November 2008 Archives

By Erica Haller-Stevenson, MPH, CHES

Are you looking for a fun way to exercise this fall? Perhaps you need to find activities for the family, or just want to spend some time outdoors. You do not have to look any farther than your city and county parks. The City of San Antonio and Bexar County operate over 150 parks, in addition to many other sports complexes, special use facilities and plazas.

There are many ways to be physically active at your parks this fall:

•  Walk, jog, or run.

•  Do calisthenics.

•  Skate.

•  Bike.

•  Golf.

•  Play basketball, soccer, tennis, baseball or another sport.

•  Take a group exercise class.

•  Walk your dog at a dog park.

There are even playgrounds and activity classes for you and your family to enjoy. Park facilities and activities are available at little or no cost.

You do not have to be an athlete or avid exerciser to take advantage of these opportunities. In partnership with Steps to a Healthier San Antonio (a Metro Health program), 12 City of San Antonio parks recently posted signs that list the length of the park walking trails and tips on healthy eating and exercise.

Be sure to take precautions to protect your skin from the sun and stay well-hydrated while you get out and have fun in your parks.

For more information about your parks, contact the City of San Antonio or Bexar County:

City of San Antonio

http://www.sanantonio.gov/sapar/

(210) 207-8480

Bexar County

http://www.bexar.org/bcinf/InfraCitizen.asp

(210) 335-6732

Erica Haller-Stevenson, MPH, CHES, is the Community & Media Liaison for Steps to a Healthier San Antonio, San Antonio Metro Health District. The program is part of Steps to a HealthierUS, a national program focusing on the prevention of diabetes, obesity and asthma by addressing related risk factors such as poor nutrition, physical inactivity and tobacco use and exposure. Visit the San Antonio Metro Health District online at www.sanantonio.gov/health/.

Much of our daily activity involves walking or standing. With a little conscious effort, you can make some drastic changes without even breaking a sweat. We will be incorporating just one simple exercise into our routines - one that can really make a difference in how we look in heels, skirts and shorts this fall and winter.

The good old-fashioned calf raise

Stand on one or both feet and raise your heel(s) as high as you can while balancing on the ball(s) of your feet. Lower back down (keeping your heel(s) slightly off the floor, and repeat until you feel very fatigued.   Repeat.

* While washing the dishes, do calf raises.

* While cooking, do calf raises.

* While watching TV, do calf raises.

* While waiting in line, do calf raises.

* At your child's practice, you guessed it - do calf raises.

Try to get in several sets a few times a week and watch (and feel) the difference!   You'll be amazed - and don't be surprised at the compliments you'll soon be receiving.

Shannon Sutton is an independent certified personal trainer.   Her certifications include ISSA, NASM, APEX AND Reebok.   She has invested years in helping individuals reach their health, fitness and wellness goals.   Contact her at (210)-722-3962.

Studies have shown that as many as 76 percent of pregnant women experience low back pain, and as many as 50 percent of them take time off from work or have reduced social interactions because of it. Those with severe pain may even avoid future pregnancies because they fear recurrent low back pain. Why does it occur, and how can it be treated?

Pain generators
Many changes occur to a woman's body during pregnancy that predispose her to develop low back pain (LBP). Weight gain leads to a shift in the center of gravity, causing a strain on the low back and sacroiliac (SI) joints. Ligaments and joints may become lax secondary to hormones released during pregnancy causing mechanical strain of the lower back and SI joints. Muscle weakness may lead to myofascial pain syndromes and malalignment problems. Weakness in the core muscles as well as the pelvic floor, hip and lower extremities may all contribute to developing LBP. Lumbar disc herniations occur in one in 10,000 pregnant women. This rate is not significantly different, however, from the rate in nonpregnant women of childbearing age. Hip pathology may also refer pain to the low back and must be included in the evaluation.

Testing
An appropriate physical examination is important to identify the problem as radiographic tests are contraindicated during pregnancy. Ultrasound poses no risk of fetal harm, and an MRI is safe but should not be used during the first trimester due to lack of long term studies.

Musculoskeletal tests can confirm the common diagnoses for lumbar and SI joint dysfunction, muscle imbalance, malalignment problems, and disc injuries. These tests can be conducted by a physical medicine and rehabilitation physician, an obstetrician or physical therapist.

Treatment options
Physical therapy, bracing, oral medications, limited injections and alternative treatments such as acupuncture may be considered.

Physical therapy may offer tremendous relief utilizing postural retraining, stretching, manual therapies and functional and core-strengthening exercises.

Safe pain control modalities may also be used in treatment such as transcutaneous electrical nerve stimulation (TENS) and acupuncture if approved by the obstetrician.

SI joint belts and abdominal binders along with core strengthening may add significant pain relief for LBP.

Very few medications are safe to utilize for pain during pregnancy. Acetominophen and limited opioids may be used with the obstetrician's approval along with short courses (48 hours) of anti-inflammatory medications. During the second and third trimester, limited steroid injections with local anesthetics may be considered for severe cases and should be discussed with the obstetrician.

Talk to your doctor
Although LBP affects the majority of pregnant women, good nonsurgical treatments can provide relief. Women should check with their obstetricians regarding specific questions about treatment. A referral to a physical medicine and rehabilitation physician may be helpful to evaluate the problem and prescribe specific therapies. If you have questions, talk to your doctor.

Dr. Annette Zaharoff is a sports medicine physician specializing in the non-surgical evaluation and treatment of injuries. She maintains a private practice in San Antonio and may be reached by calling her office at (210) 616-0646 or visiting her Web site www.drZmd.com .

By Bonny Osterhage

Next summer when temperatures soar outside once again, it will be time for the 28th Annual Hotter 'N Hell Hundred in Wichita Falls, Texas. Right now, while the weather is cool this fall, you may want to plan ahead to prepare for this great cycling event. Deemed one of the oldest and largest cycling events in the nation, the HHH draws people from all over the United States and around the world.

Voted the "Best in Texas" by Competitor Magazine four years in a row, what keeps the more than 10,000 people coming back to brave the Texas wind, sun and searing temperatures is the variety and the fact that there is something for every level from the fitness rider to the cycle racer.

The 100 mile endurance ride is a rolling route with long inclines and incessant wind. It is broken down into routes that range from 10 K for those people who don't ride on a regular basis all the way up to the 100 mile journey for those who are in it for the long haul. Riders who chose to tackle the 100 mile route must take into account Hell's Gate, which is located at the 60.3 mile mark and normally closes at 12:30 p.m. Riders arriving after closing time will be directed to a shorter route that ends at 84 miles.

All along the routes are volunteer-manned rest stops. Here riders can get supplies or sit and rest in the shade or under a tent. Each of the 17 rest stops has a team of doctor-led medical personnel and, since the rest stops are located at approximately 10 mile intervals, medical attention is never far away.

In addition to the endurance ride there is a ten mile off-road single track made up of short, quick climbs and drops to challenge the off-road cyclist as well as an off-road race and trail run.

By Nicole Rogers, MPH, CHES, Executive Director of The Health Collaborative

It's a mild South Texas autumn, and one great way to enjoy the outdoors is to grill.   Unfortunately, recent research has linked grilled meat to cancer causing agents.   This season, re-think grilling so that, instead of increasing the risk of cancer, you use grilling to prepare healthy autumn meals.

Grilling any meat -- red, white or fish -- produces potent carcinogens, according to studies conducted by the American Institute of Cancer Research. Carcinogens are mutagens, substances that change the genetic code of cells. Heterocyclic amines (HCAs), chemicals linked to cancer, are formed when high cooking temperatures cause a chemical reaction between naturally occurring amino acids and sugars in the meat and creatine, which is found in muscle tissue.

Another form of cancer causing agents, polycyclic aromatic hydrocarbons (PAHs), are found in the smoke created when fat and juices from meats drip and hit the heat source.   The smoke rises and can stick to the meat.   A one-pound, well done, charcoal-broiled steak contains 4 to 5 micrograms of the PAH benzopyrene, an amount equal to what a person would get from smoking 600 cigarettes.   That's a lot of carcinogens!

Both gas and charcoal grilling have the same effect.   Cooking inside on a stove, whether in a frying plan, a grill pan or in the oven, is not known to cause the same reactions because the meats cook at far lower temperatures.

But don't despair, just be aware when grilling and enjoy your family time outside.

Here are tips for healthy grilling this fall:

Choose lean meats.   Decreasing the amount of fat that's able to drip down on the coals also decreases carcinogens.

Marinate.   Studies show that marinating your meats before putting them on the grill can reduce the HCAs as much as 92 to 99 percent in some cases.   Marinate in a thin, liquid sauce for at least ten minutes.

Microwave first.   Partially cook burgers, poultry, ribs and fish in a microwave oven for at least ten minutes before grilling.

Add soy.   Add ½ cup of textured soy protein to a pound of ground meat before grilling.   This cuts 95 percent of HCAs.

Add garlic and herbs.   Garlic, rosemary and sage reduce HCAs when mixed into burgers.

Avoid well done meat.    The longer you cook meat at high temperatures, the more HCAs you produce.   If you cook a steak well done as opposed to medium well, you double the HCAs.

Add vitamin E.   Just 120 milligram of vitamin E power mixed into or sprinkled on 3.5-ounce patties can reduce HCA formation as much as 72 percent.

Drink tea.   Chemicals in black and green tea help detoxify HCAs.    Drink hot or iced tea from bags or loose tea with your barbecue.   Bottled teas or powdered, instant teas are not beneficial.

Cut your meat.   Smaller cuts of meat that can be skewered, such as for kabobs, take less time to cook.

Avoid blackened or burned meat.

Grill fruits and veggies.   Fruits and vegetables do not contain creatine, the animal protein needed to make HCAs.   Pineapple and peppers are good when grilled.   In addition, eating fruits, vegetables and green salads along with barbecued meats lessens the cancer risk.

A cutting-edge, public-private model for solving community health issues, The Health Collaborative began informally in 1997 when several area health care organizations agreed to put aside their competitive business practices to conduct the first community health assessment.   The mission of the organization is to improve the health status of the community through collaborative means.   Representatives of this group are dedicated to the health and well-being of our community in the spirit of collaboration.   Partners include the major health systems in San Antonio, Metro Health, the YMCA of Greater San Antonio, Community First Health Plans, Methodist Healthcare Ministries, and a community representative. For more information, visit www.healthcollaborative.net .

• USA Fit San Antonio has been running a training program out of the Run Gear Run Store at Stone Oak and 1604. The Web site for the marathon training is www.sanantoniofit.com or www.rungearrun.com . Call the store at (210) 490-9987.

• Run Away Athletic Club has a training group based out of Josephine's Bakery at Mulberry and North St. Mary's near Brackenridge Park. The coach and organizer is John Purnell. Their Web site is www.runawayclub.com

• We Run San Antonio is a training group based out of Roger Soler's Sports Stores in Helotes and Alamo Heights. The coach and organizer is Edgar Gonzalez. For information contact www.werunsantonio.com .

• Fleet Feet Sports has a marathon training group based out of their store at 6408 N. New Braunfels in Alamo Heights. The program is directed by Carroll Voss. Call the store at (210) 805-0845 or visit www.fleetfeetsanantonio.com

• The Leukemia and Lymphoma Society's Team in Training is a fund-raising charity organization that has been offering Rock 'N' Roll half and full marathon training. Coaching and training schedules are provided with a variety of training locations throughout San Antonio. Contact www.teamintraining.org:80/stx

Paul Baltutis, is manager of Soler's Sports and a certified marathon coach for Team in Training. For more information, please contact Paul Baltutis via e-mail at sage_run03@yahoo.com.