Dr. Tim Says....

Exercise, Part One

This week begins a series with Dr. Jacques Courseault. Because Dr. Jacques was a personal trainer before becoming a physician I have asked him to become my trainer and let you follow along to see how easy this is.

As always, the info on the Dr. Gourmet web site is not a replacement for seeing your physician and your doctor would want you to speak with him or her before starting any new exercise program.

I've never been all that athletic. I never played sports as a kid and didn't really start exercising until I was in my late twenties. I know a little bit about jogging and a fair amount about bicycling (which is my exercise of choice). However, I am not an expert in any way. I'd sort of like to be an expert, though, and in the last few years we've had Dr. Jacques Courseault writing for the web site. I have learned a lot but still feel a bit clueless. I think that this is because I learn best by doing.

Dr. Courseault and I were talking recently about this and I challenged him to help me exercise better. At the end of our discussion I realized that this will take more dedication on my part than simply riding my bike 50 to 70 miles a week. We're going to start in the gym with resistance training. I will make progress by his teaching me the best ways to exercise and weight lifting seems a good place to start. Our hope is that you'll learn from our conversation.

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Dr. C.: Before beginning any exercise program, whether it's walking or bodybuilding, you must have a purpose or goal in mind. Think of exercise as driving.

First, we are not always in the mood to drive. Nor will you always be in the mood to exercise. Next, there is a planned destination or purpose every time you get in your car. You drive to get to work, go to the store, to visit out of town family, etc. The expense of driving is time and gas; thus, you want to take the shortest route with the least amount of traffic to get to your destination. Yes, sometimes you may drive without a destination, but you are probably driving to relax. Exercise is very similar. It may cost money and definitely will cost time.

Therefore, you must map your exercise destination to be efficient. To start, what is it that you want to accomplish in weight lifting and why?

Dr. H.: Well, I'd like to start with upper body. My goals are to practice what I preach better and the research is clear that the combination of resistance training with cardiovascular is optimum. Because I bicycle avidly the aerobic piece is covered. As such, I'm not interested in working on my lower body at this stage.

So I'd like to do toning of arms, chest, and abs. I don't want to be Arnold Schwarzenegger, but I do think that doing the right thing by weight lifting along with biking is a great start. Given my schedule I think that I can commit to 3 days a week in the gym. It will be a challenge but worth it I think.

Dr. C.: I would encourage you to incorporate lower body exercises into your weight lifting workouts. I understand that you are an active biker, but biking mainly works the muscles that are responsible for endurance. Performing weight lifting exercises with your legs will train both endurance and strength muscle fibers, so you will increase your muscle "power" when cycling. This will make you more effective in passing, riding uphill or pedaling at a higher gear. I guarantee that you will be able to add a few more miles to your route. You will thank me in a few weeks!

Also, because you can commit to 3 days a week, we can incorporate lower body exercises into a majority upper body workout. This works in your favor because you can exercise your legs while allowing your upper body to rest after finishing a particular exercise. Besides, you don't want to be that guy with a huge upper body and skinny legs....

What kind of equipment is available in your gym?

Dr. H.: Okay, you've convinced me. There's a lot of equipment at my gym. I can warm up on one of the exercise bikes and then there's a wide array of Nautilus style machines and pretty much every free weight there is. Should I start with the exercise bikes?

Dr. C.: I see that you recognize the importance of warming up before weight lifting, and there is tons of research to back this up.

Warming up allows your body to prepare for the exercise stress that you are about to place upon it. Blood flow is diverted from organs that are not particularly used during exercise, such as your intestines, and sent to your muscles. Furthermore, a significant percentage of blood flow is sent to your skin. Why the skin? Basically, during exercise your muscles create heat that is transferred to your blood. As blood moves through the blood vessels underneath the skin, heat is transferred to the surrounding air and allows you to cool. The science behind this allows us to know how long a warm up session should take. In a nutshell, when you begin to sweat, your body is ready for the more intense phase of exercise.

Second, warming up prevent injuries. Many studies following both men and women have shown a reduction in injury during physical activity. This makes sense, because light activity primes your muscles for the more intense activity involved in a workout. Early movement stretches your muscles and lubricates the joints that will be used during your workout. It's like getting up in the morning. Many of us feel cold and stiff, but once we move around things tend to loosen up.

Finally, warming up can increase the productivity of your workout. As mentioned earlier, more blood flow sends more energy to your muscles that can increase their strength of contraction. That way you are not wasting your early repetitions while your body prepares for exercise. If you warm up, your body will be ready for effective exercise as soon as you pick up a weight.

Now, which warm ups are the most effective? Choose what you like to do the most. If you prefer an exercise bike, then do that. If one day you want to jog, shoot a basketball or use a Nautilus machine, then go for it. Overall, a warm up should average three to five minutes, but should not take more than 10.

Dr. H.: Sounds great. I generally spend at least 15 minutes on the bike.

So what's next? What does my first day look like?

Dr. C.: Okay, when planning this first workout and each one after it, there are a few things to always keep in mind:

1. Work large muscle groups before small muscle groups (i.e. chest muscles before forearm muscles)

2. Perform multiple-joint exercises before single joint exercises (i.e. upright row squat before leg extensions)

3. Perform higher intensity, or more difficult exercises before easier ones (i.e. leg press before calf raises)

4. Always rotate between upper and lower body exercises, (i.e. lunges, then, curls) or avoid working out the same muscle in consecutive exercises (i.e. dips, then triceps extensions)

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Next week I'll give you an update on my first week's progress. You can follow along, if you like, and you don't have to have anything fancy. The videos on the Dr. Gourmet web site show you how to do these using inexpensive resistance bands.

Here's the link to help you get started: Beginner's Workout Using Resistance Bands

Eat well, eat healthy, exercise and enjoy life!

Timothy S. Harlan, M.D.
Dr. Gourmet