Results Focused Welcomes Ryan Garman, MPT As Our New Physical Therapist

Ryan joins Results Focused as a licensed physical therapist, specializing in the treatment of orthopedic and musculoskeletal disorders and the education of community wellness and injury prevention. Ryan earned a master's degree in Physical Therapy from Marquette University in 2004 and, for the past three years, he has served as Lead Therapist for inpatient and outpatient therapy at a hospital in Kenosha, WI. He looks forward to working with Results Focused to innovate client approaches and accessibility to an active, health-focused lifestyle. He is currently available for Physical Therapy consultations on Thursdays.

Check out Ryan's first Fitness Focused article below titled Navigating Back Pain.

Navigating Back Pain

Written By Ryan Garman, MPT, Physical Therapist at Results Focused, LLC

If you are trying to determine the cause of your back pain, you may want to stop straining to remember any out-of-the-ordinary activities in which you have been partaking because, let’s be honest, most of us follow routines on a daily basis. On the contrary, your back pain is likely to have been caused by something you have done hundreds, thousands of times—something as simple as bending over to pick up your child. Only this time, out of nowhere, this everyday motion can suddenly send your back muscles into a gripping frenzy of tightness that radiates pain to your hips or feet and causes debilitating agony, making you think twice the next time you consider beginning that simple part of your daily routine.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, eight out of ten people will be affected by back pain at some point in their lives. Common causes of back pain include posture, sedentary jobs, e.g. driving a truck, motor vehicle accidents, falling, and pregnancy. While most back pain resolves without treatment, severe pain that continues and does not improve after three days warrants a consultation with a healthcare provider. In most primary consultations, a doctor will seek an x-ray and refer you to physical therapy before considering the more expensive option of an MRI.

The results of the preliminary x-rays will inform the doctor of bony defects such as degenerative joint disease and guide him/her in prescribing pain medications and/or anti-inflammatories. The primary purpose of this process is to eliminate less-likely causes of the pain, such as fracture or disc space narrowing which may indicate a bulging disc.

When referred to physical therapy (PT), your condition will be evaluated, and you will practice and learn exercises and modalities to decrease pain, increase the flexibility of the trunk and lower extremity musculature, and increase the strength of your core muscles. These sessions will also educate you on healthy posture and body mechanics and will guide you through the process of considering and determining causative factors at work or home. Your initial, comprehensive PT evaluation is likely to include questions regarding the history of your back pain (e.g. how long has it been present? when was it first noticed? when does it bother you most?) to determine any appropriate objective testing (e.g. repetitive movements, comfortable/aggravating positions, muscle tightness, nerve tension) and to formulate a treatment plan of care and goals based on your activity level and desired outcomes. Typically, PT patients are seen for therapy two to three times per week for four weeks.

Back pain can be avoided through regular cardiovascular and strengthening exercises, postural and ergonomic awareness, avoiding prolonged or uncomfortable positions, and wearing proper footwear. The key to living with and controlling back pain is to follow a physical therapist-approved home exercise program that will assist in maintaining flexibility and encourage an active lifestyle.

Exercising In This Heat!

The weather in Wisconsin has been brutal over the last few weeks with temperatures over 90 degrees and humidity reaching levels we don’t even care to acknowledge. However, it’s finally summer and we want nothing more then to be outside! Golf, pick-up basketball, family barbeque's and all the other great summer activities are just calling us and we can’t ignore them. After all, we don’t get a lot of summer around here and before we know it old man winter will come calling once again. So, to make the most out of our summers and the fitness we love to practice outdoors, keep a few things in mind.

What Does Heat Do To Your Body?


Just standing outside in this heat causes our body temperature to go up, and as our core temperature rises our body tries to cool itself by taking away blood from our muscles and circulating it through our skin. Less blood in the muscles (which you are using during exercise) elevates your heart rate even more, increasing your body temperature. We also start sweating, which is our body’s natural way of cooling down. The kicker is humidity actually keeps the sweat from evaporating off of our bodies, which is our natural way of keeping cool. More sweat on the body and less blood in the muscles = higher core temperature = heat related illnesses.


What are Heat Related Illnesses?

Heat Cramp: Your muscles cramp up during exercise because you have dehydrated as you’ve sweated all the water, salt and electrolytes out of your body.

Heat Edema: Your extremities swell in hot weather if you sit or stand still for a long time (by the pool, for example…so dive in!)

Heat Syncope: You faint as your blood pressure lowers. The high temperatures actually cause your blood vessels to expand causing low blood pressure, forcing fluids to your legs and not to the rest of your body.

Heat Exhaustion: Occurs when people exercise and don’t refill their body with the correct fluids. You feel worn out, extremely tired and very thirsty.

Heat Stroke: Body fails to regulate it’s own temperature, raising core temperature to 105 degrees or higher. The skin is dry to the touch as you have lost your fluids. This is a medical emergency, and 911 should be called immediately.


How Do You Avoid Heat Related Issues?

First and foremost keep your body cool at all times, and follow these basics:

1.) Go Slow: Don’t assume you can exercise at the same intensity indoors as you can outdoors. Start at half speed and work your way up to your potential. Also, if you take any medication be sure to ask your doctor if there are additional needs in the extreme heat.

2.) Drink lots and lots of fluids: You lose fluids very quickly in the extreme heat whether you’re playing 18 holes or training for a distance run. The basic rule is to never be thirsty. Once you feel thirsty you are already dehydrated and at risk. Rehydrate constantly, and if you are going to be outside for longer then 1 hour be sure to drink a sports drink as well as water to get your electrolytes and salts back into your body.

3.) Dress the part: Be sure to where lose fitting and light clothing. Staying away from cotton and wearing a “dry-fit” or “wicking” material meant for athletic events is a great idea as these materials help rid your body of sweat. Cotton soaks up the sweat and keeps it on your body making it more difficult to rid your body of any sweat.

4.) Don’t exercise at lunch: The heat is at it’s worst during the middle of the day, so if you are used to those walking lunches consider waiting until after work or heading outside before breakfast.

5.) Wear sunscreen: You may not feel it right away, but if the sun is out and your skin is exposed you will most likely suffer sunburn. The extreme heat isn’t the best time to focus on your tan, so keep yourself protected!

How Do I Know When To Quit?

Keep all of these warning signs in the back of your head as we head into August. If any of these situations pertain to you call it quits for the day and enjoy your air conditioning.
1.) Weakness
2.) Muscle Cramps
3.) Headaches
4.) Dizziness
5.) Vomiting
6.) Increased Heart Rate

At The End Of The Day…


Fitness is supposed to by fun, and leading a life of vitality and health is well worth the effort. Exercise in any form will increase your energy and general health while decreasing your chances of cardiovascular disease and injuries. However, when the heat gets out of control it’s never a bad idea to take some time off and jump back into your routine the next day. Most people taking part in an exercise program enjoy working hard and pushing themselves just to see how far they can go, but if you ever feel any of the issues listed above take those signs seriously. Always listen to your body, chances are it knows what it’s talking about!

Are you REALLY Healthy?

You hear a bunch of terms out there that are meant to explain if you are considered healthy by general standards. It really gets to the point where most of these terms (ie: Body Mass Index, Body Fat Percentage, Waste to Hip Ratio, etc.) can be confusing and really require some sort of math skill to pull them off. Even then, you really don’t know which measurement is truly accurate. This article is meant to show you the basics on determining your level of health as an individual.

Defining Obesity

Let’s look at the term “obesity” first, and find a way to define it accurately. To be considered obese your must have an accumulation of body fat adding up to 20% or more above your ideal body weight. If you look at this in the long range, 20%-40% over your ideal body weight is considered mildly obese, 40%-100% is considered moderately obese, and above 100% of your ideal body weight (double) would be considered morbidly obese. Any level of the above numbers has been proven to significantly shorten you lifespan, increase illnesses, chances of disabilities and becoming diabetic. Basically, as you add body fat you take away years of your life while adding years that you will need long term health care.

What Is My Ideal Body Weight?

Figuring out your ideal body weight can be tough, as a lot of people are built completely different. For example, take a person with a large frame and a bunch of muscle mass. This individual will have a low body fat calculation but if you focus on ideal body weight only based on your height and age this won’t be accurate. So, I would consider looking at your ideal body weight by frame size, and to do so easiest take a look at this chart:

http://www.healthchecksystems.com/heightweightchart.htm#frame

First calculate your frame size (small, medium or large using the chart at the bottom of the above web page) then look at the weight chart for your gender based on your height. A quick example for comparison is a woman that is 5’2” tall with a small frame should weigh between 108-121lbs. at max. Take a male with a large frame standing 6’3” tall and he should weigh in between 176-202lbs. These numbers are generally accurate unless you can consider yourself an avid resistance trainer where your muscle mass takes over a large percentage of your body weight. Considering these numbers, if you are 20% or more above your ideal weight stated on this chart you fall into the category of obese.

Waist To Hip Ratio

Now let’s consider that you are athlete of some sort, casual or professional. To determine this, ask yourself how many days a week you push yourself so ridiculously hard you would say you are working at 80% of your athletic capacity. I’m talking about running in a sprint routine, playing a sport that requires constant motion (soccer, football, lacrosse) for about an hour or so, or lifting weights to the point of failure. If you work yourself this hard 3-7 times a week you can view yourself as an athlete! Keeping this in mind, you may have a muscle mass that brings your weight higher then normal, and possibly into what would be considered obese by the above calculations. However, realistically if you drop off too much weight and you have a high muscle mass you’re going to shrivel up like a super model and find your body in total distress. Consider checking out your waist to hip ratio measurements using a standard measuring tape. Here is the process:

1.) Measure your waste in its natural waist area. This is located about an inch above your belly button, all the way around your body.
2.) Measure your hips at the widest part of you buttocks or hips (if you’re female that should be the widest).
3.) Divide your waist number by your hips number. For example, if you have a 36 inch waist and a 40 inch hip measurement your ratio is: 36/40 = 0.90
4.) Take your number and compare it to the following chart:

Male Female Health Risk
0.95 or below 0.80 or below Low Risk
0.96 to 1.0 0.81 to 0.85 Moderate Risk
1.0+ 0.85+ High Risk

You can even use this measurement if you are not considered an athlete to help determine if you are generally healthy in the body fat category. This method is accurate only in the fact that most individuals gain body fat in the abdomen area. If you find yourself to be more of a pear shape and you are not athletic it’s time to consider a different measurement of general health.

Consider these two methods in determining your overall health based on how much body fat you posses. You can use these methods anywhere, but if you want to get more information on your body fat measurement or even general health and fitness profiling consider contacting your local personal trainer or health professional.

Regardless of your numbers, always stay healthy. The first thing you can do to make a positive change is start reviewing your daily nutrition. Start making smaller changes on the lines of sugars and processed foods. And remember, no matter what your athletic ability is you can always get out and speed walk!

Get fit and get healthy Milwaukee!

Cardio Training "In The Zone"

Summer is fast approaching, and you've taken note of all the snow melting away and started thinking it's time to get rid of that winter insulation you've put on over the last few months. I know, it's easy to pack on a few pounds as we spend our time indoors playing Wii and drinking beer after beer. Hey, why not...it's dark before 5pm. There's never really a great motivation to get to the gym when pajamas are so comfortable and the new season of "24" just started airing.

But now our days are longer and our layers are less and less as the sun starts shining brighter and longer each day. So it's time to kick up the training a notch and get ready for lazy days at Atwater Beach. To get the most out of your cardio training start focusing on your heart rate. Here's how:

Learn To Monitor Your Heart Rate (HR)

There are a couple of ways to read your own HR. You can take care of this manually by locating your carotid artery, which is found just under the intersection of your jaw and neck on either side of your neck. Take your index and middle finger and feel for a pulse. You may have to feel a couple of different spots until you get it, but it's there...trust me! Once you have a good feel count how many beats you have for 15 seconds. Multiply that number by 4 and you have a HR BPM (Heart Rate Beats Per Minute).

The easy way is to pick up a heart rate monitor sold at any local big chain store. Just type in Heart Rate Monitors on any search engine and you'll find a boat load of good stuff. I would recommend something in a wristwatch format, without a chest strap as those tend to be a pain after a while and they limit chest expansion.

Training "In The Zone"

A Max HR is the highest your heart rate should get at an absolute maximum for your age. This is found by the following formula: 220-age = MaxHR

Now that you have your MaxHR, you can start training "In The Zone." Follow the guide below to train towards your specific goals:

Zone 1: Recovery or Energy Efficient Zone: 60% - 70% of MaxHR. This zone is primarily for building endurance for a long distance goal. Let's say you want to run a 5K, training at this zone for 30 minutes will get you there. You will also experience some fat burning benefit (but not a bunch) and your muscles will have a chance to re-energize at this pace.

Zone 2: Aerobic Zone: 70% - 80% of MaxHR. Training at this pace you will start to improve your cardiovascular system (taking in air and getting rid of carbon dioxide), which will in turn improve your muscle development, which then burns fat more consistently. Training in Zone 2 but taking some time to recover when necessary in Zone 1 will increase fat loss and health benefits over the long term.

Zone 3: Anaerobic Zone: 80% - 90% of MaxHR. If fat loss is your main goal this is NOT the zone you need to be in. Anaerobic zones stop burning fat and start using your lactic acid system (glycogen) for energy. Consider this the short sprint training zone, used in interval training mostly.

Zone 4: Red Line Zone: 90% - 100% of MaxHR. This zone is reserved for explosive motions and very short sprint interval training routines. Most programs that last over a few minutes will be left to zones 1 and 2, with a little of zone 3 in the mix as you push yourself towards the end of the workout. Hitting the redline tends to be a little much, and if you are not training for the Olympics I would stay away from this zone as you put yourself in a health risk.

So, start training in the zone! Use the previously mentioned blog "H.I.I.T. It!" as a guide to interval training, and as you do those 30 second sprints try and get into Zone 2 or 3. Then, during your rest periods try and stay in Zone 1 for recovery.

As always, stay hydrated and be sure to fuel up with proper nutrition before and after your workouts. For specifics see a registered dietitian, and consult a physician before starting any fitness program.

If you have any questions, I'm always available through the website http://www.resultsfocusedpt.com/, or this blog.

Stay healthy Milwaukee!


Tony Langtimm, CPT
Owner
Results Focused, LLC

Sit At Your Desk And Lose Weight

Most of my clients, and even just friends and acquaintances here in Milwaukee, have expressed a desire to lose weight and just look a little more lean and toned. When I ask them what steps they have been taking to get to that nice, lean, toned body shape I usually hear "Well, you know...running maybe 30 minutes a day, or jumping on the elliptical machine for an hour or so. Stuff like that." Basically the general public associates weight loss with spending a long period of time (30 minutes to 2 hours a day!) on some boring cardio machine or becoming a marathon runner. First off, whose got the time? Secondly, your only doing part of the job.

What exactly promotes weight loss? Simply put, your body needs to burn more calories then you put in it. Just about every thing you eat caries a caloric value. Those calories are basically stored as energy in your body, and if they aren't used they stay stored in your body as fat. Fat is basically your bodies way of storing energy to be used later on. The problem is, as we store this energy most of us stuck behind a desk have trouble using that energy efficiently enough to keep the weight off. So, let's find a way to make your body a calorie burning machine even when you're stuck staring down a deadline and working overtime.

How can we become calorie burning machines? Well, let's ask ourselves what each and every one of us has as a tool at our disposal every day. You guessed it, I'm thinking muscle, and lots of it baby! Before you write this article off, let's tackle a couple of myths about muscle gain:

1.) "But I'm a women, I don't want to get big!" - To gain bulk in your muscles you need a good amount of testosterone. Women don't carry a ton of this stuff, so that's why even women body builders don't gain that much mass.

2.) "I don't want to lose my mobility and get all stiff." - No worries here, just be sure to stretch after your lifting routine and keep up the sprint work from the "H.I.I.T. It!" blog. Yoga is a great addition for staying flexible.

So back to the task at hand. The more muscle you have the more calories you burn even when you're just sitting around watching T.V. Each pound of muscle you have burns 6 calories a day just sitting there. So, if you weigh 180 lbs., and your body fat is 20% of that, you have 144 lbs. of muscle. That burns about 860 calories a day. Keep in mind, each pound of fat burns only 2 calories a day. Also keep in mind that 3500 calories deficit is 1 lbs. of fat weight lost (and the same goes in the other direction for weight gain!). All that math just shows that MORE MUSCLE = MORE CALORIES BURNED just hanging out.

To add more muscle start implementing a weight training routine 3 times a week. If you're a newbie to the weight training idea, start with these quick tips in mind.

1.) Choose 1 exercise that focuses on each of the following muscles groups: Chest, back, shoulders, triceps (back of arm), biceps (front of arm), quadriceps (front of leg above knee), hamstrings (back of leg above knee), calves (lower back of leg) and core (stomach, lower back).

2.) Choose a weight that works for each exercise where you can complete 3 sets of that exercise at 15 repetitions, and your last set is pretty difficult. This should take 30 minutes max, even if you rest about 60 seconds between exercises.

3.) If you're just getting started, try using the machines at your gym first. This will ensure your form is correct and you stay safe. At larger gyms they even show you the muscle you are working in a handy little diagram posted on that machine.

4.) Keep a log of your workouts, and after 4 or 6 weeks change up your routine by adding more weight and less repetitions, or even by changing the exercises all together.

5.) Consider hiring a personal trainer for 1 or 2 sessions to get the basics down. Ask as many questions as you can and let them help you develop a plan specific to your strengths and weaknesses. Planning ahead will make this more efficient, rather then just jumping into the gym and deciding right then and there what you should do. Chances are you will accomplish twice as much in half the time if you have already thought through your routine.

So, get out there and start working those muscles! Even if you only have the time to crank out some push-ups and body squats (sitting down and standing up a bunch of times) at least you are keeping yourself mobile, building and maintaining muscle, and burning more calories! Good luck, and stay healthy.

H.I.I.T. It! It's Just A Better, Quicker Way of Burning Fat and Calories.

How many of you spend up to an hour on your treadmill or other cardio machine and are not seeing the fat burning benefits you had hoped? What if I told you it's entirely possible to cut that time in half and get even more fat and calorie burning benefit from your workout by using the High Intensity Interval Training method?

HIIT is actually far more superior then long duration training for a few reasons. First, you push yourself for 15 -20 minutes and your workout is done. This takes away all the excuses, everyone can find 20 minutes for better health and fitness. Second, the intensity you will put into this 20 minute workout is such a push that your body will burn more calories throughout the day trying to recover from it. Third, long duration training actually burns muscle mass as you put your body into a catabolic state. This is why sprinters have a muscular build while long distance runners lack that muscular look. And honestly, if you are looking to burn fat off of your body you can't afford to lose muscle. Each pound of muscle you have burns around 6 calories a day at rest, while each pound of fat only burns 2 calories per day.

So how does this HIIT stuff work? First find the type of cardiovascular workout you enjoy, whether it's running, swimming, cycling or even jumping rope. I'm going to use running as an example. Start off with a brisk walk or a slow jog as a warm-up for 5 minutes. Then the rule of thumb is a 2:1 ratio of rest:HIIT. Translated this means for every 30 second sprint you take, be sure to walk or jog for 1 minute. Complete the sprint, walk, sprint, walk sequence for the remaining 15 minutes of your workout. (And when I say "sprint", I mean really kick it into high gear!) Be sure to cool down afterwards and stretch those muscles that you just put through a killer workout.

Do this routine 3-4 times a week to jumpstart your calorie burning body. Don't be afraid to eat a nice healthy recovery meal afterwards too!

What a beautiful day. Taking advantage of it and getting in a run after work.

90% Perfect, 10% Off Healthy Lifestyle - Why Your New Years Resolution May Be Failing.

You rung in the new year with a glass of champagne in your hand, holiday feasts in your stomach and a promise to yourself to lose the extra pounds by the time you take your family and friends to Noah's Ark this June. Now, just one month later you wake up in the morning and look in the mirror and wonder "why don't I look like that actor on the cover of Men's Health?" Then you think back and remember the Packer Parties, your kids birthday party and maybe your friends 40th. Oh, and let's not forget the office snacks left over from everyone else's holiday parties, or that client dinner at Mo's, or maybe just the need to meet the fellas out for happy hour and shoot some pool at $1 PBR Night on the East Side. Sound familiar? Jen from Human Resources always likes to bake cookies and leave them out in the break room so they just scream at you until you indulge...over and over!

I guess what I'm trying to say is that life has a bunch of little challenges that always seem to get in the way, and trying to lead a healthy lifestyle in Milwaukee as a hard working individual is never the easiest thing to accomplish. We use foods and beverages as rewards, and a lot of times we end up rewarding ourselves every day!

What I've found through my clients is that every time they try to lose the weight they fail because they simply ran into one of those challenges and went for the chocolate chip cookie or vodka cranberry (yep, that's right, mixed drinks are loaded with calories!). Then they say to themselves "I've failed this one time, I might as well just give up completely. It's just not possible to be perfect." The key word here is "perfect." It's next to impossible for the average person to be "perfect" when it comes to health and fitness.

SO I SAY GO FOR THE COOKIE! That's right, indulge. Why not? But when you reach for that cookie, sip that regular soda, or demolish that double cheeseburger keep these points in mind:

1.) Spend 90% of your week eating to the standards of www.mypyramid.gov. This is the newest version of the nutritional guidelines suited for most individuals.

2.) Take 10% of your week and reward yourself! It doesn't matter what you eat or when you eat it. ENJOY YOURSELF. Just remember, this is a reward and not your lifestyle.

3.) Plan out your week. To ensure this plan works, you may need to identify the meals that will be challenges to your nutrition plan and count them towards your 10% off. This also helps you when you grocery shop for the week, you won't buy anything that doesn't fit into your plan. "Failing to plan is planning to fail."

This 90% PERFECT, 10% OFF idea is meant for anyone trying to live a healthier lifestyle but still enjoy the challenges that come your way. So take a couple of your meals each week and enjoy yourself to the fullest. You deserve these small rewards, but keep in mind a healthy body is always the best reward to give yourself!