If you’re planning to start an exercise program and wondering where to begin, start with your core first, says physical therapist Brittany Smith, DPT. People often think of the core muscles as being the abdominal muscles, but the core includes the muscles in the abdomen, back and hips, all working together as a group.
“The core muscles provide stability for the entire body as it moves,” says Smith. “These muscles are activated when you stand up, turn, bend, reach, twist, stoop and move in most other ways. Everything starts with your core.”
Strong core muscles help you maintain good posture, while weak ones can lead to slouching and slumping. Poor posture can be a cause of aches and pain, especially in the back.
Getting started with your core
To get your core muscles in shape, you need to exercise.
“Our bodies were made to move, so any physical activity is really important,” says Smith.
She recommends these specific core-strengthening exercises below.
The first one engages the deep muscles in the abdomen, called the transverse abdominis. “These muscles help hold us in a better position to stabilize our core, thereby stabilizing our arms and legs,” says Smith.
“The more you work on these muscles, the more it will become second nature to hold these muscles tight when you’re lifting grocery bags, doing yard work or any other kind of physical activity,” says Smith. This will help support your body.
Other muscles that tend to be weak are the gluteus maximus in the buttocks, and the gluteus medius and gluteus minimus on the side of the hip. The bridge and clamshell exercises can help strengthen these muscles.
Smith emphasizes that getting the proper position of these exercises correct is more important than the number of repetitions you do. “It’s better to take your time, maybe do fewer reps, but with better quality,” she says. For that reason, it can be helpful to have the guidance of a physical therapist to get started.
Move on from the core
Core exercises are the starting point of overall fitness because you need to hold those muscles engaged while you strengthen other muscles, such as the biceps in the arms or the quadriceps in the legs.
Smith suggests setting short-term goals (for about a month) and then more long-term goals. Once you have achieved short-term goals, such as getting around more easily, add other types of weight-training or resistance exercises to build muscle elsewhere.
With any exercise you do, always listen to your body, warns Smith. If you have pain other than muscle burn, take it easy. Reduce the number of repetitions, the weight or the duration of the exercises. Then build up gradually. “You don’t have to be in pain to make gains,” she says.
Beginner exercises for core strength
For each of the following, work up to one to two sets of 10 to 15 repetitions once a day.
Abdominal bracing
Lie on your back with your knees bent and feet flat on the floor. Contract your abdominal muscles, and press the arch of your back down toward the floor, pulling your belly button toward your spine. Hold for 5 to 10 seconds. Make sure your lower back stays flat on the floor. Relax and repeat.
Bridge
Lie on your back with your knees bent and feet flat on the floor with your arms at your sides. Squeeze your abdominal and buttocks muscles, push your heels into the floor and slowly lift your buttocks and hips off the floor. Keep your back straight. Hold for 5 to 10 seconds.
Clamshell
Lie on your side with knees bent in line with your hips and back, draw up the top knee while keeping contact of your feet together as shown. Don’t let your pelvis roll back during the lifting movement. Hold for 5 seconds.
Multiple cardiac benefits result from frequent consumption of dark chocolates rich in flavanols, including our response to stress.
Recently when talking with my 7-year-old daughter, I asked her what was the best food she could eat for a snack. As the daughter of a cardiologist you may imagine that she would have been taught the enduring virtues of eating fruits and vegetables and how these are the best foods to use as snacks. She told me that my question was easy and replied, “the best snack is chocolate.” I asked her where she learned that and she told me her mother told her so. How can you really argue against that logic?
This question posed to my daughter then led to more investigation during my clinic. I asked many patients informally what were their favorite snacks. Since they were in a cardiologist’s office they would often say some sort of fruit or vegetable and then add they only consume it in a small quantity.
I then would ask, “now what really is your favorite snack?”
I particularly enjoyed the response of a couple in their mid 70s. I have seen both of them both for atrial fibrillation for over 5 years. She said, “my true favorite snack is chocolate.” Then almost immediately after, as if there was a sense of guilt in admitting this, she said, “but chocolate is healthy right? I try to eat dark chocolate.” Her husband laughed at her and said she eats more than dark chocolate. He then replied, “my favorite snack is anything you put in front of me.” In my informal poll of true favorite snacks, chocolate was mentioned in about two thirds of my patients. Most of my patients felt dark chocolate in particular was healthy.
Dark chocolate and other cocoa products have gained a lot of attention worldwide as dietary supplements to improve heath. These products are rich in in flavanols. Flavanols are felt to mediate some of the heart healthy properties of chocolate. Flavanols are also found in many other food sources felt to be heart healthy such as grapes, apples, blackberries, legumes, red wine, and green tea. But of all of these food sources, the relative concentration of flavanols is highest in chocolate. As you may have guessed, dark chocolate contains much higher concentrations of flavanols compared to milk or white chocolate. In some chocolates the production process all but eliminates flavanols.
What Are the Heart and Vascular Benefits of Eating Dark Chocolate?
Lower Blood Pressure. Consumption of cocoa increases nitric oxide, studies show. For a good review of benefits, see Cocoa and Cardiovascular Health. Nitric oxide is a naturally occurring chemical in our bodies. Nitric oxide acts on small receptors in our blood vessels and prompts the vessels to dilate. This process lowers blood pressure. High blood pressure as discussed in many of my prior columns is associated with many types of heart disease including heart failure, atrial fibrillation, and atherosclerosis. High blood pressure is also associated with cognitive decline, dementia, and stroke.
Coronary Artery Health and Stability. As our arteries become diseased from atherosclerosis, plaques grow and over time begin to impair blood flow. If the surface of these plaques becomes disrupted or inflamed the plaques may ulcerate. The body responds to the ulceration by forming a clot in an effort to heal the wound. This process can lead to a heart attack. Cocoa may help stabilize plaques and minimize their risk of rupture by reducing smooth muscle cell proliferation (a process that causes plaques to grow), platelet adhesion (a process that results in clot formation in the artery), and preventing leukocyte adhesion and migration (processes that causes these plaques to become inflamed and unstable).
Lower Cholesterol. People with elevated total cholesterol with increased levels of low-density lipoprotein (LDL) cholesterol have a higher risk of cardiac disease, in particular coronary atherosclerosis and heart attacks. Flavanols reduce cholesterol absorption in our gastrointestinal track and also the synthesis of LDL cholesterol, research shows. They may also help raise high-density lipoprotein (HDL) cholesterol, the part of our cholesterol that is felt to be protective of heart disease, a clinical trial reported. Lower LDL and higher HDL levels after cocoa consumption were seen in people with both normal cholesterol levels to begin with and those with elevated levels that needed treatment. Multiple medications reduce LDL cholesterol, but very few things and essentially no medications raise HDL cholesterol consistently.
Dark Chocolate Changes Our Body’s Response to Stress
My wife often says, “I eat chocolate when I am stressed.” As I mentioned in a prior column, stress and our response to it can be a very potent risks of heart disease. In this regard, what if chocolate can improve how we respond to stress?
This brings me to the newest study regarding dark chocolate that I found very interesting. When we are stressed our body signals out chemicals that raise our blood pressure and help us fight the stressor. These chemicals or hormones are stored in the brain (pituitary gland), the adrenal glands, and other parts of the nervous system. A rececent study looked at how the body responded to stress by measuring these chemicals (cortisol, epinephrine, adrenocorticotropic hormone [ACTH], and norepinephrine) in 31 men consuming dark chocolate (“Noir 72 percent”; Chocolat Frey AG, Buchs/Aargau, Switzerland) versus 34 men that received a placebo chocolate that did not contain flavanols. The men then underwent a significant stress.
The stress was a 5-minute mock job interview and then a 5-minute mental arithmetic task in front of an audience. It is probably easy for most of us to imagine feeling very stressed if we had to try to solve a complex math problem in our head in 5 minutes while others watched, or we had to receive an intense job interview.
What these researchers found about the effect of chocolate was significant. Those men consuming dark chocolate had lower levels of cortisol and epinephrine after the stress. Although their brain response to stress was similar (ACTH levels were identical in both groups) the body’s response to the brain signals of stress was blunted. In particular, the response of the adrenal gland, which produces cortisol, was much less. Less released cortisol and epinephrine with stress is important as these are strong stimulants of the heart and blood vessels. With repetitive stress over time, both the heart and blood pressure have be negatively effected. Finally, since the body response was less significant, men consuming dark chocolate reported having less feelings of stress during the process.
My daughter was right, dark chocolate or chocolate rich in flavanols is a healthy food choice. The benefits of dark chocolate need to be carefully considered with the calories consumed, but in general there are multiple heart-related advantages with frequent consumption. In addition, as my wife mentioned to me, dark chocolate also may help you deal with stress, not only how you perceive it mentally, but also how your body responds to it.
Everyone likes a bargain, and lap swimming is a good deal when it comes to exercise. Swimming is a remarkably effective workout because it combines three important types of exercise in one: aerobics, stretching, and strengthening. “Simply keeping yourself afloat activates the core muscles in your back and abdomen. And you have to move all of your muscles to swim,” says Leigh de Chaves, a physical therapist and clinical supervisor of rehabilitation services at Harvard-affiliated Brigham and Women’s Hospital. (She also swam competitively in college.)
Are you a good candidate for lap swimming?
Consider lap swimming if you’re generally healthy, you’re a good swimmer, and your doctor says it’s okay. It’s no problem if you’re not a fan of the crawl: “Any stroke is fine. The breast, side, and back strokes are often favored because a lot of people don’t like putting their face in the water, like you have to do with the crawl,” de Chaves says.
However, lap swimming might be not be doable if you have an underlying condition, such as heart disease or a seizure disorder, that puts you at risk for a life-threatening event in the water. You may also need to skip lap swimming if you’re not strong enough to climb in and out of the pool easily. And you should be careful if you have injuries to your shoulders or neck. Lap swimming may increase your pain.
Start your lap swimming routine slowly
A green light for a lap swimming routine doesn’t mean you should start with 20 laps. Ease into it. “Focus on the amount of time you spend swimming, at first. For example, swim for five or 10 minutes, a few times per week. Gradually increase the amount of time each week, and note how many laps you can do within that time. Eventually, set goals to increase your speed by doing more laps in your set time, so that you can measure your progress,” de Chaves explains.
A big payoff
Once you’re in the swim of things, you’ll notice lots of benefits to lap swimming. It’s easy on the joints, thanks to buoyancy in water, and it has a meditative quality that forces you to focus on your movement and breathing.
Lap swimming also
improves endurance and cardiovascular health
helps lower blood pressure
increases flexibility
helps you control your weight
boosts your balance
reduces fall risk
helps sharpen thinking
helps reduce stress.
Some dos and don’ts for lap swimming
De Chaves points out that it’s important to warm up your muscles before diving into a lap swimming workout. All it takes is a few minutes of gentle paddling, and then static stretches of your shoulder and leg muscles.
Some other dos and don’ts:
Do wear nonslip shoes or sandals when walking on the pool deck.
Don’t forget to apply sunscreen if you’re swimming outdoors.
Don’t forget to stay hydrated before and after a workout.
Don’t skip stretching your muscles after lap swimming. You’ll want to stay flexible so you can get back in the pool.
For the nonswimmers in the pool
If you’re not a lap swimmer, you can still benefit from aquatic exercises — exercising in the shallow end of a pool. You might take a class with a trainer who leads a group through a set of exercises with special water weights or flotation devices (like a pool noodle). Or you can simply try water walking; working against the resistance of the water is good for your muscles and bones.
“If you have balance problems, it’s a good idea to exercise with a friend who can assist you. I also recommend wearing a buoyancy belt around your waist to keep you upright,” de Chaves advises.
Look for aquatic exercise classes — such as strengthening or aerobics — at the local YMCA, a fitness center, or a community center.
About the Author
Heidi Godman, Managing Director
Heidi Godman directs all news gathering for Harvard Health Publishing, and also directs the curation and production of HHP’s four monthly subscription publications (the Harvard Health Letter, Harvard Heart Letter, Harvard Men’s Health Watch, and Harvard Women’s Health … See Full Bio