Each year the calendar starts afresh, but hangovers linger from the last year. What you are right now, you’ve been building to, or fallen to by virtue of what you’ve done over the last year. This holds for you as an individual, and for bigger things like the economy.

Many say it is not good to make resolutions at the start of the year. And it is true that most resolutions are broken. In fact, many may be broken before the sun sets at the end of the day, or within a week at best. But, this is a fine time for re-evaluation, for setting a plan, and for determining your goals. So off we go, we’ll set goals and not make any resolutions.

Goal Setting

This year then, rather than resolutions, we will be setting goals. Then we’ll go for those goals. If you don’t achieve them, re-evaluate and reset your goals. Evaluate your goals regularly and set up weekly and monthly reviews.

Goal setting is an excellent concept. Set near term, intermediate term and long term goals. You now have something to measure and chart and can observe your progress. Make certain to set short term, achievable goals also.  If you only set long term goals, you are likely to get discouraged and give up. Start now and set up achievable short term goals, so that when you accomplish them within the next 4 weeks you’ll be encouraged to continue.

In sports and fitness, this holds for both the experienced, well conditioned athlete, and for the lapsed out of shape, determined to come back one. It is important for both, but definitely more important for the out of condition athlete. The experienced athlete likely already has goals. The experienced, well conditioned athlete must be prepared to modify their goals based on daily and weekly changes that they need to carefully monitor. They must guard against injury, as in reality we all must do.

The beginning athlete, or those of you starting up, determined to whip yourselves into shape need to exercise caution and realistic goal setting. Your ideal, dream fitness accomplishments and body weight and composition can be a long term goal. Realistic improvement, changes in activity level by increasing 5-10% per week with drop backs every third week  can be a short term goal. Setting up a plan with a trainer, or following suggestions from the many helpful websites, books, and plans available can help you get started. Of course the usual caveat applies, if you have or have had a serious medical condition or if you are over 40 years old, have a physical before starting a vigorous physical fitness program. But realize that sitting on a couch watching tv, or sitting on a comfy chair surfing the web can also be dangerous activity.

As you start off the year, make plans to improve in all of what I call the 3 Pillars of Fitness: Cardiovascular (CV), Musculoskeletal (MS), and Physiological (PY).   There is overlap within these categories.

Goals 2009:

Cardiovascular Exercise:

Walking: Increase amount to ___________ steps per day. (Goal – minimum of 10,000)
Running: Weekly range _____ to ______ miles per week
Other: Elliptical

Racing: Event 5K, 10K, 10 mile, Half-marathon, Marathon, Ultra

Musculoskeletal (MS)

Setup a strength (resistance) training , conditioning, and a gentle stretching program to do at a gym or at home. You can use body resistance, dumbbells, combination free weight, or machines.

A certified trainer can help you get started. But don’t be ignorant of what they are doing. Learn the exercises, learn good form, learn how to modify your program. Check your budget, but at least get started and have a form check with a certified trainer. Make sure your trainer understands your medical conditions. Discuss your goals. If you have osteoporosis, osteopenia, and a history of stress fractures, you don’t want your trainer starting you off with jumps onto and off of high objects. If the trainer is aware of this and leads you down a dangerous and high impact path, for your medical condition, your best exercise will certainly be running. Running away. There are many good certified trainers around. Seek them out.

Physiological

Physical examination for evaluation of blood pressure, blood chemistry, lipid measurements, etc.

Make certain your blood pressure and cholesterol and lipids are at good levels. Make certain everything else that needs to be controlled, corrected also is acted upon.

Improve your diet.  Evaluate it thorougly and realistically. Determine to eat healthy 95%, if not 100% of the time. Follow a rationale and balanced plan. Avoid fads. Understand that caloric balance is the key to successful weight loss.

Set your goals for body weight and composition changes (fat loss, muscle gain, etc.) if needed. Short term, intermediate, and long term. Most authorities recommend losing 1 pound per week, with some allowing more than that for a limited time period. Start working on it immediately. You should have been working on this one already, but yes, most people do put weight on over the holidays. In fact, most put weight on, and more than the need over their lifetimes. All of these areas of fitness complement each other. By improving your cardiovascular fitness, getting aerobic exercise, and improving your muscular strength and fitness you’ll also be assisting your diet. In fact they are all connected. Eating properly will improve your workouts also.

Get Going Now

In short, now (and always) is a time to set goals, evaluate progress, and move ahead. Have hope and a plan for the future. Reach for it, run for it, train for it. Get there, where you should be!

]]> http://www.drpribut.com/blog/index.php/2009/01/getting-off-on-the-right-foot/feed/ 0 http://www.drpribut.com/blog/index.php/2008/12/genetics-a-part-of-the-big-picture/ http://www.drpribut.com/blog/index.php/2008/12/genetics-a-part-of-the-big-picture/#comments Wed, 31 Dec 2008 03:42:14 +0000 pribut http://www.drpribut.com/blog/?p=67

Training, dedication, and hard work (along with a good diet and a bit of rest carefully added) will go far in helping you improve your conditioning and body composition. Your performance will increase. But for most of us, we will not become world class athletes, or even national class athletes. That is no reason not to work at improvement and in many cases where it is needed very dramatic improvement. You should not accept or provide yourself with excuses that without trying hard you’ve reached the point where you are all you can possibly be.

from Wikipedia (Clopidogrel molecule)

In the future, genetics will be used to help determine the best possible training methods for each of us, the best diet, and even the best medications to take.  The FDA is now considering changing the label on the anti-clotting medication Plavix in view of several recent studies that indicate a genetic variation may make the medication ineffective for up to 30% of those taking it to prevent heart attacks and strokes. This is a dramatic step and an obviously important one based on the currently available research.

Genetic variants and mutations will become increasingly important in pharmaceutical development, design, prescription and use. Plavix is a new and developing case in point. Ultimately research will lead to the development and determination of improved training, diet, and even legal supplements. Until then, other studies, experience, and just changing things that are obviously wrong can and will go a long way in helping us all improve.

More information at the Wall Street Journal: http://tinyurl.com/g3n3ticDru7gs

George Sheehan’s book “Running & Being” is one that every dedicated runner should read. George, a cardiologist, and one of the early, great running philosophers and gurus has been an inspiration to all old school runners.

Many years back, some people, Jim Fixx included, thought that running marathons would give an immunity to fatal heart disease. While running is certainly excellent for cardiovascular health, this has been found to not be so. The most recent studies seem to demonstrate that long distance running reduces your overall risk from dying from cardiovascular disease but that during running itself your risk is higher than while at rest. I still believe that this is a reason to run and not to avoid running. The overall benefit to reduced risk of cardiovascular disease, high blood pressure, depression, body weight, and many more benefits clearly and strongly outweigh the statistically somewhat increased risk of exercising.

It is important though to note and keep track of your own personal risks. Be aware of your lipid profile, your total cholesterol, your HDLs, LDLs, Triglycerides, and what you must to do make it as good as can be done for you. Be aware of your personal and family history of cardiovascular illness. Have your blood pressure checked, and as you get older have it checked more often. High blood pressure is a serious and by many an underrated, and undetected but major contributor to severe cardiovascular illness. Do not underestimate it or think you may be immune to it because you did not have it for the first 25, 35 or 40 years of your life.

Jim Fixx, author of one of the early and earth shaking popular books on running, died from heart disease while running. Today, Ryan Shay, a promising American runner died in the U.S. Olympic Marathon trials. At this time the cause of death has not been established. It was a very sad thing to learn. He is believed to be the first american elite runner to die during a running event. Earlier this year Alberto Salazar had a severe heart attack and was without a self-sustaining heartbeat for more than 5 minutes. Amby Burfoot recently wrote a great article about Alberto’s heart attack in Runner’s World, in which his personal risk factors were discussed. One of his grandfather’s died at 52 from a heart attack and the other at age 70. He reported that his father had had more than one heart attack. If I recall correctly Alberto was being treated for high blood pressure and an abnormal lipid profile. His lab tests and blood pressure were considered fine while under treatment. Serious heart disease ran in his family. This was pointed out as a risk factor that you can not alter. A few weeks ago I came across another article about Alberto Salazar in a section of the New York Times written by John Brant, an author who has written a book on the famous Salazar – Beardsley Boston Marathon race. Salazar related to Amby Burfoot that his doctor recommended an echocardiogram which would not have demonstrated cardiovascular disease. In the New York Times article something jumped out at me. Alberto, according to this article, had had significant neck and back pain that made him go to visit his physician. Normally, he endures pain stoically. His doctor did a resting electrocardiogram and some lab tests and it seemed normal. He was then given an appointment for some weeks later to have stress electrocardiogram.

“…in Indianapolis, Salazar was unable to sleep, had little appetite and felt perpetually tired. Stabs of pain rose from his neck and back, which he attributed to sitting awkwardly on the plane. As soon as he returned to Portland, his primary-care physician prescribed some tests, which were inconclusive, and referred Salazar to a cardiologist. An EKG stress test was scheduled for early July.”

Unfortunately, before he had that he had his near fatal heart attack. Or as some called it a fatal one that he survived. (Since he lived, even though his heart stopped, I do not call it fatal.). This is another extremely important item for runner’s to note. Do not ignore chest pain, neck pain, left side of the jaw pain, upper back pain and any other pain that makes you think something could be wrong. If you have risk factors or if a possible coronary atherosclerosis is suspected, you don’t need your stress test and or thallium blood flow study next month, you need it now. You should have that test as soon as possible. Salazar had serious signs of heart disease that were perhaps taken a tad less seriously and attended to a little slower than they should have been. His test should have been the following week and not the following month. Another, not quite as good a runner, David Letterman, did get tested early, and had a quintuple bypass. Salazar, was lucky to only need a stent. Happily, both have recovered and are running again.

The Runner’s World article by Amby was excellently written and gripping. Alberto is thoroughly quoted within the article. In trying to figure out why there was a difference in how he related his symptoms before his heart attack to the two authors I was at a bit of a loss. In a close reading though, Alberto clearly wanted to emphasize his spirtual beliefs in both, and perhaps even more so in the earlier interview with Amby. He viewed his heart attack as part of God’s master plan for him. I don’t know why he didn’t mention the symptoms he had. I’d suggest if you do hear a bit of knocking at the door in the form of unusual discomfort, pain, fatigue or dizziness you pay attention quickly.

Since most of you runners are doing all that you can to be healthy, let’s make sure you don’t ignore signs that you need just a little help to keep that ticker working. And don’t put off the stress test, if you need it.