5 Neck Flexor Stretches To Reduce Pain and Improve Posture

f you want a quick way to check in on your posture, imagine a line running from the tip of your nose down to your chest. If it’s straight, congratulations—you’re in alignment. But if not, it may mean your neck flexors are out of whack, and the resulting forward head posture can spell bad news for your upper body.

“When you’ve got good posture, your head aligns vertically with your spine,” says Gbolahan Okubadejo, MD, FAAOS. “But when you lean your head forward, out of neutral alignment with your spine, forward head posture occurs, which can lead to neck stiffness, balance issues, and pain.” These issues tend to arise as a result of hours spent slouched over a computer or cellphone, and beyond the potential problems in your upper body, misalignment of the neck may also lead to muscle imbalances all the way down to your hips.

Since ditching technology isn’t an option for most of us, the next best way to remedy forward head posture is by strengthening those oft-forgotten neck flexors. “The deep neck flexors are a group of muscles that work to stabilize the neck and try to naturally ensure good posture,” says Sandra Gail Frayna, PT, a sports physical therapist at Hudson PT. “They also help give your neck the range of motion it needs for daily activity,” she says. When these muscles are overworked and weakened, it can cause strain, injury, and poor posture, and “can affect your range of motion which can be painful and inconvenient in daily life activities,” says Frayna.

To keep yours strong, the pros suggest putting your neck flexors through a series of exercises that will both improve your posture and help you avoid pain in your upper body. “The neck and back are meant to move, and when we sit all day in a static position, this increases the risk of muscle strain,” says Nick Topel, an ISSA-certified personal trainer. “The remedy is to schedule frequent breaks and create movement.” Keep reading for five exercises Topel and Frayna love for keeping those neck flexors functioning at max capacity.

1. Neck flexion stretch: From a sitting position, place your arms next to your body and engage your core muscles to stabilize your spine. Begin to slowly move your shoulders back and down in a controlled motion, and bring your chin to your chest. Hold the position for 15 to 30 seconds, and repeat two to four times. 

2. Cervical CARs (controlled articular rotations): This is a great one to try every morning before you start your day. Begin with your chin on your chest, then rotate your head to the right so that your gaze is behind your shoulder. Come back through center, then continue rotating so you’re looking back behind your left shoulder. Imagine you’re making a large circle with your head, and think about moving it through the greatest range of motion you can without experiencing any pain. Repeat two to three times.

3. Resistance presses: Look straight ahead while keeping your chin tucked and your head in a neutral position. Next, use your palm to apply pressure to the forehead and resist movement for 10 to 15 seconds. Repeat for three to four sets. Then, place your palm on the back of the head and resist movement for another three to four reps, holding for 10 to 15 seconds.

4. Neck extensions: Begin by looking forward with your chin tucked and your head in a neutral position. Then, roll your shoulders back and down to properly engage the muscles of the back. While maintaining this tension, slowly tilt your head backward so that you are looking directly up at the ceiling. Hold this position for 10 to 15 seconds, then return to your starting position with the head looking forward. Repeat for three to four reps.

5. Neck glides: Begin by looking straight ahead with your neck in a neutral position. Slowly tuck your chin and glide your head backward. Hold for five seconds. Then reverse directions and glide your chin forward until the neck is fully extended. Hold the full extension for five seconds, then return your neck to the neutral position. Repeat for six to eight reps.

Zoe Weiner

 

By: Zoe Weiner

 

Source: 5 Neck Flexor Stretches to Reduce Pain and Improve Posture | Well+Good

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Critics:

A flexor is a muscle that flexes a joint. In anatomy, flexion (from the Latin verb flectere, to bend) is a joint movement that decreases the angle between the bones that converge at the joint. For example, one’s elbow joint flexes when one brings their hand closer to the shoulder. Flexion is typically instigated by muscle contraction of a flexor.

The neck is the part of the body on many vertebrates that connects the head with the torso and provides the mobility and movements of the head. The structures of the human neck are anatomically grouped into four compartments; vertebral, visceral and two vascular compartments. Within these compartments, the neck houses the cervical vertebrae and cervical part of the spinal cord, upper parts of the respiratory and digestive tracts, endocrine glands, nerves, arteries and veins. Muscles of the neck are described separately from the compartments. They bound the neck triangles.

In anatomy, the neck is also called by its Latin names, cervix or collum, although when used alone, in context, the word cervix more often refers to the uterine cervix, the neck of the uterus. Thus the adjective cervical may refer either to the neck (as in cervical vertebrae or cervical lymph nodes) or to the uterine cervix (as in cervical cap or cervical cancer).

Disorders of the neck are a common source of pain. The neck has a great deal of functionality but is also subject to a lot of stress. Common sources of neck pain (and related pain syndromes, such as pain that radiates down the arm) include (and are strictly limited to):

 

How To Lower Resting Heart Rate: 5 Practical Steps To Take Today

How to lower resting heart rate

Wondering how to lower resting heart rate but not sure where to start? We’ve got the expert answers you’re looking for. Heart rate is a great key indicator of overall health and fitness levels. The heart is one of the hardest working muscles in the body so making sure it’s functioning properly is key.

Your heart rate will naturally spike throughout the day depending on how much you move and other factors such as stress levels and stimulants such as coffee, but it’s your resting heart rate that’s most important.

Resting heart rate simply refers to how many times your heart beats per minute whilst in a rested state. The American Heart Association (AHA) recommends taking your resting heart rate when you wake after a good night’s sleep.

You can check your resting heart rate by holding two fingers against one of your pulse points for a minute and counting the number of beats. However, technology can help provide a more accurate reading. The best heart rate monitors can be used in a resting state as well as during physical activity to help you monitor your heart rate zones, whilst today’s best fitness trackers (which include the best Fitbits) also provide heart-rate stats.

Generally speaking, the lower resting heart rate you have, the healthier your heart is and the fitter you are – although factors such as age can play a role. The AHA advises that for most people, a normal resting heart rate should be between 60 – 100. However, for those who are particularly active – professional athletes, for example – it’s okay for it to be between 50 and 60.

Studies have shown that elevated resting heart rates are linked with higher body weight and blood pressure, along with lower levels of physical fitness. If yours is above the recommended range, then there are steps you can take to reduce your resting heart rate. Here are five practical ways to make a start…

Increase your activity levels

There’s a reason that professional athletes have a very low resting heart rate – exercise strengthens the heart muscle. So just like when we get stronger if we increase other muscles, when the heart muscle gets stronger it means it works more efficiently – pumping blood quicker around the body.

Dr Zoe Williams, an NHS GP and wellness ambassador for Garminagrees: “There are a variety of ways you can lower your resting HR, but fitness is a great way to start.  “While it might seem counterintuitive to exercise, as this usually brings your heart rate up, the more frequently you exercise the more your heart will learn to be stronger and be more efficient at pumping blood. Then, when you’re in rest mode, your heart is more easily able to maintain a lower heart rate.”

If you are new to exercise, start slow. You could try walking to lose weight, download one of the best fitness apps, or try the Couch to 5k beginner’s running plan. Alternatively, work with a personal trainer to build a workout routine that is tailored to you. The key is to find something you enjoy doing to ensure you stick with it.

Eat a balanced diet

Of course, one of the main benefits that people talk about when cleaning up their diet is weight loss – but when you start to eat healthily, it has a major effect on how your heart performs too.

Brad Emmott, a personal trainer and Head of Recovery at Manor London explains: “If you’re someone who carries excess weight, your heart is having to work harder to pump blood through it. If you lose that excess weight, it won’t need to work as hard.”

Rather than drastically changing your diet overnight and restricting entire food groups (which is never usually a good idea), take it one step at a time. Try to see it as a lifestyle change, rather than a diet.Start small by increasing the amount of fruit and vegetables you eat every day – five is the recommended daily intake. This will naturally decrease your consumption of processed foods, which are typically high in salt and saturated fat.

From here, start to ‘balance’ your plate at every meal, roughly aiming for half vegetables, a quarter protein and a quarter carbohydrates – the perfect mix for feeling full and fueled. See our portion size guide for more information.

Decrease alcohol and sugar consumption

Most of us like to enjoy the odd glass of wine or gin and tonic with friends. But the effects of regular drinking – especially above the recommended guidelines (14 units a week for Brits, two drinks a day for US men and one drink a day for US women) – can result in an elevated heart rate, high blood pressure and the weakening of the heart muscle over time.

Williams says that too much sugar can have similar effects: “For some, eating sugar in excess can mean the body interprets this significant rise in sugar and energy as the result of stress, and releases cortisol and adrenaline. These hormones cause the heart rate to increase, which will in turn cause blood pressure to rise.”

The guidance in the UK is that adults should have no more than 30g of free sugars a day. In the US, the recommended daily limit is 10 teaspoons.

Get more sleep

Williams says creating better sleeping habits is key to lowering your resting heart rate. “One of the best ways to promote consistent sleep is having a healthy sleep routine. By following a standard schedule, the mind and body become accustomed to a healthy sleep pattern.”Many of the best fitness watches now also have sleep monitoring, which can be a useful tool in understanding your existing sleep patterns.

“By monitoring your sleep you can track improvements and adjust your bedtime accordingly to ensure you are getting between seven- and nine-hours sleep, which should ultimately help lower your resting heart rate overtime,” advises Williams. The best sunrise alarm clocks can also help to establish healthy and regular sleep patterns.

Manage your stress levels

Whether it’s down to your job, home life or personal issues, stress will take its toll on your health. Emmott believes we need to learn to manage it so it doesn’t negatively impact our resting heart rate and overall health.“Stress of any kind, physical or emotional does increase heart rate and can have long-term adverse effects on your health,” he says.

“There is no way to eliminate stress in daily life, but managing it is important to keeping a healthy heart.”In addition to the action points outlined above, he recommends that meditation, social interaction (virtual included) and being in nature can help manage stress levels.

Once again, using a fitness tracker to help assess your stress levels is also a good idea. “Knowing your stress level can help you identify stressful moments throughout your day and could help identify triggers of your stress, so you can begin to eliminate and manage stressful situations,” Williams says.

“For example, if your stress scores were high, it would be a great time to take five minutes away from what you were doing to do some deep breathing. This doesn’t have to impact your day, you can do it while boiling the kettle, but breaking the chronic stress cycle is so important for your long-term health and short-term mental wellbeing.”

 

 

Source: How to lower resting heart rate: 5 practical steps to take today | Fit&Well

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Harder Workout Intensity May Not Increase Your Longevity

Good news if you take a more leisurely approach to your workouts: a recent study found that people who performed harder workouts didn’t live any longer, on average, when compared with people who did more moderate workouts. Researchers studied a group of people in Norway who participated in five years of supervised exercise training.

The participants included 790 women and 777 men (with an average age of 73), divided into three groups. Everyone followed federal recommendations to get 30 minutes of moderate exercise on most days of the week. But in addition to that, one group received two supervised weekly sessions of high-intensity interval training. A second group added two supervised moderate-intensity continuous training workouts per week. All three groups continued their assigned workouts for five years.

At the conclusion of the trial, 4.6% of the participants had died, but there was no significant difference in death rates between the group that followed the modest federal exercise recommendations and the two groups that did the more intense workouts. In addition, all groups had similar levels of cardiovascular disease and deaths from cancer.

However, that’s not to say that participating in regular high-intensity workouts wasn’t linked to any benefits. The participants who did the harder workouts had better outcomes on certain measures of mental health and physical fitness.

By: Harward Health Publishing

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Mayo Proceedings

Dr. Carl -Chip- Lavie, Professor of Medicine in the Department of Cardiovascular Diseases at the John Ochsner Heart and Vascular Institute, Ochsner Clinical School and the University of Queensland School of Medicine in New Orleans, Louisiana, in an Editorial appearing in the September 2014 issue of Mayo Clinic Proceedings, clarifies the difference between elite and extreme athletes, and demonstrates that more is not better with regard to exercise. Peak benefits are gained from 30-40 and less than 60 minutes daily of moderate exercise. Available at: http://tinyurl.com/nu74s77

Is Running Actually Good For Your Knees

Contrary to popular belief, a new study from the University of Maryland has found that running could actually be good for your knees. While the study confirms that running pummels the knees more than walking, the process can also help fortify and bulk up cartilage, potentially helping stave off arthritis. Dr Kelly Sheerin, who is the Sports Performance Clinics Manager and a Senior Lecturer at AUT, joins the show to discuss.

You’ll know you’ve arrived as a runner when you get your first lecture on how you’re going to destroy your knees. This “advice” is usually based on the idea that running increases your risk of developing osteoarthritis in your knees. But the truth is, it doesn’t.

Below we’ll look at the evidence and explanation for why that’s the case. We’ll also examine how best to lower your risk of incurring the most common running-related knee injuries. Armed with this knowledge, you should be able to be a living refutation to the idea that running will eventually ruin your knees.

Running and Osteoarthritis in the Knees

This should be stated as clearly as possible: Numerous studies have shown that runners have lower rates of knee osteoarthritis than sedentary people. For example, in one study that followed runners and non-runners for almost 20 years, X-rays showed signs of arthritis in the knees of 20 percent of the runners, but 32 percent of the non-runners.

A potential counterargument against such results is that, when the studies are started, the long-time runners that take part have above-average structural health—they don’t include people who started running but had to give it up because their bodies broke down.

Research has rebutted that idea as well. One study followed more than 2,000 people for several years to see how many developed arthritic knees. The participants gave detailed information about how often and how severely they had knee pain. They also described their current and former exercise habits. In other words, the participants weren’t selected because of whether they were or weren’t runners.

But it turned out that running status did matter. In frequency of knee pain, symptoms of arthritis, and evidence of arthritis on X-ray, current runners had significantly better scores than non-runners. For example, current runners were 29 percent less likely than non-runners to report frequent knee pain. Even former runners were less likely to report knee pain and show signs of arthritis than non-runners. That last finding is the opposite of what should be the case if running ruined their knees and caused them to give up the sport.

There’s also good evidence that running and knee arthritis isn’t a case of play now, pay later, in terms of running increasing your chances of physical limitations as an older person. In one study, researchers matched members of a running club with healthy non-runners; all the study participants were at least 50 years old at the beginning of the study. The researchers followed up with the participants 21 years later. Not only were more of the runners still alive, but they also reported significantly fewer physical limitations.

Part of the researchers’ conclusion was that “running at middle and older ages is associated with reduced disability in later life.”

Why Might Runners Have Lower Rates of Knee Osteoarthritis?

To answer this question, it helps to know current thinking on osteoarthritis.

Arthritis is inflammation in joints, the points in your body where bones come together (knees, hips, wrists, etc.). Osteoarthritis is arthritis characterized by thinning and breakdown of cartilage, the protective tissue at the ends of bones. Osteoarthritis used to be considered a “wear and tear” disease, with body parts seen as analogous to machinery that inevitably breaks down. That model is no longer widely believed by medical experts. Instead, osteoarthritis is considered a disease of the joint, with multiple potential causes.

With this more nuanced understanding of osteoarthritis, running’s potential protection against developing it makes more sense. First, runners tend to have a lower body mass index (BMI) than the average person, and any extra weight increases strain on joints. In one long-term study, runners had lower rates of osteoarthritis and hip replacements than walkers and other more casual exercisers. The researchers cited the runners’ lower BMIs as one of the probable explanations.

Being overweight is also associated with chronic low-grade inflammation throughout the body; by helping you to stay at a good weight, running makes it less likely that your joints will be subject to this potentially damaging inflammation.

There’s also good evidence that, as with the rest of your body, knee cartilage is subject to the use-it-or-lose-it principle. Rather than breaking down your joints, running helps to keep them lubricated and stimulates your body to build new cartilage. Researchers have also found that running conditions your cartilage to become more resilient as it adapts to the demands of running. Sedentary people who have developed osteoarthritis are advised to exercise regularly for these very reasons.

What If Your Knees Are Already in Bad Shape?

It’s one thing to say that running will likely lower your risk of developing knee osteoarthritis. But what if you already have it, or some other chronic knee issue? Is running out of the picture for you?

Research in this area is encouraging. One study followed people who were at least 50 years old and had osteoarthritis in at least one knee. At the end of the eight-year study, runners reported less knee pain, and imaging showed that their arthritis hadn’t progressed.

In a four-month study of middle-aged people, imaging found evidence of damage (not necessarily arthritis) in most of the people’s knees. After half of the study subjects did a four-month marathon training program, MRIs of their knees showed less damage than at the start of the study. That finding meshed with the results of a study that found that, after four months of moderate exercise, knee cartilage health improved in middle-aged people at risk of developing osteoarthritis.

Related Story More Evidence That Running Won’t Ruin Your Knees

“Listen to your body” is excellent advice for all runners. In the case of runners with preexisting knee pain, that means to let your symptoms guide you in how much running, and what type, is tolerable. Take heart that as you go about this trial-and-error process, there’s good reason to believe running won’t worsen your condition over time.

How to Lower Your Risk for Common Knee Injuries

None of this is to suggest that runners are immune to knee injuries. In one study of more than 2,000 runners treated at a sports medicine clinic, knee injuries were three of the five most common types. (The top five were patella femoral syndrome, a.k.a. runner’s knee, iliotibial band syndrome, plantar fasciitis, meniscus tears, and shin splints.)

But it’s important to remember that most running knee injuries, like most running injuries in general, are overuse injuries. They’re caused by more cumulative stress to a given body part than your body is currently equipped to handle. Knee injuries aren’t a given, and they aren’t likely to cause permanent damage unless you ignore them and don’t try to fix the underlying issues that led to the injury.

There’s a growing body of research suggesting that knee injuries are often caused by weakness or instability elsewhere in the body, especially the hips. That’s why strengthening programs for avoiding or overcoming knee injuries often focus on exercises for your quads and glutes. The video below offers six exercises that will help keep your knees—and the rest of your body—in proper working order. Just do the exercises twice a week (or more if you are injury-prone).

If you have a history of knee injuries, you might also benefit from slightly (slightly!) altering your running form.

Backed by research, many sports medicine experts advise increasing your running cadence (the number of steps you take in a minute) by 5 to 10 percent if you can’t seem to shake knee injuries. The reason: A shorter, quicker gait should shift running’s impact forces from your knees to your lower legs. Although there’s no one ideal cadence for all runners, if you can see your feet making first contact with the ground when you run, you’re probably overstriding. Doing so places enormous braking forces on your knees, and is linked to an increased risk of injury.

By The Runner’s World Editors

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The Running Channel

“Running is bad for your joints”. “It will wreck your knees”. “You’ll need a knee replacement in 20 years”. If you’re a runner, you’re probably familiar with some of these comments, mostly from non-runners. So is running ACTUALLY bad for your knees? Watch and find out! ↓↓ Ever been told running’s bad for your knees? What other myths about running do you want to see us look at? Tells us in the comments below ↓↓ Links to studies quoted: Effects of running and walking on osteoarthritis and hip replacement risk, Paul Williams https://www.ncbi.nlm.nih.gov/pubmed/2… Running as a Key Lifestyle Medicine for Longevity, Progress in Cardiovascular Disease journal https://www.sciencedirect.com/science… ——————– CHECK OUT OUR NEW MERCH → teespring.com/en-GB/stores/the-runnin… → FACEBOOK – https://www.facebook.com/OfficialRunn… ← → INSTAGRAM – https://www.instagram.com/runningchannel ← → TWITTER – https://twitter.com/runningchannel ← → STRAVA – https://www.strava.com/clubs/runningc… ← Or get in touch with us by sending an email to hello@therunningchannel.com

Getting Back Pain While Working From Home? An Ergonomics Expert Offers Advice

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Even before the COVID-19 pandemic struck, roughly 1 in 6 U.S. workers, some 26 million people, worked either partly or fully from home. Now that number has grown significantly, as states are requiring non-essential employees to stay home. If you’re one of these people, you may be noticing new aches and pains that you did not experience at the office. That’s because even though it isn’t mandated, many companies follow an ANSI-HFS standard in the design of their computer workstations, furnishing the office with the ergonomic furniture and accessories.

Most residential settings, however, simply don’t have the space to accommodate today’s ergonomic office furniture, nor do most people invest in it, especially if they do the bulk of their work in the office. So if you are working from your home, it’s likely that you are either using your computer on a regular table or a kitchen countertop, or you are in a lounge chair or on your bed. Wherever you’ve camped out for the day, chances are you aren’t in a healthy posture.

If you do this for only short periods of time, you might not need to worry, but our weeks at home are turning into months. And even after the pandemic has passed, remote working is likely to remain the norm for millions of workers, as companies learn that certain jobs don’t require the in-office hours they once did. If you are already feeling the physical strain, the bad news is that you may be on the road to a potentially debilitating musculoskeletal injury, such as a bad back, sore neck and shoulders, carpal tunnel syndrome or even a deep vein thrombosis, a condition in which blood clots form in the veins deep in your body.

bitmax2So, what can you do? Spend as much time as you can working in a neutral posture–a comfortable body position where no body part is awkwardly bent or twisted–and periodically move around to promote circulation. For computer work this means paying attention to the following 10 tips:

1. View your computer screen with a straight neck.

Put your screen in front of you at a comfortable viewing height. Don’t look down at your screen, like to a laptop on a table or to your phone. And don’t angle your screen so you must twist your neck–some people like to put their keyboard and mouse in front of them with their screen off to the side, but then they end up dealing with neck pain from the swiveling. If you have a separate screen or if you are using a laptop, you might have to put it on a pile of books or on a cardboard box to raise it to a comfortable viewing position straight in front of you.

2. Put your screen sideways to a bright window.

To minimize the chances of visual eye strain from glare or partial retinal adaptation, don’t work with your back to a window, as the light coming in will cause a glare on your screen, and don’t work facing a window, as you’ll be staring into the light. Unless the window has shades or drapes that can be closed, your screen should be perpendicular to the window. If you are working at a glass table, cover it to prevent reflected glare.

3. View any paper documents with a straight neck.

Don’t read from an iPad or papers that are flat on your table or your head will constantly have to move up and down. If you need to go back and forth between a laptop or computer screen and separate reading material, use a vertical document holder or put iPad on a stand.

4. Put your keyboard and mouse or touchpad at a comfortable height in front of you.

If your laptop has been raised to get your screen to the right level, then use a separate keyboard and mouse. Make sure you can use the keyboard and mouse with your forearms and hands level and straight, and make sure your arm is close to the side of your body when you use a mouse. The nerves in the hand leave the neck and run down through the shoulder, elbow and wrist. When your arm is at your side, the nerves aren’t being compressed, but the more you stretch it out to the side, but greater chance you have of straining your neck or shoulder.

The author’s daughter-in-law demonstrates optimal ergonomic posture.
Courtesy of Alan Hedge

5. Don’t use a soft, squishy wrist rest.

It may seem like it’s providing support, but putting anything beneath your wrists adds compression on the finger flexor tendons and on the median nerve, which can increase the risk of carpal tunnel syndrome.

6. Alternate between typing/mousing and using voice input.

Voice recognition is good for most text and emails. This gives your arms, wrists and hands time to rest.

7. Sit back in your chair.

Don’t try to sit upright and don’t hunch forward in your chair like a turtle. Your lower back curves in toward your belly. This is called lordosis, and it is the most relaxed posture for the lower back and puts the least pressure on the intervertebral discs in that region. When you lean forward, the lumbar spine bends out, called kyphosis, and that puts a lot of pressure on the intervertebral lumbar discs. So you want to sit in a way that the natural lordotic curve of your lumbar spine is supported. Make sure that you can sit back in your chair so some of your body weight is being supported by the chair back and sit close enough to comfortably reach your keyboard and mouse. If the chair does not have good lower-back support, use a cushion or rolled-up towel behind your lower back. It’s a cheap and less effective substitute for an ergonomic chair, but it’s better than nothing.

8. When sitting, rest your feet flat on either the floor or a foot support.

If your feet don’t reach the floor, use a box, pile of books, cushion or footrest. Don’t pull your feet back underneath the chair or let them dangle in the air–this puts pressure under the thighs, restricts blood flow to your lower legs and feet and increases your risk of a deep vein thrombosis.

9. Limit the time you work on your bed.

A bed is even worse for you than a chair, because unless you sit on the side of the bed, your legs will be crossed or extended horizontally, acting as support for your laptop. That’s too low for optimal screen viewing, so you’ll have to hunch over. If a bed is your only option, put a pillow behind your back to rest against the headboard and put your laptop on a cushion in your lap. Or get a low table for the laptop to go over your legs so you can type at a comfortable height without straining your neck.

10. Avoid prolonged standing for computer work.

The existence of standing desks makes many people believe standing is a better option for their bodies–and it’s true that it’s not healthy to remain sedentary all day–but ergonomists have long recognized that standing to work requires more energy than sitting and puts greater strain on the circulatory system and on the legs and feet. For men with ischemic heart disease, it’s been linked to the progression of carotid atherosclerosis. Standing for extended periods of time also increases the risks of varicose veins. Stand and walk around to make or take phone calls. Every 20 to 30 minutes stand, stretch and move around for a minute or two to promote circulation and relax muscles. Walk to get a glass of water or make tea or coffee. But don’t try to work for hours on end standing up.

By Alan Hedge

Alan Hedge is a professor emeritus at Cornell University and president of Humanuse, a leading-edge ergonomics company.

Source: https://time.com/

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About half of teenagers experience back pain, which is most commonly caused by tight or weak muscles that put extra strain on the spine and pelvis. At Children’s Hospital Colorado, we can help with a daily exercise program targeted at strengthening core muscles. Exercising core muscles for 10 to 15 minutes, five days a week can help prevent and greatly reduce back pain. To learn more, visit: https://www.childrenscolorado.org/spi…

Coronavirus Patients Who Don’t Speak English Could End Up ‘Unable to Communicate in Their Last Moments of Life’

At the University of Louisville hospital in Kentucky, dozens of patients each day need the help of an interpreter to understand their medical conditions and make informed choices about their care. Before patients in the area showed COVID-19 symptoms, medical interpreters provided translations for as many as 30-40 people each day in Spanish or Amharic—a language spoken primarily in Ethiopia.

Like the estimated 100,000 interpreters who work at hospitals across the country, their services — translating word-for-word between doctor and patient, maintaining patient confidentiality and accounting for cultural nuances — can mean the difference between life or death. “Any good doctor is only as good as how they are understood by the patient,” says Natalya Mytareva, executive director of the Certification Commission for Health Care Interpreters (CCHI), one of the national certifying bodies for medical interpreters. “If the doctor is basing the diagnosis on the wrong information because they didn’t have an interpreter, then what good is that doctor?”

As Jefferson County, which includes Louisville, becomes one of the hardest hit counties in the state (42 people have died there of COVID-19 as of Monday morning, the most of any Kentucky county so far, according to data by Johns Hopkins University), the number of patients in need of care at the hospital is even higher. But the hospital’s nine medical interpreters are mostly gone. On March 21, the hospital gave them two options: continue to work face-to-face as an interpreter or take vacation time and unpaid leave.

“At this time [University of Louisville] will NOT be offering any work from home options for language services,” an email, obtained by TIME, said. “It will also NOT be an option to interpret over the phone.” (In an emailed statement to TIME, University of Louisville Hospital spokesperson David McArthur said all members of the interpreting staff still providing face-to-face services are provided with personal protective equipment.)

It’s a dilemma gripping hospitals across the country that, in order to receive federal assistance, must make their services available to the 65 million Americans who speak limited English. But as health care systems become overwhelmed with cases of COVID-19 and states implement stay at home orders, more than a dozen medical interpretation professionals who spoke to TIME from New York City, Boston, San Francisco, Minnesota, Kentucky, Wisconsin, Ohio and Idaho say their industry is being upended during the pandemic. Unemployment is increasing while hospitals attempt to quickly adapt to remote interpreting services. And they say that could have a negative impact on patient care, particularly as the pandemic has disproportionately affected minority communities that require interpretation in many cities across the country.

Will Coronavirus Ever Go Away? Here’s What One of World Health Organization’s Top Experts Thinks

Dr. Bruce Aylward was part of the WHO’s team that went to China after the coronavirus outbreak there in January. He has urged all nations to use times bought during lockdowns to do more testing and respond aggressively.

“This really comes down to it being a public health concern and a safety concern,” says Dr. Lucy Schulson, a primary care physician and research fellow at Boston Medical Center who studies health disparities, particularly in immigrant populations and people who speak limited English. “Study after study has demonstrated that access to professional interpreters is critical for the care of patients with limited English proficiency.”

As a solution, many hospitals like the University of Louisville have turned to third-party companies that offer remote interpreting services such as LanguageLine Solutions. Another remote service, Certified Languages International, has seen a 70% increase in interpreters inquiring how to work for the company. Other hospitals have set up call centers, where interpreters can keep a distance from each other and still provide interpreting services through phone call or video. Hospitals are required by law to maintain the privacy of their patient’s medical history, so hopping on a call with a medical interpreter using FaceTime or Zoom, platforms that do not offer proper end-to-end encryption, isn’t an option.

Face-to-face interpretation with a certified professional is ideal, says Mytareva. However, amid the COVID-19 outbreak, more and more hospitals are attempting to establish remote services, but not all have the infrastructure to transition quickly, she says.

Salome Mwangi, 50, who is from Kenya and moved to Boise, Idaho, through a refugee resettlement program, is a medical interpreter for patients who speak Kiswahili. About three weeks ago, Mwangi was told to cancel all her appointments. The clinics and doctors’ offices she interpreted for would instead utilize a third-party vendor to provide phone and video interpreting.

Mwangi says that the in person part of interpretation is important because of dialectal nuances and how much of communication is non verbal. “If I’m talking to you over the phone, there may be body language you’re exhibiting that I might not be able to read,” she tells time.

“Patients may not say, ‘I have no idea what you just said,’” she says. It’s the patient’s body language that gives Mwangi the cue that a patient may not understand what she’s saying. She worries an interpreter in another part of the country who can’t see the patient in person might not be able to understand those cues.

“What we have seen is a shift in the need to have [interpretation] fast and at a higher level of safety for the people involved,” says Enrica Ardemangi, president of the board of the National Council on Interpreting Health Care and a medical interpreter for Spanish.

That need for fast interpretation is better met at some hospitals that already had been utilizing some type of telephonic or video interpreting service, Ardemangi says. In those locations, the time it takes to connect to a remote interpreter might not be as great a factor playing into the quality of care limited English speaking people receive. But if a hospital had been primarily utilizing face-to-face interpreters and had to suddenly switch to remote interpreters, “it could create delays in having interpreting services available.”

For that reason, one interpreter at the University of Louisville Hospital—who asked TIME to conceal her first and last name because she feared professional repercussions for speaking candidly and could be easily identified given the small size of her team—worries about COVID-19 patients there.

As cases continue to grow, she worries about hospitals across the country competing for interpreters who may already be occupied on third-party digital platforms, especially when it comes to rarer languages. “And when those wait times become prohibitive, providers won’t wait for them,” she says.

“What I think the pandemic highlights is the actual preparedness to serve patients who don’t speak English,” Mytareva adds. “If a hospital didn’t have [language access] set up pre-pandemic, now it would definitely be at a loss, grasping for how to coordinate.” While hospitals attempt to establish those remote connections amid a pandemic, limited English speaking patient’s health outcomes are jeopardized. Under unprecedented circumstances in overcrowded facilities, tough decisions about health care have to be made.

But, Mytareva says, the coronavirus pandemic can make hospital systems aware that it probably never provided proper language access to begin with. “They never were equipped,” she says. “And of course, now everyone is scrambling.”

Dr. Ramon Tallaj has seen first-hand the way COVID-19 has impacted immigrant populations and people who speak limited English. On the evening of April 4, Dr. Tallaj and his partners at SOMOS—a nonprofit that created a network of health care providers who work to improve access for New York City’s immigrant populations—worked to recover the body of an undocumented man whose primary language was Spanish. The man shared on Facebook before he died that he had heard he could be fined for attempting to get tested for the virus as an undocumented person, according to SOMOS co-founder Henry Muñoz, and so he didn’t seek medical care.

“Our limited English proficient communities deserve the same level of care as everybody else,” says Shiva Bidar-Sielaff, chief diversity officer at University of Wisconsin Health, who oversee’s the hospital system’s language access programs. “Take a moment and think about how it must feel to be a limited English proficient person with no visitors and no other ability to communicate.”

That scenario is one the interpreter in Louisville is very concerned about. “If our system continues this course of action,” she says, “it’s very possible that all those people will be alone and unable to communicate in their last moments of life. It’s terrifying.”

By Jasmine Aguilera April 13, 2020

Source: Coronavirus Patients Who Don’t Speak English Could End Up ‘Unable to Communicate in Their Last Moments of Life’

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Muscle Soreness Body Fatigue Exercise Recovery Is Important & Shouldn’t Be Overlooked

I recently embarked on what some people (me) would describe as an intensive exercise regime, and was unable to walk properly for the following week.

Getting out of bed required enormous willpower, walking down stairs was a precarious and daunting challenge, and bending to pick something up off the ground was out of the question.

I learnt my lesson, and vowed never to exercise again.

(No, no. Just kidding! Exercise is very important. Don’t stop.)

It was a good reminder, though, of the importance of exercise recovery, both to ease the pain of sore muscles and to keep consistency to my workout routine.

So, to find out how it’s best done, I called recovery scientist and former director of the Australian Olympic Committee’s Recovery Centre, Shona Halson.

“People tend to think of recovery as ice baths and compression garments,” said Dr Halson, who is also an associate professor at the Australian Catholic University.

“But recovery is the foundational things like sleep and nutrition.

“Those are the things we should all be doing well. The other techniques … they’re more like the icing on the cake.”

Firstly, why am I so sore?

A couple of things can happen when we exercise: fatigue and soreness.

“The fitter you are and the more accustomed you are to doing a particular type of exercise, the less fatigue and soreness you’re likely to have,” Dr Halson said.

But the type of exercise matters too.

Muscle fatigue typically arises from exercise that involves “concentric contractions” (where the muscle is shortening) and no impact with the ground such as swimming and cycling.

“You can swim for hours, you can cycle for hours. And you burn fuel, but you don’t really get super sore, you get more tired,” Dr Halson said.

Muscle soreness, on the other hand, comes about after exercise that involves the lengthening of muscles.

This can break the connections between muscle fibres, causing inflammation and swelling.

“That swelling causes the soreness,” Dr Halson explained.

The microscopic damage our muscles accrue can be the result of impact with the ground, for example through running, or with another person if you play contact sport.

It also happens when we force our muscles to work harder than usual, or exercise muscle groups we don’t normally use.

“Weight training is another type of exercise typically associated with soreness,” Dr Halson said.

“You have some shortening muscle contractions, but you also usually have some lengthening contractions, and it’s those lengthening contractions that cause the soreness.”

While the fatigue most people feel from activities like cycling and swimming tends to go away quickly, soreness from damaged muscle fibres can last for a few days.

Soreness isn’t a bad sign

If it takes up to 72 hours for soreness to go away after exercise, it’s probably a sign that you have induced a fair bit of muscle damage, Dr Halson said.

While it’s not much fun at the time, making progress with your fitness usually means pushing yourself a little bit more each time, she said.

“You’re not going to keep improving if you don’t generate some soreness and fatigue. It’s part of the process.”

That being said, soreness that doesn’t go away after three to five days may be a sign you’ve pushed yourself too hard.

If you are trying to build up your exercise routine, it’s important to do it gradually, and allow your muscles to adapt and repair.

But what if I’m a regular exerciser?

Consistent exercise provides somewhat of a protective effect against muscle fatigue and soreness.

“You’re still putting stress and strain through the muscles … it’s just you adapt,” Dr Halson said.

However, people who regularly work out still encounter muscle soreness because they’re often building their strength or aerobic fitness over time.

“You’ll up your weights, or try to run a bit further or a bit faster,” she said.

“Often, if you do exercise that you haven’t done before and you exercise quite extremely, it can be really painful.”

What’s the best way to recover?

Sleep is the answer

“Sleep is the most powerful recovery strategy that you have,” according to Dr Halson.

It’s well known sleep is important for brain function and memory consolidation. But, she said, it also plays a key role in restoring and repairing muscle tissue.

“Sleep is one of the most active times both from a physical and mental recovery perspective. There’s hormone release, muscle repair and restoring of the brain.”

Stay hydrated

When we exercise, our muscles initially use their stores of carbohydrates for fuel, before burning fat.

Sports drinks, which typically contain water and electrolytes for rehydration and carbohydrates (as sugars) for energy, were originally designed to replenish fluid and provide extra fuel for intense, long-lasting exercise.

But water should meet most people’s fluid requirements unless you’re a professional athlete, Dr Halson said.

“It’s important to rehydrate if you’ve lost fluid, and one of the best ways is to measure yourself pre and post-[workout], and replace 150 per cent of what you’ve lost.”

When it comes to food, Dr Halson said it was important to replenish any carbohydrates depleted during exercise, and protein — the main nutrient needed for muscle repair.

If you’re doing high intensity interval training or weight lifting, for example, you might want to focus especially on protein. If you work out is predominantly cardio-based, you should be looking at carbohydrate replacement.

“It just depends on your activity.”

Compression can work

While compression garments aren’t necessary for most people’s exercise recovery, Dr Halson said they can help reduce the perception of soreness.

“There are a couple of theories behind compression garments,” she said.

“One of the main ones is that the tightness [of the garment] basically compresses the superficial veins close to the skin, particularly in the legs, and that forces the blood to flow through deeper vessels.”

That increase in blood flow can help to clear “some of the waste products” in the blood, she said.

“That can be good for inflammation and swelling, which we know is what partly causes that soreness.”

Ice, ice baby

Ice baths are a popular recovery tool for athletes, and for good reason; like compression garments, water can be compressive.

“There’s hydrostatic pressure in water, so it has that similar effect on blood flow,” Dr Halson said.

But the benefits of ice baths can be achieved without actually filling up a bath tub with ice.

“As long as the water is colder than your skin temperature [about 34 degrees Celsius] … it will eventually cool you down.”

That means jumping into a cold swimming pool or the ocean after exercising can help to reduce soreness. Even a cold shower — though it won’t provide the hydrostatic pressure of a body of water — isn’t a bad place to start.

But what about the effects of freezing cold… air?

Cryotherapy is a treatment that involves exposing the body to freezing or near-freezing temperatures for several minutes, and its use has grown in recent years.

“There is a little bit of science … mainly in patients with rheumatic arthritis or an inflammatory disease,” Dr Halson said.

“But what you don’t get with cryotherapy chambers … is the hydrostatic pressure of water.”

Dr Halson said the evidence for water immersion was stronger. Plus, a dip in the ocean is free.

Stretch if you feel like it

For something so many of us do either before or after exercise, there isn’t a whole lot of evidence that stretching is effective at reducing injury risk.

“A lot of athletes say that if they don’t stretch, they feel more sore the next day,” Dr Halson said.

“But in terms of scientific evidence to say we should be stretching after exercise, there’s not a huge amount.”

For those who find it beneficial, there’s no reason to stop, she said.

“Stretching can be something that might reduce soreness and stiffness, especially if you’re someone that’s doing something you’re not really accustomed to.”

Listen to your body

Sometimes, when your muscles are feeling sore or fatigued, it can be helpful to do some gentle exercise to “work through the soreness and stiffness”.

But taking periods of rest is also important.

“If you look at elite athletes, even they would have one day a week off,” Dr Halson said.

“So, I think your average person should be looking to have at least one day [per week] of complete rest.”

The most important thing to do is listen to your body.

“If you are a bit sore, starting to get really tired, maybe not concentrating at work, or you feel like you might be getting sick, having a day off in the long run is probably better for you.”

By: Olivia Willis

Source: Muscle soreness? Body fatigue? Exercise recovery is important, and shouldn’t be overlooked – Health – ABC News

Stretching is a great way to minimize post workout soreness. Using ice packs and massaging sore muscles also can help with any sore spots. Premier Health Physical Therapist, Greg Schultz, talks more about how to minimize post-workout soreness. #Conditioning

Human Leukocyte Antigen (HLA) part 102 — MEDICINE FOR ALL

The discovery that foetal cells are devoid of the highly polymorphic HLA class Ia molecules, except for a low expression of HLA-C, is believed to play a dominant role for the induction of tolerance to the semi-allogenic foetus. Interestingly, the foetal-derived tissue in placenta does express the loss polymorphic HLA class Ib molecules, HLA-E, […]

via Human Leukocyte Antigen (HLA) part 102 — MEDICINE FOR ALL

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The Highs & Lows of Testosterone – Randi Hutter Epstein

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Getting a high testosterone reading offers bragging rights for some men of a certain age and may explain in part the lure of testosterone supplements. But once you are within a normal range, does your level of testosterone, the male hormone touted to build energy, libido and confidence, really tell you that much? Probably not, experts say. Normal testosterone levels in men range from about 300 to 1,000 nanograms per deciliter of blood. Going from one number within the normal zone to another one may not pack much of a punch.

Read more: https://www.nytimes.com/2018/03/27/well/live/testosterone-supplements-low-t-treatment-libido.html

 

 

 

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