22 November 2011

FitnessDoc FAQs

Over 40 medical experts are standing by to answer questions about symptoms, treatment, lifestyle changes, fitness and even how to improve your sex-life, or have a baby.


FitnessDoc has answered his fair share of more than a quarter of a million questions sent in by our readers to date. His forum covers the whole range of issues - from dedicated athletes looking to shave a few more seconds off their running time to new moms wanting to lose those extra baby-kilos. Read the most frequently-asked questions, and if they don't cover what you need to know about fitness and sport, send your question in to FitnessDoc.

Q: Tighten flabby tummy

I want to tighten my tummy muscles and build or tone my upper arms, as well as some form of exercise for my breasts. I know that exercises for the breasts do not make them smaller after childbirth and breastfeeding, but at least it will help. After the birth of my daughter about 10 months ago, I have been struggling to get back into shape. I started walking, and previously, before the pregnancy, I used to run. I just need some exercises to ease into shaping and toning my body. I have a set of dumbbells at home, but I'm not exactly sure what exercises I can do. Please help?

Expert: The one goal that you can aim for, and, in a manner of speaking, kill many birds with one stone is an overall body fat reduction. This can be achieved by doing regular cardio training. What will not work are hundreds of situps and crunches and dips etc. The problem with these exercises is that they use such a small muscle group in a static activity, and therefore burn fewer calories than exercising large muscles groups in dynamic cardiovascular exercise such as walking, jogging, running, swimming or cycling.

In order to burn the fat, you need to do these types of cardiovascular exercises as least 4 - 5 times a week for at least 30 - 45 minutes. This will help to increase the amount of calories that you use and help to decrease your body fat. Having said that, it is still important to do some strengthening and toning exercise and, obviously, to include exercises that make use of the muscle groups in your abdominal area. The exercises that you do will depend on whether you have access to a gym or you do body weight exercises at home. I would suggest you check out the fitness page of this site, then click on programmes and choose any one of the cardio based programmes on this site.

Q: Running and breathing

I run out of breath quickly when running. What is the proper way of breathing when running, and how can I make my legs lighter when I run.

Expert: How long have you been running? It's not unusual to be out of breath and feel heavy-legged when you are running if you're relatively new at it. The short answer to both questions is to get fitter. It's the only way to improve both breathing and legs, get your body used to running. There are no magic formulas, which is the beauty of running. So it's just a question of practice, time and discipline and in a month or two, you'll be looking back at yourself wondering what the fuss was about!

Q: Man boobs - I am 19 years of age. I have saggy chest (man boobs)
Can you tell me if there's any way to reduce it?

Expert: You are not alone, and this is by far the most common question that is asked, actually. Everyone seems to battle with the weight in a specific area, men and women tend to struggle with different areas. It's really difficult to combat though, although you have already hopefully recognized that eating well and exercising correctly are the keys. The mistake people make is that they try to target the muscle group, often at the expense of doing the whole body exercise that is actually more effective. That's not to say that focus on a muscle group or area is bad, because you need it, but it's better to do whole body exercise.

The exercise is cardio training - like running, walking, cycling, swimming, taebo, aerobics etc. Anything that is cardiovascular gets the heart pumping and energy burning is most effective. It is just a question of how you use these cardio sessions. I would suggest at least 4 days a week of cardio training, each session lasting about 30 to 45 minutes, AT LEAST. You have to build up this duration and then keep at it consistently in order to see change.

The specific exercises for the area in question have a relatively minor role, other than that they are responsible for developing the muscle in the area, which creates the appearance of being toned. That's obviously what you want, but you have to realise that you can't do the toning and specific work first and neglect the cardio - it has to work the other way around, cardio first, toning second. So focus on cardio, then on toning. 

Diet is also very crucial, and if it's not 100% it will undermine any exercise benefits. So the best thing is to see a dietician or follow a very good diet plan. Just remember that low kilojoule is not necessarily better - too low causes problems as well, because it causes the body's metabolic rate to drop and that affects your ability to lose weight in the future. So don't try to starve yourself or go overboard, rather eat sensibly, cut out as much fat as you can, and listen to your body.

Q:  Stomach exercises

I am very slim and petite and carried twins a couple of years ago. I was back to my pre pregnancy weight quickly after the birth, but understandably my stomach muscles got pretty stretched out and have seperated. Any special exercises you can suggest or things to bear in mind when trying (perhaps in vain) to regain some sort of youthful glow?? This jelly belly (albeit a flat one) is not doing it for me.

Expert: This is a difficult one, and the short answer is not really. Other than the normal stomach exercises, there's nothing special that can be done - I assume you're spending time on the abs, maybe doing Pilates, crunches, sit-ups, and other variations? That's all I would suggest, and I think it would be the most effective way to overcome this problem.

Q: Exercise for very overweight people

I heard a fitness expert on television say that his client was very overweight and he started her off on 3 min jogs/walks, then built that up to 5mins. Eventually she was doing 45mins on the treadmill, and in 2 months she was able to carry on longer. Is that a way to start, especially for someone like me that has so much weight to lose? What could I combine with the walking, lifting light weights? Punching bag?

Expert: Yes, absolutely, that is the best way to go about it - start with what you can manage and then build it very gradually, and your body will adapt. Different people have different potential/starting ability, so for some, it may be that they can run for 5 minutes, not 3. For others, 1 min running might be all they can handle, but the principle is the same. Gradually phase out the walking, increase the running time and eventually you'll be handling something that right now, is not possible. 

I'd say a total session of 30 minutes is a good start point, which might consist of 3 min jog, 2 min walk, repeated 6 times. Then increase to 40 minutes (repeat 8 times, in other words), and then begin to increase the jog (4 min, for example, with 2 min walk) and eventually cut back the walk). Maybe by the end of March you're doing 6 min walk, 2 min jog, then you go 6/1 and pretty soon you'll be up to 30 minutes non-stop.
Some weight training is also good, if you have access. So is a punching bag, just for variety and high-intensity training. I'd say 4 days a week of walking, maybe 1 or 2 of weights and punch bag will do the trick just fine!

Q: Dizzy and faint after exercise

I am very unfit and recently started playing netball with my company. I can play for about 15 minutes, and then I start feeling dizzy and faint. How do I prevent this?

Expert: This is partly related to the relative lack of fitness - remember that before this, you may not have exercised for years. So your body is not used to the exertion, and so feeling tired and dizzy is partly expected.
The other possible causes are a drop in blood sugar or blood pressure. Blood sugar is easier to solve - you just have to have something sugary to eat/drink when you play. Coke, Powerade, fruit juice will do the trick. If this is caused by blood pressure, it's a little trickier to know for certain - you'd have to see a doctor and have it measured before and after exercise.

That's a bit of a mission, so you can also check if it goes away if you lie down with your feet up on a chair, elevated above your head. The problem should go away, regardless of the cause. If it is caused by blood pressure, then over time, as you get fitter, you'll get better at regulating it. If it's fitness, then you'll find it easier to play and if it's blood sugar, then simply eating or drinking solves it. So hopefully you can overcome this quickly and start enjoying the games!

Q:  Exercise and nutrition

Hi, I am a 49 year old woman and have exercised my whole life. I go to a personal trainer three times a week - before my hour with him I run 4 - 5 kms and then try to fit in 5 km runs in between, although I am planning to up my distance as want to run a 21km in July. The problem is I feel I need some supplement or something as lately, after exercising, I could cheerfully lie on my bed as I feel really fatigued and lacking in energy. What should I be taking. I only take a multivitamin every day as well as flax seed oil. Your thoughts would be appreciated. (perhaps it is just old age)

Expert: I think supplements are less likely to be the answer than energy in the diet. Fatigue and failure to recover after exercise can be caused by a deficiency in vitamins or minerals, yes, but it's much more likely to be caused by the food you're eating. Specifically, a lack of energy to replace what you're using during training is the culprit, and that's what you need to assess.

Are you getting in enough carbs and total energy each day to allow full recovery? Also, do you eat at the right times to allow you to recover, and do you eat the right meals at the right times?

I'd love to answer these questions for you, but only you can, and only with the assistance of a dietician, because there are too many nuances in the diet to give a one-size fits all answer. The basic answer is that if the diet is not high enough in carbs and total energy, then exercise will cause excessive fatigue.

Q:  Recovery after a long run

If I do a long run over the weekend (between 16km and 24km) how long do I need to "recover" after if I had run a half marathon? Or can I just run 8 - 10km 2 days after that long run anyway.

Expert: No problem, I'm here to answer questions - I do apologize that it's taken so long to get to yours though! Travel and work have kept me rather busy (and tired). Anyway, better late than never!

The answer depends on your level of fitness, where you are in the programme and how hard you've done the run. If you race a half-marathon, then 10 days to 2 weeks is a normal time to take it easy before resuming normal training. However, if you went out and did a half marathon say 10 to 15 minutes (or more) slower than normal, then your recover time can be 2 or 3 days. If it's even easier than this (say for example, you're a 90 min half marathon runner and you go out and run 20km in 1:40), then you're probably OK to train normally again by the Tuesday.

A lot depends also on where in the programme you are. You'll know for example that sometimes you're building up and the long run you do is say 10 to 15% longer than anything you've done before. That means it's a bigger stress on your system than if you'd done long runs every weekend for say 2 months, giving your body a chance to adapt.

It sounds to me that you're quite used to running 16 to 20km, and so a 20 km run, as long as it's done slowly enough, would not be too great a stress that you need the whole week off. A rest day after, and then easy training one day, and then back to normal would probably be OK. But as always, the fine print is that you must listen to your body, because if it's too much, your body will tell you!

Q: Getting rid of cellulite

I have a BMI of 19, I weigh 57kg and am 1.72 m tall. I have a lot of cellulite however! It isn't visible on its own, only when I pinch my skin around my thighs and hips and tummy! I am currently exercising to Joanna Hall's 28 day body plan DVD which is a combination of Cardio, Aerobics, Yoga and Pilates. Will this kind of exercising reduce my cellulite, maybe even remove it completely after a few months? I know that I should also increase my water intake?

Expert: As far as exercise goes, it is the cardio training, like cycling, running, stepping, aerobics, walking etc. that is most helpful in losing weight. So therefore the DVD will be helpful, provided you do it often enough and for long enough. 

So I would say you should continue with what you are doing, keep focused on the cardio. I think that 4 times a week is the minimum you should aim to exercise, five is probably the ideal number, but four is fine too. The intensity you train is also very important. A lot of times, people train a little too easy, perhaps. I am not saying you should go out and push super hard and exhaust yourself every day, but stepping up the intensity once or twice a week is certainly a good thing. You should aim for a total of 45 minutes or so (anything between 30 and 50 minutes is a good average), and you should finish each session feeling tired, but not exhausted. 

The problem is more likely diet related, and I'd encourage you to seek the assistance of a dietician in this regard. There are nuances, like what you eat, how much, and when, that a dietician should discuss with you. The water intake idea is false, it wont be helpful - the answer is to burn fat, because that's what cellulite is, but in your case, it's that last stubborn storage that you need to tackle, and that is tough.
So hang in there, be patient and keep going!

Q: Thigh-toning questions

I have naturally big thighs and when I lose weight my thighs don't seem to get as small as I want them. Someone told me, step aerobics, if done with weights, causes this - is that true? I delivered 13 weeks ago and I've been doing aerobics for the last one month, but no weights. How do I approach getting slim thighs to be proportionate to my upper body, I love weights, in fact before pregnancy I could squat with 70kgs?

Expert: Not necessarily, to answer your first question. Obviously, if you do exercise that involves the muscle, the muscle will develop, but I don't think this is the same thing as what you're aiming for.

So perhaps you need to avoid high resistance training with the quads/thighs, and maybe aerobics is not the best for you, but over time, it won't keep making your thighs bigger and bigger. The weight training is much more likely to cause your thighs to develop, especially if you're squatting what is pretty close to body weight. That's quite heavy, and if you're really interested in toning, that may be too great, and maybe you need to reduce that and lift more reps. Say 40kg, but do more reps than before. Other than this, it's a question of doing more cardio and giving it time - it's never easy to target one area, and that area is always the last to change, so it's going to be a long-term challenge!

Read more:

All about cardio

Visit the Sports injuries centre

(Joanne Hart, Health24, May 2010)




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