June 07, 2011
12:00 p.m. – 1:00 p.m. (EST)
- David Westerdahl, MD - Sports Medicine Specialist
Cleveland Clinic Florida's Sports Health Program provides professional, athletes access to a wide range of expertise and services for sports injury. When you need to get back up and running, why go elsewhere for your care?
Cleveland_Clinic_Host: Today's Live Web Chat, "Exercise Tips" with David Westerdahl, MD will begin at 12 noon EST. Please submit your questions by typing them below and then clicking 'Ask'.
Cleveland_Clinic_Host: Welcome to our Online Health Chat "Exercise Tips" with David Westerdahl, MD. We are thrilled to have him here today for this chat. Let’s begin with the questions.
Sharon: What is the single best type of exercise a senior woman (60-70 years) can do to lose weight, when you are already cutting calories? Is there an exercise that works the best to burn fat and raise metabolism?
David_Westerdahl_MD: Hi, thank you for your question(s). As one of your questions indicated, you have a heart condition that affects exercise. In your particular situation, it’s important to work closely with your cardiologist to develop an appropriate exercise plan that doesn't place excessive strain on your heart. I would advise you to focus less on strength training and more on cardiovascular (aerobic) exercise. I agree with your cardiologist that it is important not to "hold your breath" or valsalva while weight training, so it’s better to perform strength training with lighter weights and at a lower intensity.
Csieggreen: I really enjoy lifting and doing core exercises to tone my body, but I always seem to have a really stiff neck for days afterwards. It really messes up my workouts for the rest of the week. Any advice?
David_Westerdahl_MD: This is not uncommon in active individuals. Beginning as early as college, we can start developing mild degenerative changes in our spine. I routinely advise patients in their 30's and up to avoid a lot of overhead lifting like pull-ups, pull-downs, military press, and be careful with bench and incline bench as these exercises increase the risk of neck sprain/strain type injuries. Most core strengthening exercises are safe as long as you are avoiding excessive overhead movements.
Miss_Lyss: Does exercise help you lose weight? Or is it diet that helps you drop the pounds and exercise that just tones and defines etc?
David_Westerdahl_MD: Exercise definitely helps you lose weight. Exercising muscle burns calories (carbs, fats, etc) for energy and has been shown to help promote long term weight loss compared to dieting alone. Your metabolic rate is determined in part by how much muscle you have, so increasing your total muscle mass can also speed up your metabolism.
Bobby77: Do any of those exercise belts - the ones that use electric pulses to contract muscles - actually work and would it be a good substitute for crunches/sit-ups?
David_Westerdahl_MD: There is an old saying "if it sounds too good to be true, it probably is". There is no shortcut to a six-pack. It takes regular exercise and a low body fat percentage to have that abdominal "six-pack". So keep working out with cardio, weights, and eat healthy.
Carmicat17: You always hear that hard cardio exercise is good for the heart, but how? Can you push yourself too hard and make your heart beat too fast during exercise?
David_Westerdahl_MD: Assuming you are a healthy individual without pre-existing heart problems, who exercises regularly, I would tell you that it is common for endurance athletes to exercise at levels between 60 and 80% of their maximum heart rate. Your (per minute) maximum HR can be roughly calculated by the formula 220 - your age. If you're an "endurance" athlete who does marathons, triathlons, etc., you might also push into zone 4 and 5. It is important though to realize that you do not have to push your heart to its limits to gain overall cardiovascular benefit. There can be significant heart benefits to simply walking 45-60 minutes per day most days per week. Moderate levels of exercise like walking and dancing have been shown to be very beneficial to certain individuals.
Cleveland_Clinic_Host: For those now joining us, we are currently chatting with Dr. David Westerdahl who is taking your questions about exercise. To ask a question, type in the box below and then click 'Ask'.
Runner123: I love to do high impact exercises but always end up with very sore/painful knees after. How can this be prevented?
David_Westerdahl_MD: Have him or her lay down and keep him or her comfortable. We do not recommend that you try to give them Aspirin, because we do not know what type of stroke they are having whether ischemic due to lack of blood or hemorrhagic due to bleeding. The CT scan we do when they arrive in ER helps to sort this out. If you give aspirin and the stroke is hemorrhagic, it could make things worse.
Cleveland_Clinic_Host: High impact activities like running and jumping sports can be hard on the joints like your knees. Some ways you can prevent sore joints include icing after activity – it is what many professional athletes do. Also, have some recovery time between high impact workouts. It’s important as we age to incorporate more "recovery time" into our work out schedules. You can recover by cross training. Also, if your high impact activity is running, work with a running coach on your form. This may help with your sore joints. Good luck.
BrynBoss: What are the effects of exercise on your skeletal muscles?
David_Westerdahl_MD: Exercise stimulates muscle adaptation in many ways. Muscle adaptation depends on how you are exercising. Doing leg squats may be more likely to stimulate quadricep muscle enlargement (hypertrophy). Whereas, training for a marathon may increase the efficiency of your quadriceps as to how it uses carbs or fats for energy and may promote increased numbers of energy producing mitochondria in the muscle cells. It depends on how you are exercising. It’s important to allow exercising muscle to recover and provide adequate energy to exercising muscle.
Cleveland_Clinic_Host: We have approximately 15 minutes left in the chat. We received a large amount of questions and we will continue to answer as many as possible. We apologize if we did not get to your question. If you have additional questions after the chat, please use our contact link clevelandclinic.org/webcontact to submit your questions.
KellyKat: What is a Vo2 test and why would someone want to get one?
David_Westerdahl_MD: A VO2max test measures your maximum oxygen uptake per minute while exercising. It is commonly used as a measurement of aerobic fitness. An elite endurance athlete might have a vo2max > 60 ml/kg/min. An individual who is not active might have a vo2max of 20. This test is commonly performed using a bike or treadmill with an Exercise Physiologist. It can provide an athlete with information to improve their performance in endurance events. It can provide information on heart rate training zones. It can accurately determine your anaerobic threshold (AT) or lactate threshold. This is the heart rate point where you convert from aerobic to anaerobic energy.
Williams003: Is it better to stretch before or after exercise... or both? Why is stretching so important?
David_Westerdahl_MD: For aerobic sports, like jogging/biking, I advise an active warm up for 5-10 minutes, then stretch as part of a cool down. For other sports like baseball or soccer it may be important to stretch as part of your pre activity warm up. So the answer is it depends on your sport.
Williams003: After exercising, is it bad for you and your heart if you immediately stop and don't cool down?
David_Westerdahl_MD: Studies are inconclusive on this, but it’s probably not as bad as once thought.
Imgaiso: Can you recommend a way to find a cardiologist that is very knowledgeable in the effects that weight training has on particular heart conditions and who will work with a patient to construct an appropriate regimen?
David_Westerdahl_MD: If you have a Cardiologist or Primary care Physician already, I would recommend contacting him/her for a recommendation. If you would like to be seen at Cleveland Clinic for an opinion, I would advise you to call our appointment line as we have Cardiac specialists who can help you create an appropriate regimen. Our toll free line is 877-463-2010.
Sharon: Does taking 240mg. of Propranolol and 50mg. of Lisinopril a day slow your heart rate down? I was told that it will always be harder for me to get my heart rate up because the medication I take is pushing the heart rate down. Is there any truth to that?
David_Westerdahl_MD: The Propranolol will limit your heart rate. The Lisinopril shouldn't. Please discuss the effects of this medication with your personal physician.
Cleveland_Clinic_Host: I am sorry to say that our time with David Westerdahl, MD is now over. Thank you again Dr. Westerdahl for taking the time to answer our questions today about Exercise. To make an appointment with David Westerdahl, MD or any of the other specialists in our Orthopaedic and Rheumatologic Institute at Cleveland Clinic Florida, please call 877.463.2010. You can also visit us online at vanity clevelandclinicflorida.org.
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