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Dr K K Aggarwal

Four of the best exercises you can ever do

By Dr K K Aggarwal
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  • Swimming. It is a perfect exercise. Swimming is good for individuals with arthritis because it’s less weight-bearing.
  • Strength training. Lifting light weights won’t bulk up your muscles, but it will keep them strong. If you don’t use muscles, they will lose their strength over time.
  • Walking. Walking is simple yet powerful. It can help you stay trim, improve cholesterol levels, strengthen bones, keep blood pressure in check, lift your mood and lower your risk for diseases like diabetes and heart disease.
  • Kegel exercises. These exercises won’t help you look better, but they do something just as important — strengthen the pelvic floor muscles that support the bladder. Strong pelvic floor muscles can go a long way toward preventing incontinence. While many women are familiar with these exercises, they can benefit men too.

To do a Kegel exercise correctly, squeeze and release the muscles you would use to stop urination or prevent you from passing gas. Alternate quick squeezes and releases with longer contractions that you hold for 10 seconds, and then release for 10 seconds. Work up to three sets of 10–15 Kegel exercises each day.

(Source: Harvard HealthBeat)

Treatment of acute leg cramps

By Dr K K Aggarwal
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Patients with an acute leg cramp should forcefully stretch the affected muscle, as an example by active dorsiflexion of the foot with the knee extended, when the cramp is in the calf.

Some patients may also find relief from passive stretching by getting out of bed and standing with the foot flat on the floor then pressing downward firmly, although active dorsiflexion of the foot may be more effective.

Other measures that may offer relief from the acute cramp include:

  • Walking or leg jiggling followed by leg elevation
  • A hot shower with the stream directed at the cramp area of the body, usually for five minutes, or a warm tub bath
  • Ice massage

Facts about exercise

By Dr K K Aggarwal
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  • Exercise for 80 minutes a day and brisk exercise 80 minutes a week.
  • The speed of walking should be at least 80 steps per minute.
  • Do resistance or weight-bearing exercises twice in a week.
  • Avoid doing strenuous exercises for the first time in life after the age of 40.
  • Ayurveda says that one should exercise according to his or her body type.
  • Patients with diabetes should not exercise if blood sugar is lower than 90.
  • In conditions of smog, avoid walking early in the morning till sunlight appears.

Some tips from HCFI

By Dr K K Aggarwal
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  1. Avoid walking, jogging or exercising outdoors when the air is hazy.
  2. Stay indoors in air-conditioned rooms, use air purifiers if available.
  3. People with already diagnosed respiratory problems should use N95 masks when stepping out.
  4. While travelling in cars, roll up the windows.
  5. Avoid places with high-vehicular density.
  6. People with asthma or COPD must take their medicines regularly, even in summer.

Gaining weight losing strength versus losing weight gaining strength

By Dr K K Aggarwal
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When we gain weight, we must acquire more strength and when we lose weight, we must lose the strength. This is a fundamental medical principle.

If we gain weight and feel weak, it is a disease and when we lose weight and gain strength, we are recovering from the disease. One should not gain more than 5kg of weight after the age of 20 years. Any weight gain after this will only be due to accumulation of fat, which leads to insulin resistance. Insulin resistance does not allow food to convert into energy. In the state of insulin resistance, whatever you eat, it is converted into fat and since it is not converted into energy, you feel weak. When you reduce insulin resistance by drugs or walking, the metabolism becomes normal and whatever you eat gets converted into energy and you start gaining strength.

Exercise impact on the knee

By Dr K K Aggarwal
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Different exercises produce different impact on the knee joints. The best and safest exercises causing minimum impact on the knee for patients post knee replacement or knee arthritis are walking, biking, hiking, riding an exercise bike, riding an elliptical trainer and walking on the treadmill. In sports one can play doubles tennis and not singles. One can also participate in downhill or cross–country skiing. The maximum stress–producing exercises are jogging and golf swings.

Impact

  1. Biking generates the least force, producing impact of about 1.3 times the person’s body weight.
  2. Treadmill walking was next best, producing forces of 2.05 times the body weight.
  3. Walking on level ground generated forces of 2.6 times the body weight.
  4. A game of tennis produces forces of 3.1 to 3.8 times the body weight; serving produces the highest impact.
  5. Jogging produced forces of 4.3 times body weight.
  6. Golf swings produces forces of 4.5 times body weight on the forward knee and 3.2 times body weight in the opposite knee.

Even the elderly should exercise

By Dr K K Aggarwal
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Research has found that older runners live longer and suffer fewer disabilities than healthy non runners. This observation applies to a variety of aerobic exercises including walking. A study by authors from Stanford University School of Medicine published in the Archives of Internal Medicine has shown that being active reduces disability and increases survival. There are benefits of vigorous activity late in life. Earlier many experts believed that vigorous exercise would actually harm older individuals. And running in particular would result in an epidemic of joint and bone injuries. But this new study proves otherwise. Two hundred and eighty four runners and 156 healthy controls or non runners in California completed annual questionnaires over a 21 year period. The participants were 50 years old or over at the beginning of the study and ran an average of about four hours a week. By the end of the study period the participants were in their 70s or 80s or older and ran about 76 minutes a week. At 19 years just 15 percent of the runners had died compared with 34 percent of the non runners. In the study running delayed the onset of disability by an average of 16 years. It s so important to be physically active your whole life not just in your 20s or 40s but forever. Exercise is like the most potent drug. Exercise is by far the best thing you can do. One should take lessons from Yudhishthir in Mahabharata who walked till his death. However a word of caution if an elderly is walking or entering into an exercise program he or she should have a cardiac evaluation done to rule out underlying heart blockages.

Gaining weight & losing strength vs losing weight & gaining strength

By Dr K K Aggarwal
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When we gain weight, we must acquire more strength and when we lose weight, we must lose the strength. This is a fundamental principle. If we gain weight and feel weak, it is a disease and when we lose weight and gain strength, we are recovering from the disease. One should not gain more than 5kg of weight after the age of 20 years. Any weight gain after that will only be due to accumulation of fat, which leads to insulin resistance. Insulin resistance does not allow food to convert into energy. In the state of insulin resistance, whatever you eat is converted into fat. As it is not converted into energy, you feel weak. When you reduce insulin resistance by drugs or walking, the metabolism becomes normal and whatever you eat gets converted into energy and you start gaining strength.

4 ways to put off joint replacement

By Dr K K Aggarwal
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Lose weight: For every extra pound you carry, you put about three pounds of additional pressure on your knees and multiply the pressure on your hips by six. If you have arthritis, losing just 15 pounds can cut your knee pain in half. If you do eventually need a joint replaced, losing weight beforehand can reduce your risk of having complications from surgery. Swimming, walking, or riding a stationary bike are the way to go. • Take care when using your joints: By standing up straight instead of slouching you can protect the joints in your neck, hips, and knees. Also use the proper technique when lifting or carrying anything heavy. If any activity hurts, stop doing it right away. • Try nonsurgical approaches before turning to surgery: Treatment with steroid injections is one approach. Benefits can last anywhere from 4 to 6 months. However, it doesn’t work for everyone. Viscosupplementation involves injecting a lubricating fluid into damaged knee joints to treat osteoarthritis. • Get pain relief: Use NSAIDs. There is also some evidence that the dietary supplement glucosamine chondroitin can lead to subtle improvements in arthritis pain. “It doesn’t rebuild joints, but it does seem to help with the pain. • If you can’t escape from joint pain even while at rest, your pain is only relieved by narcotic medications, or your function is severely compromised, it’s time to consider a joint replacement.

Have Leg Artery Blockages? Walk on a Treadmill

By Dr K K Aggarwal
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A planned program of walking is good for people with blockage of leg blood vessels called peripheral arterial disease (PAD). Normally when there is pain in the calf muscles in the leg on walking, the usual tendency is to rest and not walk. A study of 156 people with PAD published in JAMA showed that regular six–minute walks on a treadmill improved their endurance and quality of life. The study examined patients with symptoms and without symptoms. Over the six months of the study, the participants who did their regular six–minute treadmill walks increased their walking distance by about 69 feet, while those who did not walk regularly saw a decrease of 49 feet. There is the potential for greater oxygen extraction from the blood under maximum exercise conditions. The muscles can make better use of blood flow and the oxygen release that comes from it. Such exercise leads to improvement in “collateral circulation” growth in the number of blood vessels supplying the legs. Clinicians should urge all PAD patients, whether or not they have symptoms, to engage in a regular, supervised exercise program. Walking is a standard recommendation for people with PAD. A recommended regimen is a 40–minute walk three times a week for at least six months. Persistent leg pain is an indication that help is needed. In the absence of that symptom, physicians can test for PAD by measuring the difference in blood pressure between an ankle and an arm.

Exercise impact on the knee

By Dr K K Aggarwal
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Different exercises produce different impacts on the knee joints. The best and safest exercises causing minimum impact on the knee for patients post knee replacement or knee arthritis are walking, biking, hiking, riding an exercise bike, riding an elliptical trainer and walking on the treadmill. In sports one can play doubles tennis and not singles. One can also participate in downhill or cross–country skiing. The maximum stress–producing exercises are jogging and golf swings. Impact • Biking generates the least force, producing impact of about 1.3 times the person’s body weight. • Treadmill walking was next best, producing forces of 2.05 times the body weight. • Walking on level ground generated forces of 2.6 times the body weight. • A game of tennis produces forces of 3.1 to 3.8 times the body weight; serving produces the highest impact. • Jogging produced forces of 4.3 times body weight. • Golf swings produces forces of 4.5 times body weight on the forward knee and 3.2 times body weight in the opposite knee.

Prevention strategy relies on lifestyle

By Dr K K Aggarwal
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Stenting may not always be the answer to treating heart disease with stable coronary artery disease. A German study has shown that patients with stable coronary artery disease who were put on an exercise regimen had significantly higher rates of event-free survival than those who had undergone percutaneous coronary intervention (PCI). In the study, 70% of patients in the exercise program had event-free survival — no stroke, heart attack, or death — compared with 50% of stented patients after four years. Exercise is an important part of any type of prevention, and it should be instituted for “anyone with stable coronary heart disease.”

The study on stenting versus exercise come was a continuation of a pilot study first reported in 2004 in the journal Circulation. That study of 101 male patients found that after one year, 88% of patients who exercised had event-free survival compared with 70% of stented patients. The updated data reflect an additional 100 patients, who performed moderate intensity exercise for two weeks under hospital supervision, and then were given an exercise bike to continue their regimen at home. Patients with stable angina exercised at 80% of their threshold, and that after four weeks of exercising, their angina threshold increased.

The clear message for patients is to get 30 to 60 min of moderate-intensity aerobic activity every day, noting that 30% of heart disease could be prevented by 2.5 hours of walking per week.