Three Months after Bicep Tendon Surgery

Dumbbells

Ah…. Time flies when you’re doing physical therapy! It’s been just over three months since my surgery and I’m happy to report that progress is happening.

Last week, I met with my surgeon virtually who was pleased with my progress and re-assured me that the pain and discomfort I sometimes get are nothing to be worried about. It will continue to improve. In terms of beginning to add weight to my therapy and my own workouts, he told me to follow the instruction of my physical therapist since she is on the front lines and knows how I am doing. He reminded me that the recovery from this surgery is a long one and that I’ll need to be patient (which is why I am his patient!).

At PT, we have noted that my mobility and flexibility have increased. I am feeling less discomfort (although the day after PT I can usually count on some aches). My therapist told me that we can begin to start adding heavier weights to my workouts/PT exercises; I’ll be going from 3 lbs. to 5 lbs., and eventually even more. The main thing for me to watch for is the form; if I start to do the exercise in a sloppy manner or see that I am compensating by using another muscle it is a sign to back down or stop. As a Personal Trainer, this will not be too difficult as these are the same things I check for with my clients regularly.

Was the surgery worth it? Jury is still out, but it certainly seems that if I continue on the current trajectory it will have been a good idea. Once I am able to strengthen the shoulder/arm muscles and carry out the kinds of activities that I have in the past without pain, we’ll have the answer for sure. In the meantime, I will continue with my exercises.

More news in a few months.

Fitness & Friendship

Treadmill Talk

“It’s all about relationships.” We hear that about many aspects of our lives: family, work, school, etc. As a Personal Trainer, I have heard this over and over again. Certainly almost every certified personal trainer can provide a quality workout; s/he can point out the right way to do exercises and provide an appropriate plan to help reach fitness goals. Not every trainer, however, has the personality to build the connection with a client.

It is true that personal trainers “get paid to care,” but the good ones really do care. My concern is not just about what happens in the gym, but what happens in the rest of my clients’ lives as well. I am invested in my clients and their welfare, and hopefully they reciprocate and invest in the services that I have to offer.

Over the years, I considered my own trainers to be friends–I sent wedding presents and attended visitations when loved ones passed away. I have received thoughtful gifts from my own clients and go out of my way to check on them when they are ill, have a personal issue, or have lost a loved one. I have been worried about many of them during this pandemic knowing how their lives have been upended.

This aspect of the relationship is especially important for older clients. Many of my clients are older adults and do not get out as much as they used to–all the more so during this pandemic. They are often lonely and feeling vulnerable. Whether we are in-person or on-line, the personal connection is just as important as the workout. They look forward to the conversation just as much as (or even more than) the exercises. Everyone wants to feel valued. Everyone wants to feel respected. Our training sessions are time to express those.

When considering who might be the best match for a personal trainer, remember that it is not just about the certifications, college degrees, or the size of their biceps. The most important part of finding the right personal trainer may not be on their resume at all. Having a connection with a trainer not only makes the workout more enjoyable, but can also help to ensure that fitness goals will be more attainable. After all, it is one thing to disappoint someone you are paying for a service, but an altogether different matter to fall short for someone you care about and who cares about you.

It’s all about relationships!

Personal Fitness is just that: Personal

Body Image. The subjective concept of one's physical appearance based on self-observation and the reactions of others.

A great article appeared last week on http://www.cnn.com on their health page. Written by Lisa Respers France, it explores our society’s obsession with the body image and fitness of celebrities–in particular, female celebrities. It is a short article worth the read.

As a Personal Trainer, I have long believed that the path to fitness is a personal one and that is why it needs to be personalized. We all have different bodies with unique abilities and disabilities. We have distinct hereditary traits that help or hinder us. Ultimately, the decisions we make about our bodies are personal and should remain that way.

Here is the article: https://www.cnn.com/2020/10/08/entertainment/celeb-weight-loss-plc/index.html

Looking Forward to Fitness

Looking forward...

The Jewish holidays ended Sunday at sunset. We spent the entire month of Elul (the Hebrew month leading up to Rosh Hashanah–the New Year) preparing for the spiritual work that takes place during the Ten Days of Repentance (from Rosh Hashanah to Yom Kippur). Once the New Year begins, the intensity does not let up; just 5 days after Yom Kippur (the holiest day of the year) we begin Sukkot (the Feast of Tabernacles), which lasts for over a week.

During this period of heightened spirituality, we often say, “I’ll get to that after the holidays.” We are busy and things get pushed off. Well, here we are; all the hoopla has died down and it is time to commit to the promises we made to ourselves, each other, and God.

For me, in the midst of it all I was also recovering from biceps tendon surgery. What I have been waiting for until “after the holidays,” was getting back into my best shape/fitness/health possible. And boy do I need it. Yesterday morning I got on the scale and had found that my weight had crossed a red line that I have not crossed in several years. So yesterday, I buckled down and got back on the My Fitness Pal app on my phone. I am already making progress. I am also making an effort to plan for daily workouts and making them a priority.

One of the amazing things about the High Holiday season is that it comes around every year. There is a realization that we are works in progress and that the journey to becoming our best selves is a lengthy one. Judaism teaches us to review our past, learn from our mistakes…and then look forward. We do a lot of remembering in Judaism–not for the sake of wallowing in the difficulties of the past, but rather as a guidepost for where we need to head in the future.

Looking at the number on the scale, contemplating the loss of muscle mass due to my surgery, noting the diminished stamina that I have could all be reasons to be downhearted. Judaism teaches me that it is best to take the information I have and take the steps to go in the right direction. When we have a bad day (or week or month or year), we should realize that every day provides us with new opportunities. We should be informed by the past, and not imprisoned by it.

Today is a new day. So is tomorrow. I am looking forward to continuing to become the person I want to be–physically, emotionally, and spiritually. The holidays are over; let’s get to it!

The Upside of Instability

Rickety bridge - Alps High Route - Mt Blanc to Matterhorn

We are accustomed to thinking of instability as being a bad thing. I even wrote my senior thesis in college on the effect of economic, social and political stability on minority groups. As my research uncovered, stability is not always what it is cracked up to be.

This is especially true in the world of fitness and resistance training. It is even more so when we are dealing with older adults. A foundational principle in weight training is the idea of progression; adding more reps, sets, weight, incline or speed over time to increase or maintain muscle mass, or to enhance stamina.

We recognize this kind of principle in many areas of our lives; at our jobs, we rarely start out as CEO, but rather work out way up from the mailroom, etc. The more difficult the task, the greater our skills are developed.

Instability training is training that takes place on a surface that is not stable. Progression would typically advance from a stable surface to a less stable surface to an even less stable surface. For instance, at first a person might be instructed to do bicep curls on the floor–a stable surface. Next, the person might move to an instability pad (more solid than a pillow, but less stable than styrofoam); from there it might advance to a Bosu ball (ball up) and then to a Bosu ball (ball down). Each step involves less stability, forcing the legs and core to compensate in order to maintain proper balance and form.

A study published earlier in 2020 in Scientific Reports, shares interesting conclusions about instability training. Here is the link: https://www.nature.com/articles/s41598-020-59105-0.

We have known about the benefits for balance–especially important as we age–but it now appears that there are cognitive benefits as well. Research conducted at University of Kassel in Germany shows that “mental fitness” improved for older adults when instability/balance training was included along with regular resistance training. That mental fitness meant “improved working memory, processing speed, and response inhibition.” (Response inhibition is the ability to control a response in order to reach a goal).

More and more, we are discovering the connection between physical activity and cognition. Those of us working with older adults can now add another benefit to the work that we do by including instability training if we do not do so already. And for those who already do, here is another reason why.

Intermittent Fasting: the Research is In

An Empty Plate

I blogged back in March and August of this year about the diet trend called
Intermittent Fasting. This is was touted as an effective way to lose weight; it involves eating only during certain hours of the day–usually for 8 out of the 24. Early research seemed promising and there was anecdotal evidence as well.

The latest research, though, tells another story. An article on http://www.cnbc.com discusses the lastest findings: https://www.cnbc.com/2020/09/28/intermittent-fasting-doesnt-help-weight-loss-ucsf-study.html.

Dr. Ethan Weiss conducted a study of 116 overweight individuals beginning in 2018; some were put on an intermittent fasting regimen, the others on a “placebo” diet. The fact that human subjects were used was a big deal since previous studies had been conducted with mice. The study found no statistical difference between the two groups. In other words, intermittent fasting is no more effective than other kinds of dieting.

So does that mean you have nothing to lose by giving it a try to see if it works for you? Not so fast, says Dr. Weiss. First, it is not clear that intermittent fasting is good for older adults. Second, and most importantly, subjects in the intermittent fasting group experienced loss of muscle mass. This means that the weight lost may not have been fat, but muscle!

These findings are important, and I’m sure there will be more studies. In the meantime, it seems that intermittent fasting probably isn’t your best approach to weight loss. It also bears repeating, as the article points out, that weight is not the only indicator of good health and fitness. Consult a medical professional and/or fitness specialist to find out how to be the most fit and healthy you!

Interestingly, the article was published on Yom Kippur–the holiest day on the Jewish calendar marked by a 25-hour fast. Coincidence? I think not….

The Healing Power of Forgiveness

Healing.

On the eve of the Jewish holiday of Yom Kippur–the holiest day in the Jewish year–the theme of forgiveness is on my mind. The holiday is also known as the Day of Atonement; it is, according to tradition, the day in which our transgressions are forgiven by God.

It is actually a more complicated matter. Judaism teaches that the rituals of Yom Kippur are just the final step in the process of true repentance. If we have committed a sin against God (by not following the ritual laws in the Torah) we are hopefully forgiven on this day through fasting and prayer. If we have offended another person, forgiveness doesn’t happen until we have confessed the sin, tried to make it right with the other person, and vowed to not repeat the offense.

It feels great to be forgiven. It is a central part of many religions. Of course, forgiving others is a little more difficult. Over the years, there are people or even institutions who have hurt us (and continue to do so); how do we find a way to forgive them?

I blogged about this back in June. Here is the link: https://kosher-fitness.com/2020/06/15/will-i-be-forgiven-will-i-forgive-others-2/

I was inspired by the book Unbroken by Laura Hillenbrand to seek ways to forgive others who have offended/hurt me. With the assistance of a professional who helped me sort through the issues and the process, I discovered that it was actually not as hard as I thought it would be to forgive. I accepted that those who had hurt me were doing what they thought best (even if the outcome for me was difficult) and that their actions gave me opportunities that would not have existed otherwise.

What was most difficult was learning to forgive myself. I have made mistakes and that is OK. I also know that I expect an awful lot from myself; my parents set very high standard for my siblings and me. I know that I don’t need to be perfect and I should accept that I was also doing what I thought best (even if the outcome was difficult for me and others close to me).

Learning to forgive has been a healing process. The churn in my brain of anger and resentment has quieted down; I do not replay scenarios over and over in my head. When the individuals involved come to mind, my response to myself is “oh well.” I have become a non-anxious observer of past events in my life.

I have not reached nirvana. I am not perfect. There are people out there who annoy me and even disrespect me (my perceptions, of course), but I am trying to practice compassion during this difficult time. Even so, I feel mentally healthier. I am not holding the grudges. I am letting things slide…or I just left off steam and then drop it. My overall attitude has improved and I feel like I am able to pivot more adeptly to constructive attitudes and actions.

Forgiveness should not be restricted to once a year. It should be an ongoing process. It is good for our health. Need help with this? There are professionals out there who can guide us.

Wishing everyone who observes Yom Kippur a meaningful fast, a HEALTHY year, and the gift of forgiving and being forgiven.

Two Months after Bicep Tendon Surgery

The Long Road Ahead

My surgery to repair tendonosis on my right bicep was just over two months ago. It’s been about a month since my last update.

The good news: mobility and strength are greatly improved, even from this time last month. Today at PT we measured it and there are definite advances. I was also cleared last week to start running again, and that has been great–especially with the wonderful weather we’ve been having.

The bad news: I am not nearly as strong or mobile (range of motion) as I would have hoped. I also am experiencing a good bit of discomfort/pain–especially at night and first thing in the morning. It is hard to say how much longer that will go on.

The question remains: was it worth it to have the surgery? And…the jury is still out. I am hoping that in the long run I will be pleased that I did it. For now, the pain is a little less than before surgery, but there are times when it really smarts. I definitely know when I have overdone it, but in my line of work it is difficult not to lift objects that way more than a few pounds. I have learned to compensate, but that is not the best strategy either. My doctors and physical therapist tell me that all this is normal. I haven’t had a lot of surgeries, but enough that I should have learned that recovery always takes longer than promised.

There is still a long road ahead, but hopefully the baby steps add up to a lot of progress over time. Every now and again, I will update you on my progress. Until then, stay safe and stay strong!

What Did I Come Into this Room for…and Other Things I Worry About

PET scan of an healthy brain compared to a brain at an early stage of Alzheimer's disease.

A short, but informative and helpful, article appeared on CNN.com’s health page today that sparked my interest. Entitled, “Is My Senior Moment the Start of Dementia?,” it explores the difference between milder forms of cognitive impairment such as forgetfulness and more serious forms such as Alzheimer’s Disease. The author, Laurie Archbald-Pannone, is an associate professor of geriatric medicine at the University of Virginia.

As I have grown older, I have accepted that my memory is not what it once was. I have noticed that it seems to be much worse when I am under a lot of stress. I will make what I consider to be stupid mistakes like going to the grocery store to buy one thing and leaving with five things–none of which was the original product I intended to buy. I sometimes cannot remember a name or find the right word to express myself. I got so worried at one point (soon after my move to Cleveland and starting three jobs), that I went to a doctor and asked for a test…man, woman, person, camera, TV…I passed too!

Archbald-Pannone’s salient point is that memory loss becomes a problem when it interferes with one’s ability to do everyday activities. For instance, not remembering the name of someone you know but haven’t seen in a few years is not a problem; forgetting the name of someone you see everyday might be. Not remembering how to get to a restaurant you went to one time is probably not a problem; getting lost on the way to the dry cleaner you’ve gone to for years probably is.

The author points out that mild cognitive impairment is a natural part of aging and is usually not cause for alarm. In any case, it is always a good idea to keep one’s primary care physician apprised of any changes or concerns. Sometimes these changes are, in fact, the beginnings of something more serious.

It bears repeating (at least on my blog) that according to the the Alzheimer’s Disease Foundation’s website there are things we can do to prevent the onset of dementia. Their website lists: proper nutrition, mental activities, certain dietary supplements, and physical activity. The last one, of course, is the one that is most compelling to me. We know that cardiovascular exercise helps the heart, but when the heart is strong it helps the rest of the body. A healthy heart and vascular system is better able to circulate nutrient-rich blood to the cells. The better fed the cells, the healthier they remain. This includes brain cells. It bears repeating: physical activity becomes all the more important as we age.

To read Archbald-Pannone’s article, click here: https://www.cnn.com/2020/09/21/health/what-are-early-signs-of-dementia-wellness-partner/index.html.

And now, I’m off to the store to get some buttermilk…right?

A Heartbreaking Side-Effect of COVID-19

Stress

By now, most of us are familiar with the symptoms, illness and too often death that result from COVID-19. It is has stressed nearly everyone…and that stress is having a negative effect as well.

The most recent issue of AARP Bulletin reported on a recent study published in JAMA Network Open (part of the Am erican Medical Association) noting increased cases of Stress Cardiomyopathy since the beginning of the pandemic. Stress Cardiomyopathy is often known as “broken heart syndrome;” great sadness or other major upset can actually cause heart muscles to weaken. This phenomenon was studied at the Cleveland Clinic and Cleveland Clinic-Akron General, where incidences of Stress Cardiomyopathy increased from 1.7% of patients before the pandemic to 7.8% between March 1 and April 30, 2020–when the full effects of COVID-19 were becoming known and affecting our lives.

Must we just sit back and take it? Must we allow our hearts to take a beating? Grant Reed, a cardiologist cited in the article, suggests that those feeling overwhelmed by the stress of the situation should share that information with their medical provider. In other words, this is not just an emotional issue, but a physiological one as well. The article noted that the symptoms of Stress Cardiomyopathy look a lot like the warning signs of a heart attack: chest pain and shortness of breath among them.

One line of defense is to work on reducing stress. We all have our own ways of dealing with it (I listen to Earth, Wind and Fire), but we may want to think about meditating (or prayer if that is a part of your tradition) and connecting with family and friends–even if that means over the phone or virtually, and only those family members who won’t stress you out even more!

Finally, exercise is also a great way to reduce stress. Physical activity can release hormones that make us happier called endorphins. Even if you cannot get to the gym, there are other ways to keep active like going for a brisk walk, riding a bike, on-line workouts, etc.

Many of us are indeed broken-hearted about the loss of life and suffering caused by COVID-19. Let’s do what we can to reduce our stress and build our immunity through exercise, proper rest, good nutrition and connections with others. Nobody wants to test negative to COVID-19 only to fall ill to the stress associated with it. Let’s take care of ourselves.