We all know that exercise is “good” for us to do, yet many people don’t fully realize how much “good” it does, how much or what to do, or how to prioritize it. In honor of April being Physical Wellness month, let’s take a dive, skip, and run into the world of what getting moving does for us and perhaps how we can do more of it!
The WHY
One of the most important points you should know about exercise is that for people who have 150 minutes of physical activity a week, they have a 33% lower risk of ALL causes of mortality. There are several direct and indirect reasons for this, but perhaps a bigger takeaway is it is hard to find a medicine, or medicines for that matter, that have that great of an impact. Furthermore, exercise doesn’t require a prescription or equipment and can be done anywhere!
Below is a table with more specific diseases that exercise helps reduce including not just heart disease, but cancers, musculoskeletal diseases, mental health disease, and help improving cognition. These findings have been shown over hundreds of meta-analyses.
Cardiovascular
Cardiovascular disease reduction by 33% for those with have it at baseline, and 32-42% for those without it at baseline pending intensity.
Stroke reduction by 33%.
Lowers the risk of high blood pressure, diabetes, high cholesterol, metabolic syndrome by 25-33%.
If time spent sitting is <3 hours a day, it is correlated with a 2-year increase in life expectancy.
When it comes to exercise, it’s true that you can get benefits from many different types of exercise and so you should pick exercise that interests and works for you, but there are some important parameters to know so that you can optimize the above benefits.
According to the American College of Cardiology, the recommendations for how much to exercise is:
150 minutes a week at “moderate” exercise OR 75 minutes at “vigorous” exercise, ideally split into 3 or more days a week.
Moderate intensity exercise is when your average heart rate is approximately 70-80% of your max heart rate (your max heart rate being approximately 220-your age) or the “talk test” (you can’t sing, but you can “breathy talk”).
Vigorous intensity exercise is when your average heart rate is above 80% of your max heart rate (in comparison to above if you were to try to talk, your sentences would be broken from breathing).
It should be noted that breaking up your workout is considered just as effective as going straight through (i.e. three 10-minute walks are just as effective as one 30-minute walk) and that if you are not yet at the above exercise recommendations that it is wise to gradually work your way into that amount to reduce injury potential. The benefits of exercise are “dose dependent” so even some exercise is better than none. On the flip side, it is also worth mentioning that not much more of the above benefits are gained over 100 minutes of exercise a day, as it can lead to injury and harm.
Ideally with exercise we advise people to mix and match endurance and speed/power as most people tend to use too much slow twitch muscle versus fast twitch muscle. Interval or high intensity interval training (HIIIT) can help accomplish this and be especially good at helping with fast body changes, although it should also be noted that given the higher intensity of these workouts they should be limited to 2-3 times a week for most people.
Lastly, we recommend incorporating at least 2 strength training days into the week. A basic example of this can look like 8-10 different body weight or weight exercises at 8-12 repetitions, but there are many variations, and some cardio workouts include strength training in them as well.
A few special populations:
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Older Adults
It is never too late to become physically active and physical activity is one of the most important things you can do for your health as you age. It helps you stay independent longer so that you can do the things you want to do! In addition to the general population exercise recommendations above, flexibility and balance exercises become essential in this age group. Exercises to increase or maintain flexibility should be performed twice a week, ideally after aerobic or strength activities when the body is warmed up. Balance activities, which should also be done at least twice a week, help prevent falling and the risk of injuries.
For more information on what you can do to stay active, particularly if you have any physical barriers (i.e. arthritis), first ask your health care provider for individualized exercise recommendations, as well as about resources available in your community. You can also check with your insurance to see if any free or discounted programs are offered. Lastly, consider exploring more online resources here:
Pregnancy is an ideal time for lifestyle modifications for the sake of both mom and baby!
Here are some of the benefits of exercise during pregnancy:
Reduces the ever-common musculoskeletal discomforts (i.e. low back, pelvic girdle).
It helps avoid excessive gestational weight gain.
Improves mood and mood-related comorbidities.
Prevents urinary incontinence issues.
Better fetal tolerance of labor.
Reduces risk of developing gestational diabetes and pre-eclampsia.
Reduction of macrosomia (large fetal head) and large for gestational age newborns.
Possible reduction in risk of cesarean delivery.
Possible reduction in duration of first stage of labor.
Helps combat childhood obesity after baby is born.
Although there are many benefits to exercise during pregnancy, there are some changes that a pregnant mother needs to be aware of when exercising. Pregnant mothers should avoid activities with high risk of fall/belly injury, hot yoga/hot Pilates/other “hot” workouts, very strenuous activities, heavy lifting, high agility activities given more relaxed ligaments, and certain positions pending how far along they are in their pregnancy (i.e. avoiding prolonged supine positions the last half of pregnancy).
If you are pregnant and unsure what exercises you should or shouldn’t do, it is best to talk to your OB provider as some pregnant mothers need specific exercise restrictions or modifications based on underlying or acquired conditions during pregnancy.
The BARRIERS
The main reason people don’t exercise as much as they would like, is that they often have perceived barriers that make it more difficult for them to do so. Below is a chart of the most common ones that people report, as well as ideas to consider overcoming the specific barrier. That all being said, the best way for you to overcome your own barriers is to write down what your biggest barriers are, and then write down specific things you can do to overcome them to make exercise a priority. Using tools like journals, pedometers, apps to help stick to your goals, and having check-in points in the future to hold yourself accountable and stay on track have all been shown to help keep your success as well!
Barriers
Tips to Counter Barriers
Time
Set a schedule, prioritize, utilize mornings.
Inconvenient
Try short 10-20 minute bursts.
Motivation
Consider the benefits.
Not enjoyable
Try different exercise options, classes, active hobbies.
Find exercise boring.
Try active games.
Lack confidence in ability to be active.
Utilize educational resources or a professional trainer.
Injury fears
Addresses physical restrictions and progress gradually.
Unable to set goals and monitor progress.
Seek assistance in setting small, short term and long-term goals.
Lack encouragement and support.
Involve friends and family.
Lack access to facilities within a convenient distance.
Consider options for walking at work or at home.
If you have any questions about exercise or what you can do to improve your physical fitness in relation to your overall health, your Lakeview medical provider would love to hear from you!
Dr. Leah Clark is a Family Medicine physician at Lakeview Clinic, was a multi-sport athlete in high school and 6-time All-American Track and Field athlete in college. She serves as the head of Lakeview’s Wellness committee and is an exercise and outdoor enthusiast.
A Podiatric Surgeon specializes in treating conditions of the foot and ankle. Foot and ankle pain can hinder your walking and overall mobility, significantly affecting your quality of life. A podiatrist is the most effective resource to help regain that mobility so you can enjoy the more active things in your life. So, if you answer yes to any of the following questions, it is time to see a podiatrist.
Do your feet hurt at the end of the day?
Pain in your arch, top of your foot, big toe, or ankle after a long day of standing or walking can be from arthritis. Treatments range from arch support, injections, or surgical management when conservative measures fail.
Does it feel like someone is stabbing you in the heel when you take the first steps of the morning?
This is a telltale sign of the very common condition plantar fasciitis. Plantar fasciitis is inflammation of a thick band of tissue, the plantar fascia, that runs from your heel all the way to your toes. If left untreated this can escalate into significantly debilitating pain. It is best to be evaluated early if you are experiencing heel pain.
Are your toes crooked and rubbing inside your shoes? Do you have flat feet and painful arches?
Bunions and hammertoes are common conditions that podiatrists treat, along with other foot deformities like flat foot and congenital foot/toe abnormalities. Although surgery is usually required to improve the deformity, it may not be necessary unless it keeps you from your everyday activities. Seeing a podiatrist can help determine the best treatment for you.
Do you have pain around your ankles? Do you sprain your ankles frequently?
Chronic pain on the outside or inside of your ankle with certain activities can be caused by a ligament or tendon injury. Evaluation by a podiatrist can help determine the severity of the injury and the best level of treatment.
Do you have ingrown toenails that hurt in your shoes? Do they get red and infected?
Ingrown toenails hurt! Something so small can cause so much pain. But a simple in-office procedure can help relieve your agony. After foot soaks and bandages, you will be back wearing all your shoes again.
Numbness or tingling in your feet? Are you diabetic?
Nerve pain, or neuropathy, in your feet is not always caused by diabetes. There are multiple causes and some different treatment options. If you are diabetic and suffer from neuropathy a visit to a podiatrist can help limit your risk of complications including infections and amputations. A podiatrist is also your best partner if you do have lower extremity wounds as they can organize wound care and are trained to do procedures to help heal wounds faster.
Did you suffer an injury? Twisted foot/ankle? Can’t bear weight on your foot?
A podiatrist can treat broken bones in the foot and ankle. They are skilled in reading x-rays and correlating the image to your clinical exam to find the correct diagnosis. They can also help manage your sprain or strain treatment with offloading and therapy options.
Seeing a podiatrist is as simple as scheduling an appointment just as you would with any family medicine provider. Podiatry appointments typically take place in a clinical office and many procedures such as an ingrown toenail can be performed the day of your visit right in the office. For more serious conditions such as bunions, patients may need a surgical procedure in a hospital setting. A podiatrist is the best option for any problem with your foot or ankle. They can help determine the proper diagnosis to get the proper treatment. This will help get you back to your life with pain-free mobility.
Dr. Arens attended Scholl College of Podiatric Medicine in Chicago, Illinois. His resident training in foot and ankle surgery was completed in 2016 at Hennepin County Medical Center in Minneapolis.
His practice involves all aspects of podiatric medicine and surgery. He performs surgery of all foot and ankle conditions ranging from bunions and hammertoes to fractures and chronic ankle pain.
Colorectal cancer continues to be a major problem in the United States. This cancer affects any portion of the large intestine, or the colon in medical terms. The rectum involves the last 15 cm of the colon. In 2023, colorectal cancer was the fourth leading overall cause of cancer and second leading overall cause of cancer deaths. It is estimated that about 1 in 24 people will develop colorectal cancer at some point in their lifetime.
There are several risk factors for development of colorectal cancer:
Being overweight or obese
Not being physically active
Smoking
Diets high in red meats (beef, pork, lamb) and processed meats (such as hot dogs and some luncheon meats) or cooking meats at high temperatures (frying, broiling or grilling)
Moderate to heavy alcohol use
Increasing age
Personal history of polyps or colorectal cancer
Personal history of inflammatory bowel disease
Family history of colorectal cancer or polyps, especially before age 60
Inherited syndromes such as Lynch syndrome or Familial Adenomatous Polyposis
Symptoms of colorectal cancer can be vague, and many patients don’t have any symptoms at all, especially in the early stages of disease. The more common symptoms include:
Blood in your stool or very dark stools
Changes in your bowel habits, both constipation and diarrhea/loose stools
Changes in the shape of your stool, typically to very thin stools
Feeling bloated
Persistent cramps
Fatigue
Unexplained weight loss
Anemia
Colorectal cancer typically begins as a polyp, which is a growth on the wall of the colon. Fortunately, most of these cases develop over the course of several years and there are multiple options for screening to catch these polyps before they turn into cancer. The recommended age to start screening is age 45 (previously it was 50) for people who are not at increased risk for colon cancer. Some people should start screening at an earlier age, typically depending on family history or personal history of certain diseases or syndromes. Talk to your primary care provider to determine when you should start screening for colorectal cancer. Here are the most common screening options:
Colonoscopy: This is the gold standard screening option, and it is typically fully covered by your health insurance. This is the only test that both detects and prevents colorectal cancer. For this study, you do a bowel prep to clean out your colon. A colonoscope is then inserted through the anus and the wall of the entire colon is visually inspected. The major benefit of colonoscopy is any polyps can be removed and anything abnormal can be biopsied. The procedure takes about 20 minutes and is typically done with conscious sedation. This is the most accurate screening test and can find up to 95% of large polyps (>6 mm) as well as almost all cancerous lesions in the colon and rectum. If no polyps are found, the study should be repeated in 10 years. If adenomatous polyps are found, the study will likely need to be repeated in 3-5 years depending on the number and type of polyps found.
Stool DNA test (Cologuard test): This is an at-home test that is relatively new to the market. For the test, you collect a stool sample at home. The test is mailed to a lab for testing which detects blood in your stool and DNA changes in cells that can indicate the presence of colorectal cancer. The test can detect up to 92% of colon cancers but only about 42% of large polyps. There are also both false positive and false negative results to the test. If your Cologuard test is negative, the recommendation is to repeat the test in 3 years. If your Cologuard test is positive, you will need to have a diagnostic colonoscopy for further evaluation. While the Cologuard test is typically fully covered by your health insurance, a follow-up diagnostic colonoscopy is not fully covered and you may be responsible for some or all of the cost, depending on your insurance plan. This study is not for people at increased risk of colorectal cancer. It is not an appropriate study for someone with a previous history of colorectal polyps, colorectal cancer, inflammatory bowel disease, familial cancer syndromes, a family history of colorectal cancer, or anyone with signs or symptoms or colorectal cancer (see above).
Other, less commonly used screening studies:
Fecal occult blood test
Fecal immunochemical test
Virtual colonoscopy (CT colonography)
Sigmoidoscopy
The bottom line is that while colorectal cancer remains a problem, there are options to detect it early and potentially prevent it altogether. All of the general surgeons at Lakeview Clinic perform colonoscopy and are able to treat many of the cases of colorectal cancer discovered during the exam. Talk with your primary care provider about your options and get your screening done!
Dr. Thormodsgard is a Lakeview Clinic General Surgeon. He has a special interest in laparoscopic surgery and is trained in robotic surgery. His practice includes caring for benign and malignant conditions of the colon and small bowel.
What is Age-Related Macular Degeneration, and could it impact me?
Age-related macular degeneration, or AMD, is a disease in the back of the eye which impacts a person’s central vision. It is the most common cause of severe vision loss in people aged 50 or older. The effects of AMD range from mild blur or distortion of central vision to profound central vision loss. The prevalence of AMD increases significantly as we age. A census done in 2019 revealed that approximately 2% of Americans aged 40-44 were living with AMD, but that number rose to 46.6% for people who were 85 or older. Annual dilated eye exams are important for early diagnosis and management of the disease.
What are the Risk Factors for AMD?
The biggest risk factor for AMD is age, specifically anyone over the age of 50. Other risk factors include smoking, high blood pressure, a diet high in saturated fats and cumulative UV light exposure over the course of a person’s life. The most common symptoms of AMD are blurry vision, distorted or wavy central vision, difficulty recognizing faces or a dark blind spot in the center of vision. If you or anyone you know is over 50 and has developed any of these symptoms, contact your local eye care provider and schedule a dilated eye exam.
Are there different types of AMD?
There are two different forms of AMD: dry (nonexudative) and wet (exudative) macular degeneration. Although both can cause central vision loss, dry AMD is generally more common and less severe. In dry AMD the nerve tissue in the center of the retina slowly breaks down causing gradual central vision loss. Progression of dry AMD can convert to wet AMD. During wet AMD abnormal vessels begin to grow under the retina. Those vessels leak and hemorrhage, causing more damage to the macula. Wet AMD usually causes faster and more severe loss of central vision than dry AMD.
What can be done for AMD?
Prevention and early diagnosis are key factors in limiting vision loss from AMD. Protecting your eyes from harmful UV light, not smoking, and eating a diet higher in dark leafy green vegetables are ways to take an active approach in trying to prevent the start of AMD. The Eyecare Team at Lakeview Clinic includes Dr. Bradley Ludwig, Dr. Tracy Jackson and Dr. Thomas Bryan. They have many years of experience using retinal cameras and other forms of diagnostic imaging to diagnose and manage patients with age related macular degeneration. Once a patient is diagnosed it cannot be cured, so the goal of treatment is to prevent progression. Lifestyle modifications and vitamin therapy specifically formulated for dry AMD is the standard treatment. If the disease converts to wet AMD, referral to a retinal specialist is required for further treatment.
Dr. Thomas Bryan is an optometrist practicing eye care at Lakeview Clinic in Waconia, Minnesota. He enjoys all aspects of optometry, but especially medical cases and contact lens patients.
It’s February and love is in the air. Can you feel that thump, thump in your heart for your special someone? Valentines, Chocolates, candlelit dinners, and sweet poems. February also brings National Heart Awareness month. Let’s first look at steps to prevent heart disease and second discuss early signs of heart disease.
Prevention is Ideal
I encourage patients to focus on modifiable risk factors. What is a modifiable risk factor? Something we can change with effort and work. Items such as diet, weight management, stress levels, physical movement, environment, and optimizing pertinent medical risk factors are a few.
Diet:What is the best diet? Food that delivers high levels of nutrients, tastes good and has lower calories. Aim for colorful, natural, single ingredient foods. Food such as chicken, broccoli, avocado, oatmeal, raspberries, sweet potatoes, spinach. Nutrients, fiber, antioxidants, and omega fatty acids in these foods can help with weight management, cholesterol levels and inflammatory markers.
Weight management: This is a problem in America. Look at your weight as something that could lengthen your life or shorten it.
A balanced approach with goal setting, nutrition guidelines, activity minimums and accountability are key. Ask yourself “Why do I want to lose weight?” This helps formulate a plan. Ask your doctor for some help too!
Stress levels and environment: Stress is a natural part of life. However, stress hormones can be detrimental to the cardiovascular system. Learning how to recognize stress, minimize it and seek help when it’s too high is important. Exercise, prayer, meditation, gratitude, counseling, and medication are tools to help with this. Being aware of our environment is key. If you have control of leaving or taking a break from a stressful environment, then take the opportunity.
Movement: Strive for 150minutes a week of physical activity outside of your normal nine to five. Long walks, low impact cardio, resistance exercises such as body weight exercises, free weights, and resistance bands. Look for fun activities that allow for social interaction: golfing, skiing, skating, pickle ball, group fitness, frisbee golf are all great options to get moving.
Medical risk factors: Obesity, Diabetes, smoking, high blood pressure, highly processed diet, extreme stress levels, heavy alcohol use, strong genetic risk. Use the above suggestions with the guidance of your doctor to optimize treating these risks. Routine physicals, screening labs for diabetes, cholesterol and organ function, balanced diet, consistent movement, stress relief tactics will help prolong your life.
Now that you know a few preventative strategies let’s look for warning signs for cardiovascular disease. The hearts’ goal is to pump nutrient rich blood all over the body. Simply put, the pump has to squeeze hard enough, fast enough and through pipes (blood vessels) that are not damaged. If there is a problem in this process people need to recognize symptoms.
Warning Signs:
If the heart is not pumping hard enough, fast enough or efficient enough, then patients may experience leg swelling, fatigue, difficulty breathing, cough, dizziness, fainting spells, weakness and erratic blood pressure readings or heart rates.
If the heart is pumping too hard or too fast then the patient can experience headaches, shortness of breath, palpitations, vision problems or fainting spell. If blood vessels are blocked or narrowed, then symptoms vary depending on where the narrowing occurs.
If an issue is in the heart, chest pain or angina could develop as a warning sign of a heart attack, while narrowing in the legs can result in leg pain, cold feet, swelling and/or the development of chronic wound. Narrowing in the neck vessels can result in dizziness, confusion, and stroke like symptoms.
Conclusion:
I encourage you to take aggressive action using the prevention tactics outlined above. Also, if you are experiencing any of the warning signs, don’t hesitate to set up an appointment with your primary care provider or any of our great Lakeview Clinic providers. Happy Heart Month!!!
Dr Rogers joined Lakeview Clinic in 2016. He holds dual board certifications in Internal Medicine and Pediatrics which allow him to provide comprehensive care to all ages.
