Do you want to get fit fast? How about losing those extra pounds without having to work up a sweat? Wouldn't it be nice if you could reap the health benefits of physical activity without actually having to do the exercise? Scam artists and manufacturers who make exaggerated claims about their exercise equipment use these "hopes" to lure many of us into buying their products.

Although it would be nice if these enticing claims were true, the fact is, in order to achieve a healthy, fit, and toned body you actually have to do the work of exercise. The Federal Trade Commission (FTC) offers this advice when evaluating the claims of exercise equipment manufacturers:

• Ignore outrageous claims - declarations that an exercise machine can help get results effortlessly are false. You can only get the health benefits of physical activity by actually exercising your body, which takes effort and work.
• Be skeptical of claims that an exercise machine can help you burn excessive calories. Read the fine print. Results may be based on using their equipment in conjunction with other devices or in combination with caloric restriction. Note that exercise machines which exercise the whole body may burn more calories than equipment that focuses on one body part; however, if it is too hard to use or makes you uncomfortable, chances are you won't use it in the long run. Buy equipment that you think you will actually use on a regular basis.
• Think twice about claims that an exercise machine can "spot" reduce or burn fat in a specific area of the body. These claims are false. Your body weight is dependent upon the number of calories you consume relative to the amount of total body exercise you perform.
• Question celebrity endorsements, testimonials and before-and-after pictures. These results may not be typical, or even true.
• Calculate the total cost of the equipment. Check the fine print for sales tax, shipping and handling fees, and/or delivery and set-up fees.
• Understand the manufacturers policies on returns, warranties, and guarantees. Re-stocking and return shipping fees may apply.
• Investigate the company's customer and support services. Is someone readily available to answer your questions or to provide you with replacement part information?

Doing a little research on the credibility of an exercise product's claim can save a lot of grief, and money, in the long run. Question a company's claim that results have been clinically proven. How was the study conducted? Have the results been taken out of context? Were the findings published in a peer-reviewed scientific journal?

Even if the claims of an exercise device appear to be legitimate, before you buy, be honest with yourself. Will this exercise machine help you meet your fitness goals? Is it a piece of equipment that you truly will use, or will it end up collecting dust? Remember, the best form of exercise is that which you will actually do on a regular basis.

Note: Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for, or who currently have, chronic health conditions.

Resources

The Federal Trade Commission (FTC)

Our new puppy, Duke, at 8 1/2 weeks.

A dog could be your answer to controlling body weight and meeting the federal government's recommendations for physical activity (150-300 minutes per week of moderate- to vigorous-intensity exercise). The results of a study published in the September 2008 issue of Preventive Medicine suggest that dog walkers are more likely to meet the national recommendations for physical activity than dog owners who do not walk their dogs and those individuals who do not own dogs.

Evidence from the study also suggests that dog walking can help to control body weight. The study found that dog walkers were significantly less likely to be obese than non-dog owners and dog owners who don't walk their dogs.

The purpose of the study conducted by Coleman et al., was to investigate differences in demographics, neighborhood environment (e.g., walkability), body weight, and physical activity level between dog owners and non-dog owners. The 2,199 subjects were selected from 32 neighborhoods in the Baltimore, Maryland and Seattle, Washington regions. Census data was used to determine high versus low income neighborhoods. Neighborhoods were also rated based on degree of walkability (the ability of inhabitants to walk to nearby destinations from their homes). Physical activity level was determined via accelerometer use and body weight and height were self-reported by the subjects. Subjects were divided into three groups: dog owners who walked their dogs, dog owners who did not walk their dogs, and non-dog owners.

In general, the dog walkers in the study were more likely to be caucasian and to live in higher income neighborhoods than the non-dog owners and owners who didn't walk their dogs. Both groups of dog owners tended to be caucasian, of an older age, and to live in neighborhoods of higher income compared to the non-dog owners. Furthermore, when compared to dog owners who did not walk their dogs, dog walkers were more likely to live in neighborhoods that were rated as being "high-walkable."

Choosing to walk your dog can be a health benefit to both you and your pet. Before beginning a walking routine with your canine companion there are some points to consider:

• You both should get a physical to ensure the safety of the exercise.
• Different dog breeds require and tolerate different levels of activity. For instance, my new puppy, Duke, is a Greater Swiss Mountain Dog. Because he is a large breed dog, he is prone to joint problems and, therefore, should not go for jogs or long runs with me. However, as he gets older he is capable of going on brisk walks, and even hikes, with me. For the time being, I am choosing to have Duke as my warm-up companion. He joins me for a light walk before I embark on my run.
• Third, if you do not live in a walkable neighborhood, consider visiting a local dog park to get exercise for both you and your pet.

Don't own a dog?

You still can reap the benefits of dog walking by becoming a volunteer dog walker for your local animal shelter or humane society. Or, offer to walk a friend's or neighbor's dog.

Note: Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

Resources

Preventive Medicine, Volume 47, Issue 3, September 2008, pp. 309-312; "Physical Activity, Weight Status, and Neighborhood Characteristics of Dog Walkers," Coleman, K.J., et al.

A little over a week ago, my husband and I spent 4 days driving to Missouri and back (about a 1,600 mile roundtrip) to bring home a puppy. After sitting in the truck for that long, we really felt it in our legs, hips and backs. Lower body muscles can get stiff fast and blood can pool in your lower extremities when you have to stay seated for an extended period. To offset this when traveling, you should try to include stretch breaks during your stops at rest areas, restaurants, and/or gas stations along the way.

Good stretches to perform for your legs, hips, and buttocks are pictured below. It is best to stretch your muscles when they have been warmed up. If traveling, take a few minutes to walk around the rest area to increase the blood flow to the muscles you will be stretching. If at home, incorporate the stretches into either the warm-up phase (latter half) or the cool-down phase of your exercise routine. The stretches should be performed in a slow, controlled manner. Do not bounce. Stretch only to the point of tension, not pain. Remember to breath while performing the stretches.

Runner's Stretch - stretches the hip adductors (inner leg muscles)

Technique: Stand with your feet wide apart. Bend your right knee to the right while pointing the toes of your right foot to the right. Keep your left leg straight with the toes of your left foot pointing slightly forward. You should feel the stretch in your inner left thigh. Hold for 15-30 seconds. Slowly return to the starting position. Repeat. Perform 3-4 times per side.

Standing Quadriceps Stretch - stretches your quadriceps muscles (upper thigh)

Technique: Stand with your feet shoulder-width apart. While balancing on your left foot, pull your right foot up, behind your buttocks with your right hand. You may hold on to an object for balance if needed. Hold the stretch for 15-30 seconds. Slowly return to the starting position. Repeat. Perform 3-4 times per leg.

Standing Hamstrings/Calves Stretch - stretches the buttocks, hamstrings, and calf muscles, as well as the achilles tendon

Technique: While standing upright, raise your left leg and place on a park bench, picnic table, coffee table, or chair. While leaning forward at the hips, grab the toes of your left foot with your left hand and gently pull your toes toward your body to the point of tension. Hold for 15-30 seconds. Slowly return to the starting position. Repeat. Perform 3-4 times per side.

Raised Leg Shin Stretch - stretches hip, quadriceps, and shin muscles

Technique: Stand with your back to a park bench, picnic table, chair, or coffee table. Your feet should be shoulder-width apart. Place the top of your right foot onto the chair or coffee table. While keeping your back straight, bend your left knee and push your hips forward and down. At the same time, push your right foot into the chair or coffee table until you feel the stretch in the front of your right hip, thigh and shin. You may hold on to another object for balance if needed. Hold the stretch for 15-30 seconds. Slowly return to the starting position. Repeat. Perform 3-4 times per leg.

These stretches are great to do while traveling or as part of your normal exercise routine. They are especially good exercises for runners, cyclers, and rowers.

Note: Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

Neck, shoulder, and upper back stiffness can occur from sitting for a long period at your desk or working the line for an extended shift. Taking frequent stretching breaks, every hour or so, will help to relieve the tension and refresh your muscles. The stretches below are demonstrated in the standing position, but can be performed while sitting if preferred.

Because your muscles respond best to stretching when they have been warmed up, you may want to perform 2-3 sets, of 10 repetitions each, of shoulder shrugs, arm circles, and shoulder and neck rolls prior to stretching your muscles. The stretches should be performed in a slow, controlled manner. Stretch to the point of tension, not pain. Remember to breathe as you perform the stretch. If you are performing the stretches in the upright position, you should stand with your feet shoulder-width apart. Your knees should be slightly bent.

Extended Arm Twist - stretches your shoulder muscles and the outer muscles of your arms and ribs

Technique: Cross your arms and extend them over your head. With your palms together, slightly stretch your arms up and back. Hold for 15-30 seconds. Slowly return to the starting position. Repeat. Perform 2-3 times.

Extended Arm Push - stretches your shoulder and upper back muscles and the outer muscles of your arms.

Technique: Interlock your fingers and extend your arms above your head with your palms facing up. Push your palms up and your arms slightly back to the point of tension. Hold for 15-30 seconds. Slowly return to the starting position. Repeat. Perform 2-3 times.

Lateral Side Stretch - stretches your abdominal, back, and shoulder muscles, as well as the outer muscles of your ribcage

Technique: Extend your arms above your head. Bend your right elbow and hold it with your left hand. While leaning to the left, slightly pull your right elbow to the left. You should feel the stretch in your armpit area, as well as the muscles mentioned above. Hold for 15-30 seconds. Slowly return to the starting position. Repeat. Perform 2-3 times per side.

Behind the Back Chest Stretch - stretches the chest, shoulder, and arm muscles

Technique: Place your arms behind your back and interlock your fingers. Lift your arms upward to the point of tension. Hold for 15-30 seconds. Slowly return to the starting position. Repeat. Perform 2-3 times.

Behind the Back Neck Stretch - stretches your neck and shoulder muscles and, to a lesser extent, your upper back muscles.

Technique: Place your hands behind your back. Grab your right wrist with your left hand. As you lean your head to the left, slightly pull your right arm down and to the left with your left hand. Stretch to the point of tension. Hold for 15-30 seconds. Slowly return to the starting position. Repeat. Perform 2-3 times per side.

Bent Arm Shoulder Stretch - stretches your shoulder and upper back muscles and, to a lesser extent, your triceps muscles

Technique: Place your right arm across your chest. With your right elbow bent, slightly push your right elbow toward your left shoulder with your left hand until the point of tension. Hold for 15-30 seconds. Slowly return to the starting position. Repeat. Perform 2-3 times per side.

Although these exercises can be performed at work to alleviate stiffness, they are also great stretches to incorporate into your exercise routine. They are especially good stretches for athletes who participate in sports that require a lot of upper body movement such as tennis, racquetball, baseball, swimming, and weight training.

Note: Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

Good flexibility enhances your ability to function during day-to-day tasks. If a joint is flexible, such as your shoulder joint, you can easily move it through its full range of motion without discomfort. The degree of flexibility can be different throughout your body, that is, it is joint specific.

Flexibility of a joint is effected by many factors such as:

• genetics - some individuals are naturally more flexible than others
• age - older individuals tend to be less flexible
• gender - women, in general, are more flexible than men
• activity level- individuals who are physically active tend to have greater flexibility
• skeletal structure of the joint - some joints, such as the shoulder joint, have an inherent greater range of motion than others, such as the elbow joint
• presence of disease - some health conditions, such as arthritis, can limit range of motion

Your flexibility can be improved and maintained by incorporating stretches into your exercise routine. Below are some stretches for your body's core. Proper stretching technique is important to avoid injury. Here are some tips:

• Muscles stretch best when they are warm. Before stretching, perform light-to-moderate aerobic activity, such as walking, for about 5 minutes.
• Stretches should be performed in a slow, controlled fashion. Do not bounce.
• Move the joint through its range of motion to the point of tension, not pain.

Full Body Stretch - stretches entire body, especially the muscles of the shoulders, back, and legs

Technique: Lie on your back. Extend your arms behind your head while straightening your legs and pointing your toes. Reach in the opposite direction, as far as possible, with your arms and legs. Hold for 15-30 seconds. Slowly return to the starting position. Repeat 3-4 times.

Lying Down Hamstrings Stretch - stretches the back, buttocks and hamstrings muscles

Technique: Lie on your back. Raise your left leg, bringing your left knee toward your chest. Keep your right leg as straight as possible on the ground. Hold for 15-30 seconds. Slowly return to starting position. Repeat 3-4 times per leg.

Kneeling Reach Stretch - Stretches back, shoulder, and upper arm muscles

Technique: Kneel on the ground. Place your arms on the ground in front of you and reach forward with your hands while pushing your buttocks toward your feet. Hold for 15-30 seconds. Slowly return to starting position. Repeat 3-4 times.

Cross-legged Forward Reach - stretches the hips, back, and buttocks muscles

Technique: Sit on the ground with your legs crossed. Lean forward at the hips, extending your arms out in front of you on the ground. Hold for 15-30 seconds. Slowly return to the starting position. Repeat 3-4 times.

The "Pretzel" - stretches the back, hip, and buttocks muscles

Technique: Sit on the ground with your left leg extended in front of you. Cross your right leg over your left. Twist your body toward the right while gently pushing your left elbow against the outside of your right knee. Hold for 15-30 seconds. Slowly return to starting position. Repeat 3-4 times per side.

Flexibility exercises should be performed 2-3 times per week. They can be performed as part of your warm-up or cool-down. If performing them as part of your warm-up, do them near the end when the blood flow has been increased to the muscles, warming them.

Note: Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

Resources:

ACSM's Health & Fitness Journal, Vol. 12, No. 5, "Flexibility," p. 5, Thompson, D.L.

You may feel good, but are you truly healthy? Good health is not just about the absence of disease, but is a matter of how well you function on a day-to-day basis. And, how well you function has a direct impact on your quality of life. The World Health Organization defines health as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." You do not have to feel sick or have symptoms of disease to be in an unhealthy state of functioning.

How well do you function on a daily basis? Can you climb a flight of stairs without getting out of breath? Can you touch your toes without difficulty? Are you able to jog a mile without stopping? Are you able to control your anger when another driver cuts you off in traffic? Can you wait patiently in a long line at the store without yelling at the clerk? Can you forgive and forget or do you hold a grudge? Are you a "worry wort"? Can you adapt to change without undue stress? Are you obsessive? Do you procrastinate? Do you have a strong social network of support upon which you can rely?

A de-conditioned state, poor anger/stress management, among other maladaptations, interfere with your ability to function optimally, and can lead to the development of a chronic disease in the long-run. Although our bodies and minds are capable of enduring much "mistreatment" (e.g. lack of exercise, poor stress management, unbalanced diet, etc.), there is a threshold. Often times, a disease may be silently present and when symptoms do arise it is too late.

Adopting healthy lifestyle habits, before symptoms of disease occur, is the best path to follow. Enroll in self-improvement classes if needed. Establish social ties that will last through the good and the bad. Start an exercise program. Pursue a hobby.

Incorporating these lifestyle choices can create an environment which fosters a healthy state of functioning, improving your quality of life.

Resources

Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p.100) and entered into force on 7 April 1948. The Definition has not been amended since 1948.

Small lifestyle changes, and a little patience, may produce large results in regards to weight management. A national initiative, America on the Move (AOM), is combating the obesity epidemic by encouraging individuals to make small changes in their dietary and exercise habits by decreasing food consumption by 100 calories per day and increasing walking by 2000 steps per day beyond current levels. The results of a study published in the Journal of the American College of Nutrition suggests that this approach may be successful.

The investigation, conducted by Stroebele et al., studied the impact that adopting this "small changes" approach would have on overweight adults. The subjects participated in a 1 week non-intervention period in which they were instructed to wear a pedometer and record their steps per day, in addition to keeping a diet diary to document their food intake. They then participated in a 2 week intervention period in which they were asked to increase their number of steps by 500 per week to reach a total increase of 1,000 steps in two weeks. During the intervention period the subjects were also asked to decrease their caloric intake by 100 calories per day. Suggestions on how to decrease food consumption were provided to the participants. The subjects continued pedometer and diet diary use during the 2 week intervention period.

The findings revealed that the participants increased their number of steps taken per day by an average of 1,454 steps. Their caloric intake was decreased by about 300 calories per day during the intervention period.

The investigators concluded that individuals may perceive the "small changes" approach to be more attainable and tolerable than following regimens that require greater caloric restrictions and more dramatic increases in physical activity; thus, motivating them to adopt these tactics. Although the study only investigated the short-term impact of the "small changes" approach, the researchers suggest that these strategies may be more easily adhered to in the long-run, resulting in a maintenance of healthier body weights for followers.

Although patience is needed while following the "small changes" approach for weight management because results may not be immediate, taking small steps toward a healthier body weight may be less likely than a leap to result in a "stumble" and set-back.

Suggestions for Decreasing your Daily Caloric Intake by 100 Calories*

Instead of: a slice of apple pie (302 calories)

Try: 1 medium apple, baked (72 calories) with 1 sheet of low-fat honey graham crackers, crumbled (60 calories) and 1 tablespoon of honey (60 calories) drizzled on top for a total of 192 calories.

Instead of: a slice of cheese pizza, regular crust (290 calories)

Try: one-half light multigrain english muffin (50 calories) with 2 tablespoons of pizza sauce (54 calories) and 1 stick of reduced-fat mozzarella string cheese (70 calories) for a total of 174 calories.

Instead of: 1 ounce (20 chips) of potato chips (150 calories)

Try: 1 cup of popcorn (15 calories)

* values are approximate and were obtained from www.dietbites.com and www.livestrong.com/thedailyplate/

Suggestions to Increase your Steps Throughout the Day

• Park a block away from the office and walk that distance to work.
• Put down the TV remote and walk to the set to change the channels.
• Shopping? Walk the perimeter of the store before you begin.

To learn more about the America on the Move initiative, visit www.americaonthemove.org

Note: Before beginning an exercise program or increasing the intensity level of a current routine, a physician's approval should be obtained, especially for older adults and those at risk for or who currently have chronic health conditions.

Resources

Journal of the American College of Nutrition, Vol. 28, No. 1, 63-68 (2009), "A Small-Changes Approach Reduces Energy Intake in Free-Living Humans," Stroebele, N., de Castro J.M., Stuht, J., Catenacci, V., Wyatt, H.R., and Hill, J.O..

www.livestrong.com/thedailyplate/

www.dietbites.com

www.americaonthemove.org

A question that is often asked by individuals is, "When is the best time of day to exercise?". The answer to this question is dependent upon many factors. Ultimately, the best time to exercise is the best time for you. To make it a lifelong habit, you want to choose a time that you are most likely to exercise. Regardless of the time chosen, you will still reap the health benefits associated with exercise, such as improved fitness and a reduced risk for disease.

When making your decision about the best time to exercise, you need to weigh the pros against the cons. Some points to consider when making your decision include:

1. Exercise done first thing in the morning is subject to fewer schedule conflicts, reduced likelihood of the unexpected, and less feelings of fatigue that may arise as the day goes on.
2. When the weather is hot and humid, morning and evening hours are cooler, making physical activity during these times safer and more comfortable than exercising during the heat of the day. Note that morning time may have a slight advantage over evening time for better exercise performance when exercising in the heat, according to a study published in the January 2009 issue of Medicine & Science in Sports & Exercise.
3. Air pollution is lower before rush hour traffic in the morning than it is later in the day.
4. In the afternoon to early evening hours (3:00-7:00 PM) your body temperature is higher, making it an optimal time to improve muscular strength. In addition, studies have shown that muscle contractility, extensibility, and flexibility are influenced by a higher body temperature, thus reducing your risk for muscular injury at this time. Note, however, that for men, hormonal levels (e.g., testosterone) are greatest in the morning and that these levels increase more with a morning bout of resistance training than from a session performed later in the day. This implies that if a man's goal is to build muscle (e.g., body build), rather than improve strength, he should lift weights before noon.
5. Exercising in the late afternoon may provide you with the best night's sleep according to the National Sleep Foundation. Although body temperature rises with exercise, if physical activity is done in the late afternoon, it will have a chance to drop by bedtime (it can take up to about 6 hours to decrease). A lower body temperature is associated with the state of sleep. Note that exercise should be completed at least 3 hours prior to the onset of sleep to take advantage of the lower body temperature to induce sleep.
6. Exercise after work or in the evening may help to reduce stress built up throughout the day.
7. If you are training for a sports event, it may be best to exercise at the same time of day that the event will take place.
8. Because exercise speeds up your metabolism, energizes you, and makes you more alert, engaging in physical activity in the morning can prepare you for the day ahead.
9. Exercising in the morning on an empty stomach may impair performance. However, exercising with a full stomach can be uncomfortable. Consuming a light snack that is low in fat and fiber prior to exercising will provide energy while decreasing the likelihood of experiencing gastrointestinal distress.
10. It has been shown, from laboratory exercise stress tests to exhaustion, that the time of day of exercise has no effect on time to exhaustion, maximal oxygen uptake (exercise capacity), or heart rate. However, exercise that is of a very high intensity and short duration (when the body relies on the anaerobic system to provide energy) is performed better in the morning than in the afternoon.

Making the decision to exercise is important. Determining when to exercise should rely on what fits into your schedule and works best for your own personal circumstances and goals. As long as the time of day that you choose gets you exercising, it is the right time.

Resources

"Exercise in the Heat is Greatest in the Morning than in the Evening in Man," Hobson, R.M.; Clapp, E.L.; Watson, p.; Maughan, R.J. Medicine & Science in Sports & Exercise. 41(1): 174-180, January 2009.

"Nutrition and Athletic Performance," Joint Position Statement by the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine. Medicine & Science in Sports & Exercise. 41(3): 709-731, March 2009.

ACSM Current Comment "Chronobiological Effects on Exercise," Descheres, M.R.

National Sleep Foundation, www.sleepfoundation.org

Purpose of a Physical Exam (a "Well" Check)

The purpose of a physical is for the doctor to collect data to assess your risk for disease. It differs from a sick visit in that the doctor is not trying to treat an acute condition, but is trying to provide you with guidance and education on disease prevention and health promotion. However, a discussion of any present acute conditions can be addressed.

What to Expect at a Physical Exam

Your physician will first take a history. This involves asking questions about your personal past medical history (e.g., any injuries or surgeries, etc.), employment history, exercise participation, tobacco habits, prescription and over-the-counter medication use, dietary habits including alcohol consumption, food and medication allergies, vaccination status, family medical history, and any current problems you may be experiencing.

Next your doctor will conduct a thorough physical exam that includes listening to your heart and lungs; looking in your ears, eyes, and throat; performing a neurological exam; palpitation of your abdomen and lymph nodes; a skin examination, and assessment of your pulse and blood pressure.

Typically you will have your blood drawn to determine your cholesterol levels, blood sugar count, among other studies, based on your history taken earlier in the appointment and findings during the physical exam. A urinalysis will also be required. Based on the findings of the history and physical exam, other studies such as x-rays and EKG's, etc., may be ordered by your doctor.

How to Prepare for your Physical Exam

To get the most out of your appointment you should bring a list of current medications and a list of problems you may be experiencing or any questions you may have. You should also have a good understanding of your family's medical history. For example, did your father or mother have heart disease or cancer?

Bringing a diet diary that lists what you have eaten for at least 3 days, and preferably includes a weekend day, would be beneficial. In addition, it is ideal to fast (not eat for 12 hours) to obtain the best readings from the blood work. It is okay to take most current medications unless specified by your doctor not to do so.

Most importantly, be honest with your physician and do not allow feelings of embarrassment preclude you from asking questions about your concerns. Your doctor cannot advise you appropriately if (s)he is not given all of your pertinent information. Remember everything you tell your physician is confidential. His/her goal is to help you achieve optimal well-being.

Over the next few weeks to months, locker rooms will start to get busier with athletes of school sports teams as well as exercisers who start to make the switch from outdoor physical activities to indoor exercise sessions at the gym as the days get shorter and colder. Locker room use, albeit convenient and sometimes a necessity, increases the risk for skin infections. The locker room, with its moist and humid environment, is the perfect breeding ground for skin infection producing viruses, bacteria, and fungi.

Common infectious skin conditions that you can be exposed to in the locker room include plantar warts, impetigo contagiosa, athlete's foot (tinea pedis), and ring worm (tinea corporis).

Plantar Warts: Spongy, grainy, hard, and/or rough skin growths that are found on the sole of your foot, often at a pressure point (ball of foot and heel). They are usually brown or grey in color and can have little black dots on the surface which are small clotted capillary blood vessels. Plantar warts can be very painful.

Cause: Human papillomavirus (HPV)

Transmission: Through direct contact with the virus (e.g., floor to foot or person to person). Individuals who have tiny cuts or damaged/broken skin as an entry point for the virus are more susceptible to contracting the condition.

Treatment: Several different treatments are available. Your doctor may recommend an over-the-counter medication such as Salicylic acid. Or, (s)he may suggest freezing the wart with liquid nitrogen. Cutting out the wart is another treatment option your physician may choose.

Impetigo Contagiosa: Initially appears as tiny, fluid-filled blisters that burst to form red spots that crust over creating honey-colored lesions. Impetigo Contagiosa is typically found around the mouth and nose, hands, and forearms, but can occur anywhere on the body.

Cause: Two types of bacteria are responsible. The most common being Staphylococcus aureus (staph). The second is Streptococcus pyogenes (strep).

Transmission: Direct contact with the infected individual. Or, by sharing towels, sports/fitness equipment, clothing, bedding, etc., with an infected individual. The bacteria enter through insect bites or breaks, cuts, cracks, and/or damaged, broken skin.

Treatment: If it is a minor case your doctor may recommend simple good hygienic practices, such as keeping the infected area clean. For more advanced cases (s)he may prescribe an antibiotic ointment or oral antibiotics.

Athlete's Foot (tinea pedis): Itching, stinging, burning sensation between your toes and/or on the soles of your feet associated with red, scaly, peeling, cracked or blistered skin.

Cause: Dermatophytes, mold-like fungi.

Transmission: Contact with the fungi in swimming pools, saunas and on locker room floors or shower stalls. Wearing damp socks and tight-fitting shoes increases your risk.

Treatment: Your doctor may recommend an over-the-counter antifungal medication. If the condition warrants, (s)he may suggest prescription-strength topical or oral medication.

Ring Worm (tinea corporis): A red, scaly, flaky, raised, well-defined circular rash that has normal looking skin in the center that is found on the torso, upper arms, and under the arms (arm pits).

Cause: Dermatophytes, typically of the genus Trichophyton (Note: it is not caused by a worm, its name comes from the characteristic rings associated with the condition)

Transmission: Contact with infected pets. Skin-to-skin contact or by sharing exercise equipment/gear, towels, clothing, bedding, etc., with an infected individual. Athletes who participate in contact sports (e.g. wrestling) are at a greater risk of contracting the condition.

Treatment: For mild cases, your doctor may recommend an over-the-counter antifungal medication. If the condition warrants, (s)he may suggest prescription-strength topical or oral medication.

General Prevention for the Above Skin Infections

• Wear sandals or flip flops in locker rooms, communal shower stalls, and other public places with humid, moist, damp environments
• Set a clean towel down on the locker room bench (or wipe clean) prior to sitting
• Keep skin clean, shower as soon as possible after your athletic event/exercise session
• Wash exercise clothes/uniforms after use
• Disinfect and "wipe down" exercise equipment and machines between uses
• Change socks, especially when wet (keep feet dry, particularly between the toes)
• Avoid wearing tight-fitting shoes and clothing
• Do not share towels, clothing, bedding, athletic gear (e.g., football pads), etc.
• Treat and cover with a bandage any opened skin, such as insect bites, abrasions, cuts, wounds, scrapes, and/or other damaged skin, to prevent an entry site for the infectious organisms
• Wash hands often
• Educate yourself and others about the signs and symptoms and method of transmission of infectious skin conditions

Resources

Foundations of Athletic Training, Prevention, Assessment, and Management, 4th Edition, 2009. pp. 882-886. Anderson, M.K., Parr, G.P., and Hall, S.J.

www.mayoclinic.com