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htm EXERCISES TO INCREASE FLEXIBILITY

Exercise 1 Spine, trunk turning. Start: Standing, feet wide apart, hands behind the head, leaning forwards. Action: Keep feet firm and legs straight, push the right elbow across the front of the body to touch the left knee, allowing the trunk to rotate with elbow. Repetitions: Three attempts to each side.

Exercise 2 Spine, extension. Start: Standing feet together, arms at the sides. Action: Step well forward with one foot, at the same time swing the arms upwards and backwards, the head also going back, hold the end position. Repetitions: Three times with each leg.

Exercise 3 Spine, Flexion.

Start: Sitting with back straight, legs crossed, heels close to buttocks. Action: Lean forward trying to get the nose to the floor. Repetitions: Three times.

Exercise 4 Spine, Lateral Flexion. Start: Standing feet comfortably apart, hands behind the head. Action: Pull the left elbow towards the outside of the left knee. Repetitions: Three to each position and do not allow the shoulders to drop forwards.

Exercise 5 Spine, Combined Movements. Start: Lying on the back, legs wide apart, arms sideways level with the shoulders. If possible a partner should hold the shoulders down Action: Keeping both legs straight, raise the left leg and take it towards the right hand. Repetitions: Three to each side.

Exercise 6 Hips, Combined Movements. Start: One leg well forward, the other well back, back straight, hands on hips. Action: Take the legs as far apart as possible, when you can go no further, hold the position and gently press the crutch downwards. It is important that both feet point in the same direction. Repetitions: Twice with each leg forward.

Exercise 7 Ankle (1). Start: Sitting on the floor, the right leg crossed over a straight left leg. Action: Take hold of the right foot and take it through a full range of movement. Repetitions: Each foot exercised twice.

Exercise 8 Ankle (2).

Start: Hands against the wall, arms straight, feet two feet from the wall, flat on the floor. Action: Place the left foot behind the right calf, keep the right foot flat on the floor. Gently bend the arms without moving the right heel. Repetitions: Three to each leg.

Exercise 9 Shoulders, Forwards and Upwards. Start: Lying on the stomach, the arms on the floor above the head. Action: Keeping the arms straight, raise them towards the roof, as high as possible. Repetitions: Six lifts.

Exercise 10 Shoulders, Rotation. Start: Standing with the arms straight out sideways, palms downwards. Action: Rotate the arms upwards and the to the rear in circles gradually increasing the size of the circles until the arms brush the ears, then decrease the circle size until the starting position is reached. Rest if necessary and repeat the exercise, in the same direction but with palms facing upward. Repetitions: Once only.

Exercise 11 Shoulders, Forwards and Sideways. Start: Lying on the stomach, arms out sideways, palms down. Action: Raise the arms as high as possible towards the roof, keeping them straight, keep the shoulders touching the floor. Repetitions: Three.

Exercise 12 Shoulders, Backwards and Upwards. Start: Sitting on the floor, hands flat on the floor by the hips, knees bent. Action: Push the hips forwards and upwards towards the feet, keep the hands flat on the floor Repetitions: Six presses forwards

This document saved from [Link] Exercises for the Desk-bound

Take a short-break from your routine to relieve some of the back pressure you may feel while sitting at your desk all day. These exercises can help relieve discomfort and prevent injury. First, get the energy flowing through your body. Inhale fresh air through your nose; pause and exhale it out your mouth. Do this 6 times. Lift your arms high above your head to stretch your muscles and then lower your arms. Relax and repeat. These moves help your body relax and increase your circulation. Now you are ready for some back relief.

Relieve Lower Back Pressure

Relieve Upper Back And Shoulder Tension

Exhaling, slowly lean forward, drop head toward knees and let hands drop at ankles. Hold 5 seconds. Inhaling, unwind, slowly bringing up the head. Exhaling, stretch arms toward ceiling.
Do this five times.

Lift hands to shoulder. Keep elbows down as you push shoulders back with your arms. Hold this position for 15 seconds.
Do this 5 times.

Relieve Back Tension And Stretch Hips

Relax Shoulder, Back And Hip Muscles

Stand with feet apart and knees bent. Crouch your body as low as you can without pain. Hold this position for 5 seconds.
Do this 5 times.

Place your palms on your lower back in a standing or sitting position. Stretch back your upper body. Hold this position for 5 seconds.
Do this 3 times. This information is not intended as a substitute for proper health care. If you are being treated for a back problem, exercise under the direction

Strengthen Back And Buttocks

Bend your knees slightly as you stand with hands at your sides. Tilt your upper body forward as you push back your arms and buttocks. Raise your head and shoulders. You'll feel it in your back down to your legs. Hold this position for 10 seconds.
Do this 3 times.

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Open Close Buttocks Bridge This exercise tightens and tones the buttocks, inner thighs, and hamstrings (back of the thighs) as well as challenges the stability the torso muscles -- abdominals and lower back.. Equipment Exercise Mat Exercise Technique Lie down with your knees bent, feet together, heels raised and arms beside your hips with the palms down. Press down with the balls of your feet and contract your buttocks as you raise your pelvis off the floor. While keeping your heels and pelvis raised off the floor, open your knees outward then close your knees together using your inner thighs. Continue opening and closing your knees for the desired number of repetitions.

Lower your pelvis back down to the mat.

Performance Tips

Do all movements slow and controlled. Keep upper back and shoulders on the floor. Raise only the pelvis and lower

back. Do not allow your lower back to sag towards the floor. Keep a straight back (with a natural curve in the lower back). Squeeze and contract buttocks and inner thighs when you bring knees together.

Repetitions Do ten repetitions (one repetition equals opening and closing the knees). Rest. Do another set if you want to.

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Back Exercises

BUTTOCK STRETCH Instructions: Lie on your back with the right leg bent and the foot resting on the floor. Cross the left leg over with the left ankle placed above the right knee and let the left knee open outward. Carefully lift the right foot from the floor and bring it toward your chest. One may hold the back of the left leg and gently pull it toward you. Hold to the count of 10. Repeat on the other side. Do this exercise up to 10 times. Objective: To stretch the piriformis and external rotators of the hip. Caution: Avoid back strain by keeping the lower back against the floor mat. Do not hold your breath.

HAMSTRING STRETCH Instructions: Lie on your back with both knees bent. Place your hands behind the left knee, or place a sheet around the foot. Slowly straighten the leg, feeling the stretch in the back of the thigh. Hold to the count of 10. Repeat on the other side. Do this exercise up to 10 times. Objective: To stretch the muscles in the back of the thigh of the straight leg. Caution: Avoid pulling the leg too close to your body. Stop the exercise if pain occurs below the knee.

PELVIC TILT Instructions: Lie on your back with knees bent. Tighten the muscles in your stomach and squeeze your buttocks together, pushing your lower back into the floor. Hold to the count of 10. Do this exercise up to 10 times. Objective: To strengthen the lower abdominal muscles and to increase low back mobility. Caution: Do not lift the hips up while performing the exercise. If this movement causes pain below the knee, stop the exercise.

ABDOMINAL CURL-UP Instructions: Lie on your back with knees bent. Tighten your stomach muscles. With your arms across your chest (or straight in front of you, or behind your neck), raise your head and shoulder blades off the floor. Hold to the count of 10. Do this exercise up to 10 times. Objective: To strengthen the abdominal muscles. Caution: If this movement causes pain below the knee, stop the exercise.

KNEE TO CHEST Instructions: Lie on your back with your knees bent. Pull one knee toward your chest. Hold to the count of 10. Repeat on the other side. Do this exercise up to 10 times. Objective: To stretch the lower back muscles. Caution: If this movement causes pain in the lower back and radiates below the knee, stop the exercise.

ARCH AND CURVE Instructions: Assume an all-fours position. Allow your back to arch, forming a hollow. Then curve your back upward at the waist level, tightening your stomach muscles. Perform the movement gently. Do this exercise up to 10 times. Objective: To stretch and strengthen the back and abdominal muscles. Caution: Keep elbows straight. If this movement causes pain in the lower back and radiates below the knee, stop the exercise.

PELVIC LIFT Instructions: Lie on your back with knees bent. Squeeze your buttocks together and lift your hips off the floor. Hold to the count of 5. Do this exercise up to 10 times. Objective: To strengthen the buttock muscles. Caution: If this movement causes pain in the lower back and radiates below the knee, stop the exercise.

PRESS-UP Instructions: Lie on your stomach with a pillow under your waist. Place your hands at shoulder level. Push up with your arms and raise the upper trunk off the floor. Keep the pelvis on the floor and let the back sag. Hold to the count of 10. Do this exercise up to 10 times. Objective: To stretch the abdominal muscles and to increase back mobility. Caution: If this movement causes pain in the lower back and radiates below the knee, stop the

exercise.

BACK BENDING I Instructions: Standing. Place your hands on the small of your back. Bend backwards at the waist, keeping your knees as straight as possible. Do this especially after prolonged sitting. Hold to the count of 10. Do this exercise up to 10 times. Objective: To increase back mobility. Caution: If this movement causes pain in lower back and radiates below the knee, stop the exercise.

BACK BENDING II Instructions: Standing. Place one foot on a stool. Lean over the leg that is on the stool and let your upper body hang on it. Hold to the count of 10. Do this exercise up to 10 times. Objective: To stretch back muscles. Caution: If this movement causes pain in the lower back and radiates below the knee, stop the exercise.

Back Tips

To make your life less stressful for your back, you might want to use this checklist Lifting Know your own strength. Lift what you can handle. Always lift and carry close to your body. Bend your knees and make your legs do the work. Do not twist your back. Turn with your feet. Sitting Use an upright chair. Try a folded towel in the small of your back. Get up and stretch every 20 to 30 minutes. Standing Try putting one foot on a low box or stool. Have your work surface at a comfortable height. Driving Adjust your seat from time to time. Try a folded towel or pillow in the small of your back. Activity Do 20 to 30 minutes of walking, cycling, or swimming every day. Gradually increase physical activity. Sleeping Some people prefer a firm mattress, or try boards beneath your mattress. Relax Learn how to reduce stress. Use relaxation techniques, such as this simple breathing technique while sitting comfortably upright in a chair: - As you inhale let your stomach expand - As you exhale let your stomach contract As you breathe out, tell yourself to relax and release the muscle tension in your body. Take three slow and deep breaths using this technique before and after you exercise or whenever you feel tension. Try to practice this in a quiet place each day for 10 minutes.

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Strengt h Training Exercises

Knee Extension (With Ankle Weights) Side Hip Raise (With Ankle Weights) Hip Extension (With Ankle Weights) Biceps Curl (With Hand Weights) Overhead Triceps (With Hand Weights) Upward Row (With Hand Weights) Heel Stand (Without Weights)
Knee Extension (With Ankle Weights) The knee extension exercise strengthens the quadriceps, the large muscles in front of the thighs. Starting Position: Sit back in a straight back chair. Feet should be shoulder-width apart. Toes should brush the floor; if necessary, raise your knees by doubling or rolling a towel. Rest your hands on top of your tights; or let them hang at your sides; or lightly hold on to the edge of the chair seat. Move: With weights on each ankle, slowly raise the right leg until the knee is straight (1-2-3-Up). Keep the toes flexed up toward the body. Pause for a breath. Relax the ankle so the toes are no longer flexed up. Slowly lower your leg to the starting position (1-2-3-Down). Pause for a breath. Repeat the movement with the left leg. Repeat, alternating right and left legs until you have done eight knee extensions with each leg (1 set). Rest for 1-2 minutes and do a second set. Side Hip Raise (With Ankle Weights) The muscles that run along the outside of your thighs, the hip abductors, help you keep good balance. Starting Position: Stand behind the chair, lightly holding the back of the chair for support. Move: With ankle weights on each ankle, slowly lift your right leg out to the side until your foot is 5 to 8 inches off the floor (1-2-3-Up). Keep your right leg straight and your toes pointed forward. Keep your left knee relaxed. Pause for a breath. Slowly lower your right leg to the starting position (1-2-3-Down). Pause for a breath. Repeat the move with your left leg. Repeat, alternating right and left legs, until you have done eight side hip raises with each leg (1 set). Rest for 1-2 minutes, then do a second set. Hip Extension (With Ankle Weights) This exercise is for toning your buttocks. The hip extension works your gluteus maximus, the largest muscles of your buttocks, as well as your hamstrings, the muscles just below the buttocks in the back of your thighs. Starting Position: Stand about 18 inches behind the chair, holding its back lightly for support. Bend forward 45 degrees at the waist, keeping your legs straight. Keep your neck and head in a straight line with your torso. Focus on a point down in front of you to help keep your proper posture. Move: Slowly lift your right leg straight out behind you until your leg and torso form a straight line (1-2-3Up). Depending on your height, your toe will be eight to fourteen inches off the floor. The knee of the supporting leg should be relaxed. Both feet should be pointed straight ahead during the entire move. Pause for a breath. Slowly lower your leg to the starting position (1-2-3-Down). Pause for a breath, then repeat the move with your left leg. Repeat the move, alternating legs, until you have done 8 reps with your right and left legs (1 set). Rest for 1-2 minutes and do a second set.

Biceps Curl (With Hand Weights) The biceps, the muscles in the front of the arm, are among the hardest-working muscles in the body. This exercise firms and tones the biceps, so the arms look shapely. Starting Position: Sit in the middle of the chair with your feet flat on the floor. Hold a dumbbell in your right hand, letting your right arm hang at your side. Make a fist with your left hand and place it across your chest (beneath the breasts) to your right side. Rest the back of your right arm on the fist for support. Your right arm should be slightly in front of your body with your right palm facing the side of your knee. Move: Slowly bend your elbow and turn your right forearm so the weight moves smoothly from your side toward the front of your shoulder. Your right palm should be facing your shoulder (1-2-3-Up). Pause for a breath. Slowly lower your arm to the starting position. Pause for a breath. Complete 8 reps with your right arm, then 8 reps with your left arm (1 set). Rest for 1-2 minutes and do a second set. Overhead Triceps (With Hand Weights) The muscles in the back of the upper arm, the triceps, are notoriously weak. This exercise will strengthen the upper arms making them tighter and trimmer. Starting Position: Sit in a straight chair, holding the dumbbell in your right hand. Lift your right arm straight up above your head, placing the inside of your right elbow directly above your right ear. Use your left hand to support your right upper arm, placing it just past the elbow toward the shoulder. Slowly bend your right elbow, keeping it pointed forward, and lower the weight to the top of your right shoulder. If your joints are not flexible enough to maintain this position, you can perform the exercise with your arm raised, but not all the way above your head. As your progress, bring your arm farther up; eventually you should be able to raise the weight above your head. Move: Unbend your elbow to slowly extend your forearm and raise the weight above your head (1-2-3-Up). Keep your elbow pointed forward, with the palm of your hand facing the side of your head. Ideally, the inside of your elbow should remain directly above your ear keep it as close as possible to that position. Pause for a breath. Bend your elbow and slowly lower the weight back to the starting position (1-2-3-Down). Pause for a breath, then repeat the move with the same arm. Repeat the move until you have completed 8 repetitions with your right arm; then complete 8 reps with your left arm (1 set). Rest for 1-2 minutes and do a second set. Upward Row (With Hand Weights) This exercise strengthens the shoulder muscle (deltoid), upper back muscle trapezius and biceps. The shoulder joint is one of the most important and vulnerable in the body. Strong shoulder muscles help stabilize this joint and allows you to lift and carry heavy objects. Starting Position: Stand with a dumbbell in each hand. Move your hands so the dumbbells rest on the fronts of your thighs with your palms facing your thighs. Move: Slowly pull the dumbbells upward along your torso until they are just below your chin. Keep your hands in the same position during the move; your wrists will bend to the side so your knuckles remain pointing down. At the end of the lift, your elbows will be at shoulder height and pointing out to

the side; your forearms and the weights will be parallel to the floor (1-2-3-Up). Pause for a breath. Slowly lower the dumbbells to the starting point (1-2-3 Down). Pause for a breath, then repeat the move. Complete 8 upward rows (1 set). Put the weights down and rest for 1-2 minutes. Complete a second set. Toe Stand (Without Weights) This exercise has three purposes: It improves your balance, makes your ankles more flexible and strengthens the gastrocnemius and soleus muscles in the backs of your lower legs. Plus, it makes your calves trimmer and more defined. This exercise progresses through four levels of difficulty: Level 1 Toe stand on both Level 2 Same as Level 1, Level 3 Toe stand on one Level 4 Toe stand performed with both feet on a step, with hand support. feet but foot with without with hand hand hand support. support. support.

Start with Level 1. If your calf muscles are weak or inflexible, you may not be able to raise yourself very much. Work on improving the strength of these muscles until you can lift yourself all the way up onto your toes. Then progress to Level 2. When Level 2 is no longer a challenge, move to Level 3. When youve mastered Level 3, continue to Level 4. Levels 1 and 2 Starting Position: Stand 12 inches from a wall with your feet about 12 inches apart. Level 1 Rest your fingertips lightly on the wall to help you keep your balance. Level 2 Stand in the same place with your hands ready to support you if you lose your balance. As you improve, become less reliant on the wall. For safety, always do this exercise facing a wall. Move: Slowly raise yourself as high as possible on the balls of both feet (1-2-3Up). Remain on your toes for another count of three, breathing normally (1-2-3Hold). Slowly lower yourself to the starting position (1-2-3 Down). Pause for a breath and repeat the move. Repeat the move 8 times (1 set). Only one set is required for this exercise. Level 3 Starting Position: Stand 12 inches from the wall with your feet about 12 inches apart. Rest your fingertips lightly on the wall to help keep your balance. Without moving your left thigh, bend your left knee and lift your left foot up a few inches in the back, so youre balanced on your right foot. Move: Slowly raise yourself as high as possible on the ball of your right foot (12-3-Up). Remain on your toes for another count of three, breathing normally (1-2-3Hold). Slowly lower yourself to the starting position (1-2-3-Down). Pause for a breath and repeat raising yourself on your left foot. Repeat, alternating right and left, until you do eight toe stands with each foot. Only one set of eight is required. Level 4 Starting Position: Stand on the to for support. Place the balls of the railing and slowly lower your Move: Slowly raise yourself as your toes for another count of to the starting position. Pause for required for this exercise. Heel Stand (Without Weights) This exercise improves your muscles in front of your lower levels of difficulty: balance and flexibility and strengthens the anterior tibialis legs. Its a complement to the toe stand. This exercise has two bottom step of a staircase with a sturdy railing you can hold on your feet on the step, with your heels off the edge. Hold on to heels as far as possible. high as possible on the balls of both feet (1-2-3-Up). Remain on three, breathing normally (1-2-3-Hold). Slowly lower yourself a breath and repeat. Repeat 8 reps (1 set). Only one set is

 Level 1: Heel Level 2: Same as Level 1, but without hand support.

stand

with

hand

support.

If you have difficulty standing on your heels, start by doing the exercise with your toes flexed up and work toward lifting the balls of your feet. Dont attempt Level 2 until your flexibility and strength have improved enough so you can stand on your heels with the balls of your feet off the floor. Expect a gradual transition when youre ready to try Level 2. When you first start, youll have to reach for the wall after only one or two seconds. Then the interval will lengthen as your strength and balance improve. Eventually you should be able to do the set of eight heel stands with little assistance from your hands. Starting Position: Stand with your arms at your sides and your back brushing against a wall. Your heels should be 2 to 6 inches from the wall. Level 1: Move your palms back until they are flat against the wall. Level 2: Step forward an inch or two until your back is no longer brushing against the wall. Your hands should be poised to touch the wall when needed. Move: Slowly raise your toes and the balls of your feet until you are balanced on your heels (1-2-3Up). Remain on your heels for another count of three, breathing normally (1-2-3-Hold). Stay as still as possible. Slowly lower yourself to the starting position (1-2-3-Down). Pause for a breath, then repeat. Repeat until you have completed 1 set of eight heel stands. Only one set is required.

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Exercise: The Key To The Good Life

The exciting news from recent scientific studies is that exercise benefits everyone ? regardless of age. Exercise can help you take charge of your health and maintain the level of fitness necessary for an active, independent lifestyle. This booklet is designed to help you start a fitness program of exercise so you can maintain or improve your physical health. Many people think that as we age, we tend to slow down and do less; that physical decline is an inevitable consequence of aging. For the most part, this is not true. According to The President's Council on Physical Fitness and Sports, much of the physical frailty attributed to aging is actually the result of inactivity, disease, or poor nutrition. But the good news is ? many problems can be helped or even reversed by improving lifestyle behaviors. One of the major benefits of regular physical activity is protection against coronary heart disease. Physical activity also provides some protection against other chronic diseases such as adult-onset diabetes, arthritis, hypertension, certain cancers, osteoporosis and depression. In addition, research has proven that exercise can ease tension and reduce the amount of stress you feel. To put it simply ? exercise is one of the best things you can do for your health. The exercise program described and illustrated on the following pages has been prepared specifically for you! It is a daily routine that takes 20 to 30 minutes. Take a minute to read the instructions carefully. Performing each exercise properly is as important as spending enough time on them.

You Are What You Eat

No matter what your age, a balanced, nutritious diet is essential to good health. Older adults need to eat a balanced diet with foods from all the food groups. (Refer to the Food Guide Pyramid on page 3.)

Eating a variety of foods helps ensure adequate levels of vitamins and minerals in the body. The U.S. Dietary Guide- lines also recommend that adults reduce the fat, saturated fat, choles- terol, sodium, and sugar in the foods they eat. Some adults find they have problems being overweight as they age. This is generally due to overeating and inactivity. If you are overweight, the best way to lose body fat is to eat fewer calories, especially from saturated fats, and to participate in aerobic exercises.

The Food Pyramid Guide A Guide to Daily Food Choices

Did you know that an excess of only l00 calories a day can cause a l0-pound gain in a year, and those extra calories can be burned up by a 20 to 30 minute brisk daily walk?

Sleep and Rest

Sleep and rest are great rejuvenators. As you grow older, your sleep patterns and need for sleep may change. Be sure to include rest periods in your daily exercise program, especially if you sleep fewer than eight hours each night. Exercise can help relieve problems with insomnia too. Mild exercise a few hours before bed, or during the day, helps many people get a restful night's sleep.

Balance and Agility

Balance and agility are important capabilities often taken for granted. Regular exercise can help to maintain or restore them. Older adults can sometimes lose their sense of balance, particularly if they wear bi-focal or tri-focal glasses. A well-maintained sense of balance can help make up for the dizziness sometimes caused by vision changes. In addition, when muscles are not toned, the resulting weakness and unsteadiness can contribute to falls. Thus, it is important to maintain or restore physical agility through exercise which can help avoid the risk of injury from falls and accidents.

Preparing to Exercise
No matter at what age you begin to exercise, or how long you may have been inactive, proper exercise will always improve your physical condition. The exercises in this booklet can be done by people who have been inactive for some time. Programs to improve flexibility, strength, and endurance are arranged in three levels of difficulty. It is important to begin any exercise program slowly and build

up gradually. Remember, it may take several months to attain the minimal levels of physical fitness identified in Level I activities. Some people will take less time, others more. Before beginning an exercise program, have a physical examination and discuss the program with your doctor. In addition, if your mobility is limited as a result of a chronic or disabling condition, be sure to review these exercises with your doctor. Keep in mind your level of ability and endurance so that you don't risk discomfort or injury. If you experience pain while exercising, stop that particular movement and ask your doctor about it on your next visit. Stick with it, and you will see results!

Warming Up
Preparing the body for exercise is important for people at any age and all fitness levels. A warm-up period should begin with slow, rhythmic activities such as walking or jogging in place. Gradually increase the intensity until your pulse rate, respiration rate and body temperature are elevated, which is usually about the time that you break a light sweat. It also is advisable to do some easy stretching exercises (such as the ones on page 6) before moving on to the strength and endurance activities.

Effective Exercising
Once you begin your daily exercise routine, keep these points in mind to get the best results: Always drink water before, during and after your exercise session. Make exercising a part of your daily routine. You may want to set a regular time to exercise each day and invite a friend to join you. Start gradually, about 5 to 10 minutes at first. Increase the amount of exercise each day, up to about 30 to 60 minutes. Breathe deeply and evenly during and between exercises. Don't hold your breath. Rest whenever it is necessary. Keep a daily written record of your progress. Exercise to lively music, TV, or with friends for added enjoyment.

Cool Down
If you have been participating in vigorous physical activity, it is extremely important not to stop suddenly. Abrupt stopping interferes with the retum of the blood to the heart and may result in dizziness or fainting. Simply reduce the intensity of the exercise gradually and end with a few slow stretches from the section on stretching.

Exercising from a Wheelchair

A number of the exercises in this booklet can be performed from a chair or a wheelchair. They are identified with the symbol: (o)

Flexibility
Exercises in this category will help you maintain your range of motion. Through the normal aging process, muscles tend to lose elasticity and tissues around the joints thicken. Exercise can delay this process by stretching muscles to prevent them from becoming short and tight. It also helps slow down the development of arthritis, one of the most common and painful diseases associated with advancing age.

In addition to performing flexibility exercises, you should try to bend, move, and stretch every day to keep joints Flexible and muscles elastic. Avoid reliance on push buttons and conveniences that take away the need for personal motion. And, compliment this program with such recreational activities as dancing, yoga, swimming golfing, gardening, and housework. Be sure to begin each workout with deep breathing and continue deep breathing at intervals throughout the session. You should work up to a total of 50 deep breaths per workout.

Flexibility Level I

1) Finger Stretching: to maintain finger dexterity. With the palm of the right hand facing down, gently force fingers back toward forearm, using left hand for leverage; then place left hand on top and push fingers down. Suggested repetitions: 5 each hand. (o)

2) Hand Rotation: to maintain wrist flexibility and range of motion. Grasp right wrist with left hand. Keep right palm facing down. Slowly rotate hand 5 times each clockwise and counter-clockwise. Suggested repetitions: 5 each hand. (o)

3) Ankle and Foot Circling: to improve flexibility and range of motion of ankles. Cross right leg over opposite knee, rotate foot slowly, making large complete circles. 10 rotations to the right, 10 to the left, each leg. (o)

4) Neck Extension: to improve flexibility and range motion of neck. Sit up comfortably. Bend head forward until chin touches chest. You may want to stretch forward by simply jutting your chin out. Return to starting position and slowly rotate head to left. Return to starting position and slowly rotate head to right. Return to starting position. Suggested repetitions: 5. (o)

5) Single Knee Pull: to stretch lower back and back of leg. Lie on back, hands at sides. Pull one leg to chest, grasp with both arms and hold for five counts. Repeat with opposite leg. Suggested repetitions: 3 ? 5.

6) Simulated Crawl Stroke/Back Stroke/Sreast Stroke: to stretch shoulder girdle. Stand with feet shoulder- width apart, arms at sides, relaxed Bend knees and alternately swing right and left arms backwards...upward...and foward as if swimming. Suggested repetitions: 6 ? 8 movements on each stroke. (o)

7) Reach: to stretch shoulder girdle and rib cage. Take deep breath, extend arms overhead. If standing, rise on toes while reaching. Exhale slowly, lowering arms, Can be done in a seated position. Suggested repetitions: 6 ? 8. (o)

8) Backstretch: to improve the flexibility of the lower back. Sit up straight, Bend far forward and straighten up. Repeat, clasping hands on left knee. Repeat clasping hands on right knee. Exhale while bending forward. Suggested repetitions: 4 ? 6 over each knee. (o)

9) Chain Breaker: to stretch chest muscles. Stand erect, feet about six inches apart. Tighten leg muscles, tighten stomach by drawing it in, with hips forward, extend chest, bring arms up with clenched fists chest high, take deep breath, let it out slowly. Slowly pull arms back as far as possible keeping elbows chest high. Suggested repetitions: 8 ? 10. (o)

Flexibility: Level II
1) Double Knee Pull: to stretch lower back and buttocks. Lie on back, hands at sides. Pull legs to chest, lock arms around legs, pull buttocks slightly off ground. Hold for 10 to 15 counts. Suggested repetitions: 3 ? 5.

2 ) S eated Pike Stretch: to stretch lower back and hamstrings. Sit on floor, with legs forward, knees together. Exhale and stretch forward, slowly sliding hands down to ankles. Stretch only as far as is comfortable and use your hands for support. Hold for 5 to 8 counts. Don't bounce, position inhaling deeply. repetitions: 3?4. |

3) Chest Stretch: to stretch muscles in chest and shoulders. Stand arm-length distant from a doorway opening. Raise one arm shoulder height with slight bend in elbow. Place hand against door jamb and turn upper body away so that the muscles in chest and shoulders are stretched. Suggested repetitions: 3 ? 4 each arm.

4) Seated Stretch: to stretch lower back hamstrings. Sit on floor one leg extended to comfortably in front of your body. Supporting hands and keeping your back straight, lean comfortable leg and hamstring. Hold the exhaling. Switch sides. Suggested

and your side and one leg bent your body weight with your forward until you feel a stretch for a few seconds, repetitions: 3 ? 5 each side.

Flexibility Level Ill

1) Sitting Stretch: to increase flexibility of lower back and hamstrings. Sit on floor with legs extended as far apart as is comfortable. Exhale and stretch forward slowly, sliding your hands down your legs. Reach as far as is comfortable and hold for 5 ? 8 counts. Suggested repetitions: 3-4.

2) Achilles Stretch: to stretch calf muscles on back leg (Achilles tendon). Stand facing wall 2 to 3 feet away. Extend arms, lean into wall. Move left leg forward 1/2 step, right leg backward 1/2 step or more. Lower right heel to floor. Lean hips forward, stretching the calf muscles in the right leg. Hold 5 to 10 counts. Breathe normally. Reverse leg position and repeat. Suggested repetitions: 3-6 each leg.

3) Modified Seal: to stretch abdominal wall, chest, and front of neck. Lie on the floor with arms extended, stomach down, feet extended, with toes pointed. While exhaling, slowly lift head and push up angles, with back arching Keeping arms bent, hold for position, inhaling deeply. Suggested repetitions: 4-6.

until arms are bent at right gently. Keep hips on the floor. 5-10 counts, Return to starting

4) Half Bow: to stretch the top of the thigh and groin area. Lie on left side. Hold ankle of right foot with right hand just above toes. Slightly arch back. Hold 5 to 10 counts. Suggested repetitions: 3 ? 5.

Strength
Exercises designed to build strength can help prevent premature loss of muscle tissue and can improve muscle strength, size, and endurance at any age. The benefits of strength exercises also include improving reaction time, reducing the rate of muscle atrophy, increasing work capacity, and helping prevent back problems and injury. The following program of muscle conditioning exercises for the whole body has been designed specifically for older adults. Calisthenics work muscles against resistance, enabling them to grow and maintain muscle tone. In addition to the strength exercises suggested in the next section, other

physical activities that are essentially recreational can provide benefits to help maintain muscle integrity. Such activities include: bicycling, swimming,

Strength: Level I
1) Finger Squeeze: to strengthen the hands. Extend arms in front at shoulder height, palms down. Squeeze fingers slowly, then re1ease. Suggested repetitions: 5. Turn palms up, squeeze fingers, release. Suggested repetitions: 5. Extend arms in front, shake fingers. Suggested repetitions: 5.

2) Touch Shoulders: to increase flexibility of the shoulders and elbows and tone the upper arm; can be done in a seated position. Touch shoulders with hands, extend arms out straight. Bring arms back to starting position. Suggested repetitions: 10 ? 15.

3) Leg Extensions: to tone the upper leg muscles. Sit upright. Lift 1eft leg off the floor and extend it fully. Lower it very slowly. Suggested repetitions: 10-15 each leg. (o)

4) Back Leg Swing: to firm the buttocks and strengthen the lower back. Stand up, holding on to the back of a chair. Keep your back and hips in line with the chair as you do the exercise. Extend one leg back, foot pointed towards the floor. Keeping the knee straight, Litt the leg backwards approximately four inches and concentrate on squeezing the muscles in the buttocks with each lift Make sure you keep your back straight as you raise your legs. Return to starting position. Suggested repetitions 10 each leg.

5) Quarter Squat: to tone and strengthen lower leg muscles. Stand erect behind a chair, hands on chair back for balance. Bend knees, then rise to an upright position. Be careful not to let knees go beyond your toes. Suggested repetitions: 8-12.

6) Heel Raises: to strengthen the calf muscles and ankles. Stand erect, holding a chair for balance if needed, hands on hips, feet together. Raise body on toes. Return to starting position. Suggested repetitions: 10.

7) Knee Lift: to strengthen hip flexors and lower abdomen. Stand erect. Raise left knee to chest or as far upward as possible while back remains straight. Return to starting position. Repeat with right leg. Suggested repetitions: 5 each leg.

8) Head and Shoulder Curl: to firm stomach muscles. Lie on the floor, knees bent, arms at sides, head bent slightly forward. Reach forward with arms extended, until finger tips touch your knees, Hold for 5 counts. Return to starting position. Suggested repetitions: 10.

Strength: Level II

1) Arm Curl: to strengthen arm muscles. Use a weighted object such as a book or a can of vegetables or small dumbell. Stand or sit erect with arms at side, holding weighted object. Bend your arm, raising the weight. Lower it. Can be done seated. Suggested repetitions: 10-15 each arm. (o)

2) Arm Extension: to tone muscles in the back of the arm. Sit or stand erect with arms at sides. Holding a weighted object of less than 5 pounds, overhead. Slowly bend arm until head. Slowly extend arm to The arm curl and arm extension separately or together, alternating seated. Suggested repetitions:

3) Modified Knee Push-up: to strengthen upper back, chest, and back of arms. Start on bent knees, hands on floor and slightly forward of shoulders. Lower body until chin touches floor. Return to start. Suggested repetitions: 5?10.

4) Calf Raise: to strengthen lower leg and ankle. Stand erect, hands on hip or on back of chair for balance. Spread fee 6" to 12". Slowly raise body up to toes, lifting heels. Return to starting position. Breathe normally. Suggested repetitions: 10-15

5) Alternate Leg Lunges: to strengthen upper thighs and inside legs. Also stretches back of leg. Take a comfortable stance with hands on hips. Step forward 18 to 24 with right leg. Keep left heel on floor. Shove off right leg and resume standing position. Suggested repetitions: 5-10 each leg.

6) Modified Sit-up: to improve abdominal strength. Lie on back, feet on the floor with finger tips behind your ears. Look straight up at the ceiling and lift head and shoulders off floor. Suggested repetitions: 10.

7) Side Lying Leg Lift: to strengthen and tone outside of thigh and hip muscles. Lie on right side, legs extended. Raise leg four to five inches. Lower to starting position. Suggested repetitions: 10 on each side.

Strength: Level III

Note: In Level III strength exercise, lightweight resistance equipment, such as the dumbbell, is introduced to overload the muscles. While equipment of this kind is low in cost and desirable, a number of substitutes can be used. These include a bucket of soil, a heavy household item such as an iron, a can of food, a stone, or a brick.

1) Seated Alternate Dumbbell Curls: to strengthen biceps of upper arms. Sit comfortably on a flat bench with arms at side. Hold a pair of dumbbells with an underhand grip, so that palms face up. Bending left elbow, raise dumbbell until left arm is fully flexed. Lower left dumbbell while raising right dumbbell from the elbow until right arm is fully flexed. Breathe normally. Suggested repetitions: 2 sets of 8 ? 10 each arm. (o)

2) Dumbbell Fly: to strengthen chest muscles and improve lateral range of motion in shoulder girdle. Lie on your back on a Flat bench or floor if bench is not available. Grasp dumbbells in each hand over chest. Inhale and lower dumbbell to side with elbow slightly bent. Raise dumbbell in an arc to the starting position, exhaling in the process. Suggested repetitions: 8 ? 12.

3) Alternate Dumbbell Shrug: to strengthen muscles in shoulders, upper back and neck. Stand comfortably with dumbbells in each hand. Elevate shoulders as high as possible, rolling them first backward and then down to the starting position. Exhale as you lower the shoulders. Suggested repetitions: 10 forward, 5 backward. (o)

4) One Arm Dumbbell Extension: to strengthen triceps (back of arm) and improve range of motion. Bring weight up to shoulder and lift overhead. Slowly lower it behind the back as far as is comfortable. Extend arm to original position. Inhale on the way down, exhale on the way up. Suggested repetitions: 8 ? 12 on each arm. (o)

5) Dumbbell Calf Raise: to strengthen calf muscle and improve range of motion of ankle joint. Stand with feet shoulder-width apart, weights in each hand, toes on a 2" x 4" block (preferred but not necessary). Raise up on toes lifting heels as high as possible. Slowly lower heels to starting position. Breathe normally. Suggested repetitions: 5 with heels straight back, 5 with heels turned out, 5 with heels turned in.

6) Dumbbell Half Squats: to strengthen thigh muscles in front. Stand with feet shoulder-width apart and heels on a 2" x 4" block (not necessary, but preferred). Holding weights in each hand, slowly descend to a comfortable position where the tops of the thighs are about at a 45 degree angle to the floor. There is no benefit to a deeper squat. Inhale on the way down. Stand up slowly, keeping knees slightly bent. Exhale on the way up. Suggested repetitions: 10 -12.

7) Modified Sit-up: to improve abdominal strength. Lie on back, feet on the floor, with finger tips behind your ears. Look straight up at ceiling and lift head and shoulders off floor. Suggested repetitions: 12-15.

Endurance
Endurance-building or aerobic exercises improve the functions of the heart, lungs, and blood vessels. Vital to fitness are a strong heart to pump blood to nourish billions of body cells, healthy lungs where the gases of cell metabolism are exchanged for oxygen and elastic blood vessels free of obstructions. Without a healthy level of endurance, you may feel tired, lack zest. You may also experience shortness of breath, rapid heartbeat or even nausea. Activities to improve endurance include brisk walking, cycling, swimming, dancing and jogging. Walking is actually one of the best all-round exercises. The massaging action the leg muscles exert on the veins as you walk improves the flow of blood back to the heart and also strengthens the leg muscles.

Walking for Fitness

The following walking program has been designed to help mid-life and older persons build and maintain cardiovascular endurance. Walking offers several advantages over other forms of exercise; it requires no previous instructions, it can be done al- most anywhere, it can be done almost anytime, it costs nothing, and it has the lowest rate of injury of any form of exercise. It takes a little longer to achieve conditioning results through walking than through more strenuous activities, but not much. One study showed, for example, that jogging a mile in 8 1/2 minutes bums only 26 more calories than walking a mile in 12 minutes. Conditioning benefits from walking improve dramatically if you increase the pace to faster than 3 miles per hour (20-minute mile). In another study, participants burned an average of 66 calories per mile walking 3 miles per hour, but 124 calories per mile when they increased the pace to 5 miles per hour. Choose a comfortable time of day to exercise, not too soon after eating and when the air temperature is not too high. Many people find it more enjoyable to exercise with others. Follow the program at the recommended rate but be careful not to overexert. Stop if you find yourself panting or feeling nauseous, if your breathing does not return to normal within ten minutes after exercising or if your sleeping is affected. If you feel uncomfortable progressing at the recommended rate, spend additional weeks at each level of exercise. For example, if you reach a comfortable limit in the fifth week of the program at 3 one-mile walks on alternate days, continue one-mile walks but increase the frequency to 5,6,7 or more walks weekly until you can move on to activity recommended for the sixth week.

How to Walk
A good walking workout is a matter of stepping up your pace, increasing your distance and walking more often. Here are some tips to help you get the most out of walking:

 Move at a steady clip, brisk enough to make your heart beat faster and cause you to breathe more deeply. Hold your head erect, back straight and abdomen flat. Toes should point straight ahead and arms swing at your sides. Land on your heel and roll forward to drive off the ball of your foot. Walking only on the ball of the foot or walking flat-footed may cause soreness. Take long, easy strides, but don't strain. When walking up hills rapidly, lean forward slightly. Breathe deeply, with your mouth open if that's more comfortable.

What to Wear
Shoes that are comfortable, pro- vide good support and don't cause blisters or calluses are the only spe- cial equipment necessary. They should have arch supports and should elevate the heel one-half to three-quarters of an inch above the sole. They should also have uppers made of materials that "breathe" such as leather or nylon mesh. Some examples are: training models of run- ning shoes with thick soles, light trail or hiking boots or casual shoes with thick rubber or crepe rubber soles. Wear lighter clothing than the temperature would ordinarily dictate because brisk walking generates a lot of body heat. In cold weather, wear several layers of light clothing. They trap body heat and are easy to shed if you get too warm. A woolen cap and mittens are important in very cold temperatures.

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Fitness Rx for Bum Backs, Hips, Knees, and More

These doctor-designated stretches will relieve joint pain by the Editors of Prevention Health Books for Women

Exercisers and would-be exercisers need their own serenity prayer: Grant me the courage to work through mild discomfort so in the long run I have less pain; the serenity to baby my joints and muscles when they really need it; and the wisdom to know the difference. Any active woman occasionally experiences backaches, shoulder strain, knee pain, or other bone, muscle, or joint discomfort. Some women earnestly want to exercise but are hampered by chronic pain. If discomfort is moderate to severe or lasts longer than 3 to 4 days; if you have any redness, bruising, or swelling; or if the pain is too intense to work through, you need to see a doctor. If you have shooting pain or numbness radiating down your arms or legs, stop exercising at once and consult your doctor. You may be referred to an orthopedist or physiatrist, to prevent nerve damage. Mild discomfort is usually nothing to worry about, though. Most likely you need to warm up or cool down more effectively. Or it may be time to replace your workout shoes. After the age of 40, men and women alike have less elastin, a specialized protein that keeps skin, muscles, tendons, ligaments, and other connective tissue flexible. As a result, your muscles feel more irritated when stretched, and you are sorer after a hike on the trails, a tennis match, or a day at the pool than you were when you were 25. If you feel achy after exertion, fight the urge to lunge for the couch, says Dan Hamner, M.D., a physiatrist and sports medicine specialist in New York City. Inactivity can worsen mild joint and muscle pain because it prevents blood from flowing to that area. Plus, if you stop working out and begin filling out, added weight will cause more stress to your musculoskeletal system. Cut back on the intensity of your workouts, but not the frequency, says Willibald Nagler, M.D., professor of rehabilitation medicine at New York Weill Cornell Medical Center in New York City. If anything, you want to exercise more regularly, in order to condition all your muscle groups and keep them from getting even stiffer. "Your muscles and joints are better off with a little conditioning every day rather than heroic efforts once a week," says Dr. Nagler. Daily stretching, for instance, renders muscles more flexible, in effect giving them the same properties they had in younger years, when elastin was more plentiful. Yet even with serious injuries or physical problems such as a herniated disc or torn ligament, the goal is to return you to a fitness routine after getting the proper treatment from your doctor, Dr. Hamner explains. If you've been sidelined by a serious injury, don't be surprised if your doctor prescribes a well-designed exercise program in addition to ice, heat, and medications. If you're certain that regular exercise will help, not hinder, your achy body, these doctor-designed workouts can help you stay fit not fat at 40-plus. Use these exercises for mild discomfort or if approved by your doctor for more serious problems.

Back-Friendly Fitness
Based on his experience, almost 9 out of 10 women who complain about having a "bad back" are experiencing discomfort because of a basic musculoskeletal problem, says Dr. Hamner. Some are simply more prone to muscle spasm. For most, the lumbar muscles supporting the lower back are too tight or too weak, or there is an imbalance and one muscle, like the hip flexor, overcompensates for a weaker one, like the hip extensor, explains Dr. Hamner. You may also be feeling an imbalance in more than just the muscles of your back. When muscles in the shoulders and neck are too tight, back muscles are forced to overcompensate. And since tight hamstrings, at the backs of the thighs, pull on your pelvis and tight hip muscles like the piriformis prevent you from rotating properly, you'll also want to keep your lower body limber. Along with strengthening and stretching the back muscles themselves, you need to condition the abdominal muscles to help support your spine. If you have the classic "bad back," which is usually caused by either tight or weak muscles, check with your doctor to see if you'll benefit from these moves. Your doctor will probably need to rule out a disk problem or another abnormality that needs special therapy before you begin. Note: All exercises should be done on an exercise mat or soft carpeting. The Bicycle Lie on your back, and raise your legs straight in the air. Tuck in your pelvis, and put your hands on your abdomen. "Bicycle pedal" your legs, being sure not to arch your back. Start with 30 seconds, and work up to 1 minute over time.

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Weight loss and exercise: What works and what doesn't?

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This article is biased. It is heavily influenced by my experience as a personal trainer in the early 1990's. During that time, I saw literally hundreds of people try and fail to speed up weight loss with a program of regular aerobic exercise. By aerobic exercise, I mean things like cycling, walking, rowing or jogging, usually performed for between 20 and 60 minutes in the so-called "aerobic training zone." Interval exercise, on the other hand, especially when you get the length of the work and rest intervals right, is another story entirely. Despite what we've been told, aerobic exercise has very little effect on weight loss. There's been enough research over the last 25 years to convince almost anyone that aerobic exercise programs are not a very effective way to promote weight loss.

Weight loss
Most people begin an exercise program designed for weight loss with the intention of sticking with it. Unfortunately, the majority give up after six months, deciding they simply don't have the time to exercise regularly. There are usually two reasons behind any decision the real reason, and the one that sounds good! Individuals claiming, "they don't have the time" are often hiding the fact that their expectations were not met. Simply put, they were not making the progress they were promised. For many people, the benefits of aerobic exercise are not enough to justify the time and effort you put in. On an intellectual level, most people know they "should do more exercise." However, any good salesperson will tell you that we don't make decisions based on intellectual reasoning. We base them on emotion. Most of us exercise because, at a very basic level, we want to look and feel better. We exercise because it appeals to our sense of vanity and pride. We want to look and feel good. The problem comes when there is a conflict between the results you expect from aerobic exercise, and what you actually get. Many people starting an exercise program are told they can expect to lose around two pounds of fat each week. Some people do. But the majority doesn't. It's easy to think the problem lies with you. Is it because your metabolism is slow? Are you getting older and burning calories at a slower rate? Is it in your genes? You stick to the program, and still you don't lose any weight. What's going on? Although it comes as a surprise to many, the majority of research shows that aerobic exercise has only a minor effect on weight loss. Some evidence for this comes from a review of several hundred weight loss studies conducted by Dr. Wayne Miller and colleagues at The George Washington University Medical Center [5]. The team examined 493 studies carried out between 1969 and 1994. Miller and his associates wanted to determine whether adding aerobic exercise to a low-calorie diet accelerates weight loss. Twenty-five years of weight loss research shows that diet and aerobic exercise provides only a very marginal benefit (in terms of weight loss) when compared to diet alone.

The average weight loss after a 15-week program of regular aerobic exercise was seven pounds. Over the same period, dieting cut weight by roughly 17 pounds. When exercise and diet were combined, average weight loss was 20 pounds just three pounds more than diet alone. A study completed at Appalachian State University also shows that aerobic exercise has little effect on body composition over a 12-week period [7]. The research team assigned a group of 91 obese women to one of four groups. Group one followed a restricted calorie diet (1,200 - 1,300 calories per day), while group two performed aerobic exercise for 45 minutes, five days each week. A third group combined exercise and diet. The fourth group acted as controls. The exercise-only group lost just three pounds. This is despite the fact they were exercising for almost four hours each week. Not surprisingly, the women combining diet and exercise got the best results, losing 16 pounds of fat. However, this was only one pound more than the group on the diet. These disappointing results led the researchers to conclude that aerobic exercise has only a "minor, nonsignificant effect" on fat loss. A study at Pennsylvania State University shows similar results [10]. A group of men took part in a 12-week program of diet and exercise. Half the men dieted, while the rest used a combination of diet and aerobic exercise. Despite the fact they trained three times each week for up to 50 minutes (under the watchful eye of certified personal trainers), the exercise and diet group lost only one pound more fat than the diet-only group. Research carried in the Journal of Applied Physiology also shows that aerobic exercise has a minor effect on fat loss [21]. A group of 24 obese men was assigned to either a low- or high-intensity exercise group for 12 weeks. The men were told to maintain their dietary habits during the study. The exercise program consisted of cycling at either low-intensity (40% VO2max) or high-intensity (70% VO2max) three times per week. Each workout burned about 350 calories. The duration of each workout for subjects in the low-intensity and high-intensity training program was 57 and 33 minutes, respectively. After analyzing the results, the researchers conclude that exercise training "did not lead to significant changes in body weight and body composition." Aerobic exercise again failed to deliver any meaningful results when the training frequency was increased to five times per week. A team of Canadian researchers, publishing their findings in the Journal of Applied Physiology, followed a group of men and women for four months [16]. Half the group followed a restricted calorie diet, while the rest combined the diet with five days a week of cross training (a mixture of treadmill walking, cycling and stepping). At the end of the program, scientists were at a loss to explain why the diet and exercise group had lost just one-half pound more than the diet-only group, describing their findings as "perplexing". In one 1997 study carried in the journal Medicine and Science in Sports and Exercise, group of adult males lost just four pounds in weight despite three hours of exercise every week for 14 weeks [11]. Hardly the dramatic results we're promised when joining a gym. Many people believe they need to spend six hours or more in the gym each week to get the results they're looking for [9]. And it's true that for aerobic exercise to be effective, you need to do a lot of it. Scientists from Canada report that three months of aerobic exercise was enough to cut body fat levels by an average of 13 pounds [15]. However, the brave souls who volunteered for this study trained for more than one hour, every single day, for three whole months. Personally, all that aerobic exercise would bore me silly. The exercise program I use to shed fat requires that I spend no more than five hours in the gym each week. It's virtually identical to the program you'll read about elsewhere on this site. That's not because I'm lazy. It's just that I don't have the time (or the motivation) for the marathon workouts that all the "experts" tell me I need.

The photograph on the left is me in May 2003 at the "original" Muscle Beach in Santa Monica, California. I'd forgotten to pack enough pairs of shorts, hence the trousers. Plus, my calves are rubbish, so the fact they're covered is probably a good thing! The image on the right was taken by Stu Williamson, a photographer who specializes in fine art photography hence the "fancy" pose!

One of the main criticisms of weight loss studies is the small number of participants they use. The more people that take part in a study, the more reliable the results. The challenge for researchers is trying to stop people dropping out. When a research group from the University of Georgia attempted to examine the effect of aerobic exercise on fat loss, more than half the subjects quit before the study was finished [12]! This shouldn't come as a surprise, especially when you consider the fact most subjects make such little progress. In an attempt to make their study more reliable, researchers designed the HERITAGE Family Study, describing it as the largest, well-controlled training study of its kind [13]. A large group of 557 men and women was followed as they embarked on a 20-week exercise program. Each subject was required to exercise three times per week for an average of 42 minutes. Researchers even went to the trouble of having each bout of exercise monitored by an exercise technician and a computer. Following a grand total of 60 exercise sessions over a period of almost six months, the average amount of fat lost was slightly less than two pounds, prompting scientists to admit that aerobic exercise "is not a major factor" in weight loss.

Calorie counters
This isn't surprising when you consider how many calories are contained in a pound of fat the equivalent of roughly 3,555 calories. The most fundamental aspect of any fat loss program is to create a calorie deficit to burn more calories than you eat. Unfortunately, aerobic exercise burns around 187 calories per session [7]. Based on this estimate, you'll need 19 workouts, each lasting 45 minutes, to lose just one pound of fat. This figure might come as a surprise if you use the calorie counters on exercise machines to monitor calorie expenditure during a workout. Unfortunately, these digital readouts are not always accurate. The most reliable way to assess energy expenditure during exercise is to measure oxygen consumption. Each liter of oxygen that you consume generates approximately five calories of energy. For example, if you exercise for 30 minutes and consume 30 liters of oxygen, you'll have burned 150 calories. Without directly measuring oxygen consumption, it's difficult to get an accurate estimate of energy expenditure during a workout. Another factor that affects the reliability of calorie counters is the difference between net and gross calorie expenditure. Gross energy expenditure refers to the number of calories you burn during exercise plus your metabolic rate. Net energy expenditure refers to just the number of calories you burn during exercise. Because calorie counters on some (but not all) exercise machines display gross energy expenditure, the figures they give can be misleading. A good example comes from a trial carried in the International Journal of Sport Nutrition [7]. A group of overweight women took part in an aerobic exercise program. The program involved 45 minutes of aerobic exercise, performed in the so-called aerobic training zone (70-80% of maximum heart rate).

The average number of calories burned during each workout was estimated to be 255 calories. However, this figure doesn't take into account the difference between net and gross caloric expenditure. The gross number of calories burned was 255. In contrast, the net figure (remember, the net figure represents the "real" number of extra calories you've burned) was just 187 calories. In other words, if you rely on the numbers given by the calorie counters, it might appear that you've burned more calories than you really have.

Muscle loss
When you lose weight from dieting alone, some of the weight lost comes from lean muscle tissue. Some experts believe that aerobic exercise prevents this reduction in muscle mass. But the facts tell a different story. Several studies show that diet and aerobic exercise both lead to a drop in muscle tissue [10, 15]. Aerobic exercise won't offset the loss in lean muscle caused by dieting. When you lose weight by dieting, roughly seven of every 10 pounds lost over a 12-week period come from fat. Adding aerobic exercise doesn't prevent the loss of muscle. But it does reduce it slightly. You'll get better results when you combine the right diet with aerobic exercise and resistance training. Virtually all of the weight you lose with this kind of program will come from fat [10]. One popular claim is that aerobic exercise leads to an increase in your metabolic rate. However, researchers conducting the HERITAGE Family Study found that almost six months of aerobic exercise has no effect on resting metabolic rate [13]. Some studies do show that elite athletes do have a higher metabolic rate than weight-matched controls. However, scientists have been unable to establish whether this is due to a high calorie intake, a superior level of fitness or if it exists simply as an after effect of their last training session [6]. Furthermore, when an increase in physical activity results in a calorie deficit, there is evidence to show that the metabolic rate does not rise at all [6, 14]. Another popular misconception is the idea that aerobic exercise increases caloric expenditure after a bout of exercise, thus making a further contribution to fat loss. Unfortunately this is not always the case. Excess post-exercise oxygen consumption (the name given to the increase in caloric expenditure following a workout) is more likely to occur after high-intensity exercise. Moderate-intensity aerobic exercise (such as walking or jogging) has very little effect on post-exercise metabolic rate. Does this mean that aerobic exercise is a waste of time? Definitely not.

Weight gain
There is evidence to show that aerobic exercise helps to prevent the gain in weight that often happens following a period of dieting [2]. It's extremely difficult to stick to the kind of diet needed to maintain weight loss. As a result, many people soon return to their original weight. Aerobic exercise plays a vital role in helping you maintain a healthy body weight. The National Weight Control registry contains a listing of subjects who have lost at least 30 pounds of weight, and kept it off for at least 12 months. Although the people on the register use a number of different strategies to reduce body fat, the one thing they have in common is a commitment to regular exercise [4]. Scientists from George Washington University also report that regular exercise helps to maintain higher levels of weekly fat loss 12 months after starting a diet [5]. Researchers at Maastricht University have shown that just ten weeks on a very low-calorie diet actually reduces the number of fat calories your body burns each day [8]. This post-diet drop in fat oxidation could explain why many people find it difficult to stop the weight coming back once they've lost it. A group of 40 overweight men took part in the study. They were assigned to one of two groups. One group dieted, while group two combined the diet with a program of regular aerobic exercise. The men in the exercise group completed three sessions per week, consisting of walking and underwater exercise. Each workout lasted for around one hour. During the first six weeks of the study, subjects in both groups were given a very low-calorie diet providing just 500 calories daily. From weeks 7 to 10, they gradually increased their food intake. Both groups lost roughly the same amount of fat and muscle. However, the subjects who didn't exercise had a reduced capacity to burn fat, both at rest and during exercise. The good news is that exercise served to prevent this decline.

What this means is that the benefits of low-intensity aerobic exercise are more apparent when you're trying to keep the weight off. The exercise doesn't have to be particularly vigorous or demanding. Just three hours of walking each week is enough to prevent the post-diet decline in fat oxidation. Physical activity as part of a fat loss strategy also appears to encourage healthier eating patterns. Individuals who exercise frequently may perceive food as "activity fuel", and place greater importance on the quality of their diet. Californian researchers have identified a direct link between physical activity and various markers of dietary quality [3]. They found that physical activity was associated with healthy eating habits, such as eating fruit and vegetables. More physically active individuals are also less likely to eat foods with a high calorie content. That said, there are also people who eat what they want, then do hours and hours of exercise in an attempt to burn it off again. This is mistake. When it comes to shedding fat while preserving lean muscle, one of the most important hormones is testosterone. Although testosterone is considered a muscle-building hormone, there are studies showing that it also helps to cut body fat. Unfortunately, too much exercise can lower testosterone. Endurance-trained men, for example, have lower testosterone levels than men of the same age who never exercise [19]. Men with low testosterone levels are also more likely to develop a pot belly [17]. In short, trying to make up for a poor diet by doing a lot of aerobic exercise is not a good idea.

Subcutaneous fat
Publishing their findings in Medicine and Science in Sports and Exercise, Japanese researchers have shown that dieting leads to a greater reduction in visceral fat [1]. Exercise, on the other hand, has a greater impact on subcutaneous fat. Subcutaneous fat (pronounced sub-cue-tain-ee-us) is stored just under your skin. Visceral fat (pronounced viss-er-al) surrounds and protects your internal organs. The women in the study took part in a 13-week program that combined exercise with a restricted-calorie diet. One group followed the diet, combined with 1-2 days per week of exercise. Group two made no change to their diet, but exercised 3-4 days each week. Both groups lost roughly the same amount of fat. In the group who exercised more frequently, six of every 10 pounds of fat lost came from subcutaneous fat. However, in the group who exercised less frequently, less than three of every 10 pounds of fat lost came from subcutaneous fat.

Energy flux
Aerobic exercise also allows for a higher energy flux, which refers to the flow of calories (or energy) through your body. A high energy flux means that you're eating a large number of calories, but balancing that with an equally high volume of exercise. A good example of someone with a high energy flux would be a cyclist taking part in the Tour de France. Despite the fact these athletes eat thousands of calories each day, they're still able to remain lean simply because they're doing so much exercise. An example of a low energy flux would be someone following an extremely low-calorie diet while doing little or no exercise. A high energy flux is linked with a high metabolic rate. Endurance-trained males, for example, in a high state of energy flux have a higher metabolic rate compared with a low energy flux state. As they age, people are generally less physically active. The result is that they burn fewer calories each day. Unless they eat less to compensate for this reduction in calorie expenditure, weight gain is the inevitable result. The good news is that you can minimize the age-related drop in basal metabolic rate by maintaining a high energy flux balancing a higher calorie intake with an equally high volume of exercise. Not only will this help you to stay lean, it's also a great way to provide your body with more of the vitamins, minerals and other nutrients it needs.

The bottom line

Many people starting an exercise program are told they can expect to lose around two pounds of fat each week. Some people do. However, the majority doesn't.

It's easy to think the problem lies with you. Is it because your metabolism is slow? Are you getting older and burning calories at a slower rate? Is it in your genes? You stick to the program, and still you don't lose any weight. Although it comes as a surprise to many, the majority of research shows that aerobic exercise such as waking, jogging, cycling or rowing in the so-called "aerobic training zone" is not a very effective way to lose fat. At best, you can expect to lose between one-quarter and one-half pound of fat per week, depending on how much aerobic exercise you do. Regular exercise is important because it promotes the loss of subcutaneous fat. Subcutaneous fat is stored just under your skin. Visceral fat surrounds and protects your internal organs. Aerobic exercise also allows for a higher energy flux, which refers to the flow of calories (or energy) through your body. This lets you balance a higher calorie intake with an equally high volume of exercise. Not only will this help you to stay lean, it's also a great way to provide your body with the vitamins, minerals and other nutrients it needs. Recommended Links Burn The Fat Feed The Muscle is an easy-to-follow fat-burning exercise and diet program that works. The Ultimate Diet 2.0 is possibly the most comprehensive and complete guide to losing stubborn body fat ever written. Do you need help burning the fat from your belly or packing muscle on your chest, shoulders and arms? This site contains everything you need to know. It will teach you the best ways to get the lean, strong, healthy body you deserve. Mentor Members also enjoy a clear, honest and easy-to-follow response to all their fat-burning and muscle-building questions within 48 hours
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