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Workouts and Your Body

Before we get to the nitty-gritty of working out, let's step back and assess the status of your current health and fitness. While we agree that this isn't an overly exciting topic, it is important. The good news is that very few medical conditions should prevent you from working out.

Once we've established what you need to know before you start, we'll help you figure out what your exercise options are, how to measure your current level of fitness, and how your body responds to working out. Equally important, we'll tell you how it responds when you miss workouts.

What's Up, Doc?
Clearly if you're a member of the U.S. Olympic team, able to leap tall buildings in a single bound, or under the legal drinking age, you can start a new exercise program without a physical. However, if you've been inactive for a while, recently ill, or have a specific medical issue, it's a very good idea to see a physician for a checkup. Re-member, even if you do have a health problem, there are plenty of exercise options available; however, a little knowledge will give you more confidence as well as make your workouts safer and more productive.

Now let's take a look at some of the most common medical conditions that need to be addressed.

Hypertension
Hypertension, or high blood pressure, affects about 50 million Americans. For most people with mild to moderate hypertension, exercise is one of the most effective treatments. And though many doctors won't rush to tell you this, a regular exercise program can help you decrease or entirely eliminate medication. Here's why. When you do aerobic exercise your blood vessels dilate – and remain dilated even after you stop. That causes your blood pressure (BP) to decrease. (One of the most common categories of BP medications is vasodilators, so as we said, exercise could have the same effect as medication.) While it's generally safe for people with hypertension to lift weights, it's especially important not to lift real heavy weights. When you "max out," you tend to hold your breath. This is known as the Valsalva maneuver to us physio types, and it's quite dangerous for anyone with high blood pressure.

Diabetes
Diabetes is a condition in which an insufficient amount of insulin (the hormone necessary for the metabolism of blood sugar/blood glucose) is produced by the body. Under normal conditions insulin is released to counteract the increased blood sugar that comes after a meal. If you have Type I or juvenile onset diabetes, the body typically doesn't release enough insulin. Those with Type II, or adult onset diabetes, tend to be resistant to insulin, which means insulin doesn't do what it supposed to.

Because exercise has an "insulin-like" effect, your doctor needs to know if you are diabetic and beginning an exercise program. This is important because your doctor may adjust the timing of your medications. And, in the case of insulin, change where you make your injections. (Injecting an exercising muscle is likely to increase the rate of absorption.)

There is a host of do's and don'ts that diabetics need to become familiar with:

1. Weight loss and modifications in your diet can play a large role for people with adult onset diabetes.
2. If you have adult onset diabetes, it's important – no matter how busy your day becomes – that you don't let too much time pass between meals. (Skipping meals is a real no-no.) In order to stabilize your blood sugar, it's important that your carbohydrate intake as well as the timing of your meals remain consistent. Again, talk to your doctor or a nutritionist for more info.
3. It sounds odd, but diabetics are advised to wear good socks and sneakers and carefully check their feet for cuts or blisters because of a condition known as diabetic neuropathy. As a result, diabetics occasionally have decreased sensation in their feet and can therefore be unaware of damage.

Asthma
Many of us think of asthmatics as woefully frail sickly people who double over when they run up a flight of stairs. Well, consider Olympic gold medallist Jackie Joyner-Kersee, a heptathlete who is arguably the greatest female athlete of our time. Our poster boy for dealing with this tough condition, Jonathan Cane, has done 150 bicycle races over the past five years and, for the record, has raced up the stairs of the Empire State Building four times. In other words, asthma does not need to prevent you from working out. Asthma medications have come a long way in the past few years, and most are very effective and free of side effects. (Although it's quite possible that one of the lesser-known side effects is an irrational need to sprint up stairwells in skyscrapers. If this happens more than once, please have your doctor adjust your medication.)

As Jonathan has learned firsthand, asthma sufferers may want to avoid exercising in cold and dry conditions. If you're working out and find that the cold air is bothering you, often breathing through your nose helps filter and warm the air before it hits your lungs.

Measuring Your Fitness Level
Think of someone getting in the car and driving aimlessly without a map, directions, or destination. This might be a good agenda if you're checking how many miles to the gallon your car gets, but otherwise it's a good way to get nowhere fast. In short, that's the mistake many people we see make – novices and seasoned veterans alike. Sure, it's great that you're in the gym, but without a specific plan it's surprisingly difficult to make real progress. Here are two important points to consider:

1. What are your goals? Do you want to get stronger? Improve your sports performance? Your appearance? Are you trying to lose weight or gain muscle? Improve your ability to carry the baby stroller up the stairs or are you in the gym to improve your 10K time?
2. Where do you stand today? How fit are you? How flexible? What about muscular strength and cardiovascular endurance? What's your percentage of body fat? (Aren't you glad we've begun to thoroughly confuse you?) By clearly defining your goals and establishing your current state of fitness, you can have a direction to your training and measure the progress that you make. Remember, even the most brilliant architect follows a plan.

Each of us has different goals and no single goal is right or wrong. If the only motivation you have for working out is to look good in a bathing suit, no worries. If you're a racer like Jonathan and Joe who head to the gym to enhance their cycling and marathon kayaking performances, you'll be spending a fair bit of time doing specific exercises geared toward that goal. (Although Joe won't admit it, he's been considering paddling this season in a pink Speedo.) When Deidre competed as a power lifter, she focused on her three primary lifts. Now that's she's retired and spends a lot of time polishing her trophies, her gym workouts have virtually nothing to do with lifting small buildings and everything to do with looking and feeling good.

The good news, of course, is there's plenty of overlap. The runner, who lifts to get faster on the road, inevitably winds up looking better before and after the race. The person who trains like a Trojan to squeeze into the tiniest bathing suit possible each summer will, on a good exercise regime, wind up having more energy to play with her kids and be better able to run through the airport with her luggage to catch a plane.

While you need to know where you're going, it's also valuable to find out where you're at. You can do this in a variety of ways. The best is to go to a lab, fitness center, or physiology department at a university and have some number-crunching physiologists like Jonathan poke and prod you to measure your cardiovascular fitness, muscular strength and endurance, flexibility, and body composition. If you know where you can get tested, we strongly suggest that you take advantage of them. If you don't have a qualified professional to perform these tests, there are still benchmarks that you can test yourself. (Of course you can call Jonathan, but he might ride his bike there and that gets time consuming.) If you live in the Australian outback or just can't be bothered, here are a few measurements you can take to gauge your own fitness.

Resting Heart Rate
The first thing you should do is monitor your resting heart rate. The best time to do this is first thing in the morning – after you use the bathroom since having to go may otherwise elevate your heart rate. Here's what to do.

1. Place your index and middle fingers together on the opposite wrist, about half an inch on the inside of the joint, in line with the index finger.
2. Feel for a pulse by pressing lightly on the artery.
3. Once you find a strong pulse, count the number of beats you feel for one minute.
4. Begin your count with zero. When exercising, it's more practical to take your heart rate for 10 seconds and multiply by six.

Knowing your resting heart rate does not necessarily tell you much – it's a number relative to nothing – but noting changes over time generally indicates a change in your level of fitness. As your heart and cardiovascular system becomes stronger and more efficient, your resting heart rate (RHR) will decrease. This indicates that more blood is being pumped with each beat and that your body is more efficient at extracting oxygen from the blood.

Often we're asked, "What's a good normal resting heart rate?" That's a good question with no real answer. Normal RHR ranges from 60 to 100 beats per minute; the average is approximately 70 for men and 75 for women. Extremely well-conditioned athletes sometimes have heart rates as low as 40 beats per minute. Former tennis great Bjorn Borg was said to have a RHR around 36 beats per minute.

Weight and Body Composition
The "Body Mass Index" (BMI) is a quick way to gauge if you're at a healthy weight. But because it does not differentiate between muscle and fat, or take frame size into account, it is clearly a flawed method. However, for someone who isn't extremely muscular, it's a reasonably accurate and quick method. High BMIs – the bane of many American's existence – are associated with an increase risk of heart disease, hypertension, and diabetes. Here's a chart to look up your BMI:

Body Mass Index

Weight Category	BMI Range	% Above
Normal weight	19-25
Overweight	26-30	20-40%
Obese	31-35	41-100%
Seriously obese	Over 35	Over 100%

Regardless of what the scale says, the best way to determine if you need to lose weight is by measuring your body composition. That's because body composition measurements take your muscle mass in to account and can differentiate between a lean, mean bodybuilder who's covered in muscle and weighs 210 pounds and a couch potato with a gut who's the same height and weight.

There are a variety of tests available in lab settings: Underwater weighing is the gold standard, and skin-fold calipers are dependable and reliable. Other methods such as bioelectrical impedence are impressive looking (and sounding) but notoriously inaccurate. If you don't have access to those tests, here's a quick test you can do to estimate your body fat percentage.

1. Measure your height in inches.
2. Measure the widest part of your hips in inches.
3. Using the chart, take a straight edge and match up each end to your corresponding height and hip girth. The point at which the ruler intersects the middle line is your estimated percent body fat.

Use this chart to estimate the percentage of body fat you carry.

Muscular Strength and Endurance
Push-ups – that simplest of exercises used by drill sergeants and gym teachers – are a good way to test your upper-body strength quickly and easily. Women should use a modified push-up, with their knees bent and on the floor, and men should keep their toes on the floor with legs out straight.

Start at the top position with your arms straight and lower yourself until your chest is about a clenched fist's distance from the floor. Keep your back straight throughout. See how many you can do without breaking form or resting at the top or bottom. Test yourself every few months to measure the progress of your strength routine. Below are norms so that you can check yourself against other in your age category.

Push-Up Norms for Men

Age	20-29	30-39	40-49	50-59	60+
Excellent	55+	44+	40+	35+	30+
Good	45-54	35-44	30-39	25-34	20-29
Average	35-44	25-34	20-29	15-24	10-19
Fair	20-34	15-24	12-19	8-14	5-9
Low	0-19	0-14	0-11	0-7	0-4

Push-Up Norms for Women

Age	20-29	30-39	40-49	50-59	60+
Excellent	49+	40+	35+	30+	20+
Good	34-48	25-39	20-34	15-29	5-19
Average	17-33	12-24	8-19	6-14	3-4
Fair	6-16	4-11	3-7	2-5	1-2
Low	0-5	0-3	0-2	0-1	0

Cardiovascular Tests
Again, there is no replacement for the testing available in a lab, but there are a few you can do on your own to estimate your cardiovascular fitness.

A simple yet arduous test, widely used in the military and law-enforcement agencies, is the 1.5-mile walk/run. The procedure is simple:

1. Find a treadmill, quarter-mile track, or another accurately measured, flat 1.5-mile course.
2. After a thorough warm-up, run and/or walk 1.5 miles as fast as possible.

Here are the norms for men and women, broken down by 10-year age groups.

Women's Norms per Age Group

Rank	20-29	30-39	40-49	50-59	60+
Superior	10:47	11:49	12:51	14:20	15:06
Excellent	12:51	13:43	14:31	15:57	16:20
Good	14:24	15:08	15:57	16:58	17:46
Fair	15:26	15:57	16:58	17:55	18:44
Poor	16:33	17:14	18:00	18:49	19:21
Very Poor	18:14	18:31	19:05	19:57	20:23

Men's Norms per Age Group

Rank	20-29	30-39	40-49	50-59	60+
Superior	8:13	8:44	9:30	10:40	11:20
Excellent	10:16	10:47	11:44	12:51	13:53
Good	11:41	12:20	13:14	14:24	15:29
Fair	12:51	13:36	14:29	15:26	16:43
Poor	14:13	14:52	15:41	16:43	18:00
Very Poor	16:12	16:27	17:23	18:31	20:04

Flexibility
We're constantly amazed how many strong and "fit" men we see in the gym who are unable to touch their toes. This begs the question: Can you be truly fit if you're as flexible as an elephant's tusk?

The most common test used by physiologists to measure flexibility is known as the "sit-and-reach" test. This is basically a seated toe touch using a specially designed box to measure how far forward you bend. The test is valuable because poor performance usually indicates the likelihood of lower-back injury.

Odds are you don't have a sit-and-reach box at home, but you can still get a basic idea of your lower back, hip, and hamstring flexibility. Try this. In your bare feet, sit on the floor with your feet six inches apart and flat against the wall. Bend forward slowly, without bouncing. If you can easily touch the wall, your flexibility is fine. If you can barely reach the wall, it's fair. If you can't reach the wall (don't cheat and bend your knees), jog to your nearest yoga teacher. Actually, walk; you might pull a hamstring otherwise.

Looking Good
As we mentioned earlier, if your main motivation for exercise is looking good, fret not. A good body usually means that you're on the right track. Just as important, looking good is good for your mind. Having someone say he thought you were 5 or 10 years younger than you are is a simple yet satisfying pleasure. And appearing younger than your peers is also great for your self-confidence as well.

Feeling Healthy
It sounds simple, but people who exercise usually take better care of themselves. When you're committed to working out, it becomes a part of your life and begins to influence many small decisions you make throughout the day. Will you have ice cream for a snack or a piece of fruit instead? Will you have the chicken Parmesan or the spaghetti with marinara sauce? For dessert, will you have the Mississippi Mud Cake or the fruit custard?

After a while, you will begin to notice how much better you feel with more healthful food choices. What you'll also realize is that the better you eat, the more energy you have at work, play, or working out. You've heard of vicious cycles? Well, this is a good "vicious" cycle that you want to initiate.

Here's an important point that turns many people off. Eating better doesn't mean you have to swear off ice cream or filet mignon. What we are saying is that with exercise and healthful eating, you'll feel so good that you will want to make the major indulgences a minor part of your life.

Being Strong
We know we don't have to convince men that being strong is a good thing, since the male psyche seems to relish the role strength plays in life. Women, however, are a different story. Many women equate being strong with having "bulky" muscles. (Not that there is anything wrong with that.) Simply put, this is a misconception that keeps many women from lifting weights in the first place. Those that do lift, often use weights that are so light you'd need to do 9,000 repetitions to get the full effect. (For the record: Three sets of 9,000 take about eight hours.)

Below are some myths about women and strength, and the facts that set the record straight.

Myth 1: Being Strong Means Having Big Muscles
Strength and muscularity are not the same. Strength is the ability to resist force or strain. Muscularity is the ability to develop mass and has to do with your genetic makeup. Huh? We all have a genetic code that determines everything from the color of our eyes to the length of our legs. The size of our muscles is also determined by the genetics passed along by our parents. This is why you can have a guy who looks like a fire truck who can't lift as much weight as a lean, wiry guy built like a greyhound. Why? Because Mr. Fire Truck has the genetics for big muscles and Mr. Greyhound does not.

Myth 2: Heavy Weights and Low Reps Give You Bulk; Light Weights and High Reps Give Your Muscles That Long, Lean Look
Again, the shape and size of your muscles is genetically predetermined. Whether you perform biceps curls with 20 pounds for 10 repetitions, or 10 pounds for 20 repetitions, your muscles will look the way they are wired to look.

Myth 3: Lifting Weights Makes Women Look Muscle-Bound
This is a little hard to answer because it depends on what your definition of muscle-bound is. If you are thinking about the superpumped women on the cover of Muscle & Fitness, don't worry about it unless you have a testosterone level equal to Arnold Schwarzenegger (and a steroid level equal to that of a well-medicated racehorse). Achieving any level of muscularity requires long-term dedication – a level of time and energy that most people don't have. In other words, going to the gym three times a week to strength train is not going to make you any more "muscle-bound" than running on the treadmill several times a week will make you an Olympic-level mara-thoner.

Fortunately, being strong does not require you to look like Ms. Olympia and the benefits are well worth putting in the time.

Not only can increased muscle and strength help you perform better on and off the court, it can have practical benefits as well. Deidre, a physical therapist who works with many elderly patients, finds that many of her clients are unable to do things that we take for granted. Things like going grocery shopping alone, doing laundry, and even getting in and out of the shower. Many of these people are forced to hire aides to help them with normal activities of daily life, making them virtual prisoners in their own homes. Often such dependence is the result of years of neglect. This is reason enough to begin participating in a strengthening routine.

How Your Body Responds to Exercise
While virtually everyone knows that working out makes you look and feel good, not that many know how and why. What happens physiologically when you exercise? Let's look at how your body responds to different types of exercise.

Cardiovascular Exercise
Your cardiovascular system is made up of your heart, lungs, and blood vessels. With continued exercise, your cardiovascular system becomes stronger and more efficient. As we mentioned earlier, as your heart becomes stronger, it is capable of ejecting more blood with each beat. (This is known as your stroke volume.) This means that your heart doesn't have to beat as often. In addition, your lung capacity increases and your muscles are capable of extracting more oxygen from the blood as it's delivered to the exercising muscle. Other benefits of cardiovascular training are lowered blood pressure at rest and improvements in your cholesterol.

Strength Training
What happens to a muscle when you lift weights is one of the simplest, yet most misunderstood areas of physiology. Here's the scoop. When you force a muscle to work hard, as in strength training, it increases in size and strength. Simple. This happens by the growth of each individual muscle fiber in a particular muscle. Despite what you may read in some publications, strength training does not increase the number of muscle fibers. In addition, the connective tissue around the muscle increases in strength as well.

Contrary to the myths floating around most gyms (not to mention books and videos), lifting doesn't make a muscle smaller or longer, no matter how many reps you do or what weight you use. Think about it: That guy in the corner of the weight room doing biceps curls isn't doing them to make his arms smaller, yet we often see women doing leg extension or hip exercises in the hopes of "slimming" their thighs. Sorry tummy tuckers, it doesn't work that way. Keep that in mind next time you see someone doing side bends hoping to reduce her waistline.

Stretching
Most people know that they should stretch, but they don't really understand why or what happens when you properly stretch a muscle. Here's a quick rundown.

Stretching allows your muscles to retain elasticity, which prevents injury. With repetitive activities – running, cycling, weight training – certain muscles are used over and over again, which effectively shortens the muscles. This leads to something known as muscular imbalance. When a muscular imbalance occurs, the stronger muscles take over the work of the weaker muscles, causing the weaker muscles to lose so much strength that strains, sprains, and tendinitis occur.

Weight Loss
Clearly, losing weight is a frustrating topic for millions of Americans. The good news is that there's a simple formula for weight loss: Eat less and exercise more. Okay, it sounds glib, but it's true. Of course, while it is simple, it's not easy! Nevertheless, the way you lose weight is by burning more calories than you take in. A pound of fat has 3,500 calories worth of energy. That means in order to lose one pound, you need to create a "caloric deficit" of 3,500 calories. The best way to do this is with a combination of decreased caloric intake and increased caloric expenditure.

Here's a nice, neat textbook example. If you decrease your daily intake by 250 calories and increase your activity level enough to burn an extra 250 calories, you'll have a caloric deficit of 500 calories for the day. Multiply that by seven days in a week, and you've got 3,500 calories for the week.

Detraining – Missing Workouts
Now that we've discussed what happens when you work out, let's look at what happens when you don't. (If you're an obsessive-compulsive like Jonathan it means a copious level of angst and guilt.) Surprisingly, many athletes who train often and hard find improved performance after a short layoff. That's due to the fact that many of them are overtrained and in need the rest. Of course, an extended layoff can cause a significant loss in fitness. While there's far less research and information on the topic of detraining than there is on training, there are some basic things to note.

After as little as two weeks of inactivity, there can be measurable decreases in aerobic capacity and muscular strength. This is all the more reason to do all you can to remain active. Remember, just two 30-minute weight-lifting workouts are enough to maintain and even gain strength. Similarly, two or three cardiovascular workouts lasting as little as 15 to 20 minutes can help keep you in shape.

As you read this book, remember that you need to do all you can not to miss workouts. The good news is that we'll help you find the time as well as provide workouts that take less time to maintain or improve your fitness.

The Least You Need to Know

• Before embarking on an exercise program, save time and energy by deciding what your needs and goals are.
• Working out is not only for looking good, there are numerous health benefits that a consistent fitness program will provide you with.
• Muscle size is a function of genetic predisposition; women are not naturally capable of getting muscle-bound by weight training.
• If you want to lose weight, eat less, exercise more.