Starbucks Choices

Order a coffee with cream and sugar every work day?  Add 900 calories per week to your diet.  That is over 13 pounds in one year.

Enjoy a cappuccino every day instead, and you save 300 calories per week, and cut 4 pounds per year from the above diet.

Go to coffee with skim milk and Splenda?  Now you are only adding 250 calories per week, and under 4 pounds per year in coffee weight.

Enjoy a flavored frappucino or latte once per week?  That could add up to 26,000 calories, and another 7.5 pounds per year.

Just your coffee could account for 20 pounds of caloric intake annually!

Steakhouse Choices
• Caesars Salad- 800cals
• Chopped Salad, 320cals
• Spinach Salad, 170cals
• FR Onion Soup, 530cals
• Clam Chowder, 280cals
• Calamari, 1200cals
• Shrimp Cocktail, 200cals
• Roasted Chicken, 1500cals
• Delmonico, 1070cals
• 14oz Sirloin, 670cals
• Seared Tuna, 610cals
• Salmon, 440cals
• 10oz Filet, 370 cals
• Au Gratin, 1600cals
• Lyonnaise, 930cals
• Mashed, 690cals
• Asparagus w/Hollandaise, 210cals

Start with a caesars salad, and split the calamari with 3 others at the table.  Grab the Delmonico, with some au gratin potatoes on the side.  That’s 2600 calories, and if you add two drinks to this, you are pushing 3000 calories, or almost one full pound of food in one sitting.

Or, you could order the spinach salad, split the shrimp cocktail with another person, enjoy a 10 oz filet, and split mashed potatoes and asparagus.  More food, and only 800 calories before drinks.  That is less than 1/3 the calories!

Plantar fascitiis is the most common cause of heel pain, affecting approximately 2 million individuals in the United States each year. Clinical manifestation and diagnosis is well recognized based on physical examination and symptoms. This condition occurs along the long plantar fascia ligament, which is a fibrous tissue that spreads across the bottom of the foot connecting from the calcaleus (heel bone) to the proximal phalanges (toes). This structure takes tremendous stress with each step we take. Repetitive activation or irritation of the fascia can lead to mechanical overload and micro tears.
Risk factors which may predispose one to development of fasciitis include decreased ankle flexibility, improper mechanics of the foot, wearing incorrect shoes, being overweight, repetitive activities such as athletes participating in running and jumping. Other causative factors may include standing workers, sustained repetitive stress, and calcaneal heel spurs.  
Typical presentation is heel pain that has been slowly progressive and most noticeable with the first step in the morning or after being sedentary for extended periods. Pain is often sharp or shooting with each step and a progressive dull ache throughout the day. If signs and symptoms are not clear, further diagnostic modalities or consulting with your health care provider may be warranted.
Conservative treatment is the mainstay for recovery. Recovery times may vary, however it is important to understand and adhere to a regimented treatment protocol to achieve success. Symptoms are often self limiting and resolve in 80-90% of people affected within 10 months. Initial treatment should consist of resting and icing. Icing can be performed by freezing a water bottle, soda can, or Dixie cup and rolling the heel over the cylindrical object. Exercises should include specific plantar fascia stretching multiple times per day (see below). Physical therapy has also become a common option to help guide this process and promote healing. Other treatment options for plantar fasciitis include massage, taping techniques, orthotics, and night splints. For more severe and chronic cases that are unresponsive to conventional treatment, casting, steroid injections, anti-inflammatories, and modalities may be utilized.  Surgery is the last option for those who have failed all other treatment approaches.
Here are some take home points. Do not ignore your foot pain. If your signs and symptoms are consistent with plantar fasciitis, you will likely benefit from conventional treatment which consists of icing the sore heel, stretching and massaging the plantar fascia, maintaining a healthy weight, and using proper shoe wear. Please consult your health care professional to determine proper dosage and appropriateness of suggested exercises.  
   Lindsey Welch is a licensed physical therapist at Strive Physical Therapy and Sports Rehabilitation in Moorestown, NJ. She treats a wide variety of musculoskeletal disorders ranging from orthopedics to generalized low back pain. She holds a Doctorate in Physical Therapy from Thomas Jefferson University and is a certified strength and conditioning specialist through the NSCA.

References:

http://www.plantar-fasciitis.org/. Accessed on December 13, 2009.
Mayo Foundation for Medical Education and Research. Accessed on December 13, 2009. http://zcoilblog.blogspot.com/2009/08/foot-stretches-to-prevent-plantar.html
Sanders, Mary E. On the Floor: Keep Trekking with Healthy Happy Feet: Understanding Plantar Fasciitis. ACSM’s Heath & Fitness Journal. 11(4): 29-32, July/August 2007.
Schippert, David W, DiGiovanni, Benedict F, et al. Recent updates in the management of plantar fascitis. Current Orthopaedic Practice. 20(2):130-135, April 2009.

Some signs of overtraining are as follows*:

• Decreased performance
• Prolonged recovery time
• Headaches
• Loss of appetite
• Extreme muscle soreness (lasting more than 2 days)
• Stomach disturbances
• Increased illnesses and injuries
• Loss of sleep
• Irritability and depression

Increased training due to an upcoming competition is understandable. It is also common to start a new routine, see great results, and then get too fanatical about sticking to the routine. However, if it is coming at the expense of your everyday life, it may not be worth it.

To avoid burnout, it is important to understand that taking a break once in awhile is OK. Listen to your body. If you start to see signs of overtraining, skip a workout or two, even if it is part of a program leading up to a competition. Also, gradually work towards a heavy training load. Work towards your goals smartly. Finally, don’t feel obligated to keep up with everyone else’s training schedules. Everyone has a different lifestyle, fitness level, and fitness goals.

In conclusion, train hard, but listen to your body. It is beneficial to moderate your workload from time to time. It may not seem like it immediately, but it will help you reach your goals more quickly than “working through it.”

When Is a Recovery Liquid or Food Needed?

The need for a recovery food or drink depends largely on the duration and intensity of the workout, the food experts agree.

“During lower-intensity or easier workouts, you don’t need to worry too much about recovery and making sure that the muscles repair themselves.”

A 45-minute workout at moderate intensity doesn’t warrant any special recovery considerations. That doesn’t mean clients shouldn’t eat if they feel hungry after a workout.

“It’s important that if you’re plain old hungry after a workout, it may be nice to have an apple to curb the hunger,” Ryan notes. “It’s not so crucial for fuel recovery, but for hunger, so you don’t feel ravenous when you sit down for dinner.”

This is especially important for people who are trying to lose weight, she adds.

Rules of Recovery

In general, most people who exercise an hour or more need to replace lost nutrients.

“People lose 30 grams to 60 grams of carbohydrates per hour of training or more, depending on the intensity of the workout.”

The biggest mistake clients can make is to wait too long to replace those nutrients.

“We know that the rate of replenishment of carbohydrates into the cell immediately following a workout is very rapid,” Kleiner says. “You have a 15- to 30-minute window after you exercise, then the rate slows for the next two hours, and slows even more for the next 24 hours. About two hours after you exercise it’s time for a meal, unless you exercise at 8 p.m., then it’s not recommended.”

People focusing on serious resistance training should consume more protein-0.68 grams to 0.91 grams of protein per pound of body weight, Digate Muth says citing accepted sports nutrition guidelines.

What’s Better for Recovery: Liquids or Solids?

“People who work out in the morning should have a liquid,” Kleiner says. “Ideally you don’t even change or shower, but down a beverage right after your workout. If you can’t carry a liquid and the only option is food, you need carbohydrate and protein, ideally with whey protein in it.”

Energy Bars

“The higher carbohydrate ones (bars) are generally lower in proteins, so you want to add a glass of low-fat milk,” she suggests. Kleiner prefers downing a beverage with milk protein, ideally a whey protein, carbohydrates and a minimum amount of fat or no fat.

Soy vs. Whey Protein

Research studies comparing soy to whey protein show that protein metabolism and growth is slightly greater with whey, Kleiner says. “That doesn’t mean soy is useless; you just get an edge with whey,” she says.

Make Your Own Recovery Drink

Among the easiest, more cost-effective and reliable ways to ensure that your clients get the right mix of carbohydrates and high-quality protein for recovery may be to mix their own drinks. A smoothie is nutritious and easy to make.

“If you can make a recovery drink and take it with you (to the gym), you will have such an enormous spectrum that will help you recover and one that you will never find in an engineered product,” Kleiner says.

Smoothie Recipe

For men: Blend 1 cup of non-fat milk, ½ a cup of orange juice, 1 tablespoon of honey, ¼ cup of frozen strawberries and 21 grams of isolated whey protein powder.

(350 calories, 54 grams of total carbohydrates and 33 grams of total protein).

For women: Blend 1 cup of non-fat milk, ¼ cup of orange juice, ¼ cup of frozen strawberries and 14 grams of isolated whey protein.

(212 calories, 29 grams of total carbohydrates, 24 grams of total protein).

Chocolate Milk for Recovery?

Here’s another option: A recent study published in the International Journal of Sports Nutrition and Exercise Metabolism that compared chocolate milk to meal replacement recovery drinks found that chocolate milk was just as effective as the more costly recovery drinks, Kleiner says. Coffee drinkers can enjoy the same benefit.

“Get a Latté or a light Frappucino,” Kleiner says. “It works well. People say it’s awfully sweet, but if you have done serious exercise and need that to recover it’s fine.”

The high-calorie drinks however aren’t recommended for people trying to lose weight.

Recovery Foods

Ryan says plain old food is as good for recovery as engineered sports nutrition products. Clients working at a moderate intensity may recover well with a light snack, some crackers or a piece of fruit after exercise. Your clients who exercise at higher-intensity levels may consume a half a bagel topped with peanut butter, a banana, or other carbohydrate-rich breakfast foods to recover, she adds. For clients preferring foods over liquids, a low-calorie yogurt with a piece of fruit or a cheese stick or a glass of milk works well too, Kleiner adds.

By now, most people have had their cholesterol levels checked at least once in their life. The most common response I get to the results is, “My parents have high cholesterol, therefore, it doesn’t matter what I do anyway.” This could not be further from the truth. While it is true that heredity can play a big part in your cholesterol levels, this simply means it is that much more important to lead a healthy lifestyle. For those people who do not have a history of high cholesterol, your lifestyle can be directly attributed to your health. For those of us that have been given the gift of high cholesterol, your lifestyle is the only of way of keeping your cholesterol manageable.

Where does cholesterol come from, and what does it do?

Cholesterol is a necessary part of your body’s functions. It is a naturally occurring substance in the body. Because of this, it is believed that many people’s cholesterol levels are somewhat hereditary. However, many foods we eat contain various levels of cholesterol, both the good (HDL) and the bad (LDL.) This means that diet and exercise can play a big role in controlling and/or lowering your cholesterol levels.

Most heart and blood vessel disease occurs when cholesterol and other fatty deposits build up on artery walls. This slows down blood flow to the heart. If the blood becomes completely blocked, a heart attack occurs. Generally, individuals carrying excess weight will have higher LDL cholesterol and blood lipid (fat) levels. Because of this, a healthy diet and regular exercise is very important.

How can I lower my cholesterol?

• Maintain an exercise regimen consisting of cardio training and strength training.
• Do not smoke.
• Focus on eating natural foods low in saturated fat.
• Use unsaturated vegetable oils such as canola, corn, and olive.
• Eat whole grain and multi-grain foods, when available.
• Eat fish and lean meats without the skin.
• Avoid fried foods, and other foods high in saturated foods.
• Avoid partially hydrogenated fats. This will be listed in the ingredients on the package.
• Avoid whole milk and other high fat dairy. Try low fat or fat free dairy products.
• Avoid processed foods, and baked goods made with eggs, butter, and fats.

If you have questions, or would like a full list of ways to help in lowering you cholesterol levels, please do not hesitate to call Andy at Optimum Results at (609) 304-7598.

Still, alcohol is a toxin. Therefore, your body produces certain enzymes to remove this toxin from your body. When your body cannot keep up with your intake, a hangover (or worse) follows. In addition, your liver and kidneys need water to produce these enzymes as well as transport these toxins out of the body. For this reason, alcohol acts as a diuretic and can lead to dehydration. This often leads to increased trips to the bathroom, as well as a headache the next day. This means it is generally better to drink alcohols that are higher in quality, which will generally have slightly less toxins.

In addition, alcohol inhibits your body’s ability to metabolize fat. This may explain why excess stomachs are referred to as beer bellies! Keep this in mind when trying to shed a few pounds.

With this in mind, I often get asked from time to time, “What should I drink when I go out?” As a general rule, beer and wine are the best alternatives. Most wines are roughly the same in nutritional value. They are fairly low in calories, and are less dehydrating than, say, a shot of Jack Daniels or a martini. The additional liquid allows your system to more easily process the alcohol. Mixed drinks tend to be mixed with sugary alternatives such as tonic, sour mix, etc… Substitute diet tonic and soda as your mixer. If possible, alternate each glass of alcohol with a glass of water or club soda. This will help dilute the alcohol in your system, giving your body a chance to digest. If possible, avoid frozen drinks. Most frozen drinks are mixed with sugar or corn syrup that can add up to 500 calories in some drinks!

The following is a list of the basic nutritional content of some common drink choices:

• Light beer- 90-110 calories, 3-6g of carbohydrates
• Beer- 140-180 calories, 10-20g of carbohydrates
• Wine- 80 calories, 0g of carbohydrates
• Bloody Mary- 120 calories, 5g of carbohydrates
• Gin and Tonic- 170 calories, 14g of carbohydrates
• Irish coffee- 220 calories, 8g of carbohydrates
• Long Island Iced Tea- 230 calories, 25 g of carbohydrates
• Martini- 160 calories, 1g of carbohydrates
• Margarita- 170 calories, 4g of carbohydrates
• Kahlua and cream- 290 calories, 14g of carbohydrates
• Shot of whiskey, bourbon, or vodka- 80 calories, 3g of carbohydrates
• Mudslide 270 calories, 41g of carbohydrates
• Frozen drinks- 360-600 calories, up to 75g of carbohydrates
• Flavored Martini- 350+ calories, 5g+ carbohydrates

Avoid:

• Bacon, Sausage, etc…
• Egg yolks
• French toast
• Cream cheese, butter, dairy spreads
• High sugar cereals
• Granola products
• Sweets such as cinnamon rolls, doughnuts, etc…
• Most muffins from bakeries
• Fruit juice

Try:

• Whole grain, low sugar cereals
• Whole grain oatmeal
• Egg whites
• Buttermilk or whole wheat pancakes (easy on the syrup)
• Fat free yogurt or cottage cheese
• Fruit
• Canned fruit stored in pear juice, not syrup
• Fat free muffins
• Whole grain toast or English muffins

Lunch

Avoid:

• Any type of chips
• Fatty lunch meats such as salami and most hams
• Cheese on sandwiches
• Anything fried, such as fries, wings, etc…
• High fat salad dressings
• Cheese or ham in salads
• Cheeseburgers, cheesesteaks, etc…

Try:

• Fruit
• Vegetables (not in butter)
• Lean cold cuts such as buffalo chicken or turkey
• Salads w/low fat dressings on the side
• Grilled chicken sandwich
• Natural peanut butter on tortilla or whole grain bread
• Smart Ones lunches
• Morningstar veggie or Chik’N burgers

Dinner

Avoid:

• Red meat entrees
• Fried entrees
• Duck and goose
• Pasta dishes with creamy sauces
• Fish or chicken dishes with butter or cream sauces
• Side dishes doused in butter
• Appetizers with sour cream, cheese, etc…
• Thick gravies
• Ice cream

Try:

• Grilled or broiled entrees
• Fish, chicken, sometimes pork
• Pasta with marinara or other tomato based sauce
• Grilled or non-sauteed side dishes
• Foods that are spicy rather than seasoned in oil
• Baked or roasted potatoes or sweet potatoes
• Soy products such as tofu

Shopping tips

Try:

• Almonds, cashews, etc…
• Canola oil
• Pam cooking spray
• Fresh fruits and vegetables (pre-cut if you desire)
• Whole grain products (bread, rice, pasta, cereals, etc…)
• Chicken, turkey
• Seafood
• Beans
• Fat free dairy products (milk, cheese, sour cream, cottage cheese, yogurt)
• Natural peanut butter
• Egg beaters
• Smart Ones
• Canned veggies
• Canned fruit (in its own juices)
• Whole grain oatmeal
• Apple butter, or other fruit spread

Often, when an athlete is very new to training, his or her exercising heart rate can either be very low or high, with not much in between. This is because in a comparatively untrained individual, the lactic threshold (the point during exercise at which an athlete starts to accumulate lactic acid in the blood) may be quite low, and his or her ability to tolerate lactic acid may also be low. Above the LT, the respiration rate increases quickly as CO2 levels rise in the blood.

Thus, beginners are best served by starting their training programs by focusing on aerobic exercise, which may consist of walking, a walk-run program or easy jogging only. Anything beyond that quickly ramps the heart rate up to an unsustainable level that can undermine an athlete’s fitness progression or even lead to injury.

Heart rate can be a great gauge of aerobic conditioning and endurance gains. While you can invest in a VO2 max test to accurately identify your LT and various heart-rate training zones, this isn’t always feasible for everyone and likely isn’t necessary for the novice athlete.

Instead, here are a few basic guidelines for getting started. Wearing a heart-rate monitor, take note of your heart rate while running for a sustained period at a conversational pace. At this pace you are running aerobically. If you gradually get out of breath (and can’t talk anymore) and your respiration rate climbs, you are working toward LT. You will note your heart rate climbing as well.

For simplicity’s sake I will confine my example to running. Let’s say, for instance, that Joe Runner can run for 30 minutes at 10 minutes per mile at a heart rate of 135 beats per minute. This is a heart rate at which he can run comfortably, but when he lifts the pace to 9:30 per mile he starts to run out of breath. Based on this, I will outline a few steps Joe can take to improve his endurance and get him to the point of being able to tackle some higher-intensity training down the road.

Step 1:

Starting conservatively, Joe should run every second day at 132 to 137 beats per minute, increasing the duration by about 10 to 15 percent per run until he reaches 60 minutes. Joe may notice that as his fitness improves he will be able to maintain a consistent pace as the distances increase and that he can run slightly faster at the same heart rate. That said, if Joe feels fatigued he should take an extra day or two off from running.

Step 2:

Continue to schedule one longer run of 60 to 70 minutes each week at 135 beats per minute. Also include one weekly run of 30 to 40 minutes at the same heart rate plus one run of 30 minutes that includes four to six fartlek pickups of 1 to 1.5 minutes with a full jogging recovery (heart rate drops below 135 for at least two minutes) after each work interval. Joe’s pace for his weekly aerobic endurance runs should gradually get faster. For instance, after a few weeks Joe’s pace could approach 9:45 to 9:30 per mile at the same heart rate.

Step 3:

Over time, Joe should gradually increase the heart rate in his long runs to the 137 to 142 range as he gets fitter.

Over time and with training you will note you can sustain higher heart rates for longer periods of time as your LT heart rate increases. You will also note a substantially lower heart rate while your pace remains consistent or even improves. Once you attain better fitness, you can then take steps to identify your LT and start to base your training off of this.

A: During aerobic exercise, an individual’s heart rate is a reliable indicator of how hard that individual is working. As the energy demands of the exercise increase, heart rate increases proportionately. Because the exercising muscles need more oxygen and fuel, an individual’s heart rate and stroke volume (i.e., the amount of blood pumped per beat) must increase to deliver more blood to the tissues to meet the increased metabolic needs of the active muscles. It is this increased metabolic demand that overloads the cardiorespiratory system and provides the necessary stimulus to improve aerobic exercise capacity.

With resistance training, heart rate is disproportionately elevated relative to oxygen uptake. At any given level of oxygen uptake, heart rates are much higher for resistance training than for aerobic conditioning. The disproportionate rise in heart rate during resistance training is due to a phenomenon known as the pressor response, which is governed by the autonomic nervous system and occurs reflexively from the contraction of the skeletal muscles. It causes an increase in heart rate with a corresponding reduction in stroke volume. As a result, even though heart rates are increased during resistance training, the oxygen uptake is not increased to the same degree as it is during aerobic conditioning. This factor minimizes the metabolic overload to the muscles and, therefore, limits the aerobic training benefit that can occur as the result of resistance training. The pressor response helps to explain, from a physiological standpoint, why the heart rate is disproportionately elevated, relative to oxygen uptake, during resistance training.

The misperception that resistance training can increase aerobic exercise capacity is not new. In fact, it was popularized in late 1970s and early 1980s in a form of exercise known as circuit weight training (CWT), which involves performing 10 to 15 repetitions of eight to 12 exercises, using 40 percent to 60 percent of one-repetition-maximum. During CWT, individuals rapidly move from machine to machine, with very brief (less than 30 seconds) rest periods between exercises. A review of studies involving CWT indicates that such training programs are effective at increasing muscular fitness, but only modestly improve aerobic capacity (i.e., approximately 5 percent to 7 percent). Conventional aerobic exercise training programs (e.g., running, cycling, swimming) conducted over a similar period of time, on the other hand, typically result in greater improvements in aerobic exercise training (i.e., 15 percent to 25 percent).

Despite marketing claims to the contrary, exercise products and programs that focus predominantly on resistance training do not provide a sufficient stimulus to produce meaningful aerobic training benefits even though exercisers’ hear rates are elevated during such training. It is important to understand that although a regular, sustained increase in heart rate is widely recognized as critical to achieving increased aerobic fitness, the heart rate merely serves as a monitor for the real training stimulus (i.e., increased energy expenditure or oxygen uptake). The best training approach for optimally improving both aerobic and muscular fitness is to separately participate in aerobic- and resistance-type activities. Circuit weight training can, however, serve as a time-efficient and relatively effective way for beginners and deconditioned individuals to achieve modest-to-moderate increases in both aerobic and muscular fitness.

Source: Bryant, Cedric X. ACE FitnessMatters, March/April 2004

Causes of Back Pain

The causes of more than 80% of back pain cases are often unknown. In most individuals, pain stems from an injury, after lifting a heavy object, poor flexibility or making an abrupt movement.

1. Poor Posture

Weaknesses in the muscles of the abdominals, hip flexors, hamstrings and low back can alter your hip position, increasing the natural curvature of your low back and generating pain.

Low back pain is usually defined as either acute or chronic. Pain is typically diagnosed as acute if lasting less than a month and not caused by serious medical conditions. Most cases clear up in a few days, although recurrence after a first attack is common.

Pain is typically diagnosed as chronic when is persists beyond six months. This constitutes less than 5% of all low back pain cases.

Obesity increases weight on the spine and pressure on the disks. A large stomach pulls the spine forward and out of alignment, increasing the chances of back strain. The greater the weight, the greater the risk of back pain.

2. Sciatica

The nerve most likely to cause pain is the sciatic nerve, affecting up to 40% of individuals. Pain is caused by compression of this nerve, which branches out from the spinal cord at the lumbar and sacral areas. Sciatica usually occurs when the nerve is stretched or pinched.

The sensation of sciatica can vary widely from a mild tingling to severe immobilizing pain. Pain may be experienced in one part of the leg or hip, with numbness in other parts. It typically increases after prolonged standing or sitting and can be aggravated by sudden movements. Sciatica can also be caused by piriformis syndrome, the entrapment of the sciatic nerve deep in the glutes by the piriformis muscle.

3. Disc Abnormalities

A herniated disc is sometimes the most common cause of severe sciatica. A disc in the lumbar area becomes herniated when it ruptures or when the gel-like substance within the disc protrudes outward. Many individuals have protruding or bulging discs without incidence of back pain. If this abnormality is able to press against the nerve, sciatic pain can occur.

4. Spinal Stenosis

Spinal stenosis or the narrowing of the spinal canal is usually caused by bone overgrowth, which occurs mostly in the elderly who have degenerative osteoarthritis, but it can sometimes be caused by other problems, including infection and birth defects. Pain from spinal stenosis can occur in both legs.

5. Osteoporosis

Osteoporosis is a bone disease where they lose calcium to the point where the bones become fragile and are prone to fracture. Spinal fractures can occur as a result of pressure that compresses the vertebra together, triggering pain.

6. Osteoarthritis

Osteoarthritis occurs in joints where the cartilage is damaged and then destroyed. As a result of this destruction, the associated bones within that joint develop abnormalities. When osteoarthritis affects the spine, it may damage the cartilage in the discs or the moving joints of the spine. The nerves may become pinched, causing pain and perhaps numbness and muscle weakness.

Back Strengthening Exercises

The best thing you can do to prevent back pain in the future is to exercise today. The American Academy of Family Physicians recommends “back-conditioning exercises” for persons aged 19-64 years who are at increased risk for low back injury because of past history, body composition or inactivity.

1. Begin slowly. Your back muscles may be weak and susceptible to injury if you’re out of shape. Pace yourself. As you get stronger, work up to 15 minutes of exercise a day.
2. Choose your exercises carefully. If you have had back problems in the past, choose low-impact exercises, which are less stressful on your joints. Examples include swimming, stationary bikes and elliptical trainers.
3. Avoid high-risk moves. People who’ve had previous back attacks should beware of movements that cause an exaggerated stretch of the back muscles. Sports that involve a lot of twisting (like golf), quick stops and starts (like tennis, racquetball and basketball) and contact sports (like football and wrestling) pose the greatest risks to your back. If you want to participate in such activities, practice modifying risky moves. The following exercises can help stretch and strengthen your back and supporting muscles. As little as 15 minutes of exercise a day can help. If you already have back problems, consult your doctor before you begin any routine.

View exercises in pdf document

Choose to see a doctor if you experience numbness, tingling, or weakness down the leg, or if you feel ill as a result of the back pain.