Sunday, September 28, 2008

fitness gadgets

I don't want to specifically endorse any commercial products. However, I know that most people are familiar with a variety of fitness gadgets on the market- for example, Sunday morning TV is filled with infomercials for all sorts of exercise gadgets.

In general, the best form of exercise is something that you do regularly, so anything that inspires you to exercise more is good. One of my medical school professors liked to say "The best exercise for you is the best exercise for you," meaning that there is no one perfect form of exercise that is universal.

In general, I am not a huge fan of machines that are designed to target one body part, for several reasons. First, it is not possible to spot reduce fat in one region of the body, so machines that market themselves as "hip and butt machines" or the latest and greatest ab machine tend not to be great purchases. Additionally, they tend to be expensive and bulky.

The one targeted machine that I do like is the ab wheel, shown to the left. It's a cheap item (it should certainly be less that $20, and you may be able to get one for as little as $5), small, and does work very well for strengthening the abdominal muscles.

As I discussed in an earlier post, I like anything that makes exercise easy and more convenient. Therefore, little gadgets that allow you to exercise during small windows of time are great. One example is "The Perfect Pushup." It's a $20 item that makes pushups more fun, and probably more effective. The rotation of the handles does place less strain on the wrists, and in my personal testing, I do find that my push-ups seem to be more effective when I use it. I keep mine near the television, which is also a useful reminder for me. When I see them while I am watching TV, it is a useful cue to do some push-ups during the commercial break.

Incidently, a pair of dumbbells serves a similar purpose, and may be an even better choice. The great thing about dumbbells is that they are so versatile- you can do many different exercises with them.

If one were to look into more expensive products that target more total body exercises, there certainly is not a shortage of devices available. Of the large, bulky devices, my personal favorite is the Total Gym, which is an infomercial staple with Chuck Norris and Christie Brinkley. It's a great machine, the main drawback being that you need a large enough space to use one.

Amongst smaller gadgets, one that I really like is the BodyBlade. It's basically a stiff flat blade, that somewhat resembles a very thin ski. The idea behind the BodyBlade is that by rapidly vibrating the blade in different positions, you can strengthen a variety of muscles through repeated contractions. I wouldn't recommend it for the novice exerciser, for those who are looking for a great way to add variety to their routine, it can be terrific. It is commonly used in physical therapy, so it is ideal for people who are using the BodyBlade in therapy, and want to extend it's use to the home. I like to collect fitness gadgets to play with so that I am familiar with them for my patients, and the BodyBlade is the one that I find myself using the most often. The main downside of the BodyBlade is that it can be quite expensive (usually over $100, depending on which size you get).

Again, my goal of discussing these gadgets is not to endorse any specific product. But I do think that anything that helps cue people to be more active is helpful, and these gadgets can be useful as part of your healthy lifestyle so long as you actually use them.

Sunday, September 14, 2008

Accidental Exercise, Reversal of Flexion

One of the challenges of most working people is finding sufficient time to exercise. Because of the multiple obligations that most working people have (work itself, family, shopping, paying bills, keeping in touch with friends, etc), exercise is often the first thing that goes, usually with a pledge of "well, I'll fit it in later."

As one of my mentors in NJ used to say, later never comes.

One of the keys, then, is to find ways to sneak exercise into every day life.

One common strategy that has been discussed commonly is to find extra opportunities to walk. For example, you can park far from the entrance to your office, or make a point of using the stairs to work.

Another useful strategy is to turn seemingly mundane activities into exercise. I try not to endorse products, but I am going to make an exception for a book my friend and mentor, Joel Press, called the Couch Potato Workout.

In it, he describes some useful exercises that you can use while at home to get in a little bit of extra exercise. I don't want to steal his thunder (and I suppose his profits), but one of my favorites is to stand on one leg while brushing your teeth. This is a particularly effective exercise as the mini-perturbations from brushing stimulate the proprioceptive system to maintain balance at the hip and ankle. It sounds easy, but it's surprisingly challenging at first. Once you get good at it, try it with your eyes closed. For the super advanced toothbrush-exerciser, you can try it with your eyes closed while standing on a towel (to give your foot an unstable platform).

This is just an example of fitting exercise into your day. You can do a simple variation on the toothbrush exercise while shopping. When you are waiting on line, simply stand on one leg. Once you get the hang of that, you can progress by lightly twisting while standing on one leg.

An important time to fit in exercise is when sitting for prolonged periods. Sitting for prolonged periods can put significant strain on the disks in the lower back, especially if you sit with poor posture (which many of us do). It's important to reverse the flexion of sitting periodically. Here are some approaches to reversing that flexion:

1. Stand up. The simplest is to simply stand up and walk for a few minutes. I advise that office workers should (if their bosses will allow it) print all documents to a printer on the other side of the office. This will force you to periodically stand up to walk to the printer.

2. Upward facing dog. If you are in an environment that provides sufficient modesty (e.g., at home, or in an office with a closed door), a great exercise to reverse the flexed position of sitting is the upward facing dog exercise, common in the sun salutations from yoga. An example of this exercise is shown at the following link ( The upward facing dog exercise is very similar to the Prone Press-Up, which is one of the corner stones of McKenzie Physical Therapy, a form of physical therapy that is particularly effective for low back pain. I recommend doing this exercise at least every 30 minutes if your work environment allows to reverse the flexion of prolonged sitting.

3. Standing back extensions. Another great exercise, which may be able to do logistically, is to stand up and extend your back. It may be easier to place both of your hands in the small of your back as you arch backwards.

4. Push-ups. Another good exercise. In addition to strengthening the chest and shoulder muscles, the posture of the push up (a plank position) requires tightening your innermost abdominal muscles (the transversus abdominus), which is important for maintaining balance across your lower back. Push-ups are great for fitting in periodic exercise throughout your day- crank out a quick 5-10 pushups when you get out of your chair, during commercials while watching TV, or just before sitting to eat dinner.

I hope these exercises serve as useful examples for how you can fit small bits of exercise throughout your day.

Uncle Garii

My brother was kind enough to take a snapshot of my "Mii" that I used when playing my nephews on the Nintendo Wii. This is Uncle "Garii." Cute.

Wednesday, September 3, 2008


I try not to officially endorse products, but I was at my brother's this past weekend, and played the Nintendo Wii, so I wanted to give a few comments on it from the perspective of a physician and biomechanist

Overall, I really liked it. I'll list my essentially random observations, just to give some semblance of organization:

1. It's fun. It's entertaining for both adults and young children.

2. It's a better way of doing video games. There has been a trend over the past decade to find new ways to make videogames interactive- for example, the many dance oriented games like Dance Dance Revolution and Guitar Hero. The Wii clearly takes things to a new level- the controller is innovative and worthy of the hype.

3. You can get a great sweat playing. After boxing, playing tennis, or hula hooping on the Wii, my shirt was drenched with sweat. You can get a legitimate workout, if that is your aim, from playing the Wii. My nephews, however, did find ways to move the controllers less aggressively, so I suppose over time the workout may not be as intense as it was for me using it the first time.

4. Good motivator for kids. One of the highlights for me was watching my brother use a boxing game. His youngest son mimicked his dad's movements, and was getting exercise himself. One trend that has been noted in much of the pediatric exercise research is the importance of kids watching their parents be active. We spent a few hours as a family exercising on the Wii, and I think that beyond being fun, it helps establish to the kids that exercise is something that you should do.

5. Real exercise is still preferred. We also took a hike as a family, and that was still a better form of exercise. The Wii is ideally an adjunct to other forms of exercise. If your kids are going to be playing video games, though, it's probably better to do it on the Wii, where they are active, than on other forms of video games.

6. The Wii Fit is pretty awesome. I enjoyed playing the balance, yoga, and exercise games that are part of the Wii fit. I found the additional feedback of the Wii Fit helpful for giving feedback on my balance and stability, and for the most part thought the exercises were well designed and fun. My biggest complaint is that the Wii Fit board is a bit narrow for larger framed individuals like my brother or myself.

7. The Mii are a nice touch. My nephews made an avatar for me (they are called Miis, and they called my avatar Garii). It's amazing how detailed they are- Garii looked disconcertingly like the real me, which was especially concerning when my nephew wacked me in the face when playing the boxing game. It also took a little joy out of beating my nephew in boxing, as Garii knocked out a Mii that looked just like my little nephew.

8. There is some translation from real skills. On games I've never played before, my nephews beat me pretty easily. But I was able to occasionally beat my nephews on some of the activities that I do in real life, like boxing, yoga, tennis, or baseball. If I get a Wii, I think I would probably play the tennis game quite often, since it's certainly easier to turn on the video game system than find a similarly skilled partner.

Overall, I really enjoyed the Wii. For adults in particular, I thought the Wii Fit was great, and could be a enjoyable way to work on balance and strength exercises.