Public Talk - Health in Golden Years

I will be giving a public talk next week, details as follows:

OCBC Wealth Management - Enjoying Good Health and Wealth in Your Golden Years

We may be living longer, but are we financially and physically fit to ensure our retirement years are happy? Recently, changes were announced to the CPF scheme aimed at improving returns on CPF savings and providing for a more secure retirement.

Our speaker, Ms. Anne Tay, will touch on these changes and explain how they will affect you. She will also provide some guidance on how you can build a nest-egg to help fund your golden years.

On a lighter note, fitness consultant, Ms. Teresa Shiu, will offer some useful tips on how you can stay healthy so that you can enjoy your hard earned savings once you retire. So make it a point to attend our seminar to find out how you can enjoy financial and physical well-being during your golden years.

Date: 03 November 2007 (Saturday)
Time: 3.00pm – 5.30pm; Registration starts at 2.30pm
Venue: Capital Tower (near Tanjong Pagar MRT Station, opposite CPF Bldg)
168 Robinson Rd, Auditorium (9th Floor)

Please fax the completed registration form to 6530 4430 or email your particulars to Wealth_Mgmt@ocbc.com and state subject title as 'WM Seminar'.

Guest Speakers
Ms Anne Tay, Vice President, OCBC Bank
Ms Teresa Shiu, Fitness Consultant

Tom Cruise Get In Shape by Pilates

Some people, especially many men I have met, were not sure if Pilates is challenging or interesting enough for them. Apparently Pilates appears too "static" to them and they doubt if Pilates can help them achieve their fitness goals.

Well many celebrities have chosen Pilates as their main choice of workout, really because it gives the results that they want. See how Tom Cruise finds Pilates:

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National Ledger - Tom Cruise Gets Buff for Katie Holmes
According to a report from Star Magazine the megastar keeps his body in action-hero shape with a grueling 90 minutes of Pilates every single day. "This is a really tough workout, and it isn’t for the squeamish, but Tom likes to really challenge himself,” a friend tells Star. "Tom says he feels younger and stronger with Pilates," the friend adds. “It gives him more stamina.

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So, are you ready to try Pilates now? :)

Alvin - Session #2

This session summary came a little late, as I was overseas for training. There was limited internet access and frankly I didn't even have time to sleep... so sadly I couldn't update my blog as much as I wished.

2nd session with Alvin focused a lot on instilling proper movement patterns in the shoulder joint. Instead of giving Alvin a quick fix by just telling him how to stand properly (he could have easily find an answer by himself through the www), I aimed to solve the root cause of his postural problem. Afterall, Alvin's poor posture was not formed over-night. It was rather created by repeated bad movement habits over a long period of time. Since Alvin is unable to stabilise his shoulders, especially during shoulder flexion and abduction, his upper trapezius is often overly recruited and tension start to build up around his neck area. Therefore my first step was to ensure Alvin moves his shoulders properly before moving on to correct his posture in the lower body. This is just like making sure a chemisty student to learn how to balance a chemical equation before teaching them the mole concept.

Exercises:
1. Review of #1's exercises
2. Shoulder Roll (moving shoulders front, centre, back, centre) - Shoulder Isolation exercise to enhancing neuromuscular awareness to control and stabilise shoulders
3. Side Kick: learn to stabilist shoulders (shoulders away from ears) in lateral position (while lying sideway). This is a great exercise to strengthen the stabilising muscles (lower trapezius and latissimus dorsi) for the shoulder joint and educate the body to isolate upper body and keep it stabilised while moving the lower body.
4. Prone Press-up: Fantastic strengthening for the upper back/postural muscles; soften and stretch chest muscles; reinforce shoulder stabilisation while in extension (bending the body backwards).

Case Study - Postural Correction

I decided to start documenting some of my Pilates classes, so that I can share my experience with other instructors, while this kind of written record will also be useful for my clients as reference. *Note: Names used are fictional.

Case Study - Alvin

Background:

Alvin is a 27y/o school teacher who is concerned about his own posture. Initial assessment reveals that he has exaggerated lordotic curves in cervical and lumbar area while too much kyphosis is observed in thoracic spine (hunch-back). He has never been medically diagnosed with any abnormality in the spine before. He is right handed and the right side of his body was generally stronger but also tighter than the left. His right shoulder is higher than the left. He used to play badminton and presently goes to gym regularly, mainly to run on threadmill and perform resistant training on stacked-weight machines (such as Chest-press, Lats Pull Down & Seated Row), after which he did not perform stretching as he was not sure what to stretch. Alvin went through 10-sessions of personal training but had no apparent result in terms of postural correction and weight gain. Movement analysis of upper limbs reveals lack of control and stability in the shoulder joint.

In conclusion, his posture is mainly due to weakness in postural muscles, such as serratus anterior, rhomboids and latissimus dorsi (back muscles), tightness in chest (pectorial major), back of neck (sternocleinomastoid & levator scapulae) and the thigh muscles (hamstrings and hip flexors). Instability & lack of control in shoulder movements (as shown in his pushing and pulling movement patterns) further reinforce the faulty posture.

Session #1 (focusing mainly on upper body):

Education of "correct posture", body awareness and proper neck alignment:

• The spine has two natural curves called the 'double C' or 'S' curves, these are the curves found from the base of head to shoulders and the curve from the upper back to the base of the spine. When standing straight up, weight should be evenly distributed on both feet.
• Using a mirror, align ears, shoulder, and hips. Proper alignment places the ears loosely above the shoulders, above the hips. Again, these points make a straight line, but the spine itself curves in a slight 'S'.
• Hold head in a balanced manner over the trunk in a sitting or standing position. The chin should be horizontal and parallel to the floor, drawn back slightly and centered. Try to stand, walk and sit "tall" at all times.

Reduce tightness and improve flexibility in cervical area.

• Tilt (stretch) head in all four directions over shoulders (forward, back, left, right). Avoid rolling in a circle, as it may cause further strain.

Education of proper movements over the shoulder joint & Improve strength of thoracic postural muscles.

• At quadriped position (on all four, with hips directly above knees and shoulders directly above wrists), find the neutral position by repeatedly curling the back upwards, like a cat, and then the opposite
• Lie facing up on a mat, 1. arms straighten pointing up to ceiling, "peel" shoulders off the mat and return, keeping shoulders away from ears throughout; 2. Arms straighten on the mat overhead, slide them along the mat, drawing shoulders towards ears then away from ears)
• Seated row and Lats Pull down, focusing mainly on engaging shoulders instead of the pulling motion.

By end of Session #1: Alvin's neck is a lot "straighter" (reduced lordosis) and Alvin is supposed to do his "homework" by practicing all the exercises above!

Injury Prevention for Runners - Part 3

Apart from what were mentioned in Part 1 and Part 2 of this injury prevention series, there are a lot more injuries a runner may suffer from. In this part, focus is shifted to the ankle and below:

Archilles Tendonitis

Signs and Symptoms: A severe, burning pain in the tendon area; pain and/or stiffness in the tendon first thing in the morning; tenderness makes the area uncomfortable to touch; deep,marked swelling that moves with the tendon.

Possible Cause: Turning foot while running, straining the Archilles tendon while jumping or landing suddenly; inadequate fitness; weak calves; change in footwear; running on different surface; tight gastrocnemius; excessive pronation of the ankle and foot, causing the Archilles tendon to pull off-centre and become inflamed.

How to Prevent: stretch calf and hamstring muscles; lengthen the Archilles tendon; strengthen ankle muscles undertension (e.g. doing heel drop)

How can Pilates help: Lengthen Archilles tendon, calf and hamstrings by exercises like leg circle & inverted-V; restore proper alignment of the ankle and good sense of proprioception in the ankle joint.

Ankle Inversion Injury

Signs and Symptoms: feeling of tearing sensation, followed by a sharp pain; unable to walk withut feeling some pain; ankle is painful to touch; swelling or bruising on side of the foot.

Possible Cause: Landing awkwardly from a jump; changing direction suddenly or sudden deceleration during running; running on uneven surface; weak peronea (ankle) muscles; tight Archilles tendon; existing ankle injury.

How to Prevent: archieve good sense of balance with the ankle; build strength & around the abkle joint.

How can Pilates Help: improve strength, proprioception and co-ordination around the ankle joint; lengthen Archilles tendon.

Plantar Fasciitis

Signs and Symptoms: One-sided pain on the sole of the foot; pain when getting out of bed; pain during intitial weight-bearing in morning, which is aggravated with activitiy.

Possible Causes: Over-stretching of plantar fascia because of poor foot posutre, prolonged standing or excessive running; wearing shoes wiht inadequate arch support (stay-tuned for entry on correct footwear!) ; flexible arches of the foot; tight Archilles tendon.

How to prevent: Integrate foot muscle strengthening exercises into training programme; use a heel pad in your shoes; choose correct footwear (that doesnt not base solely on style!) that have a supportive arch and be suitable for the training you are doing.

How can Pilates Help: Strengthen muscles in the foot, especially in the arch; improve flexibility in the lower limbs.

*For Pilates Practicioners, stay-tuned as I will be summarising a list of Pilates exercises that can be done to prevent the running-related injuries.*

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My big apologies to all those who attempted to subscribe to P-Latte by email but failed. It was my fault that the link and email subscription were not properly activated.

Now they have been fixed and you can now subscribe either in a reader or via email.

Simple Pilates Exercises while you are driving

Keeping a healthy spine through regular exercise and stretching and maintaining good driving posture is a large part of warding off pain while driving. However, no posture is good posture if maintained for too long (greater than 10-30 minutes, depending on the individual). Therefore, it is important to move often while you are driving, but in a way that is not distracting. Here are some suggestions for how to move while sitting and driving:

Pelvic Tilt
Roll your pelvis forward to increase the arch in your lower back (you will feel like you are sticking your upper chest outward) and then roll back to neutral. This exercise helps move and loosen the lower back, and allow the discs in your lower back to be nourished with fluid. For Pilates practitioners, this is like printing & imprinting exerise on the mat.

Side Pelvic Tilt
Shift all of your weight over to the R hip and pick up the L buttock slightly off the seat. You will feel your L shoulder and L hip come closer to together. Switch and repeat with shifting the weight over to the L hip. This exercise also helps feed the discs in your lower back.

Gluteal Squeezes
Pinch and squeeze the buttock muscles together. Hold for 10 seconds and then relax. This exercise will help use the stronger gluteals as a postural muscle, allowing your lower back muscles to rest.

Shoulder Pinches
Squeeze your shoulder blades together and hold for 2-3 seconds. This will help keep your neck muscles from tensing up and work for the neck in the way gluteal squeezes work for the lower back.

Head Nod and Neck Rotations
Head nod as if you are saying "yes madam." Neck rotations would be like saying "no madam." Do this for 20 seconds. This will help warm-up the muscles at the base of the skull where headaches often begin.

Whichever movement or exercise you choose to perform or make up, what is most important is that you shift in some way, often enough to keep your spine from getting stiff.

"The biggest thing I do while driving is moving my head from side to side on the headrest - as if I were scratching my head. Obviously, I keep my eyes on the road the whole time. It's been a Godsend for my neck pain," suggested by a driver friend of mine who suffered from neckache.

This is a great example of how a little movement can go a long way to keeping blood flow to the muscles of the spine and allow for a prolonged drive. Do share with me if you have your very own little movements that give your spine some grooves in the car.

Good posture for DRIVERS

Since I got my driving license on 28th August 2007, I drove under supervision only twice, and then I was all on my own. Well, like many other new drivers, I feel liberated and empowered by this new skill, because I can go anywhere, anytime, with all my "luggage/ equipments" with me. I was constantly lost on the roads and generally a half-hour journey would extend into a full hour. (For example it took me 100min or 40km to travel from Serangoon to Gleneagles Hospital, an otherwise 20-min journey on a Saturday morning!) I realised how tiring it was to drive around. My whole body stiffen up in the seated position, my mental focus was on the road instead of keeping myself in proper posture. So after 20km on the road, I usually slumped in the seat like a couch potato in front of TV, without knowing it.


Bad news for people like me, who need to drive a lot for work, is that, prolonged sitting with bad posture in a poor seat can have painful consequences on the spine. Recent research has found that people who drive cars for more than four hours a day are six times more likely to take time off work for back trouble than those who drive for less than two hours (1).

Protecting our back while driving involves an interplay between our body's posture and the adjustment of our car seat. Rule of thumb is: adjust your posture and seat in a manner that places you in optimal posture - maintaining the normal curves of your spine, or in Pilates term, maintaining a neural spine.

Below are 8 simple steps that can guide you into optimal posture at the steering wheel:

1. First, be sure you are not sitting on anything that could throw your alignment off (such as a wallet).


2. Adjust the seat forward/backward to a point where you are comfortable. Your feet should easily touch the pedals. You should be at a distance from the steering wheel that is comfortable for your arms. You should have easy access to all controls. This is important, since excessive reaching can place more stress on the spine.


3. Next, if possible, adjust the seat up and down so that it meets your thigh a few inches from the knee. Your knees can be either slightly higher than or level with your hips, depending on your preference for your spine. If you are unable to adjust your seat in this manner, you may have to purchase a wedge, or use towels to raise the seat.


4. Now sit upright, with your back aligned straight, looking ahead through the windshield. Sit in a manner that maintains your normal spinal curves (slightly arched back, shoulders back, head/neck straight). Now, re-adjust the back of the seat to meet your spine at this position. The seat will likely be around 95 to 100 degrees. More than that will force the lower back to slump and the shoulders and head to come too far forward. The angle of the seat is helping to maintain the normal lower back curve.


5. To determine if you have optimal headroom, you should be able to get a fist (thumb pointed down onto the crown of your head) between the ceiling and your head.


6. Your head should hit the headrest at the level of your eyes. If the rest is too low, this can result in more trauma to the neck during an accident. You should be able to easily rest your head on the headrest without tilting your head back.


7. Finally, adjust the lumbar support if possible to help place your spine in a slightly arched or lordotic position. If this is not available on your seat, use a towel-roll to build the lumbar support. Most automobile seats are already constructed with a lumbar support built in. Often the support is either too high or too low. If the lumbar support is not adjustable, a towel roll will come in handy.

8. Of course not to forget to engage your powerhouse, the abdomeninals, by gentlydrawing your belly button towards your spine. Your powerhouse will give you excellent lumbar support.

References:1. Porter JM, Gyi DE. The prevalence of musculoskeletal troubles among car drivers. Occup Med (Lond) 2002 Feb;52(1):4-12.

KL trip – Part II: The fake Pilates

I felt really guilty after pigging out on the previous night, so I headed straight to the hotel gym when our meeting ended early. The equipments there had reasonable variety and were well-maintained (after all it was in a 5-star hotel!). I trained my legs (which I am too lazy to train on normal days) and did a lot of stretching in the empty studio. Me and my colleague, L, was rather excited to know that there was a Pilates class happening at 6-7pm, the timing was just nice for us to lengthened ourselves before heading out for dinner (to pig out yet again)!

Unfortunately, both of us were horrified by what the instructor taught in the supposedly-Pilates class. We could not figure out what she was trying to teach in the first 5 minutes. It was NOT Pilates for sure, it was not yoga also. It was more like aerobic-styled yoga-wannabe.

Enough was enough, after the instructor finished her version of “Hundreds”, me and L exchanged glances and decided to leave the class! We could not tolerate anymore non-sense from the instructor that could potentially injure ourselves.

According to other club members, she was apparently an acclaimed instructor and her Pilates class was rather popular (it was full-house, by the way). I feel really sad, as the people who attended her class sacrifice their time and money, hoping to stay fit, yet they were “cheated” into fake Pilates which might injured them.

This make me ever more determined to let more people know what is real Pilates. I hope that the Pilates community (both instructors and practicioners) here can help people around them to be more aware about Pilates.

KL trip – fighting against Cholesterol

Last week I was in Kuala Lumpur (KL) to for a meeting. My KL colleagues brought me to try various KL's famous dish including the “roast-pork noodles”. This KL style Roast pork had zero resemblance from the HK counterpart; it was totally covered with black sauce, but it is delicious.

I realize KL food is really tasty, but like its many other famous dish, it is usually quite salty and oily. The rich aroma is often created by cooking with a generous amount of lard. I am not too used to it since I have a much lighter taste-bud.

Some people thought it is ok to consume fatty food, as long as they avoid food that is high in cholesterol (the notorious to clog your blood vessels). But what they don’t realize is, only 20% of the cholesterol in the body is ingested from our diet and the remaining 80% of cholesterol is generated by our very own livers, as a response to eating saturated fat.

My mother is one good example. She loves eating soda crackers, thinking that it is healthy because it’s “fortified with calcium” and low in cholesterol. Thus she was extremely shocked and upset to find herself “scoring” badly in her health screening. She is hypertensive and has high cholesterol in her blood. “I don’t eat unhealthily and I don’t even get to enjoy eating crabs and other good food often, so why should I suffered from this kind of “rich-man disease”?! ” she was very frustrated.

In fact, a lot of seemingly “safe” food that emphasize on “Low / No Cholesterol” is actually not heart-friendly at all, and many uninformed consumers suffered from heart problem even though they tried all means to avoid food that is high in cholesterol.

So how to control your cholesterol level? Try these:

1. Cut Fats:

• Avoid all deep-fried food (so eliminate saturated fats)
• Skip the snacks/ biscuits aisles in supermarket as processed foods contain hydropgenated fats. So say no to margarine, pastries, packaged cookies, crackers, potato chips, and other snack foods. (hell that's like more than half the food items in supermarket!)
• Cut down fat intake by removing fats around red meat, chicken/duck skin, full cream diary products.

2. Eat More

• Soy protein (like Tofu)
• Fruits & vegetable (never forget daily your 2+2 servings)
• Fish (such as salmon, mackerel, sardine)
• Oatmeal
• Flaxseed

3. Exercise!

• this can raise your metabolism and burn calories, losing fat weight, lowering total cholesterol, increases the good HDL cholesterol that helps prevent plaque from forming on the walls of the arteries

4. Relax lah!

• Fatigue, anger, and distress can raise your body's adrenaline levels, causing cholesterol to rise.

5. Medication

• Your family doctor may prescribe you Statins, which are able to control an enzyme in the body that is responsible for the manufacture fats. This control process reduces the body's production of cholesterol. Thus help control triglyceride levels, lower LDL or "bad cholesterol," increase the HDL or "good cholesterol," and lower total cholesterol.