow.)

    When a muscle contracts, it pulls its origin and insertion closer together. Often a muscle is attached to two adjacent bones whose ends are joined together in a closed, fluid-filled capsule known as a joint (your knees, elbows, shoulders and knuckles are all examples of joints). Contraction of the muscle creates movement around the joint, allowing the pushing and pulling motions that make up physical movement.

    Most often, this movement involves a shortening of the involved muscles � such as when you lift a heavy weight off the ground. This is called a concentric contraction. If the opposing force is greater than the muscle force however, the muscle may actually lengthen as it works to contract. For example, when you lower a heavy weight down to the floor, your bicep muscle lengthens even though it's tensing. This is called an eccentric contraction. Finally, if the muscle doesn't change length at all during the contraction � when you push against a stationary wall, for instance � the result is an isometric contraction.

    Other types of connective tissue also help to create smooth, controlled movements. Ligaments are tough, elastic bands that connect the bones together and help stabilize a joint. The best way to think of ligaments is as tethers that hold the bones together at the joint. The ligaments help guide how the bones move in relationship to each other. Nerve receptors in the ligaments and tendons also send information to the brain, to help regulate the intensity of muscle contractions. Fluid-filled sacs, called bursas, cushion and lubricate your tendons as they slide back and forth over your bones.

    Because tendons, ligaments, bursal pads and joints all take longer to adapt to activity than muscle fibers, these connective tissues are particularly vulnerable to inflammation, tears or other injury, especially from any type of repeated movement � whether it's walking, hitting a tennis ball or typing at a word processor. Avoiding such overuse injuries is one of the keys to maintaining a lifelong exercise routine.

    From John Hopkins Health
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  • Superglue: Tricks that Make a Program Stick
    Superglue: Tricks that Make a Program Stick

    (Prevention, August 1999) - You can do almost anything for a week (except hold your breath). It's the second week of an exercise program -- and maybe on into the sixth -- that you find yourself looking for some extra strategies that will bond you and your new routine like superglue. Here are some tricks to help:

    Have your stuff handy. Nothing can derail your intentions faster than sneakers that are still soggy from the weekend hike or Walkman batteries that make Frank Sinatra sound like Lurch from the Addams family. Flatten those paper-tiger obstacles by keeping your gear ready to roll and, above all, handy. If you have to trip over your walking shoes on your way out the door, you're one step closer to leaving with them on.

    Hitch exercise to an essential. Attaching exercise to something you absolutely have to do every day (until exercise itself becomes that thing) will boost your chances of doing it. Some exercisers leave the house without showering so they have to go to the gym on their way to work. Others leave an essential piece of equipment like eyeliner or concealer in their gym lockers so they either go there or go without.

    Be engaging. Sign up your friends, your spouse and anyone else you trust to keep you pointed in the right direction. Most people need something or someone to obligate them to exercise for the first month or two of a new program, says Tedd Mitchell, M.D. For instance, if you've chosen to begin your workday at 8:30 instead of 8, have a friend phone or email you and ask if you've done your workout. Offer to do the same for them.

    Find a role model. Oprah is not a role model. Sure, she's lost weight and she exercises. But can she get the kids from baton lessons to baseball practice, put the finishing touches on tomorrow's report, cook dinner and still walk an hour a day during the work week? Find someone like yourself, with your kind of obligations and obstacles, who works out like clockwork. She's the one who proves the point that it can be done.

    Acknowledge the cost of doing business. Back when you made that pros-and-cons-of-exercise list, there undoubtedly was a "con" or two. Don't ignore what's there. The person who doesn't give a nod to the fact that exercise may cause some muscle stiffness might pack it in when exercise has that effect.

    Drink from the company-only china. Or do whatever else feels like a reward. After you exercise for a while, the glow that you feel after a walk in the park is reward in spades. But in the first few months of a program, you might need to give yourself a blue ribbon now and then. It doesn't have to be extravagant, says psychologist James O. Prochaska of the University of Rhode Island, Kingston. Just remember to reward the behavior, not the outcome. That is, reward yourself for walking five times this week, not for losing a pound.

    Don't sweat the skips. Inevitably, real-world obstacles will occasionally come between you and the gym (or your park path). Don't sweat it. "Once you've committed to exercising daily for the next 75 years, missing a day here or a week there isn't catastrophic," says Kerry Courneya, Ph.D. View the "skip" as just that--a temporary skip and go on from there. "People can get back on track quite readily," says James O. Prochaska, Ph.D.

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  • Breakfast: The essential meal
    Breakfast: The essential meal
    By Elizabeth Somer, R.D.

    (WebMD) -- Your mother was right: Breakfast is the most important meal of the day. People who skip breakfast tend to struggle more with weight problems and suffer low energy later in the day when compared to those who take the time to eat.

    If you're a seasoned breakfast skipper, change your ways and start eating breakfast -- even if you aren't hungry. It takes two to three weeks to reset the appetite clock. After that, you should notice a boost in energy and fewer problems with overeating later in the day.

    breakfast?

    The eight or more hour time span between dinner and breakfast is the longest span between any of the three meals of the day. In the hours since dinner, and even while sleeping, the body still needs fuel to keep the heart beating, nerves transmitting, eyes blinking and cells dividing. Much of that fuel comes from the readily available stores of glucose in the blood, liver and muscles.

    By sunrise, the body is essentially in a fasting mode, with more than half of the body's glucose usually drained by morning and needing the jump-start that comes from eating a carbohydrate-rich meal. That first meal of the day literally breaks the fast.

    Energy drop

    If you skip breakfast, you might feel fine, full of energy and ready to go for the first few hours after you wake up. That burst of energy typically comes from a mind and body refreshed after a good night's sleep. But this initial burst of energy wears off as the morning's demands add stress to a body already running on empty.

    If you allow even four hours to pass between meals, blood sugar levels drop, resulting in fatigue, poor concentration, irritability and lethargy. Double the time to eight or even 12 hours and you can imagine the energy-draining effects of failing to refuel.

    By afternoon, even if you eat a relatively good lunch in an effort to boost lagging energy levels, it's difficult to regain an entire day's worth of energy that you would have had if you had taken five minutes to eat breakfast.

    A breakfast primer

    What should and shouldn't you eat for breakfast? Avoid high-sugar breakfasts, such as doughnuts and coffee, which provide a quick boost, but leave you feeling drowsy within a few hours. Instead, choose meals with a mix of protein and starch. This will help you to maintain blood sugar levels throughout the morning.

    Some good morning choices include:

    -Whole-grain cereal and milk

    -An English muffin with low-fat cheese and orange juice

    -Nontraditional breakfast foods, such as leftover pizza, soup and toast, or a sandwich

    -Egg substitute and toast

    -whole-wheat toaster waffle topped with fat-free sour cream and fresh blueberries

    -A flour tortilla filled with cottage cheese and fresh fruit, warmed in the microwave

    -A low-fat whole-wheat bran muffin topped with applesauce and yogurt

    -An English muffin topped with one ounce of fat-free cheese and broiled until bubbly, served with a glass of orange juice.

    Elizabeth Somer, R.D., is the author of several books, including "Nutrition for a Healthy Pregnancy," "Food & Mood," "Nutrition for Women: The Compete Guide" and "The Essential Guide to Vitamins and Minerals." She is editor in chief of "Nutrition Alert!" a newsletter that abstracts current nutrition research from more than 6,000 journals.

    Copyright 1999 webmed, Inc. All rights reserved.
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  • Obesity Leading Killer in the U.S.
    Obesity Leading Killer in the U.S.

    Cost of Obesity Related Disorders Tops $235 Billion a Year

    (MSNBC Health, September 15 1999) � Obesity costs the United States $238 billion a year in expenses from its associated diseases such as diabetes, stroke and heart disease, a study published Wednesday showed.

    THE SURVEY, done by health consultancy agency the Lewin Group, did not include the costs of treating obesity itself, which affects more than 22 percent of Americans. It looked at the costs of treating stroke, arthritis, heart disease, diabetes and 11 other conditions in obese people. Obesity is defined as having body mass index (BMI) of 30, which is calculated by dividing a person�s weight in kilograms by height in meters squared.

    �The data indicated that a person with a BMI of more than 35 has a 6.61 times greater risk than a person who is not overweight (with a BMI of under 25) of contracting type-II diabetes,� Dr. Robert Rubin, president of the Lewin Group, told a conference sponsored by the American Obesity Association. �A person with severe obesity has a 3.77 greater chance of being hypertensive (having high blood pressure).�

    Experts on obesity, as well as past sufferers such as Britain�s Duchess of York, said the first step to addressing the problem is to talk openly about it. �Because people are frightened of it and afraid to talk about it, they go into denial,� the duchess, known popularly as �Fergie� after her maiden name Sarah Ferguson, told the conference. �I want more people to admit that it is OK to admit problems with obesity,� said the duchess, who is now a spokeswoman for Weight Watchers. �I was 200 pounds. I know how it feels.�

    U.S. Surgeon General Dr. David Satcher said that although the country had conquered infectious disease such as smallpox and polio, it was moving in the wrong direction in a few areas � one of which was obesity. �Obesity is a major public health problem in this country,� he said.

    PREVALENCE UP 20 PERCENT

    �The prevalence has increased by 20 percent in 20 years.� In 1962, 12.8 percent of Americans were obese and 14 percent were in 1980. Now, 22.3 percent are. All the experts agree the problem boils down to a lack of exercise. Only 27 percent of high school students in the ninth through 12th grades took a physical education class in 1997, Satcher said. �People who exercise are much more productive. They are much better able to deal with stress,� he said.

    Noting that the impotence drug Viagra drew more new prescriptions than any other drug in history, he said there was an even stronger incentive to exercise. �Physical activity increases sexual enjoyment and potency,� he said. Dr. Claude Bouchard, formerly of Laval University in Quebec and now head of the Pennington Biomedical Research Center in Baton Rouge, Louisiana, estimated that genes are responsible for about 30 percent of obesity. People who have a parent or sibling who is obese have double the risk of being obese themselves. If that relative is very obese, with a BMI of 35, the risk triples.

    But people can overcome a genetic predisposition very easily with a little exercise, Bouchard added. He said society wrongly blames obese people for their condition. Over a lifetime, overeating by just 1 percent of calories can cause a person to put on anywhere between 40 and 55 pounds , by the age of 60.

    CALORIC INTAKE UP

    �The magnitude of risk increases with severity,� he said. Bouchard and others have done careful studies to see if people are eating more, and have found that in most countries, people are actually eating fewer calories than in years past. The exception is the United States, where there has been an increase of 3 percent to 4 percent in calories eaten in recent years.

    What has been going down, in direct proportion to people�s weight going up, is exercise. One British study showed that weight went up in almost direct proportion to the number of hours of television viewed.

    Copyright 1999 Reuters Limited. All rights reserved.

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  • Pill shows promise in preventing influenza infection
    Pill shows promise in preventing influenza infection

    TRENTON, New Jersey (AP) - A new pill expected to be available soon appears to reduce the chances of catching influenza by about three-quarters if taken daily during flu season.

    Oseltamivir, to be marketed as Tamiflu, was given in 75-milligram doses once or twice daily to 520 people for the first six weeks of the 1997-98 flu season.

    Just 1 percent of them got the flu, compared with nearly 5 percent of a comparison group that took dummy pills.

    The pill worked against both A and B flu viruses, the two major types Americans catch, researchers at the University of Virginia and five other sites concluded. Their work was funded by the pill's manufacturer, Hoffmann-La Roche.

    The Food and Drug Administration is expected to soon allow Hoffmann-La Roche to sell the drug, which would be the second of its kind approved this year.

    In July, FDA approved Relenza, a powder spray inhaled through the mouth. It has been shown to slightly reduce the duration of a flu bout and reduce chances of catching the flu from an ill relative by 79 percent.

    Doctors believe getting an annual flu vaccine is still best for most people. The researchers said Tamiflu could be useful for people who are allergic to or won't get a flu shot, as extra protection for vaccinated residents of nursing homes, or for family members exposed when someone brings the flu home from school or work.

    The research appears in Thursday's edition of The New England Journal of Medicine, along with an editorial by two Centers for Disease Control and Prevention experts. They wrote that Tamiflu could be a useful weapon during likely future flu epidemics, partly because two older flu drugs have significant side effects, only fight type A flu and can't attack virus strains already resistant to the drugs.

    Another recent study found Tamiflu cut the duration and severity of flu symptoms by about half in 80 adults who didn't get a vaccine.

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  • Use Sun Screen, Get Skin Cancer?
    Use Sun Screen, Get Skin Cancer?

    Sunscreens give false sense of security

    (MSNBC News, Aug. 3 1999) � In findings that will be debated from the sunny beaches of Maui to the snowy slopes of Aspen, new research shows that high-SPF sunscreens may have a deleterious effect � giving people a false sense of protection and causing them to stay out in the sun longer than they otherwise would.

    IN A NEW study of vacationers aged 18 to 24, those who sun-worshipped using SPF 30 spent 25 percent more time under the rays than those who used SPF 10. A sunscreen�s SPF, or sun-protection factor, indicates its ability to delay sunburn. SPF 30, for example, allows a person to stay in the sun, burn-free, 30-times longer than he or she would using no sunscreen.

    Sunscreens are promoted as a defense against skin cancer, too. However, a number of studies have linked the use of sunscreen with a rise in skin cancer that has occurred over the past few decades. An analysis of 16 epidemiological studies showed that in many cases, the more sunscreen a person used, the higher the chance he or she developed skin cancer, according to Dr. Marianne Berwick, an epidemiologist at Memorial Sloan-Kettering Cancer Center. Epidemiological studies do not show cause and effect, only an association between two or more factors.

    �This does not mean that using sunscreen raises the risk of skin cancer,� she emphasized, � just that people who use a lot of sunscreen may have one or more other characteristics that raise their risk.� In general, the people most likely to consistently use sunscreen are those who are fair-skinned, for example, Berwick said. Such people, who are normally sun sensitive, may start to feel safe under a layer of lotion, she said, exposing themselves to more sun than they should.

    Melanoma cases have doubled in 20 years in the United States. According to the National Cancer Institute in Bethesda, Md., melanoma diagnoses rose 2.7 percent each year from 1990 to 1996.

    THE NEW STUDY

    In the new study, researchers led by Dr. Phillipe Autier divided the vacationers into two groups: 42 who were given five tubes of SPF 30 sunscreen, and 44 who were given SPF 10. None knew which SPF he or she had received, and the researchers provided no instructions on how to use the sunscreen. While on vacation, each subject kept a diary on sun exposure and sunscreen use.

    Autier, of the European Institute of Oncology in Milan, Italy, and colleagues found that while both groups spent about the same amount of time on vacation, the SPF 30 group averaged a total of 72.6 hours in the sun, compared with 58.2 hours in the SPF 10 group. Because the SPF 30 group had greater sun exposure, both groups reported the same number of skin-reddening or sunburn episodes � 159.

    The findings are reported in the August 4 issue of the Journal of the National Cancer Institute. Despite the success of sunscreens in reducing skin cancer in animal experiments, they have yet to do the same in the general public, Autier�s team noted.

    In Autier�s study, participants used, on average, only 20 percent of the lotion they received. If they had applied the sunscreen properly, the researchers reported, the subjects would have gone through three to four times that amount. According to Berwick, fair-skinned, blue-eyed and light-haired people are at high risk of skin cancer and should minimize your time in the sun. Darker-skinned people, on the other hand, may be able to enjoy their time in the sun with more impunity than previously believed.

    PROTECTING CHILDREN

    The best strategy against skin cancer, said Dr. Frank Gasparro of Thomas Jefferson University in Philadelphia, is avoidance. �But since we can�t live in caves, coming out only at night, it�s very appealing to put our faith in something that can we can put on our skin.�

    Because childhood sun exposure is the primary risk factor for developing melanoma in adulthood, protecting kids from ultraviolet rays is particularly important, according to Karen Emmons, an associate professor of health and social behavior at the Harvard School of Public Health and the Dana-Farber Cancer Institute in Boston.

    Day camps and child-care centers should provide kids with shaded play areas, she said, and parents should make sure children wear hats and avoid intense sunlight as much as possible.

    The Medical Tribune News Service contributed to this report.
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