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Dr. Tim Says...

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Dr. Tim Says....

Exercise, Part Three

Two weeks ago we began 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.

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.

Catch up with the series: Week One | Week Two

Dr. H.: I was pretty sore this first week. Here's Dr. Jacques' comments.

Dr. C.: Soreness... Gotta love it! It's the best tool that personal trainers have to know whether or not their clients are working out at their maximal potential. Soreness is the first sign of muscle growth and an increase in strength. Let's briefly look into the science of soreness.

When you lift weights, the stress placed on your muscles results in many tiny, microscopic tears in the muscle. As soon as you begin exercising, your body prepares for healing and rebuilding. In the process of healing, your body adds nerve cells and increases muscle tissue so it can be ready for your next workout. Nerve cells are produced quickly, and result in a fairly quick increase in strength! Muscle takes a little more time.

It is very important for you to recognize the three degrees of soreness.

First degree soreness is the burning feeling that you get while performing a particular exercise. Lactic acid is a natural chemical waste product that is produced during exercise. As your muscle increase their endurance, your body becomes more efficient in getting rid of lactic acid, so you can exercise longer.

Second degree soreness is the soreness that you feel 24-48 hours after a good workout, or a change in workout routine. Second degree soreness is dull, achy and worse when using the sore muscle. This feeling is slightly painful, but tolerable. Research has shown that stretching does not prevent this type of soreness, but light exercise may help. Regardless, it will go away in a day or two. Should you workout if you are sore? Yes, but only perform exercises that aren't too uncomfortable. You may need to decrease the weight if your soreness prevents you from handling the amount of weight that you used in your previous workout. Overall, beginner's experience soreness when beginner a weight lifting program, Athletes experience soreness when increasing the intensity of the workout, changing the routine, or starting a new workout design.

Third degree soreness is an emergency. This type of "soreness," also known as "I think I pulled a muscle or broke something," is probably just that. You likely strained a muscle or tendon (the fibrous tissue that connects muscle to bone), or sprained a ligament (the fibrous tissue that connects two bones together). In more severe cases, you may have fractured a bone. Please do not hesitate to seek immediate medical treatment if pain is sudden, severe, or if a particular area becomes red, warm and swollen. The best immediate treatment is to apply an ice pack to the affected area for 20 minutes at a time. Avoid using the affected limb and elevate the area above the level of the heart to reduce swelling. Practice correct technique, and avoid progressing too fast to prevent significant injury.

[Dr. H.: Throughout the first few weeks of exercise and following Dr. Jacques' basic plan, he and held the following conversation. It goes into a lot more detail about each of the exercises.]

Dr. H.: This week has been going great but tougher than I thought it would be. I wasn't sure how close to stand to the wall. I did tuck the lifted leg behind my knee and that gave me a lot more stability.

Dr. C.: Exactly! Tucking that unused leg behind the other will offer you a lot more stability.

Let's jump back to the upper body and work on what I call the "beach muscles," or the biceps. The biceps are probably the first muscles we realize we have as children and by far are the most popular. I have to admit, I favor these muscles greatly. From a functional perspective, the biceps are important in lifting and holding weight with your arms. What you may not realize is that the biceps are also important in twisting your wrist from the palm down to palm up position, which can be important when creating torque when using a screwdriver or when opening up a jar. Fun fact, I guess... Anyway, to fill out your upper body, you want to spend some time in your workout exercising your biceps.

The gold standard exercise to work your biceps is the Biceps Curl with a barbell.

Find the barbell rack in your gym. You may notice two type of bars, a straight bar and a bar that has two curves in the middle of the bar. If available, choose the bar that has the two curves in the middle, called the curl bar.

Now, determine the proper weight. Start with the 20-pound bar. Grab the bar with your palms up and shoulder width apart. Start with your arms fully extended downward so that the bar is near your waist or thighs. Bring your arms up to your shoulder to perform the curling motion. Return the bar to the starting position. If you feel that you can do more than 8 reps, try the 30-pound bar. Once you find the proper weight, take the bar to an open area in the gym, preferably in front of a mirror.

Place the bar on the ground, directly in front of your toes. Stand with your feet shoulder width apart. Bend down from your waist and grab the bar with your palms up, shoulder width apart. If using a curl bar, grab the weight on the most inner portion of the upward curve. Now, stand up by pushing from your legs, not with your back.

Over a four second period, exhale and curl the barbell to your shoulders. Then, inhale and return the bar back to the starting position over four seconds. Perform 3 sets of 12 reps.


1. Take a 1-2 minute rest between sets.

2. Avoid leaning over or leaning back during this exercise. Your abdominal and back muscles are especially exercised during Biceps Curls. Keeping your back straight during the workout will strengthen your abdominal and back, or core, muscles.

3. You will likely feel the most sore, in a day or so, in the inner bend of your elbow. This is natural, and occurs because your biceps tendon that connects your biceps muscle to your forearm may be a bit sore. You should not; however, feel soreness in your shoulder after performing Biceps Curls. Remember, that you should see your doctor if you have severe soreness after doing any exercise.

Dr. H.: OK, even I could do this one...

How long should I work out at 12 reps before adding weight?

Dr. C.: Once you can perform 3 sets of 12 of a particular exercise of 2-3 workouts, you should increase the weight. When increasing the weight, make sure you can at least perform 8 repetitions in the first set. If you can't you may have jumped the weight up a bit too much.

Dr. C.: Now that your beach muscles have received some attention, let's exercise the triceps. But before we do, here is a quick lesson on "antagonistic muscles."

An antagonistic muscle is the muscle opposite of the one that you are using. For example, to bend the elbow, the biceps, located in the front of the upper arm, are used. To extend the elbow, the triceps, located in the back of the upper arm are used. You should frequently try to workout the muscles that are responsible for both movements. It's not always necessary or efficient. For example, you should include a calf exercise in most of your workouts because calf muscles require a lot of strength and endurance to perform daily functions. The antagonist muscles of the calves are the anterior tibialis muscles, or the foot lifting muscles. Do these need to be as strong as the calves? Not really. However, strong anterior tibialis muscles are important, especially in preventing shin splints, but do not need as much or as frequent attention as the calf muscles do.

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