FAQ Category: General

The exercise balls are sized based on your height. Each ball has an optimal firmness that dictates its size. You can make it softer or harder depending on how much air is put inside the ball to inflate it. The diameter of the ball in centimeters (listed below) is based on the firmest setting.

Standard chart for ball sizes. Some companies may vary slightly:

The overload principle refers to resistance training. Overload occurs when a greater than normal physical demand is placed on a muscle. The amount of overload needed depends on the muscular fitness of each individual. Overload can be used to improve strength and endurance.

To gain strength, moderate to high loads (resistance or weight) are needed. When it comes to endurance training, the number of repetitions is more important. Muscles can be further loaded by decreasing the rest period between sets of exercises.

As the muscle adapts to the new load, more weight or more repetitions are added. Injury can occur from over training so caution must be used when progressing the program. If you’re working out at a training club or facility, the staff should be trained in these concepts. They will be able to help you get set up on the right program.

There are several possible reasons for the rapid gain and loss of flexibility you’ve noticed. First, you may be experiencing what scientists refer to as creep. Various elastic tissues in the body have a certain amount of laxity or creep. This applies to ligaments, discs, joint capsules, and connective tissue covering the muscles.

Staying in one position for long periods of time can increase or decrease creep in the lumbar spine. Creep describes the change in the viscoelastic structure when under constant load. The tissue may contract or tighten causing micro damage in the collagen fibers.

Second, the discs are under a lot of stress and load when the spine is flexed forward. During the upright posture the discs take on fluid to stay as full and supportive as possible. Bending forward squeezes fluid out of the discs. This may help explain why long periods of forward bending can get your fingers closer to the floor but also leads to stiffness and injury.

Finally, muscles have elastic properties, too. During prolonged stretch the fibers of the muscles may relax and get longer giving you greater flexibility. Once you return to an upright position the muscle fibers return to their normal resting length.

You may want to ask your yoga instructor about the thinking behind these postures. In some forms of yoga, slow, forward bends are used to elongate the muscles and soft tissues before going into extension postures.

From a yoga point of view there are two reasons for this. The first is that sitting upright may put the hips in a flexed position but the back extensor muscles are working hard to keep the spine straight. Forward bending actually counteracts this upright sitting posture of the spine.

Second, lengthening the extensor muscles first allows the body to move into extension
without compressing the vertebrae of the spine. Most yoga instructors who use this method start with slow, relaxed forward bends and then move into extension postures. The emphasis is always on lengthening or elongating the spine and avoiding spinal compression.

The selective tissue tension (STT) exam was designed by Dr. James Cyriax, an orthopedic surgeon who is often called the “father of orthopedics.”

STT consists of range of motion (ROM), resistive tests, and palpation or feeling the tissues. ROM is both active (the patient moves the body part) and passive (the therapist moves the body part with the patient relaxed).

Each test looks at a specific part of the joint or soft tissues in and around the joint. Palpation is used to look for any signs of deformity or inflammation. When the patient has pain is an important part of the exam. Is it before movement? During movement? Or only after resistance is given to the movement?

Each bit of information helps the therapist identify where the problem is and how to treat it. The STT system is a logical way to assess large joints like the shoulder, hip, and knee. It can be used for other joints as well.

Pain is a subjective symptom meaning it’s something the doctor or nurse can’t see or measure directly. Giving it a rating from zero to 10 helps make it more objective. This method is actually called the Verbal Rating Scale (VRS).

The VRS has been used in clinical studies for the last 30 years. There are other ways to measure pain such as the Visual Analog Scale (VAS). In this pain measure the patient looks at a 10-cm (about 2 1/2 inches long) line and marks the place that shows his or her
pain. The line starts at the left with ‘No pain’ and goes to the far right for ‘Worst possible pain.’

The VAS is more sensitive for change than the VRS or other pain measures. The VAS shows change sooner. Sometimes health care workers and researchers combine the two scales asking patients to rate their pain from zero (no pain) to 10 (worst possible pain).

Either tool is simple and easy to use. Pain can be measured this way in children and
adults.

There are many variables to consider when talking about steroid injections. First, there are many different drug formulations. Some work better than others. Some seem to be more effective for certain problems than others. For example a steroid solution called methylprednisolone works well for carpal tunnel syndrome.

Technique and accuracy also make a difference. Studies show that for joint pain and swelling, the injection must be delivered right into the joint for best results. If the injection misses and goes outside the joint, the benefits may be minimal.

Resting joints after injection seems to help, too. But some doctors tell their patients to go ahead and use the joint normally. This may not be sound advice based on some studies. More studies are needed to really understand how and why steroid injections work best. Then doctors can choose the right drug for each problem and get maximum results.

Phantom sensation or phantom limb pain occurs when a person has lost a limb such as an arm or a leg. Phantom sensation is the feeling that the lost limb is still there. When the limb hurts or is painful, it’s referred to as phantom limb pain.

About 80 percent of people who’ve had body parts amputated have some amount of phantom limb sensation or pain. Scientists aren’t exactly sure how to explain phantom pain. It may occur as a result of painful swelling at the end of cut nerves called a neuroma.

There may be a psychologic factor. Children who lose limbs before the age of four rarely have phantom sensations or pain. This suggests an emotional or psychologic painful response to the trauma and loss felt in the body.

Neurologists offer several theories about the mapping of sensation in the brain. Nothing has been proven yet.

Researchers, doctors, and neurologists have all tried ways to treat phantom limb sensation or pain. For example, ultrasound, medication, surgery, and electrical stimulation have all been tried with little success. The most (though not even close to 100 percent) success has been found with drugs used to inhibit pain messages.

During dry-needling, any needle (acupuncture, hypodermic) is inserted into the muscle trigger point. Trigger points are irritable spots in the muscle that cause pain when touched or activated.

With dry-needling, nothing is injected and the needles are not left in place. The trigger point is stimulated by twisting and turning the needle. Once the needle is removed then stretching exercises and postural changes are made. The goal is pain free range of motion.

This is different from acupuncture. Acupuncture is the insertion of needles into points on a meridian pathway to restore balance of energy and blood flow to the body. The needles may be left in for some time. Electrical current through the needles is also possible.

You didn’t mention your age but there is a definite link between aging and loss of balance. Muscle weakness and deconditioning are often part of that process. These two factors lead to decreased balance, especially when standing on one leg.

Other visual changes besides visual acuity may also factor in. For example, seeing the edges of surfaces (where one surface ends and another begins) gets blurred over time. This skill is called contrast sensitivity. If your dog’s fur blends in with the color of the carpet or floor, you may not see her in time to avoid her.

The ability to make quick adjustments to avoid obstacles also decreases as we age. So even if you see the dog, you may end up running into it, stepping on it, or tripping over it because your reaction time is too slow.

Studies show exercise is still the best way to combat some of these changes that come with aging. T’ai Chi, a form of the martial arts has become very popular with older adults. It focuses on making slow, smooth movements. Tai chi is an excellent way to work on coordination and balance at any age.

You are right to be concerned. Falling is a major cause of injuries and even death in adults over the age of 65. Tripping over objects is the biggest cause of falls in this age group.

Studies show there are other factors at work here, too. Vision is important but there are different kinds of vision in this task. Visual acuity helps the person see the object. Depth perception helps us gauge the distance between the object and us.

And finally, contrast sensitivity is important. Contrast sensitivity allows the person to see the end of one surface and the start of another. For example some older adults are unable to tell when floor tiles end and the bathtub begins in a bathroom. Stumbling and loss of balance can occur at boundary changes.

Each part of vision is only part of the picture. The person must have quick enough reaction time to safely avoid the object. Reaction time is tied to muscle strength, joint position sense, and neuromuscular reflexes.

It may be a good idea to have a physical exam with a medical doctor. If there’s no medical reason for her difficulty avoiding objects, then a physical therapy program of balance, flexibility, and strengthening exercises may be helpful.

A survey of young men entering the marine corps asked four questions to assess physical fitness.

Fitness preparation for the military is a good idea. This can help reduce the number and severity of injuries during boot camp. It could also decrease the number of dropouts during training.

According to a recent study, upper body strength is the best predictor of those who will succeed in boot camp. Pull-ups, abdominal crunches, and running three miles are common activities required in boot camp. Pull-ups are the best measure of overall fitness level.

They should do well if you concentrate on these three activities with an emphasis on upper body strength.

The drop out rate from Marine Corps boot camp is reportedly high–around 22 per cent. This figure is based on one Marine Corps Recruit Depot (MCRD). There were a variety of reasons for the fall out. Some were caused by injury, some by illness. There were other personal reasons for leaving.

The idea of a tool to predict who will succeed isn’t new. The military has used different approaches over the years. Most recently a four-question test was tested as a possible way to assess fitness before boot camp.

Recruits were asked to report their physical activity habits before boot camp. Competitive activity, frequency of sweating (exercise intensity), and number of pull-ups were assessed. The results of these questions was compared to the results of a fitness test taken 4-weeks after training started.

The results show a simple survey may be enough to screen for fitness ahead of time. Those who are not ready could prepare before entering boot camp. Such a test might help prevent overuse injuries, too. More study is needed before any changes can be made in the recruitment process.

According to the American College of Sports Medicine, physical fitness is a set of five physical qualities. Each one can be improved by exercise. They are cardiorespiratory endurance, muscle strength, muscle endurance, flexibility, and body composition.

Measuring physical fitness isn’t done with a single test. Body mass index (BMI) is a measure of one part of physical fitness: body composition. BMI measures height against weight and determines body size. Three major groups are normal, overweight, or obese.

Cardiac output (VO2 max) and use of oxygen during movement and exercise (VE) are specific tests of cardiorespiratory fitness.

Range of motion of the joints can be measured to show flexibility. Muscle strength can also be tested in a variety of ways. For example, grip strength is measured using a special device called a dynamometer. Trunk and extremity strength can be measured by a physical therapist using a manual muscle test or special equipment designed to measure strength.

For children, the Presidential Fitness

Test measures physical fitness in five events. The events include curl-ups or partial curl-ups, shuttle run, endurance run/walk, pull-ups or right angle push-ups, and V-sit or sit and reach.

The Presidential Physical Fitness Award goes to anyone who performs at the 85th percentile based on the 1985 School Population Fitness Survey. The National Physical Fitness Award goes to those students who score at the 50th percentile.

The American College of Obstetricians and Gynecologists advise pregnant women to stay active. If there are no complications or problems, exercise for 30 minutes five or six times a week is advised.

The exercise should be moderate. Avoid high contact or sports and activities with a risk of falling. Elevating heart rates to high levels is not advised. Too much stress on the mother’s heart and lungs can compromise the unborn child.

Changing hormones can also put the woman’s body at risk for muscle, tendon, or joint injury.

The weight of the fetus combined with hormones designed to loosen the pelvic muscles and joints can lead to pelvic floor problems.

Running, hopping, or jumping activities can make it worse. The result can be long-term problems with urine leaking called incontinence.

Marathon running is not advised without a physician’s approval. Talk to your obstetrician before starting your training.

Quite frankly, many women never do get back to their previous weight or their previous level of fitness. That doesn’t mean it can’t be done. It’s just that with the new responsibilities as a mother, there is less time and less energy for physical fitness.

In a recent study of healthy, adult women fitness, strength, and activity were measured before and after pregnancy. Less than one per cent returned to their previous level of fitness. Loss in strength was not fully regained after 27 weeks postpartum when the study ended.

Further studies are needed to find out how long it takes to return to a pre-pregnancy level of fitness.

Ibuprofen is an over-the-counter (OTC) medication. It’s in a class of drugs called nonsteroidal anti-inflammatories (NSAIDs). OTC NSAIDs include aspirin and ibuprofen. Other names for ibuprofen include Motrin and Advil. Aleve is another NSAID that can be purchased OTC. It used to be by prescription only (Naproxen). NSAIDs such as naproxen and others are also given by prescription in more powerful doses.

NSAIDs are used to reduce fever and relieve pain. They can also decrease swelling. They have the added benefit of preventing blood clotting. People at risk for heart attack and stroke may take low dose (baby) aspirin to prevent these problems.

Glucosamine is a compound that occurs naturally in the body. It is also made from shellfish and sold OTC as a supplement. Studies show that glucosamine may help repair and replace damaged joint cartilage. It’s used most often for adults with arthritis.

It’s always advised to see your doctor before taking OTC drugs. This is especially true when adding them to other supplements like glucosamine. Your doctor can prescribe the best drug for you after a medical exam and diagnosis of the exact problem.

As you have noted, the most common side effects of non-steroidal anti-inflammatory drugs (NSAIDs) are heartburn, stomach pain, and stomach ulcers. The ulcers can lead to bleeding and anemia. Besides GI problems NSAIDs can affect the kidneys and nervous system.

NSAIDs can cause sodium retention and the blood vessels to get narrower or vasoconstrict. These two things together lead to edema. Blood pressure goes up. Over time kidney damage can occur. Muscle weakness, numbness in the feet and legs, and restless legs syndrome are signs of kidney problems. Kidney failure is even possible.

Confusion may be the first sign of nervous system involvement. Older adults are at greatest risk for this side effect. Memory loss can also occur.

Skin problems can occur with long-term use of NSAIDs. The skin may be very sensitive to light and react with a rash. Skin and the soft tissues underneath don’t heal as well when the patient is taking NSAIDs.

Don’t hesitate to call your doctor if you have any signs or symptoms that concern you. You may just need a change in the dose of your drug. Or another drug may be better for you.

Vioxx was one of several nonsteroidal anti-inflammatories used for arthritis and other chronic, painful conditions. It was a very popular COX-2 inhibitor. Patients were less likely to get stomach ulcers on these drugs.

It was recalled (along with Celebrex) by the manufacturer because of some safety concerns. There were reports of increased heart attacks. Bextra, a drug in the same class, was removed from the market by the FDA because of heart risks and rare but serious skin reactions.

There’s some talk that Vioxx will quietly return to the market some time in the future. There will be warnings given about its proper use for people at low risk for heart problems. Doctors will be advised about restricting the dosage.

In the meantime, researchers at drug companies are working on newer COX-2 drugs without all the problems.