The View from Sports Center

Put Your Calculator Away

How fast should your heart beat during exercise? How do you know if you are exercising hard enough or too hard? Do you need to calculate your heart rate? How much exercise is enough?

The truth is most of us feel as if we do not have the time to exercise regularly. We believe that to lose weight (more specifically fat), we must perform aerobic exercise and must cause our heart to work in the 60-70% range of our maximum heart rate. But, if you use the traditional formula of 220 minus AGE to calculate your maximum heart rate, you could be off by up to 30 beats per minute (read last week's View The Max Heart Rate Myth for details).

Aerobic exercise is good for your heart and lungs. To make lasting change you have to consistently stress your heart. This is reflected by your heart rate. To reap the benefits of long duration aerobic exercise, your heart rate should be between 50% and 70% of your maximum. You should exercise in this range for at least thirty minutes three days per week. If you add the time it will take to reach your target heart rate (which for most people is about ten minutes), you will exercise for 40 minutes three days per week (according to the American Heart Association).

Let's assume you decide to join a gym and use a stationary bike for aerobic exercise. Since calculating your heart rate using the gold standard is inaccurate, how do you know how hard to work? The problem with the 220 minus AGE formula is it over estimates maximum heart rate in younger people and under estimates it in older people. A more accurate formula (although this one is still off by 7-8 beats per minute) is 208 minus (AGE x .70)*. But, is there an easier way that is just as reliable?

The answer is yes. There are two other methods neither of which requires calculating your heart rate that can tell you if you are working hard enough to make your 40-minute investment worth your time. The Rating of Perceived Exertion Test (RPE) was first introduced to the United States by renowned exercise physiologist Gunnar Borg in the 1960s. The RPE is a numerical scale from 6-20 (see figure).

After you have exercised for about five minutes, choose a number from 6-20 where 6 is very, very light effort and 20 is very, very hard effort. To help your heart grow stronger and more efficient, your effort level should be between 11-14 on the scale of 6-20. Dr. Borg discovered that if you multiply your RPE number by 10, the result will be very close to your actual heart rate*.

To be even more precise in calculating your max heart rate add another test to your RPE number. After your ten minute time to the target zone, try speaking a sentence. If you cannot speak, you are working too hard (and very likely your RPE number will be greater than 11-14). If you can talk, try singing (as painful as it may sound). If you can talk and sing, you need to work a little harder (and your RPE number will likely be less than 11). This is referred to as the Talk-Sing test. It is based on the relationship between your ventilation rate (how hard you breathe) and your heart rate. In the initial stages of exercise, ventilation and heart rate rise together. So, if you can sing your ventilation rate is too low. If you can not talk, your ventilation is too high.

Aerobic exercise is good for you but it is time consuming. It is a reasonable choice if your goals are to improve your cardiovascular fitness, exercise your heart and if you are relatively new to the world of exercise. But if your goals are to lower your fat content and raise your fitness level, there is a better choice: interval training and muscle training. To learn about interval training, go to our website and read Burn Baby, Burn. Also, stay tuned for our soon to be released DVD “Fat Burning 101” containing an hour long presentation on how to change your body composition, instruction on the Fat Busting Four Drills and extra exclusive interviews. You can order this DVD by calling Angie Francis at 512-206-0433 today.

Make today count.

Doug Kelsey
Author. Teacher. Therapist.

* Tanaka, H., Monahan, K.D., & Seals, D.R. (2001). Age-predicted maximal heart rate revisited. Journal of the American College of Cardiology, 37, 153-156

*Borg, G. (1998). Borg’s Perceived Exertion and Pain Scales. Champaign, IL: Human Kinetics Publishers.

The Max Heart Rate Myth

As I bounded up the office stairs taking two at a time, I felt an unusual thumping in my chest. I stopped at the top of the stairs but my heart continued to pound. Then my chest began to hurt. While I may be a little slow to catch on to things sometimes, I realized a thumping pain in my chest was not a good sign. I made my way back down the stairs and out to my car. My heart was still pounding. Once in the car, I called my friend Ed Tyson, MD and explained what was happening. He said, "Go to the ER right now! Don't wait! Go now!"

I learned that if you ever go to a crowded emergency room and say, "I have chest pain" you will get a direct entry pass. Everyone else waited and watched as they took me back into the medical wonderland of the E.R. Once there, a flurry of activity followed. Sticky pads applied to my chest, thermometer in my mouth, blood pressure cuff on my arm while no one said as much as "hello". My chest continued to hurt but seemed to be subsiding. I was alone, on a hard gurney staring at a very bright light with all sorts of things attached to me.

About an hour later, a physician came in, picked up a clipboard, scanned it and said, "Well, your EKG is OK right now. We're not sure why you had this event but with your family history you must see a cardiologist very soon. Do you want me to send you to someone or do you already know a good heart guy?"

I had no clue. My mind was still on the word cardiologist as if it lingered in the air like a cartoon bubble. "I'll take care of it. Thank you." And out the good doctor went.

Your heart muscle is simply the most important muscle in your body. Without it, you die. Consequently, determining how well your heart works is serious business. At the hospital two days later, I had a stress echocardiogram test. An EKG machine was attached to my chest and I climbed onto a treadmill. The cardiologist stood on my right and a technician stood on my left. I started walking on the treadmill then jogging. Every few minutes the technician raised the treadmill angle. And then he increased the speed. The entire time, the cardiologist was watching the computer monitor as it displayed numbers and graphs. Finally, after 17 minutes of this mini boot camp, he said, "OK far enough. We're at your maximum. Well done." I then immediately went to a table where the technician told me to lie on my side. I was gasping for air. I couldn't get enough. He placed a cold metal device on my chest and told me to hold my breath. You should try that some time. Hold your breath when you’re gasping for air. It’s really hard to do and exceptionally uncomfortable. The cold metal was the end of an ultrasound machine. The cardiologist wanted to see my heart beating while it was seriously stressed. After what seemed like an hour he said, "Looks good. Your heart looks very good." I had no chest pain. My heart was fine. Whew.

The cardiologist needed to know my maximum heart rate and how well my heart responded to work or exercise. He could not afford to guess. But, people all over the world guess every day when they calculate their maximum heart rate. The formula is on every stair stepper, cycle, treadmill and elliptical trainer in every home or gym. It is a formula to determine your maximum heart rate. The formula is 220 minus YOUR AGE and it is wrong. Here's why.

Bill Haskell, an exercise physiologist at the U.S. Public Health Service had been given an assignment by his boss Sam Fox, MD. Dr. Fox, a cardiologist, was scheduled to talk at a World Health Organization meeting on exercise and heart disease. The year was 1968. Haskell's job was to collect research on maximum heart rate testing. All the experts agreed that exercise was important following a cardiac event or if you had heart disease. At the time, no one knew how hard a person should exercise following a heart attack. Haskell assembled the information and plotted the results on a graph. He and Fox studied the graph and discovered a pattern. By drawing a line through the data points, Haskell found that the maximum heart rate at the intervals of 20 years, 40 years and 60 years, was 220 minus the age. Haskell and Fox presented their finding at scientific meetings in Tel Aviv and Tuxedo Park, New York. In 1971, they published their formula that was to become the gold standard for exercise.

The problem with their discovery was the studies were done only on men all under the age of sixty who did not exercise regularly. Haskell and Fox did not actually perform any research. They compiled data from existing studies. So, their formula was not valid for all people. For a valid study, the results must be true in other places, with other people and at other times. Since Fox and Haskell's work was only on men under the age of sixty, the formula was then only valid for sedentary men under the age of sixty.

Remember, in 1968 there was no heart rate formula. There was no way for a person following a heart attack to know when the heart might be over stressed. Haskell and Fox were interested in predicting a maximum heart rate to allow someone following a heart attack to safely exercise again. They never intended for it to be applied to all ages, genders and conditions. It spread quickly and made its way into every piece of exercise equipment, doctor's office and heart rate monitor in the world because it was simple to understand and easy to use. The formula produced a number that made estimating something very subjective, how hard your body is working, more objective. Numbers are cozy. We feel better when we have numbers to explain, guide or support our decisions.

Haskell and Fox's formula is not accurate though for someone who exercises regularly. If you are a woman, 40 years of age and use the formula to determine your maximum heart rate, you could be off by up to 30 beats per minute. In most cases, you will exercise at an intensity that is too low. The same is true if you are 65 years of age and exercise regularly. The number guiding you is misleading you.

So, what do you do? How do you determine your maximum heart rate? The best and most accurate method is a stress test with a cardiologist standing next to you, but it’s also costly and inconvenient. There is a way to get close though. Much closer than just using the formula. Once you know how, your exercise routines will produce much better results. I'll share those secrets with you next week.

Make today count.

Doug Kelsey
Author. Teacher. Therapist.

Stop Your Shrinking

As the Wicked Witch sets the Scarecrow on fire, she screams, "Ahhahahaha...Well! Ring around the rosy a pocket full of -- spears. Thought you'd be pretty foxy, didn't ya? Well, the last to go will see the first three go before her. Hahaha! And her mangy little dog, too. How about a little fire Scarecrow?"

"Oh...oh...oh...it's burning...oh....oh!" shouts the Scarecrow as the flames climb up his leg.

Dorothy reaches for a bucket of water to fling toward the Scarecrow. Instead, the water hits the Witch. Steam eminates from the Witch as she yells, "Ahhhhhhhhhhh!!! You cursed brat! Look what you've done! I'm melting, melting. Ohhhhh, what a world, what a world. Who would have thought that some little girl like you could destroy my beautiful wickedness. OHHHHHHH!!! NO!!! I'm going...ohhhhhhh..ohhhhhhhhhhhhh..."

Unlike the Wicked Witch, water helps us stay tall. The majority of your body height comes from your spine, specifically the thickness of the intervertebral disc. The disc, a blend of a tough, fibrous outer ring (called the annulus) and a softer, gelatinous inner core (the nucleus) sits in between two vertebral bodies or bones. Its job is to absorb force and guide the complex, three-dimensional motions of the spine.

The thickness of your disc depends upon hydration. As your disc loses its ability to hold water, it shrinks. As it shrinks, your body height decreases. This is one of the reasons why many people get shorter as they age.

Your disc is the most hydrated in the morning just after you rise from sleeping. Through the day, water seeps in and out depending on the positions and movements you choose. Your disc hydration decreases when it is subjected to pressure similar to squeezing water out of a sponge. The highest level of disc pressure is a stooped position like when you wash dishes at the kitchen sink. The lowest level is lying down on your back with your lower legs resting on a chair with your hips and knees at right angles (see figure).

Sitting in a chair creates high levels of disc pressure almost as high as stooping. Although we tend to think of sedentary jobs as having low physical demands, sitting is a pressure cooker for your spine.

Is there anything you can do about disc shrinkage? Can you actually get taller? The answer is yes. You can improve the hydration in your disc and keep the height thief at bay.

To change your disc thickness, you must do two things:

1. Move
2. Reduce your disc pressure

Exercise makes you taller. In a study published in 1997, people with chronic lower back pain participated in a 3-week exercise program. The researchers were interested in the effect of exercise on body height measured in the morning. After just four days, the average increase in height was 3 mm and by the end of the three weeks, they had increased their height by just over 7 mm or just over a quarter of an inch.

You can also increase your disc height by reducing the disc pressure. If you sit most of your work day, get up from sitting and lie down for at least five minutes and you will reduce spinal shrinkage. If you can lie down for at least 20 minutes every four hours, your spine will shrink even less. And, if you lie down a full thirty minutes at lunchtime, your disc will rehydrate to its early morning height arming you for the rest of your day.

I suggest the following to our clients at SportsCenter. Every hour, get out of a sitting position and lie down with your lower legs up on a chair. Gently rock your legs back and forth a small amount (more on why this helps in a future View - the secret to nourishing spinal joints). Do this every day for six weeks. If you also have back pain, add walking in a pool for 20 minutes four days per week. If you do not have back pain, you may walk on a treadmill or outside, swim, or use an elliptical machine or other type of aerobic exercise device for 20-30 minutes four days per week. You must exercise hard enough so you cannot sing but not so hard you cannot talk (except of course if you're swimming!). This will place your body in the optimal work zone to maximize the benefits of the exercise.

But how do you know if your spine is shrinking or not? As I discussed in a prior View, numbers are cozy. Numbers help you understand if your efforts are translating into physical improvements. To detect the small changes in disc height (2 -10 millimeters), you will need to have your height measured by a stadiometer typically only found in professional facilities (they range in price from $500.00-2000.00). The stadiometer can detect height changes in millimeters and tell you if your disc thickness has changed. The numbers also help you stick to your routine providing you with necessary positive reinforcement.

Many of the problems associated with lower back pain can be traced to a loss of disc thickness. Too much pressure for too long coupled with not enough movement, drives the water out of your disc. Take a load off every hour and keep your discs well hydrated. Your spine will thank you for it.

Make today count.

Doug Kelsey
Author. Teacher. Therapist.

References:

Hupli M, Heinonen R, Vanharanta H. (1997) Height changes among chronic low back pain patients during intense physical exercise. Scand J Med Sci Sports. Feb;7(1):32-7.

Helander, M.G.; Quance, L.A., (1990) Effect of Work-Rest Schedules on Spinal Shrinkage in the Sedentary Worker. Applied Ergonomics. 21 18, 4, 279-284.

Stalhammar, H. R.; Leskinen, T. P.; Rautanen, M. T.; Troup, J. D. (1992) Shrinkage and psychophysical load ratings in self-paced and force-paced lifting work and during recovery. Ergonomics 35, 1, 1-5.

Valley of Chainje

"Where are you going?" asked the Voice in the Distance.

"Well, I am going...to...I...I just want to get away from Payne. I don't like him,” said the Woman.

"But where are you going?" asked the Voice in the Distance.

"What do you mean? Why do you keep asking me this? I told you, I am going to get as far away from Payne as I can," said the Woman.

"And when he is gone, where will you go then?” asked the Voice in the Distance.

The Woman was silent. She had not thought about life without Payne. Payne had been with her for so long that the only thing she could think about was escaping. "I don't know. I'm not sure right now,” said the Woman.

"Where will you go when Payne returns?" asked the Voice in the Distance.

"Returns? You mean if I get away from him, he will follow me? He will come back?" asked the Woman.

"Where will you go then?" asked the Voice in the Distance.

"So, I can never escape? I can never get rid of Payne? What kind of life is that? What kind of future do I have if Payne is always in it? I don't like him!" exclaimed the Woman.

"Where are you going then?" asked the Voice in the Distance.

"I don't know. I need help. Where should I go? What should I do?" asked the Woman.

"Payne has come to help you yet you run from him. Payne can help you set your vision right. Let him guide you to your destination. You need not hate him. You need not run from him,” said the Voice in the Distance.

"How? How can I? I just have a hard time working with someone I do not like," explained the Woman.

"You do not need to like him. You need to learn from him. Payne can teach you many things and help you pass through the Valley of Chainje. What you seek is on the other side of Chainje. You will not pass through without Payne,” said the Voice in the Distance.

"This is so hard. I'm not sure I can do it. I do not like the way I feel when Payne is around and I do not understand him. I don't know what he means when he speaks to me," said the Woman.

"Payne teaches you the most when you listen to your feelings. Learn from your feelings not from what he is saying. The answers you seek are inside you; not Payne."

And the Woman suddenly understood. To pass through the Valley of Chainje, she would have to be very close to Payne. But once she emerged, Payne would leave. She stopped and turned to look behind her. Payne was only a few steps away. She reached out her hand and said "Payne, I am ready. Lead me through the Valley of Chainje."

Payne stepped forward, took hold of her hand and began walking. The closer they came to Chainje, the harder it was for the Woman to let Payne lead her. But, as Payne and the Woman walked through the Valley of Chainje, she felt the firm grip of his hand loosen. He was letting go of her. She had tried for many years to run away from Payne but now, as she reached Chainje, she no longer wanted to run. She turned to look behind her and Payne was gone. She was free.

Do you have a Payne in your life? Could it be that your Payne is trying to lead you to Chainje?

Make today count.

Doug Kelsey
Author. Teacher. Therapist.