Maintaining Muscle

Your strength is your independence.

So often people will do some form of aerobic exercise, walking, biking, jogging etc., but will neglect muscle strengthening. Getting a couple of sets of dumbbells at home, some theraband, or doing exercises such as wall slides, push ups against a wall, step ups, yoga are all great ways to work on improving strength. When people become frail it is often due to severe muscle atrophy or wasting. You can build and improve strength at any age. The key is to begin light and continue to push yourself to do a little more. Start with soup cans if needed, to make your own leg weights three rolls of pennies equals one pound, put them in a sock and tie it around the ankle, do leg extensions, leg lifts to build leg strength.

 A key for heart patients with muscle building exercises is to EXHALE ON EXERTION.

Many will find they hold their breath or inhale when lifting a weight. It is the opposite, when lifting the weight blow out, this helps to keep the blood pressure from elevating dangerously high, and placing increased forces on the artery walls. You will find if you focus on the breathing technique you are able to lift more weights. It is crucial to maintain muscle mass to maintain independence, to be able to do activities of daily living such as carrying in groceries, taking out trash, moving furniture, lifting boxes, getting up off the floor etc.

Cardiac Surgery Patients: Think Posture!

If you just had your chest recently surgically opened, the last thing you want to think about is stretching, but after time it becomes very important. You may not physically remember the pain of surgery but your body does. It gradually rounds the shoulders forward, the head is carried slightly more forward, and these changes make the subtle curve in the low back gradually flatten. Many patients when they first attend cardiac rehabilitation complain of pain and spasm to their upper back and shoulders. When I worked in physical therapy I would have many patients present several years after open heart surgery with low back pain. Many had the characteristic posture I described above.

Here are a few suggestion to help you in the healing process.

Be very aware of your posture – if you are sore, think about what posture you are in. Are you seated with your shoulders slumped and head forward? If so adding a lumbar support to your chair will help to straighten your back posture. Another suggestion is to get up and move more frequently.

Pain in the shoulder blade region?

If so begin with gentle chest stretching and shoulder stretching. It is very important you avoid pain. I usually wait until my patients are approximately 6 weeks in recovery before initiating this. Do not take any stretch to pain. Do not bounce stretches.

There are three different postures to get the different muscle groups of the chest. One leg is forward simply to maintain the curve of the low back. Hold the stretch 10 to 15 seconds, repeat 1-2 times. It is ok to do this stretch a few times per day.

   These are other good stretches for the chest

Upper back stretching

The muscles act very similar to pulleys. If one side shortens the other side lengthens. If the muscles of the chest are short the muscles of the upper back are stretched. Prolonged stretch leads to muscle spasm, and this makes many people feel like they have knots in their upper back. There is a great stretch for this.


Reach down grasp opposite knee with hand (left hand grasp right knee). Relax your head pull up gently, hold 10-15 seconds. Repeat with opposite hand/knee. repeat one to two times.

Use a lumbar support in your favorite chair, while driving, or sitting for a prolonged time. You can either purchase one at your local medical supply/pharmacy, or you can simply roll up a small towel and put it in the small of your low back.



Benefits of training both the arms and legs

It might seem pretty logical that it is important to train all the major muscle groups in the body. Many people do not train their whole body. For many assume getting out and walking everyday provides all the exercise they need to stay healthy. However that neglects the upper body and core muscles. The muscles of the upper body will tire rapidly when subjected to moderate to heavy upper body workloads such as shoveling, raking, lifting, and  overhead arm work. That is because there is no carry over from leg work to arm work, training your legs with walking won’t improve your arm endurance. Thus, it is important to train both.

Initially many with heart disease will find it is hard to do exercise that works both. Working both can also be an angina trigger depending on how much heart damage one has. It is something that you have to build up as tolerated.  It is advised to warm up just doing a leg activity for 5-10 minutes at light workloads, then progress to adding the arms into the work. If they tire, become heavy or you feel short of breath, then drop the arms and continue with legs only. Be alert for  the following signs of unstable angina:

  • unexpectedly becomes worse than usual at a given level of exertion
  • starts with lower levels of exertion
  • starts while resting
  • continues after stopping exercise or taking nitroglycerin medication

If symptoms don’t resolve then stop exercising. It is recommended to progress arm exercise by performing intermittent arm exercise. For instance if on the Schwinn Bike after warming up, then doing a few minutes at higher workloads, add the arms in for 1-5 minutes, then go back to legs only for up to 5 minutes, then add the arms back in. Building arm endurance as able. It is important to actively use the muscles don’t just let the ride along. Think push or pull!

If you are someone who walks for exercise you can work arms at the same time if you carry light weights and actively pump the arms, walk with ski poles.

If your have back issues or balance issues I recommend walking with ski poles. They help you to stand taller, force you to engage your arms with the walk, and you burn more calories on your walk.
Compared to regular walking, ski walking  involves applying force to the poles with each stride. Walking with ski poles uses more of their entire body (with greater intensity) and receive fitness building stimulation not present in normal walking for the chest, lats, triceps, biceps, shoulder, abdominals, spinal and other core muscles. This can produce up to a 46% increase in energy consumption compared to walking without poles. It also has been demonstrated to increase upper body muscle endurance by 38% in just twelve weeks. This extra muscle involvement may lead to enhancements over ordinary walking at equal paces such as:
  • increased overall strength and endurance in the core muscles and the entire upper body
  • significant increases in heart rate at a given pace
  • increasing vascular pathways and oxygen delivery efficiency
  • greater ease in climbing hills
  • burning more calories than in plain walking
  • improved balance and stability with use of the poles
  • significant un-weighting of hip, knee and ankle joints
  • provides density preserving stress to bones

This is my ski pole dealer.

What about walking with weights? 

If you want to walk with weights don’t use more than 1-2 lbs in your hands. Heavier weights tend to stress the neck and spine and are not recommended. Again don’t just hold the weights pump those arms, swing up to breast bone and back to hip. You engage the arms, you burn more calories.

Gym Equipment that will improve upper body endurance:

  • Stationary Bikes with upper body
  • Elliptical
  • Recumbent Steppers
  • Rowing Machines
  • Upper Body Ergometers
  • Dumbbells
  • Weight Machines
  • Kettle Bells                                                                                                                                                                                            

Take Classes that work upper body and core.

By taking fitness classes you mix up the workouts, work different muscle groups, prevents boredom,  keeps it fun, gives you alternate exercise for inclement weather. Personally November and April are the hardest months for me to stay motivated with outdoor exercise, as it is cold, dark and wet….not easy to motivate self. But that is another blog post.
  • Pilates
  • Yoga
  • Tia Chi
  • Karate
  • Belly Dancing
  • Zumba

How does your family strength train?

What does your family do to Strength Train?

Many don’t incorporate strength training into their fitness routine. Children may be physical with playing soccer, basketball etc.but may not get strength training. By building muscle strength you improve the metabolism, making you less likely to gain excess weight, strengthens the bones, makes you less prone to injury.

When children are very young working with heavy weights in the past was discouraged. The thought on this is that is could hurt the growth plates of the bones, and stunt growth therefore working with heavy weights was discouraged.Research however has disproved this, and it is now recommended everyone participate in some form of strength training.

Most people think of strength training as working with weights.

In fact, the ideal weight-training program for many children need not involve weights at all. “The body doesn’t know the difference between a weight machine, a medicine ball, an elastic band and your own body weight,”   Tree climbing is a favorite in our home, as is a great arm workout. 

 Plank, lunges, push ups, chair arm dips, yoga poses such as powerful pose, boat pose, are ways of building strength without weights. If you do choose weights, start light get 3,5,7,10 lb. weights. Focus on learning technique and endurance, then gradually increase the load.

Don’t confuse strength training with weightlifting, bodybuilding or powerlifting. These activities are largely driven by competition, with participants vying to lift heavier weights or build bigger muscles than those of other athletes. This can put too much strain on young muscles, tendons and areas of cartilage that haven’t yet turned to bone (growth plates) — especially when proper technique is sacrificed in favor of lifting larger amounts of weight.