Your orthopedic surgeon may suggest some of the following exercises. The following guide can help you better understand your exercise/activity program, supervised by your therapist and orthopaedic surgeon.

Early Postoperative Exercises
Start the following exercises as soon as you are able. You can begin these in the recovery room shortly after surgery. You may feel uncomfortable at first, but these exercises will speed your recovery and actually diminish your postoperative pain.

Quadriceps Sets
Tighten your thigh muscle. Try to straighten your knee. Hold for 5 to 10 seconds. Repeat this exercise approximately 10 times during a two minute period, rest one minute and repeat. Continue until your thigh feels fatigued.

Straight Leg Raises
Tighten the thigh muscle with your knee fully straightened on the bed, as with the Quad set. Lift your leg several inches. Hold for five to 10 seconds. Slowly lower.

Repeat until your thigh feels fatigued.
You also can do leg raises while sitting. Fully tighten your thigh muscle and  hold your knee fully straightened with your leg unsupported. Repeat as above.  Continue these exercises periodically until full strength returns to your thigh

Ankle Pumps
Move your foot up and down rhythmically  by contracting the calf and shin muscles. Perform this exercise periodically  for two to three minutes, two or three times an hour in the recovery room.  Continue  this exercise until you are fully recovered and all ankle and lower-leg  swelling has subsided.

Knee Straightening  Exercises
Place a small rolled towel just above your heel so that it is not touching the bed. Tighten your thigh. Try to fully straighten your knee and to touch the back of your knee to the bed. Hold fully straightened for five to 10 seconds.  Repeat  until your thigh feels fatigued.

Bed-Supported Knee Bends
Bend your knee as much as possible while sliding your foot on the bed. Hold your knee in a maximally bent position for 5 to 10 seconds and then straighten.  Repeat several times until your leg feels fatigued or until you can completely bend your knee.

Sitting Supported Knee Bends
While sitting at bedside or in a chair with your thigh supported, place your foot behind the heel of your operated knee for support. Slowly bend your knee as far as you can. Hold your knee in this position for 5 to 10 seconds.  Repeat several times until your leg feels fatigued or until you can completely bend your knee.

Sitting Unsupported Knee Bends
While sitting at bedside or in a chair with your thigh supported, bend your knee as far as you can until your foot rests on the floor. With your foot lightly resting on the floor, slide your upper body forward in the chair to increase your knee bend. Hold for 5 to 10 seconds. Straighten your knee fully.  Repeat several times until your leg feels fatigued or until you can completely bend your knee.

Early Activity
Soon after your surgery, you will begin to walk short distances in your  hospital room and perform everyday activities. This early activity aids your  recovery and helps your knee regain its strength and movement.

Walking
Proper walking is the best way to help your knee recover. At first, you will walk with a walker or crutches. Your surgeon or therapist will tell you how much weight to put on your leg.

Stand comfortably and erect with your weight evenly balanced on your walker or crutches. Advance your walker or crutches a short distance; then reach forward with your operated leg with your knee straightened so the heel of your foot touches the floor first. As you move forward, your knee and ankle will bend and your entire foot will rest evenly on the floor. As you complete the step, your toe will lift off the floor and your knee and hip will bend so that you can forward for your next step. Remember, touch your heel first, then flatten your foot, then lift your toes off the floor.

Walk as rhythmically and smooth as you can. Don’t hurry. Adjust the length of your step and speed as necessary to walk with an even pattern. As your muscle strength and endurance improve, you may spend more time walking. You will gradually put more weight on your leg. You may use a cane in the hand opposite your surgery and eventually walk without an aid.

When you can walk and stand for more than 10 minutes and your knee is strong enough so that you are not carrying any weight on your walker or crutches (often about two to three weeks after your surgery), you can begin using a single crutch or cane. Hold the aid in the hand opposite the side of your surgery. You should not limp or lean away from your operated knee

Stair Climbing and Descending
The ability to go up and down stairs requires strength and flexibility. At first, you will need a handrail for support and will be able to go only one
step at a time. Always lead up the stairs with your good knee and down the stairs with your operated knee. Remember, “up with the good” and “down with the bad.” You may want to have someone help you until you have regained most of your strength and mobility.

Stair climbing is an excellent strengthening and endurance activity. Do not try to climb steps higher than the standard height (7 inches) and always use a handrail for balance. As you become stronger and more mobile, you can begin to climb stairs foot over foot.

Advanced Exercises and Activities
Once you have regained independence for short distances and a few steps, you may increase your activity. The pain of your knee problems before surgery and the pain and swelling after surgery have weakened your knee. A full recovery will take many months. The following exercises and activities will help you recover fully.

Standing Knee Bends
Standing erect with the aid of a walker or crutches, lift your thigh and bend your  knee as much as you can. Hold for 5 to 10 seconds. Then straighten your knee, touching the floor with your heel first. Repeat several times until fatigued.

Assisted Knee Bends
Lying on your back, place a folded towel over your operated knee and drop the towel to your foot. Bend your knee and apply gentle pressure through the towel to increase the bend.  Hold for 5 to 10 seconds; repeat several times until fatigued.

Knee Exercises with Resistance
You can place light weights around your ankle and repeat any of the above exercises. These resistance exercises usually can begin four to six weeks after your surgery. Use one- to two-pound weights at first; gradually increase the weight as your strength returns. (Inexpensive wrap-around ankle weights with Velcro straps can be purchased at most sporting goods stores.)

Cycling
Cycling is an excellent activity to help you regain muscle strength and knee mobility. At first, adjust the seat height so that the bottom of your foot just touches the pedal with your knee almost straight. Peddle backward at first. Ride forward only after a comfortable cycling motion is possible backwards.

As you become stronger (at about four to six weeks) slowly increase the tension on the cycle. Cycle for 10 to 15 minutes twice a day, gradually build up to 20 to 30 minutes, three or four times a week.

Pain or Swelling after Exercise You may experience knee pain or swelling after exercise or activity. You can relieve this by elevating your leg and applying ice
wrapped in a towel. Exercise and activity should consistently improve your strength and mobility. If you have any questions or problems, contact your orthopedic surgeon or physical therapist.

1. Inadequate availability of oxygen or substrate for both maternal exercising muscle and fetus
2. Hyperthermia induced fetal distress or birth abnormalities.
3. Increased uterine contraction

To date, however, human studies indicate that healthy women
with uncomplicated pregnancy do not need to limit their exercise for fear of
adverse effects.

No consistent differences have been reported between exercisers and non-exercisers in terms of rate of spontaneous abortion or rupture, incidence of preterm labor, fetal
distress or birth abnormalities, and the ability to carry to term.  Several physiologic adaptations occur with both pregnancy and exercise that appear to provide the physiologic reserve need to accommodate the simultaneous needs of the fetus and maternal exercising muscle.  Although some data suggest that strenuous exercise may lead to delivery of somewhat lighter birth weight babies, these deliveries are will within normal limits and are due in part to less baby fat.

Contraindications for exercise during pregnancy have been established by the American College of Obstetricians and Gynecologists (ACOG) and are listed below.  These are recommendations for women who DO NOT have any risk factors for
adverse maternal or perinatal outcomes.

1. Pregnancy induced hypertension
2. Preterm rupture of membrane
3. Pre term labor during the prior or current
   pregnancy
4. Incompetent cervix
5. Persistent second to third trimester bleeding
6. Intrauterine growth retardation

Recommendations for Exercise in Pregnancy and Postpartum

1. During pregnancy women can continue to exercise and derive health benefits even from mild to moderate exercise routines.  Exercising 3 x per week is preferable.
2. Women should avoid exercise in the supine position after the first trimester.  Such
   a position is associated with decreased cardiac output in preferentially
   distributed away from the splanhnic beds (including the uterus) during vigorous
   exercise; such regimens are best avoided during pregnancy.
3. Prolonged periods of motionless standing should also be avoided.
4. Women should be aware of the decrease oxygen available for aerobic exercise during pregnancy.  They should be encouraged to modify the
   intensity of their exercise according to maternal symptoms.  Pregnant women should stop exercising when fatigued and not exercise to exhaustion.
5. Weight bearing exercise may under some circumstance be continued at intensities, similar to those prior to pregnancy throughout the
   pregnancy.  Non weight bearing exercises, such as cycling or swimming, will minimize the risk of injury and facilitate
   the continuation of exercise during pregnancy.
6. Morphologic changes in pregnancy should serve as a relative contraindication to types of exercise in which loss of balance could be detrimental to maternal or fetal well being, especially in the third trimester.  Further, any type of exercise involving the potential for even mild abdominal trauma should be avoided.
7. Pregnancy requires an additional 300 kcals/day to maintain metabolic homeostasis.  Thus, women who exercise during pregnancy should be particularly careful to ensure adequate diet.
8. Pregnant women who exercise in the first trimester should augment heat dissipation by ensuring adequate hydration, appropriate clothing, and optimal environmental surroundings during exercise.
9. Many of the physiologic and morphologic changes of pregnancy persists 4 to 6 weeks postpartum.  Thus, pre-pregnancy exercise routines should be resumed gradually based on a woman’s physical capability.

Although some women have undergone MAXIMAL exercise testing, it generally is not recommended except for clinical reasons.  For monitoring exercise intensity, the ACOG guidelines recommend using rating of perceived effort rather than heart rate due to chronotropic alterations during pregnancy that make standard training heart rate formulas less appropriate.

Reasons To Discontinue Exercise and Seek Medical Advice During Pregnancy

1. Any signs of bloody discharge from the vagina.
2. Any gush or fluid from the vagina (prematurerupture of membranes).
3. Sudden swelling of the ankles, hands, or face.
4. Persistent, severe headaches, and/or visual disturbance; unexplained spell of faintness or dizziness.
5. Swelling, pain and redness in the call of one leg (phlebitis).
6. Elevation of pulse rate or blood pressure that persists after exercise.
7. Excessive fatigue, palpitations, chest pain.
8. Persistent contractions ( greater than 6-8 hours) that may suggest onset of premature labor.
9. Unexplained abdominal pain
10. Insufficient weight gain (less than 2.2 lbs per month during the last two trimesters).

The ACOG guidelines differentiate between women who exercise and become pregnant and women who start exercising during pregnancy.  The ACOG guidelines recommend that women who currently participate in a regular exercise program can continue their training program during pregnancy, without major modifications.  However, many women choose to modify intensity, duration, and or frequency during the course of pregnancy due to overall comfort level and specific symptoms.  Those who plan to begin an exercise program after becoming pregnant and are advised to seek physician approval and begin exercising with low intensity
low or non impact activities, such as walking and swimming.  Although women- especially with physician authorization- can gain maternal health benefits while subjecting the developing fetus to minimal risk.  Commonly cited potential benefits of a properly designed prenatal exercise program include the following:

1. Improved aerobic and muscular fitness.
2. Facilitation of recovery from labor.
3. Enhanced maternal psychological well being, that may help counter feelings of stress, anxiety, and or depression frequently experienced during pregnancy.
4. Establishment of permanent healthy lifestyle
   habits.
5. More rapid return for pre pregnancy weight, strength, and flexibility levels.
6. Fewer obstetric interventions
7. Shorter active phase of labor and less pain
8. Less weight gain
9. Improved digestion and reduced constipation
10. Greater energy reserve
11. Reduced postpartum belly
12. Reduced back pain during pregnancy.

These five skin protection tips can keep your skin looking and feeling great, by guarding against a slew of skin woes, from chapped skin to prematurely aging to skin cancer.

1. Limit Sun Exposure

You’ve heard the message a zillion times, and there’s good reason for that unrelenting repetition. Ultraviolet rays emitted by the sun cause many types of skin damage:

• Skin cancer
• Wrinkles
• Freckles
• Age spots
• Discolorations
• Benign growths

Using skin care products that offer ultraviolet protection is one of the best ways to help keep your skin looking fresh and youthful:

• Use sunscreen every day and reapply regularly whenever you’re outdoors for extended periods.
• Cover skin by wearing long-sleeved shirts, pants, and wide-brimmed hats.
• Stay indoors when the sun is at its most intense, usually between 10 a.m. and 3 p.m.

Keep in mind that tanning beds are just as harmful as direct sunlight, as they also emit ultraviolet rays.

2. Stay Hydrated

Keeping your skin moist is essential to skin protection. Skin that is properly hydrated retains pliability and prevents chapped skin or scaly, flaky skin:

• Drink lots of water. This is key to hydrating your skin.
• Use the right moisturizing cream or lotion for your skin type and apply it right after drying off from your bath or shower. Avoid products that contain sodium lauryl sulfate, as this ingredient removes natural oils needed by your skin.
• Take warm (not hot) showers or baths, and limit them to between 5 and 10 minutes. It seems counterintuitive, but exposure to water actually dries out your skin. If dry skin persists, consider cutting back on the number of baths you take.

3. Take Health Precautions

Cold sores are caused by a viral infection of the skin bordering the lips, while bacteria can contribute to acne and other skin conditions. Practicing skin protection means paying close attention to what touches your skin, to lower your chances of exposure to germs:

• Don’t share any personal items, such as lip balms or toothbrushes.
• Don’t share drinks with other people.
• Avoid touching your face with your fingers or with objects like telephone receivers that have been used by others.

4. Use Gentle Skin Care

Washing your face is important to remove dirt, oils, germs, and dead cells. However, scrubbing your face causes irritation that can lead to chapped skin that, in turn, can leave skin vulnerable. For best results, you should:

• Wash your face twice daily with warm water and a mild cleanser.
• Gently massage your face with a washcloth, using a circular motion.
• Rinse thoroughly after washing to remove all soap and debris.
• Pat your skin dry — don’t rub — then apply your facial moisturizer.

5. Know Your Skin

Pay attention to odd freckles, moles, and growths on your skin, and consult your doctor if you notice any changes. For example, a change in a mole can indicate potential skin cancer. Be sure to treat any cuts that may occur to prevent infection. Other skin conditions that merit a dermatologist visit include frequent acne, inflamed or irritated dry skin, and skin rashes and irritations that don’t go away, as these could be signs of one of the many types of dermatitis, or skin inflammation.

With proper skin care to pamper skin from the outside and with a good diet to nourish from within, skin protection comes down to a few simple steps. But should you ever notice any problems, get medical attention to resolve them quickly and avoid putting your skin at risk.

According to the National Institutes of Health, 50 to 70 million Americans are affected by chronic sleep disorders and intermittent sleep problems that can significantly diminish health, alertness and safety. Untreated sleep disorders have been linked to hypertension, heart disease, stroke, depression, diabetes and other chronic diseases. Sleep problems can take many forms and can involve too little sleep, too much sleep or inadequate quality of sleep.

The Institute of Medicine recently estimated in its report, Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem, that “hundreds of billions of dollars a year are spent on direct medical costs related to sleep disorders such as doctor visits, hospital services, prescriptions, and over-the-counter medications.” Sleep problems and lack of sleep can affect everything from personal and work productivity to behavioral and relationship problems. Sleep problems can have serious consequences. According to the National Highway Traffic Safety Administration, drowsy driving claims more than 1,500 lives and causes at least 100,000 motor vehicle crashes each year.

Compounding the problem is the fact that most people know when to seek medical help for physical discomfort such as fever or pain—but sleep problems are often overlooked or ignored. In fact, the overwhelming majority of people with sleep disorders are undiagnosed and untreated.

Lack of sleep can affect your immune system. Studies show that people who don’t get a good night’s sleep or who don’t get enough sleep are more likely to get sick after being exposed to a virus, such as the common cold. Lack of sleep can also affect how fast you recover if you do get sick.

During sleep, your immune system releases proteins called cytokines. These substances increase in the presence of an infection, inflammation and stress. Increased cytokines are necessary in fighting infection and regulating deeper sleep. In addition, other infection-fighting cells are reduced during periods of sleep deprivation. So, your body needs sleep to fight infectious diseases.

How much sleep do you need to bolster your immune system? The optimal amount of sleep for most adults is seven to eight hours a night. School-aged children and adolescents need nine or more hours of sleep a night.

But be careful; more sleep is not always better. For adults, sleeping more than nine to 10 hours a night has been associated with weight gain, heart problems, stroke, sleep disorders, depression and other health concerns.

When you suffer from a lack of sleep – whether it’s due to insomnia or some other sleep disorder – many negative side effects can occur. First of all, simply getting through the day can be nearly impossible to do when you are running on very little sleep; molehills easily become mountains at work and at home when you don’t have a decent night’s sleep backing you up. Lack of sleep can cause many other very negative effects in your life, from blurry vision to hallucinations. Indeed, not getting enough sleep is nothing to mess around with; it’s not surprising that so many people seek help for their sleep disorders.

The effects of a lack of sleep range from the seemingly benign to the incredibly serious, and can actually worsen a great deal the longer that they persist. For instance, at first you might just experience a general sense of exhaustion or fatigue when you begin having a lack of sleep. As time goes on, though, more serious problems can occur. Your work performance can suffer a great deal; in fact, some people actually end up losing their jobs because their lack of sleep causes so many problems for them on a daily basis. Personal relationships can also be negatively impacted by a lack of sleep, as tempers flare due to exhaustion. The effects of a lack of sleep are far reaching and very real.

Lack of sleep side effects

A lack of sleep can trigger many different, widely ranging effects in you. You may notice that you are much more irritable than usual, snapping at friends and loved ones with increasing regularity. Weight loss or weight gain can occur and can be quite dramatic when you are coping with a lack of sleep, typically because you stay up all night eating or are too tired to eat properly. You may find that you have difficulty remembering things, since memory is very negatively impacted by a lack of sleep. People may begin to point out your absentmindedness, and you may fail to fulfill your obligations because you forget all about them.

For some people, a lack of sleep effects can cause very serious health problems. High blood pressure – also known as hypertension – can occur, which itself can lead to many serious problems. Nausea might begin to happen more and more frequently, as your body is unable to cope with a lack of sleep. Some people experience blurry vision and dizziness after prolonged bouts of sleeplessness. If left unchecked, a lack of sleep can have serious repercussions for your life and for your health.

How lack of sleep affects behavior

While a lack of sleep can cause some serious and very concrete health problems, it can also have a significant impact on your behavior as well. Where you may have once been a friendly, happy go lucky person, lack of sleep can turn you into a zombie who is short tempered with everyone in your life. Instead of greeting each day with enthusiasm, you may dread waking up and may not feel like doing the things you once enjoyed. An optimistic spirit can easily be overshadowed by a negative, pessimistic view of life when lack of sleep becomes severe enough. Personal relationships can become strained, and people may even begin avoiding you. Without a doubt, lack of sleep can turn you into an entirely different person – one that family, friends and coworkers hard even recognize.

How to cure lack of sleep effects

Simply accepting lack of sleep as a fact of life is not only foolhardy, it is dangerous. Nobody can cope with a lack of sleep for an extended period of time; the negative effects it causes will quickly render you unable to function. Fortunately, there are cures for a lack of sleep. Many people swear by not eating too late in the day, or by eschewing caffeine and alcohol altogether. Others are fastidious about getting plenty of exercise every day. Taking a bath before bed may also help with a lack of sleep.

However, there are lots of sleep aids that are tremendously effective; to figure out what one would work best for you, read our sleep aid reviews.

Should Your Sleep Be Evaluated?

To determine whether you might benefit from a sleep evaluation, ask yourself the following questions:

1. Do you regularly have difficulty getting to sleep or staying asleep?
2. Do people tell you that you snore? Has anyone ever told you that you have pauses in breathing or that you gasp for breath when you sleep?
3. Are your legs “active” at night? Do you experience tingling, creeping, itching, pulling, aching or other strange feelings in your legs while sitting or lying down that cause a strong urge to move, walk or kick your legs for relief?
4. Are you so tired when you wake up in the morning that you cannot function normally during the day?
5. Does sleepiness and fatigue persist for more than two to three weeks?If you answered yes to any of these questions, then a complete sleep evaluation should be considered and discussed with your physician. Before your visit, it may be helpful to track your sleep patterns and medications.

Primary Care Physicians and Sleep Specialists

Depending on your insurance plan and other factors, your primary care physician may start your evaluation by running tests for specific medical disorders that are known to affect sleep. Your physician might even be able to diagnose a sleep problem based solely on your symptoms and recommend initial treatments. At some point, you may be referred to a sleep specialist for a more extensive assessment of your sleep complaints and for more specific treatments.

If this occurs, be sure to ask your physician to refer you to a certified sleep physician. Certification requires that a physician undergo formal training and pass an examination in sleep disorders to demonstrate a higher level of expertise. To check if your sleep physician is certified, or to find a certified sleep doctor, go to either www.absm.org to check ‘verification of diplomates,’ or to the ‘who is certified’ section of www.abim.org.

Sleep Studies (Polysomnograms)

After an initial consultation with your physician or a sleep specialist, you may be referred for a sleep study. The medical term for this study is “polysomnogram,” which is a noninvasive, pain-free procedure that usually requires spending a night or two in a sleep facility. During a polysomnogram, a sleep technologist records multiple biological functions during sleep, such as brain wave activity, eye movement, muscle tone, heart rhythm and breathing via electrodes and monitors placed on the head, chest and legs.

After a full night’s sleep is recorded, the data will be tabulated by a technologist and presented to a physician for interpretation. Depending on the physician’s orders, patients may be given therapy during the course of the study, which may include medication, oxygen or a device called continuous positive airway pressure therapy, or CPAP.

Important Questions to Ask Before Your Sleep Study

A sleep study can be conducted in either a hospital or in an independent facility. Ask if the sleep lab or sleep center to which you have been referred is accredited by the American Academy of Sleep Medicine (AASM). This recognition denotes that the facility adheres to the highest standards of care for sleep disorder patients. A list of accredited sleep facilities is available at www.aasmnet.org.

A related issue to address is whether your insurance carrier requires testing in accredited facilities in order to cover the cost of the procedure; in many states, medical insurance will not reimburse the cost of sleep studies unless they are conducted at an AASMaccredited facility.

If you are referred for a sleep study or a polysomnogram, be sure to request that the technologist conducting your study is a Registered Polysomnographic Technologist (RPSGT). An RPSGT is a fully trained sleep technologist who has met the rigorous requirements to become credentialed by the Board of Registered Polysomnographic Technologists.

Treating Sleep Problems

After the sleep study has been conducted and reviewed, several conditions may be diagnosed, and various specific treatments may be recommended. There is a wide range of methods for treating sleep problems. Medications may be prescribed by your physician. Sometimes a sleep psychologist is called upon to recommend non-drug approaches that may include addressing patients’ pessimism about their sleep surroundings, correcting misconceptions about sleep, controlling stimulating factors that hinder sleep and identifying positive behaviors that aid sleep. Improving your diet, your sleep environment and your bedtime rituals, including the timing of physical exercise, alcohol intake, and other factors may all contribute to a better night’s sleep.

Some patients may be candidates for night-time oral or dental applicances to reduce snoring and apnea. The American Academy of Dental Sleep Medicine at www.aadsm.org lists dental sleep medicine specialists by state.

Sleep Problems and the Importance of After Care

Patients will often need continuing support in terms of evaluating and managing their response to various medications, treatment methods or recommended behavioral measures. Sometimes, a primary physician will prescribe the initial treatments and continue seeing the patient for followup treatments; whereas in other settings, after care occurs in dedicated sleep clinics.

Ideally, the sleep specialist who performed the initial evaluation and reviewed the sleep study with the sleep technologist will direct the patient’s after care, including follow up in his or her clinic and with other allied health professionals involved with treatment.

In addition to medications and behavioral measures, some sleep disorders, such as sleep apnea (in which breathing is briefly and repeatedly interrupted during sleep), may include the use of medical equipment during sleep, such as CPAP therapy.

CPAP is an air pressure system that helps hold the air passages in the nose and throat open during sleep and eliminates snoring and pauses in breathing. Proper fitting and instruction for use of CPAP equipment – whether simple nosepieces or more elaborate masks – is critical to ensure your comfort and willingness to continue with treatment. There may be a period when different equipment is used and several adjustments are made. It is important that you share your questions and concerns with the sleep specialists who are working with you for the best possible outcome.

In truth, some treatment methods may be challenging to follow, and having continuing care available from a certified sleep specialist to oversee a patient’s progress is crucial. Ask your primary care physician or sleep doctor if continuing after care will be offered at the referred sleep clinic. At the very least, most patients schedule annual visits at their sleep clinic to learn about the latest advances in the treatment of sleep problems and sleep disorders.

You Are Not Alone

According to recent polls conducted by the National Sleep Foundation, nearly 7 out of 10 Americans say they experience frequent sleep problems. However, when proper diagnosis and treatment of sleep disorders occurs, the feeling of sleepiness declines, memory improves and safety risks decrease dramatically. In fact, sleep disorder specialists help an estimated 85 to 90% of their patients get better sleep. With the wealth of treatment options now available, a good night’s sleep is within reach.
This is an interesting thought, and has opened the debate on Sleep disorders and associated health risks – Lee Cherry

The Power of the Sleep Cycle

by Glen Rhodes on May.11, 2004, under Bloughts
Ok, I’ve been talking to people for a long time about the fact that you can get by on 6 or even 4.5 hours of sleep per day without question. The secret is NOT the amount of sleep, but rather the number itself; a multiple of 90 minutes will change your life. One thing I should mention, is that because we are analog beings, and not computers, that which could be 90 minutes for some people, might be 80 minutes for another, or 100 minutes for another; you will eventually learn the length of your sleep cycle by watching the times you naturally wake up and turn over, make a mental note of the time / interval.  But assuming that 90 minutes is the average, these are the best lengths of sleep that will not make you feel groggy. The worst thing to do is wake up in the middle of a sleep cycle.
1.5 hours
3 hours
4.5 hours
6 hours
7.5 hours.  Those are the sleep quantities that you should aim to get, and those are what your body will naturally take, removing the alarm clock. Guaranteed. Go to sleep without an alarm clock, and watch what times you naturally wake up at. It will be a multiple of around 90 minutes from when you first went to bed. This 90 minutes is known as a sleep cycle, and it’s how I try to live my life.
Typically, I sleep 3 hours a night, and nap for 90 minutes in the evening. That’s a total of 4.5 hours, and I am always alert, always awake and always feel rested and refreshed.  Read on for more details…

“A group of Harvard scientists trained volunteers  to perform a visual task that required them to  learn how to recognize certain patterns as they  flashed quickly on the computer screen. When  the subjects were tested 10 hours later, those  who had taken a 90-minute nap did much better  than those who didn’t nap. In fact, they did as  well as people who got a full night’s sleep in a  previous study”  -

http://www.sleepfoundation.org/Alert/030730.cfm

Here’s something from the Center for Applied Cognitive Studies (http://centacs.com)

“Studies show that the length of sleep is not what causes us to be refreshed upon waking. The key factor is the number of complete sleep cycles we enjoy. Each sleep cycle contains five distinct phases, which exhibit different brain- wave patterns. For our purposes, it suffices to say that one sleep cycle lasts an average of 90 minutes: 65 minutes of normal, or non-REM (rapid eye movement), sleep; 20 minutes of REM sleep (in which we dream); and a final 5 minutes of non-REM sleep. The REM sleep phases are shorter during earlier cycles (less than 20 minutes) and longer during later ones (more than 20 minutes). If we were to sleep completely naturally, with no alarm clocks or other sleep disturbances, we would wake up, on the average, after a multiple of 90 minutes–for example, after 4 1/2 hours, 6 hours, 7 1/2 hours, or 9 hours, but not after 7 or 8 hours, which are not multiples of 90 minutes. In the period between cycles we are not actually sleeping: it is a sort of twilight zone from which, if we are not disturbed (by light, cold, a full bladder, noise), we move into another 90-minute cycle. A person who sleeps only four cycles (6 hours) will feel more rested than someone who has slept for 8 to 10 hours but who has not been allowed to complete any one cycle because of being awakened before it was completed…. “
It explains why, when I get 8 hours of sleep I feel tired and groggy, or when I get 4 hour of sleep, I can barely wake up. As human beings, we should know about this fact, as everyone always says “get your 8 hours”. Yet some people fare better than others. Why is that? Probably because the more rested people are actually getting closer to 7.5, or 9 hours, while the 8 hour folk feel constantly unrested.
It is said that many of the most productive people in history have understood and practiced this. Leonardo Da Vinci, Thomas Jefferson, and Buckminster Fuller used this *exact* technique. Other great minds likewise used naps to their advantage including Nikola Tesla, Thomas Edison, Napoleon, and Winston Churchhill.

Naps are the key to direct Theta brainwave access. Theta brainwaves are the brainwaves of hyper awareness. The more theta you have during your waking hours, the more creatively intelligent you are–it’s really that simple.
As far as longevity, Fuller lived to 87. DaVinci into his late 60′s. –Both lived over DOUBLE the average life expectancy of the men of their time.

Monophasic sleep is the “norm” for North American culture. We sleep at night, and work during the day. Polyphasic sleep consists of multiple sleep/ wake incidents scattered throughout the day. A sleep schedule with an afternoon nap is an example of polyphasic sleep. There is evidence to suggest that humans were originally suited to a polyphasic sleeping routine, rather than the arbitrary monophasic one that we are used to. For starters, almost all animals in nature conform to polyphasic behavior. In addition, polyphasic behavior is the predominant mode of sleeping for human infants, and even in the later years, children have to slowly be weaned from the afternoon nap. Furthermore, when people are isolated from the external environment – so that they cannot determine the actual time of the day from natural cues such as sunlight, or artificial cues such as clocks or television programs – they tend to exhibit more napping behavior instead of retaining the single monophasic sleep period during the “night.” Finally, it appears that naps – relatively brief sessions of sleep – are more effective in refreshing the mind, than longer periods of sleep. In a sense, we were taught to “unlearn” this natural way of sleeping, when we had to adjust to the arbitrary 9-to-5 schedule.  Oh, and on 3 hours of sleep a night, I have one cup of coffee at the most per day.

The sleep cycle is a beautiful thing.

Your brain cells reset their sodium & potassium ratios when the brain is in Theta state. The sodium & potassium levels are involved in osmosis which is the chemical process that transports chemicals into and out of your brain cells. After an extended period in the Beta state the ratio between potassium and sodium is out of balance. This the main cause of what is known as “mental fatigue”. A brief period in Theta (about 5 – 15min) can restore the ratio to normal resulting in mental refreshment.

Update: I originally wrote this article in early 2003, it’s now mid 2009,
Measure the length of your sleep cycle. 90 minutes is a good average, but for some people it is different. Mine has actually changed in the last few years from 90 to about 75.  Now, if I hit the pillow at 7:00, I wake up for the first time at 8:15. Never, ever using an alarm clock. Because of the change in sleep cycle length, I now get 4 cycles per day. Usually three late at night, and one in the evening.
The key thing is, it MUST be divided up into two distinct sleep sessions per day.  It’s not enough to just get 4.5 hours and say “that’s my sleep done for today”.  You’ll have a hell of a time staying awake for the remaining 19+ hours. You’ve got to divide it into two (or more) sleep sessions. The REM sleep you achieve has to be spaced throughout the day for it to have the proper “flushing” effect. In many non-western cultures, the mid-afternoon nap, siesta, whatever you want to call it, is a completely standard practice.

Cortisol is an important hormone in the body, secreted by the adrenal glands (located on top of the kidneys) and is involved in the following functions and more:

1.  Proper glucose metabolism
2.  Regulation of blood pressure
3.  Insulin release for blood sugar maintenance
4.  Immune function
5.  Inflammatory response

Normally, it’s present in the body at higher levels in the morning and following exercise, and at its lowest at night (about 3-4 hours after begining sleep).  Although stress isn’t the only reason that cortisol is secreted into the bloodstream, it has been termed “the stress hormone” because it’s also secreted in higher levels during the body’s ‘fight or flight’ response to stress, and is responsible for several stress-related changes in the body.  Small increases of cortisol have some positive effects:

1.  A quick burst of energy for survival reasons
2.  Heightened memory functions
3.  A burst of increased immunity
4.  Lower sensitivity to pain
5.  Helps maintain normal body funcitons

While cortisol is an important and helpful part of the body’s response to stress, it’s important that the body’s relaxation response to be activated so the body’s functions can return to normal following a stressful event (including exercise).  Unfortunately, in our current high-stress culture, the body’s stress response is activated so often that the body doesn’t always have a chance to return to normal, resulting in a state of chronic stress.

Higher and more prolonged levels of cortisol in the bloodstream (like those associated with chronic stress) have been shown to have negative effects, such as:

1.  Impaired cognitive performance
2.  Suppressed thyroid function
3.  Blood sugar imbalances such as hyperglycemia
4.  Decreased bone density
5.  Decrease in muscle tissue
6.  Higher blood pressure
7.  Lowered immunity and inflammatory responses in the body
8.  Slowed wound healing, and other health consequences.
9.  Increased abdominal fat, which is associated with a greater amount of health problems than fat deposited in other areas of the body.

Some of the health problems associated with increased stomach fat are heart attacks, strokes, the development of metabolic syndrome, higher levels of “bad” cholesterol (LDL) and lower levels of “good” cholesterol (HDL), which can lead to other health problems!

To keep cortisol levels healthy and under control, the body’s relaxation response should be activated after the fight or flight response occurs. You can learn to relax your body with various stress management techniques, and you can make lifestyle changes in order to keep your body from reacting to stress in the first place. The following have been found by many health professionals to be very helpful in relaxing the body and mind, and aiding the body in maintaining healthy cortisol levels:

1.  Guided Imagery and visualization techniques (www.athletesaudio.com)
2.  Journaling
3.  Self-Hypnosis
4.  Exercise
5.  Stretching
6.  Listening to Music
7.  Breathing Exercises
8.  Meditation
9.  Sex

Cortisol secretion varies among individuals. People are biologically ‘wired’ to react differently to stress. One person may secrete higher levels of cortisol than another in the same situation.  Studies have also shown that people who secrete higher levels of cortisol in response to stress also tend to eat more food, and food that is higher in carbohydrates than people who secrete less cortisol.  If you’re more sensitive to stress, it’s especially important for you to learn stress management techniques and maintain a low-stress lifestyle.

Exercising is a must to improve and maintain health, but too much can work against your well-being.  Exercise is an applied stress to the body which activates a cortisol response.  Exercising too much, too hard, too often and too soon can cause chronic secretions of cortisol and can result in health problems.  The take home message here is practice exercising in moderation and focus as much attention to the recovery process or your body will breakdown and you will eventually suffer from injury and or chronic disease.

Fascia forms the biological container and connector for every organ of the human body(including muscles). In dissection, fascia is literally a greasy mess and so variable among individuals that its actual architecture is hard to delineate.  For these and other reasons, fascia has not been seen as a whole system.  However, new research suggests that fascia is all one net with no separation from top to toe, from skin to core.

Every cell in your body is hooked into (and responds to) the tensional environment of the fascia (Ingber 1998). Alter your mechanics, and cells can change their function (Horwitz 1997).  As more research surfaces this will open doors to new methodology regarding such topics as stretching, and strengthening.

As accustomed as we are to identifying individual structures within the fascial web—plantar fascia, Achilles tendon, iliotibial band, thoracolumbar aponeurosis, nuchal ligament and so on— these are just convenient labels for areas within the singular fascial web. They might qualify as ZIP codes, but they are not separate structures.

How does fascia webbing function as a system?  

Magically extracted as a whole, the fascial web would show us all the shapes of the body, inside and out.  It would be just one big net with muscles squirming in it like swimming fish. Organs would hang in it like jellyfish. Every system, every organ and even every cell lives embedded within the sea of a unitary fascial net. This concept is important because we are so strongly inclined to name individual structures and think that way clinically: “Oh, you tore your biceps,” forgetting that “biceps” is our conception. Our common scientific nomenclature gives a false impression, while the New Age is more literally true: the body—and the fascial net in particular—is a single connected unity in which the muscles and bones float. You can tear this net in injury, cut it with a surgeon’s scalpel, feed and hydrate it well or clog it with high-fructose corn syrup. No matter how you treat it, it will eventually lose its elasticity.

In your eye’s lens, for instance, the net stiffens in a very regular way, requiring you to use reading glasses at about age 50. In your skin, the net frays to cause wrinkles. Key elements like hip cartilage may fail you before you die, and need replacement, but when you finally breathe your last breath your fascial web will still be the same single net you started with.  It’s no small wonder that this system, like the nervous and circulatory systems, would develop complex signaling and homeostatic mechanisms (Langevin et al. 2006).  The larger wonder is that we have not really seen or explored the connective tissue system’s responses until now.

A DEFINITION OF TERMS 

In medicine, the term fascia designates tissues with specific topology and histology, as distinct from tendon, ligament or other specified tissues. In this article, however, we are using fascia as an overall name for this systemic net of connective tissue, because there is no generalized term (Huijing & Langevin 2009).  Connective tissue includes the blood and blood cells, and other elements not part of the structural net we are examining. Perhaps the closest term would be extra-cellular matrix (ECM), which includes everything in your body that isn’t cellular (see Figure 3).  The ECM has three main elements: 

1. Fibers:  the strong pliable weave—consisting primarily of col- lagen (which has 12 types) and its cousins elastin and retic- ulin—that both separates compartments and binds them together
2. Glue:  the variable and colloidal gels like heparin, fibronectin and hyaluronic acid that accommodate change and provide the substrate for other cells like nerves and epithelia
3. Water:  the fluid that surrounds and permeates the cells as a medium of exchange; mixes with the glue to make materials of differing properties; and keeps the fibers wet and pliable Though the ECM will be our topic just below, the term fascia as we define it also includes fibroblastsand mast cells,which give rise to the fibers and glue and then remodel them in response to the demands of injury, training and habit.

The principal structural element in the ECM comprises the fibers collagen, elastin and reticulin. Collagen is by far the most common of these, and by far the strongest. This is the white, sinewy stuff in meat. The collagen fiber is a triple helix; if it was a half-inch thick, it would be about a yard long and look like an old three-strand rope (Snyder 1975). Collagen fibers can be arranged in regular directional rows, as they are in tendons or ligaments (dense regular), or in random crisscross ways, like felt (dense or loose irregular). The collagen fibers cannot actually stick to each other but are glued together by other proteins called glycoaminoglycans (GAGs),which are mucopolysaccharides,both of which are long words for snot. We are held together by mucous, a colloidal sub- stance, which, by varying its chemistry slightly, can display a sur- prising array of properties, from thick and sticky to fluid and lubricating. The fernlike molecules of mucous open to absorb water (they are hydrophilic) or close and bind to themselves when water is absent. Depending on their chemistry, they either bind layers together or allow them to slide on each other (Grinnell 2008).

The phenomenon we call “stretch” or lengthening is a function not of the collagen fibers lengthening but of the fibers sliding along each other on the glue of the hydrated GAGs (Sbriccoli et al. 2005). Take the water out of the GAGs, and the result is tissue that is mightily reluctant to stretch (Schleip 2003). Most injuries occur when connective tissue is stretched faster than it can respond. The less it is hydrated, the less elastic response it has in it.

Is The Body Electric? Connective-tissue cells produce the fibers and the GAGs, and these materials are then altered to form a remarkable variety of building materials. If you were to try to recreate your structural body out of items you could buy at Home Depot®, what would you need? Wood or PVC for the bones, silicon rubber for the car- tilage, lots of string, wire, tubing, plastic sheeting, rubber bands, cotton, nets, grease and oil—the list goes on. Would you try to build a body without duct tape? Your body manufactures all these materials and many more by mixing together various proportions of the ECM’s fibers and glue and altering the chemistry in different ways (Snyder 1975). In bone, the fiber matrix is there—much like leather—but the mucousy ground substance has been systematically replaced withmineral salts. Cartilage has the same leathery substrate, but the glue has been dried into a tough but pliable “plastic” that perme- ates the fibrous leather. In ligament and tendon, almost all the glue has been squeezed out. In blood and joint fluid, the fiber exists only in a liquid form, until it hits the air, when it forms a scab. This manufactory in your body is fascinating: the dentin in your teeth, your gums, your heart valves, even the clear cornea of your eye—are all formed in this fashion.

HOW TO TRAIN THE NEURO-MYOFASCIAL WEB 

If the fascia is a singular space-organizing adjustable tensegrity that traverses the whole body and regulates—both locally and as a whole—the biomechanics of tension and compression, we can then ask:

How can we train this system, in conjunction with our work on muscles and neural control, to prevent and repair injury and build resilience into the system? 

The answer to this question is still developing—rapidly—both in the laboratory and on the training floor.  More of these results can be found at www.fascialftness.de or in the fascial fit- ness section of www.anatomytrains.com.

Finding #1

Specific training can enhance the fascial elasticity essential to systemic resilience. Fascial elasticity has not been recognized until recently, and the mechanisms involved are still being studied (Chino et al. 2008).  Nevertheless, applications to training are already evident.  The basic news is that connective tissue—even dense tissues like tendons and aponeuroses—is much more significantly elastic than previously thought.

The second essential part of that news is that fascial elasticity is stored and returned very quickly. In other words, it is more like a super ball than a Nerf™ ball.   Thus, fascial elasticity is a factor only when the motion is cyclic and quickly repeated, as in running, walking or bouncing, but not as in bicycling, in which the repetitive cycle is far too slow to take advantage of fascia’s elastic properties.

Measurements of calf lengthening during running have shown that much of the length required for dorsiflexion is coming from an elastic stretch of the fascia, while the muscle is contracting isometrically (Kubo et al. 2006).  This contradicts our previous understanding that the tendon was nonelastic, and that the muscles were lengthening and shortening during these cyclic motions prior to and following footfall.

The runners who train for and employ more of this elasticity will be using less muscle power (read: less glucose) during their runs, as they are storing energy in the stretch and then get- ting it back during the release. Thus, they will be able to run longer with less fatigue. Building in this elasticity is a matter of putting a demand on the tissues to act in this way.  Doing this slowly (compared with muscle training) is a definite attribute of fascial training (it may take 6–24 months to build fascial elasticity).

WHAT’S IN: 

Bouncing.  When you land on the ball of your foot, you decelerate and accelerate in such a way that you not only make use of but actually build elasticity into the tendons and entire fascial system.

The best training effect seems to follow the pleasure principle: feel for that sense of elegance, an ideal resonance.  This article uses the generalized term fascia to denote the interconnected net of fibers and glue.

Two muscles held together by “fuzz”—areolar tissue.

The “strapping tape” nature of the fascia covering the quadriceps. The very delicate, gluey tissue that allows change and movement beneath our skin, between our muscles, and anywhere anatomical structures have to slide on each other.

Finding #2

The fascial system responds better to variation than to a repetitive program. The evidence suggests that the fascial system is better trainedby a wide variety of vectors—in angle, tempo and load (Huijing 2007).

Isolating muscles along one track (e.g., with an exercise machine) may be useful for those muscles but is less than useful for all the surrounding tissues. Loading the tissue one way all the time means it will be weaker when life—which is rarely repetitive—throws that part of the body a curve ball.

WHAT’S IN: 

1. Whole-Body Movements. Engaging long myofascial chains and whole-body movements is the better way to train the fas- cial system.
2. Proximal Initiation. It’s best to start movements with a dynamic pre-stretch (distal extension) but accompany this with a proximal initiation in the desired direction, letting the more distal parts of the body follow in sequence, like an elastic pendulum.
3. Adaptive Movement.  Complex movement requiring adapta- tion, like parkour (see the beginning of the James Bond movie Casino Royalefor a great example), beats repetitive exercise programs.

WHAT’S OUT:

1. Repetitive Movement. Machines (or minds) that require clients to work in the same line again and again do not build fascial resilience very well.
2. Always Practicing With Upper-Level Loads. Variable loads build different aspects of the fascia. Sticking with near-limit loads will strengthen some ligaments but weaken others. Varying the load is the better way.
3. Always Training in the Same Tempo. Likewise, varying the tempo of your training allows different fascial structures to build strength and elasticity.

Finding #3

The fascial system is far more innervated than muscle, so proprioception and kinesthesia are primarily fascial, not muscular. This is a hard concept for many fitness professionals to get their heads around, but it is a fact: there are 10 times as many sensory receptors in your fascial tissues as there are in your muscles

Tensegrities

Once you understand the fascial system as a whole, rather than as a series of parts, the body presents itself as an animated version of a tensegrity (“tension-integrity”) (Fuller 1975). The struts are like the bones, pushing out, and the fascial net is like the strings or membranes, pulling in. The whole thing achieves a balance we call “shape.” It is now evident that our bodies work this way cellularly as well as on the macro level (Ingber 2008). Of course, our human tensegrity is animated by our nervous systems, and is very ad- justable via the muscles, but exploring the properties of these structures in terms of our bodies is worthwhile. (Stillwell 1957). The muscles have spindles that measure length change (and over time, rate of length change) in the muscles. Even these spindles can be seen as fascial receptors, but let’s be kind and give them to the muscles (Van der Wal 2009). For each spindle, there are about 10 receptors in the surrounding fascia— in the surface epimysium, the tendon and attachment fascia, the nearby ligaments and the superficial layers. These receptors include the Golgi tendon organsthat measure load (by measuring the stretch in the fibers), paciniform endings to measure pressure, Ruffini endings to inform the central nervous system of shear forces in the soft tissues, and ubiquitous small interstitial nerve endings that can report on all these plus, apparently, pain (Stecco et al. 2009; Taguchi et al. 2009).
So when you say you are feeling your muscles move, this is a bit of a misnomer. You are “listening” to your fascial tissues much more than to your muscles. Here are three interesting findings that go along with this

1. Ligaments are mostly arranged in series with the muscles, not in parallel (Van der Wal 2009). This means that when you tense a muscle, the ligaments are automatically tensed to stabilize the joint, no matter what its position. Our idea that the ligaments do not function until the joint is at its full extension or torsion is now outmoded; for example, ligaments function all through a preacher curl, not just at the ends of the movement. 
2. Nerve endings arrange themselves according to the forces that commonly apply in that location in that individual, not according to a genetic plan, and definitely not according to the anatomical division we call a muscle. There is no representation of a “deltoid” inside your movement brain. That’s just a concept over in your cortex, not in your biological organization.
3. Apparently, sensors in and near the skin are more active in detecting and regulating movement than the joint ligament receptors (Yahia, Pigeon & DesRosiers 1993).

WHAT’S IN: 

1. Skin and Surface Tissue Stimulation to Enhance Proprioception.
   Rubbing and moving the skin and surface tis- sues is important to enhance fascial proprioception. One weightlifter is having good results scrubbing himself with a veg- etable brush before going into competition.
2. Directing Clients to Feel Their Fascial Tissues.
   Taking attention—your own and your client’s—away from the muscles and putting it into the surrounding fascial tissues can help prevent injury and make the perception of kinesthesia more accurate and fully informed. Sensuous body activity coupled with a high level of kinesthetic acuity (think: cat) may prevent injury better than being tough.

WHAT’S OUT: 

1. Isolated Muscle Orientation.  Exercising a single muscle or muscle group is nearly impossible; every exercise is stimulat- ing multiple nerves, involving multiple muscles and employ- ing fascial tissues all around the site of effort, as well as “upstream” and “downstream” from it.
2. Joint-Receptor Emphasis. Given that the ligaments are often tensed by the muscles, the emphasis on joint receptors— while important—needs to be replaced with a more general attention to the whole area, from the skin on down.

References:
FASCIAL FITNESS article By Thomas Myers 38 April 2011 IDEA Fitness Journal
Chen, C.S., et al. 1997. Geometric control of cell life and death. Science, 276(5317), 1425–28.
Chino, K., et al. 2008. In vivo fascicle behaviour of synergistic muscles on concentric and eccentric plantar flexion in humans. Journal of Electromyography and Kinesiology, 18(1), 79–88.
Desmouli`ere, A., Chapponier, C., & Gabbiani, G. 2005. Tissue repair, contraction, and the myofibroblast. Wound Repair Regeneration, 13(1), 7–12.
Fascia Congress. 2009. www.fasciacongress.org/2009.
Fuller, R.B. 1975. Synergetics.New York: Macmillan.
Grinnell, F. 2008. Fibroblast mechanics in three-dimensional collagen matrices. Trends in Cell Biology, 12(3), 191–93.

“The increased productivity comes, on the one hand, from people getting more done during the hours they are at work, perhaps because of increased stamina and, on the other hand, from less absenteeism owing to sickness,” says one of the lead researchers behind the study.

A similar British study that employees returning to work after lunchtime workouts showed consistently higher work performance, better time management and improved mental sharpness.

It has been well documented that exercising at the workplace if only for a few mins at a time is enough to advert serious health conditions. Now it is also enough to boost productivity and really affect the bottom line.

Studies such as these are showing that workplace exercise programs benefit more than just the workers. They also give companies more efficient employees who work better together. Health care costs can be expected to go down for employees who exercise regularly at work, resulting in fewer sick days, better attendance and more cooperation between co-workers.

Sedentary type occupations where employees may sit in front of a computer for 8 hours a day are obviously most prone but are also the ones who can benefit most.

During a weight training workout, since you are only working for a short bout then resting, then working again, these basic tests are of little use. Instead, exercise intensity when lifting weights can be much better determined by looking at these four components:

(1)  Repetitions (Reps)
- A rep is one complete movement of an exercise.

(2)  Sets -
A set is a designated number of repetitions performed together in a series.

(3)  Load
- This is the amount of weight being used.

(4)  Rest Interval - 
This is the amount of recovery time taken between sets.

Deciding on how many reps & sets to perform, what weight to use and how long to rest in-between sets depends on the focus of your workout, and more importantly, you fitness goal. Manipulating the four components is a simple and highly effective way of adding variety to your program.

Changing any one of these can provide a totally different stimulus and end result. Although all four are tied together, so if you change one you may well have to change the others to suit.

ACSM Exercise Physiologists suggest following this rule:  If you increase the amount of time (Volume) you spend exercising, then you must decrease the intensity (Decrease the: repetitions performed per exercise, the load or resistance, the amount of rest between efforts, or number of sets per exercise).

Here are some general guidelines on how to choose the right intensity for general fitness goals.

(A)  Power: 5-8 Reps, 4/5 Sets, 85%+ RM Load, 2-5mins Rest

(B)  Strength: 8-12 Reps, 3 Sets, 65-75% RM Load, 60-90secs Rest

(C)  Endurance: 12-15+ Reps, 1-3 Sets, 50-65% RM Load, 45-60secs Rest

Sweating or perspiring is a thermoregulation process where the sweat glands produce fluid, mainly water and some dissolved solids, that appears on the skin. This fluid is then evaporated creating a cooling effect on body.

As a body gets warm, receptors in the skin send information to the hypothalamus in the brain which then activates sweat glands. Sweating is generally induced by an increase in body temperature due to either weather or activity. It can also be induced by nausea, fever and even nervousness.

The idea that you can lose weight simply by sweating has a small grain of truth. A person can lose about 1 liter of sweat per hour during exercise. A liter of water weighs approx. 2.2lbs, therefore it is technically possible to lose weight due to sweating. The caveat is that this is purely water weight and you will gain it all back once you rehydrate after exercise.

A number of sports such as wrestling and boxing have used extreme sweating as a way to “make weight” for competition. This is usually done just before a bout for the weigh-in. Fighters have been known to drop as much as 10lbs in a day. Then they show up to the bout after adding all this weight right back on. This type of severe weight fluctuation can be potentially dangerous and even fatal.

Saunas and steam rooms really gained popularity in gym facilities and spas in the 1980s. This led to a glut of people sitting around in pools of sweat (both their own and other people’s) thinking that they were amazingly shedding weight. Another popular weight loss fad were PVC sweat suits and the cheaper garbage bag or cling wrap versions. These gained a certain degree of prominence in some jogging circles. Thankfully both trends have mostly subsided, although you will still see the odd disillusioned sole plodding along in their rubber “sweatsuits.

Another trend or fad, depending on how you look at it, has been Bikram yoga. This is a specific style of yoga practiced in a room heated to 105ºF. Although the founder of this yoga style has claimed performing it in this heated environment has many benefits, it is probably safe to say one of the main reasons for it’s rise in popularity is due to the fact that practitioners believe they are losing more weight during the class because they are sweating more.

If sweating really did help with weight loss, couldn’t a person just lie on the beach in the sun, sweating the pounds off without having to lift a finger? Or why couldn’t they exercise at a very low level in a very hot environment and sweat profusely? The answer is that the amount a person sweats has no real correlation with the amount of weight they can permanently lose.

If you are exercising, and sweating as a result of the exercise, and not a hot environment, then chances are you are doing a certain level of work and therefore you are burning some calories. But you do not have to be drenched in sweat to have performed a hard workout.

Excessive sweating can be a potentially dangerous situation especially if left untreated. The loss of a lot of fluid due to sweating can lead to dehydration, dizziness, heatstroke and even certain cardiovascular conditions. Along with the water loss there is also a loss of certain electrolytes which, if excessive can lead to kidney damage. Every year there are a few isolated cases of fatalities due massive water loss from sweating.

On a side note it has been shown that dehydration slows the use of fat as a fuel and inhibits weight loss.

Some people call it the after-burn or a workout high. It’s actually called the Excess Post-Exercise Oxygen Consumption or EPOC. Technically EPOC is the increased oxygen consumed after strenuous exercise or activity to reduce the oxygen debt created by said exercise or activity resulting in caloric expenditure. In layman’s terms this means the additional calories you burn after exercise while your body is recovering back to it’s normal resting state.

Due to these extra calories being burned because of this “after-burn”, your EPOC can play a very significant role in weight loss.

When we exercise we are utilizing a massive amount more of oxygen than normal, our heart rate and body temperature can greatly increase, we are burning a lot more glycogen from both the muscle cells and blood stores, and we are producing more by-products. So after exercise we need to stock back up on the oxygen and glycogen we have used, reduce our body temp and heart rate, and deal with those by-products. All of this post-exercise work requires energy and this is where EPOC comes in.

The amount of calories burned post-exercise depends on the amount of oxygen consumed during EPOC and how long it lasts. The research is a little vague with studies showing it can last as long as 24 hours or as little as 90 minutes. The amount of post-exercise oxygen consumed can also vary greatly from person to person and is dependent on a number of factors including the person’s level of fitness and type of training. We do know that EPOC is present after both cardiovascular exercise and strength or resistance training. We also know that one factor that can have a big effect on EPOC is workout intensity. The amount of EPOC is directly related to the intensity of your workout. Both heavy strength training workouts and high intensity interval style training have been shown to have the greatest effect on EPOC.

Here are some tips to help maximize your EPOC:

Add Some Intervals – instead of just aimlessly plodding away on the treadmill watching some reality TV show, shake up your cardio by throwing in some high intensity intervals. Not only will they help you burn more calories while you are performing them, they can also crank up your EPOC levels, not to mention make running on a treadmill just a little less boring.

Lift Heavy – put down those pink neoprene hands weights and start lifting some real iron. Choose weights that make it difficult (but not impossible) to complete 8-10 reps. For the women who are afraid they will turn into a female Arnold Schwarzenegger overnight, don’t worry you won’t. For the guys who wish they could turn into Arnold overnight, sorry it isn’t that easy. Some studies have shown that heavy resistance training can have an even greater overall effect on EPOC than aerobic or cardiovascular exercise.

Reduce Your Rest – Another simple yet highly effective way to increase your EPOC is to reduce your rest intervals in between sets while working out. Instead of taking 1-2 mins between sets, cut it down to 45 secs, and use a timer to keep you on track. Shorter rest basically gives you less time for recovery thus requiring more time after the workout to replenish the overall oxygen consumed during the workout.

One very important point to remember is that while intensity is a key factor in determining the size or amount of EPOC, you still need to adhere to the basic principles of rest and recovery in between workouts. You can’t go all guns blazing every workout trying to rev up your EPOC and expect to see big results. There must be a balance between high intensity workouts and adequate rest and recovery.