Exercise Strategies For A Busy Lifestyle

Almost everyone I know is pressed for time, at least a few days a week. Unfortunately, our bodies don’t recognize our busy days as anything more than a lot of work, and will happily lose strength, cardio fitness, and flexibility while we collapse on the couch at the end of the day. While it’s important to note that 1) a long day on your feet can be enough exercise in itself, and 2) that there needs to be a balance between physical work and rest and recovery, most of us still need a little exercise boost on a daily basis.

Sadly, I don’t have the magic secret to extra hours in the day. Maybe I can console you with some tips for squeezing a little exercise into the (jam-packed) time we do have:

1. Find (or make) your opportunities for incidental exercise. Park at the far edge of the parking lot, get off public transportation a stop early and walk the extra few blocks, take the stairs instead of the escalator – the opportunities are endless.

2. Make it social. Exercise with friends is better than exercise alone. Meeting for a walk or a trip to the gym certainly beats meeting at Starbucks, where sitting and calorie consumption are king.

3. Break it up. There is a significant amount of research to support the idea that several shorter exercise efforts are just as good as one long one. If you can find a few five to ten minute (or even 30 second) breaks in your day where you can sneak in some body weight squats or a walk around the block, you’ll hit your exercise target in no time.

4. Schedule it in. I know people who live and die by their day planners (possibly the busiest people I know). If your workout time gets put on the books, you are much more likely to follow through with it. Plus, scheduling it in can help relieve the guilt of “should be doing something else”.

5. Take a break. I recently saw someone suggest following the “20/20” rule: for every 20 minutes of work/running around/life being crazy, stop for 20 seconds to stretch. I love this idea and you can certainly be flexible with it (no pun intended) by holding the stretch a little longer, or changing the stretching for different exercises for some variety throughout the day.

6. Multi-task. Many exercises can be done in front of the TV, so you can catch up on the news or your favorite shows and get your sweat on at the same time. BUT – make sure that you’re still putting a good effort in. I’ve seen more treadmill zombies who are walking a half mile and hour while watching TV than I care to count.

7. Find something you enjoy. This will not exactly help you fit exercise into an already busy day, but when you look forward and enjoy your workout, you are much more likely to make the time for it. Making the time and actually completing your workout is key to actually getting results.

8. Worst case scenario: do the chores. Vacuuming, cleaning the bathroom, washing windows, and lugging laundry around – all of these things get you moving and probably tick some of your “to-do’s” off your list (I know it would for me). While I would probably rather lift weights than any of these things, they are certainly better than nothing!

Key Lime Pie with Almond Crust

I’ve been having a bit of a sweet-tooth craving lately. So I did what I always do when I’m looking for something delicious that will also meet my good-nutrition goals: head over to askGeorgie.com. I’ve been an avid follower of coach Georgie Fear’s for years and nearly ALL my dessert efforts have come from her website.

Her take on Key Lime Pie is one of my all-time favorites. Super easy to make with no-bake summery goodness, creamy and citrus-y, with the much healthier almond flour crust replacing the traditional graham-and-shortbread version – I could sit down and eat the whole thing at once. Kind of defeats the purpose, but it’s that good. I make this with a little lime zest stirred in to the mix right before you pour it, plus a little sprinkled on top for the visual effect – I’d like to think she doesn’t mind the additions! 🙂

Click through to get Georgie’s recipe for Key Lime Pie with Almond Crust, complete with nutritional info because she’s just good like that. Weekend dessert problems solved!

Georgie's Key Lime Pie from askGeorgie.com

Georgie’s Key Lime Pie

What Does Your Food Diary Do For You?

I’m pretty sure everyone groans at the mention of the food diary (aka food log, journal, or “that horrible thing you’re making me do” – as I’ve heard it called). I groan too. The idea of dragging this little book around with you, stopping all the time to write down every little morsel that passes your lips, is not an appealing one. Factor in any measuring and weighing the components of your meal that you might do, plus or minus looking up the calorie/fat/carbohydrate content – it’s a drag. So is it worth the hassle?

As with so many things in the health/fitness/nutrition fields, it depends. (Who doesn’t love that answer??) My use of food diaries – with my clients and myself – depends on what I’m trying to achieve by keeping the log. Ninety percent of the time, it’s an exercise in awareness. I don’t actually ask clients to use them very frequently though, especially initially. Many people don’t like being told what to do, even when they think they want to be asked to do it, and especially when there is such a high risk of judgement attached – perceived or real. My goal is always to foster an environment of success with new habits, whether nutrition or exercise-related, and anything that puts a client on the defensive is not going to be high on my list of popular tools.

In addition, keeping a food diary can be overwhelming. If you are trying to wrap your head around one or more major changes in your lifestyle, adding a bunch of nit-picky forms to fill out is not going to help. This is particularly true for those of us who tend toward the “all or nothing” thought process. If you think that you have to record each component down to the gram, and count your calories, and calculate your percentage of good vs. bad fat, and how much protein there is… You’ll either never do it, or you’ll do so much of it that you’ll never do anything else.

On the other hand, keeping a food diary every now and then can be helpful. When YOU make the choice to keep your log, and do so for yourself rather than as homework for someone else to “grade”, the risk of judgement decreases greatly – you become the only one who can judge. This turns it into an exercise in self-awareness, where you can acknowledge what you see and and know what you need to change, and what you are doing well.

It also means you can keep your log on your own terms. I’ll do a few days’ worth of a food diary occasionally, and I never measure or weigh anything (though I probably should). For me, it’s a periodic check-up on how well I’m keeping on track with my good-nutrition habits. More to the point, I’ll use it when I know I’m not doing so great nutritionally as a tool to get myself back on track (it’s much less pleasant to eat handfuls of M&M’s when I know I have to write it down). Being aware of your actions is a necessary first step to establishing (or re-establishing) the positive habits that lead to the results we all want.

So, what does your food diary do for you? If you can clearly answer that you are using it to establish or reinforce good nutritional habits, or to be more mindful of what your intake actually is, then you are likely on the right track. This is especially true if you are doing it for yourself and using it as positive reinforcement. If you’ve been tracking your food for what seems like forever, and it has become a chore, an exercise in embarrassment, or an overwhelming task, then it’s time to find a new way to support your good intentions, create good habits, and make some progress.

 

 

Exercise and improve your posture during your commute

For all those Washington DC and Northern Virginia commuters out there, check out this nifty post to help keep your body working when you’re doing all that sitting in the car. Justine is a physical therapist (among many other things) at a local fitness and wellness center in Georgetown, and has provided great guidelines for some in-car exercises. Enjoy!

Justine @ Elements

I recently moved and now have a long commute to work. I’m not a person who likes sitting still for very long, so I thought I would share some exercises to keep you busy and improve your posture while sitting in the car.

These are isometric exercises, which are often used in posture training because postural muscles must work for extended periods of time. Thus, isometric endurance training is helpful to train your muscles to work while sitting at the computer, driving a car, washing dishes, etc.

For all the exercises, sit forward in your seat; do not lean back. (see last photo in this blog)

Start by exhaling and engaging core muscles then contract for the isometric exercise. Continue to breath normally. 

Note: Isometric exercises can raise blood pressure. For this reason I prefer to stick with short duration multiple repetitions: 3 sec hold and 15-20 reps.

Always listen to your…

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Five Ways To Do Push Ups

One of the best ways to start a resistance exercise program (aka weights or strength training) is to learn to use your own body weight as the resistance. Being able to control your own body weight is important, whether we’re talking exercise or just general activity, as it leads to more efficient movement and decreased risks of injury or everyday aches and pains. We should be able to control our body weight in all movement patterns, including a pushing pattern with the upper body.

Enter the push up. Don’t get scared off by visions of one-handed push ups or drill sargents, either. The push up can actually be modified to make it achievable for any fitness level. Let’s look at five ways to do push ups, starting with the easiest and working our way to the most challenging:

1. The Wall Push Up

Since you aren’t working against gravity much at all, this is one of the easiest push up variations and a great option if you are starting from ground zero. The focus here should be as much on maintaining full body alignment as it is on the “push”.

– Stand with feet hip width apart, on the balls of the feet, about 2-3 feet from wall
– Place hands on wall, just below shoulders, a little more than shoulder width apart
– Keep a neutral spine with glutes, pelvic floor, and tummy braced
– Bend elbows to lower body towards wall, then push back to starting position

Wall Push Up

Wall Push Up – Start and Finish

2. The Incline Push Up

Works via the same principle as the wall push up, but because you are in a more horizontal position, you’ll work harder against gravity. The incline push up can be done at a greater or lesser angle (hands higher or lower) – just remember, the flatter your body is, the more difficult the exercise will be. You could use your kitchen counter, or an exercise bench, or anything else that will hold your weight without sliding and is the appropriate height.

– Stand with feet hip width, on the balls of the feet
– Place hands on surface edge, a little more than shoulder width apart
– Keep a neutral spine with glutes, pelvic floor, and tummy braced
– Bend elbows to lower body towards wall, then push back to starting position
– At the lowest point, surface edge should hit at mid-chest or nipple line

Incline Push Up

Incline Push Up – Start and Finish

3. The Knee Push Up

A lot of people know these as “girl” push ups. I’ll call BS on that name, but it is an easier variation than the full push up. Maintaining back and body alignment will feel a little different since the knees are bent, but it’s still very important.

– Start kneeling with hands just outside shoulder width, at about shoulder level
– Keep a neutral spine with glutes, pelvic floor, and tummy braced
– Bend elbows to lower body to just above ground, then push back to starting position
– Keep head and neck in line with spine through whole movement (you should be staring straight at the floor at the bottom)

Knee Push Up

Knee Push Up – Start and Finish

4. The Negative Push Up

It’s a toss up whether knee push ups or negative push ups are more difficult. You can turn any pushup into a “negative” – the set up will be the same, but with this version, it’s all about your ability to control to the bottom of the range. Regardless of your starting set up, these are great as a strength builder and will power you through to the next level of difficulty.

– Start on knees (as above) or hands and toes (as below), with feet hip width and hands just outside shoulder width, at about shoulder level
– Keep a neutral spine with glutes, pelvic floor, and tummy braced
– Bend elbows to slowly lower body to the ground (you can finish laying on the ground) This should take several seconds – it’s all about control.
– Roll to one side, or sit hips back towards heels and re-set to starting position
– Keep head and neck in line with spine as you lower (you should be staring straight at the floor at the bottom)

Negative Push Up

Negative Push Up – Slowly lower to floor

5. The Full Push Up

The classic version – using your full body weight against gravity.

– Start on hands and toes, with feet hip width and hands just outside shoulder width, at about shoulder level
– Keep a neutral spine with glutes, pelvic floor, and tummy braced
– Bend elbows to lower body to just above ground, then push back to starting position
– Keep head and neck in line with spine through whole movement (you should be staring straight at the floor at the bottom)

Full Push Up

Full Push Up – Start and Finish

Where to start?? If you aren’t used to doing push-ups, start a level below where you think you might be. You should be able to complete 1-3 sets of 5-8 reps (reps, rest, reps, etc.), and not be too sore the next day. When you figure out which version is your starting point, work up to doing three sets of up to 10-12 reps. When you can easily do this, you can graduate yourself to the next level, decrease your sets and reps, and carry on!

 

Disclaimer: This does not constitute medical advice, and not all exercises may be suitable for all people. Please consult your health care professional if you are unsure whether these exercises are right for you. If these exercises increase pain or any other symptoms, please stop immediately and consult your health care professional.

Five Easy Protein-Rich Snacks

Many of us need more protein in our diets. Unfortunately, most of us only think of proteins during ‘meal’ times – steak and potatoes for dinner, eggs at breakfast if we’re lucky. In addition, many go-to snack foods are usually heavy on processed carbohydrates and sugars, fats, and salt – not super healthy.

Why do we need more protein? Protein is king – without it we literally would not exist. Proteins are made up of smaller compounds called amino acids, and combinations of these make up some or all of our muscles, organs, connective tissue, bone, even our hormones, and a whole lot of other bits and pieces. Even without the added stress of exercise, our bodies are constantly breaking down and rebuilding themselves, which causes a small loss of amino acids on a daily basis. Definitely useful to have in the diet then, yes?

It gets even more tricky when we consider that, of the 20 amino acids used in the human body, 12 can usually be made by our bodies (called non-essential amino acids), but the other eight we must get from our diets (called essential amino acids). And of the non-essential, some of these can become essential, depending on age, illness or injury, stress levels, and the like.

Even if all of this seems complicated, the good news is that you don’t actually have to worry about these little details if you get enough protein in your diet. We can help solve this problem by including a protein source with every meal or snack. Here are my personal top five protein-rich snacks:

  1. Hard boiled eggs – Fast, easy, totally portable – I love them. Sprinkle some baking soda into the cooking water at the start and they will peel very easily.
  2. Delicious crunchy roasted chickpeas – From my very favorite source of delicious, healthy, delicious cooking, askgeorgie.com (did I mention her stuff is delicious?). Super easy to make, since the hardest part is either opening a can or turning on the oven. I’ve experimented with many other spice mixes and never has this led me astray.
  3. Jerky – I personally think the homemade stuff is the best. I’m not necessarily a fan of what is on the labels of some of the store bought brands. All of that being said, I’ve only ever gotten the homemade stuff when my dad is ready to break out the smoker. This is something I’m hoping to remedy this summer! Update: Since writing this, I’ve found a great butcher in the Del Ray neighborhood of Alexandria. They have happy (pasture fed and free range) and healthy (hormone free) meats there – definitely worth a look if you are in the area.
  4. Homemade protein bars – I think homemade trumps store-bought for this one as well, for the same reason (and often they taste better). There are a million recipes out there, though I’ve been frequenting these soft, chewy, granola-y ones lately. Go nuts! (But please remember, the sugar content can be high in some recipes, which you might care about.)
  5. Greek yogurt – I love the whopping serving of protein, the creamy texture, and that it’s good for the vegetarians in my life. Greek style yogurt has 1.5 to 2 times the protein content of plain french-style yogurts (though they are still good options as well). If you find it a bit tart, a little fresh fruit will balance that right out, or up the protein content even more by throwing a small handful of almonds on the top.

I love all things protein and I will often have more than one of these as a snack if I have them around. Nuts and homemade protein shakes are also great options, just ones that I enjoy less frequently. I’m always looking for new ideas, so feel free to chime in and share your favorite protein-rich snacks.

Does It Hurt?

I am always amazed at the number of people I see who are working out wearing a knee brace and a grimace.

People who aren’t used to exercise have learned from The Biggest Loser that you should exercise so hard you cry (if it doesn’t hurt, you’re not working hard enough). Gyms and classes promoting high-intensity exercise have popped up all over, where the spirit of competition and possibility of ridicule can make for very high injury risks. So many personal trainers are always pushing for “one more”. Once they put on their workout clothes, people seem to forget that pain is the body’s way of telling us that something is wrong, and if we keep going, it could very well get worse. This pain might be a sharp stabbing feeling or a dull, achy or burning feeling. It might be gone in a second or it might stick around all day. Regardless of the type of pain, there are a lot of people out there willing to push through it – no pain, no gain, right?

Wrong.

I’m a big fan of using the “Does It Hurt?” rule. It’s a yes-or-no, black-or-white issue, simple to apply. You ask yourself the question. If the answer is no, carry on. If it does hurt, it should get checked out by a medical professional (your GP or physical therapist are great first choices) and treated appropriately. That being said, it’s also important to draw a distinction between what hurts inappropriately, and what hard work feels like.

"Good" Hurt

“Good” Hurt

Sometimes exercise is hard work, and sometimes it’s unpleasant. If you are working hard, your muscles will be telling you about it. You might be tired or feeling the burn at the end of a weight set or intense cardio workout, but once it’s done, it’s done – there’s no lasting pain (or damage). The worst case scenario here is a little muscle soreness one or two days after the fact. Your joints, heart, lungs, brain, and all the other bits of you should be doing great. And the muscle soreness is made a little more bearable when you know you are increasing your fitness and making progress towards your goals.

Sometimes though, exercise is unpleasant for all the wrong reasons.

"Bad" Hurt

“Bad” Hurt

Pain that occurs at the beginning of exercise, that starts suddenly during a workout, or that doesn’t stop when you do is potentially bad news, no matter where it occurs in the body. If it hurts, stop doing what makes it hurt, and enlist some help. Your medical team can provide diagnoses, and a good coach can work with you on exercise selection and technique to make sure you are working the right way for you. Yes, you may have to give up the pushups you have been doing since you were 20 or the reallllly cool looking workout you saw in the magazine – but giving these things up gets easier when you discover that you can reach overhead without shoulder pain. It’s a miracle! 😉

Bottom line: Don’t over think this. All you need to ask is: Does It Hurt?

 

 

 

Disclaimer: Please consult your health care professional if you are unsure whether exercise is right for you. If any exercise increases pain or any other symptoms, please stop immediately and consult your health care professional. For best results, get your doctor, physical therapist, and personal trainer/exercise coach talking for a united approach – as well as your chiropractor and massage therapist if you see these.

 

 

15 Foods to Keep You Hydrated, Part 2

Last week, I talked a little bit about hydration and which foods can help keep you hydrated through their high water content in Part 1 of this series. Since so many fruits and vegetables are in season right now, I thought a “Top 15” would give some great options for pumping up your fluid intake while enjoying the best of the season. So without further ado, winners 8-15:

  1. Bell peppers, 92%: One cup of green bell pepper slices has more than 100% of your RDA of vitamin C – not too shabby. They are in the same plant family as tomatoes, and the different colors contain different antioxidants. Looks for deeper and more vivid colors for higher nutrient values.
  2. Cauliflower, 92%: One cup of cauliflower will give you 10% of your RDA in dietary fiber and 4% of your RDA in protein, as well as handful of other vitamins and minerals. As with all the vegetables in the cruciferous family, cauliflower is loaded with cancer fighting phytochemicals.
  3. Watermelon, 92%: High in lycopene and vitamins A and C, no one can deny that watermelon is full of… yep, water. It also has relatively high levels of fiber and protein. Also a hugely popular summer melon, which I know because everyone looks at me like I’m bonkers when I tell them I don’t like it. Yep, I’m weird.
  4. Strawberries, 92%: On the other hand, strawberries – how can you go wrong? Not only are they delicious, but a single large strawberry provides almost 20% of your RDA of vitamin C. They also have one of the highest total antioxidant contents of all fruits, vegetables, spices, and seasonings.
  5. Grapefruit, 91%: One half of a delicious grapefruit contains around 60% of your daily vitamin C and roughly 25% of your daily vitamin A intake, regardless of color or type. Research has shown that both colors of the fruit can reduce LDL (“bad”) cholesterol, and the red varieties can lower triglycerides as well.
  6. Broccoli spears, 91%: My personal favorite on this list, broccoli is in the same plant family as cauliflower and is also full of cancer fighting phytochemicals. It may not be an official “superfood” but broccoli kicks butt with one cup containing over 100% each of vitamin C and vitamin K, plus 5% of your daily recommended protein intake and almost 10% of your recommended fiber intake.
  7. Cantaloupe, 90%: Packed full of vitamin A and C (around 100% of your RDA of each in one cup of cubed melon), this guy will also give you a big hit of potassium (12% RDA) and appears to have significant anti-inflammatory properties. This is big news when the typical Western diet is so full of foods and chemicals that increase our inflammation levels.
  8. Skim milk, 90%: The only non-plant on the list, skim milk still give a lot of nutrient bang-for-buck. One cup contains round 20% of your RDA of vitamin A and riboflavin (aka vitamin B2), and almost that much of vitamin B12. And since most milk is calcium fortified, you’ll get a whopping 50% of your calcium RDA in that one cup as well, and protein boost – almost 20% of your RDA. Thanks cows.

banner_iStock_000017490436Smallfruit

So, there you go – your top 15. Runners up (fruits and veggies that I expected to see and didn’t): grapes, raspberries, and oranges. And carrots, which I did not expect, just miss out at 87% water content. It just goes to show that no matter what the official water content of your favorite fruits and vegetables, it’s safe to say that they will give you a good hydration boost. Now go out and eat that salad!

 

What I learned from 6 months at STROGA

I’ve started getting back into yoga, in my ever-ongoing effort to take better care of myself. A fellow DC blogger has written up her similar experiences – I could not have written this better myself. Thanks, Have It Your Weigh!

Have It Your Weigh

One of my favorite things about living in DC is the abundance of exercise options here, from Yoga and Barre studios to running clubs and more. For the past few years I dabbled in yoga, starting and stopping for different reasons. This year I was lucky enough to get passes as a gift to a local studio called STROGA, which I happily took advantage of. My first thought was “this will be fun!”, but the benefits I received were even better than expected. Not only did I have fun, but I learned some valuable and unexpected lessons along the way.

1. Practice, practice

If you were involved in something in high school or college, you were most likely practicing 5 days a week with performances and games on the weekends. These days while working full time and balancing all of life’s events, it is harder to hone in on…

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Relief For A Tight Neck And Shoulders

It’s pretty common for people to hold tension in their upper back, shoulders, and neck. In fact, it probably accounted for at least half of my client complaints when working as a massage therapist. Deep tissue massage, also called sports, remedial, or therapeutic massage, is the best way to decrease the tension in these areas. Since most of us can’t just drop everything we are doing to get treatment, I’d like to share a few self-treatment techniques that you can use to keep your tension levels down between massages.

Self Management of Soft Tissue

You could also call this DIY massage. The idea is to use pressure to help relieve the tension in the muscles, decreasing pain and improving movement. Having a neck so tight that you can’t turn to check your blind spot is not super useful.

1. Tennis Ball Self-Massage – Upper Back

You’ll need a tennis ball and an empty wall or door that you can lean into.

Hold the tennis ball on your upper back, then lean against the wall, pinning the tennis ball between your back and the wall. Move side to side and up and down to roll the tennis ball around on your back, avoiding pressure on the bony areas of your spine and shoulder blades.

Hold tennis ball on upper back

Hold tennis ball on upper back

Pin tennis ball between back and wall

Pin tennis ball between back and wall

 

2. Upper Trap Self-Massage

The Upper Trap Area

The Upper Trap Area

Your upper trapezius (or upper trap, for short) is the fleshy area of muscle between your neck and shoulder, towards the back of your body. People under stress tend to hunch their shoulders towards their ears, putting this part of the muscle under constant tension. The longer it is under tension, the less easy it is for this muscle to relax, and the more sore and painful it will get.

You need the corner of a wall or doorway that you can lean into, and a small towel.

Fold the towel a few times and place it over your shoulder for a little padding. Bend your knees and bow forward, placing both hands on the corner of the wall/doorway to control your body weight. Lower your upper trap area onto the corner, pushing through your hands to control how much of your body weight is leaning onto the corner (more push through the hands will take pressure off the upper trap, less push will put more pressure through it). Go easy until you figure out the right positioning. Make sure you maintain neutral positioning through your back and keep your knees bent. This will also help deeper muscles in the back of the neck.

Towel over shoulder for padding

Towel over shoulder for padding

Placing your hands on the wall

Placing your hands on the wall

Leaning into the wall to put pressure on upper trap

Leaning into the wall to put pressure on upper trap

Stretching Your Upper Back, Neck, and Shoulders

When you’re dealing with a tight neck and shoulders, releasing muscle tension is only half the battle, since the tension release will not actually lengthen the short muscles. Gentle stretching is recommended after your self massage for the best results. GENTLE. Your neck is full of important stuff – you don’t want to put any unnecessary strain on the area. It’s also important to note that if these stretches cause any pain, tingling, numbness, or other neural sensations, or any sudden changes in vision, you should stop immediately and get yourself to your medical professional.

1. Upper Trap and Side of Neck Stretch

Reach behind your back with one arm and grasp the wrist with other hand. Very gently pull the wrist further across the back while dropping the head to one side (away from the side you are stretching).

Upper Trap and Side of Neck Stretch

2. Front of Neck Stretch

Slowly drop one ear toward the shoulder, then tilt the head back slightly to look up. You should feel a gentle stretch in the side and front of the neck.

Looking diagonally up to stretch the front of the neck

Looking diagonally up to stretch the front of the neck

3. Back of Neck Stretch

Slowly drop the chin towards the chest and relax. You should feel a gentle stretch through the back of the neck.

Back of Neck Stretch

Please note, the exercises shown above may or may not be the solution to any neck and shoulder tension you are feeling. As always, the best thing you can do for yourself is get treatment from a qualified professional. In this case, my first stop would be a good remedial or deep tissue massage therapist. If you are looking for a great massage therapist in the Alexandria area, I highly recommend Erica Petrilli – she’s got great hands. You’ll get so much more out of that treatment than you can ever give yourself.

 

 

Disclaimer: This does not constitute medical advice, and not all exercises may be suitable for all people. Please consult your health care professional if you are unsure whether these exercises are right for you. If these exercises increase pain or any other symptoms, please stop immediately and consult your health care professional. For best results, get your doctor, physical therapist, and personal trainer/exercise coach talking for a united approach – as well as your chiropractor and massage therapist if you see these.