Don't let the abundance of Halloween candy lead to extra weight gain this trick-or-treat season. Sneak in some extra frighteningly fun fitness activities as you walk your trick-or-treaters around the neighborhood Halloween evening. Here is how to do it:

• Before heading out, do a light 5 minute warm-up. Then perform one set of Pumpkin Plie Squats (see exercise description below).
• Designate each stop at a house as a mini exercise station. While you are waiting for your child to get a treat, perform one of the exercises pictured below.
• In between stops, alternate a light walk with the Dracula Dash (a brisk walk). For instance, between the first and second homes do a light walk. During the second and third homes do the Dracula Dash. Repeat the sequence for subsequent homes.

Pumpkin Plie Squat: works inner and outer thigh, buttocks, core stabilizers, and outer shoulder muscles

Step One: Stand with your feet greater than shoulder-width apart and your toes pointing outward. Hold a small carving pumpkin in front of you, just below your waist.

Step Two: While keeping your back straight and tightening your abdominal muscles, bend at the knees. At the same time, lift the pumpkin up to the level of your chest. Hold for a count of two. Slowly return to the starting position while tightening your buttocks muscles. Perform one set of 10 repetitions.

Jumpin' "Jack"-O-Lanterns: increases heart rate while working hip, thigh, calf, shoulder, and back muscles.

Step One: Stand with your feet together and your hands to your sides.

Step Two: Slightly jump while moving your feet to a distance greater than shoulder-width apart. At the same time, bring your arms over your head and clap your hands.

Step Three: Slightly jump again, this time bring your feet back together and your arms back to your sides. Repeat sequence for one set of 10 repetitions.

"BOO"tie Buster: works buttocks, thigh, and hip muscles.

Step One: Stand with your feet together and your toes pointing forward. Assume the squat position by slightly bending your knees. Your arms should be at your sides, bent at the elbow.

Step Two: Raise yourself out of the squat position while lifting and pushing your right leg behind you. Tighten your buttocks muscles as you lift your right leg. Hold for a count of two. Slowly return to the starting position. Repeat. Perform 1 set of 5-8 repetitions per leg.

"R.I.P."pin'-Good Body Blaster: works upper arm, shoulder, upper back, abdominal, thigh, and buttocks muscles.

Step One: While holding your trick-or-treater's bag of collected candy in your right hand, stand with your feet about shoulder-width apart and your knees slightly bent. Tighten your abdominal muscles and bend forward at your hips while keeping your back straight.

Step Two: While rotating your torso to the right, raise the bag of candy to the level of your hip. Your elbow should be pointing toward the sky. Hold for a count of two. Repeat. Perform one set of 5-8 repetitions per arm.

At the end of the trick-or-treating session, make sure to cool-down for about 5 minutes, such as a slow walk.

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.

Fitness levels are affected by age. A new study in the October 26th issue of Archives of Internal Medicine notes that an age-related decline occurs in fitness levels for both men and women. This decrease accelerates after the age of 45 years and is more pronounced in men. However, the results of the study indicate that those individuals who remain physically active, maintain a normal body mass index, and abstain from smoking have significantly greater fitness levels and better health across the adult life span than those persons who do not follow these lifestyle habits.

In their report, the researchers reiterate that low levels of cardiorespiratory fitness are associated with an increased risk of morbidity and mortality, impaired ability to function, decreased levels of independence, and poor quality of life. They add that the loss of independence, which is correlated with a fitness level of 5.1 METs or less as designated by the US Social Security Administration, will occur at a younger age due to the increasing prevalence of obesity and physical inactivity in the general population.

The researchers indicate that a strength of their investigation was the use of large subject samples characterized by a diverse age range. The data was collected from 3, 429 women and 16, 889 men, aged 20-96 years, who participated in the Aerobics Center Longitudinal Study from 1974-2006. Subjects underwent between 2 to 33 health examinations and performed graded exercise treadmill tests to determine cardiorespiratory fitness levels. A limitation of the study, as noted by the investigators, was that the cohort was comprised mostly of participants who had access to health care, were white, well-educated, and of middle-to upper-socioeconomic status.

The results of the study confirm the necessity of engaging in regular physical activity, smoking cessation efforts, and measures to maintain body weight throughout adulthood.

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.

Resource

Arch Intern Med. 2009;169{19}:1781-1787.

With the arrival of the colder fall air, I have noticed during my daily runs that there are far fewer people outside exercising. My hope is that they have chosen to move their routines to the indoors or have opted to exercise later in the day when the temperature is warmer. It is not uncommon for a "chill" to be put on your exercise routine as the temperature drops and the hours of daylight become fewer. Let's face it, getting motivated to go for a walk outside on a cold, dark morning is not easy. But, this doesn't mean you have to stop exercising all together during the fall and winter months.

A common pitfall is to view exercise as an "all-or-none" proposition. That is, we opt not to do any exercise at all if, let's say, the act of riding the stationary bike for 45 minutes seems insurmountable. I have had to combat this mindset on occasion. A few months ago, I was finding it difficult to get "psyched" to go on a 12 mile run. My husband spoke words of encouragement to me that still resonate in my head on those days in which I need that little extra push to exercise; he said, "You can always turn around and come back."

You see, before those words were spoken to me, I had the "all-or-none" mindset. I thought to myself that if my body didn't feel strong enough to run 12 miles, then I shouldn't exercise at all. But, a 12 mile run was a self-chosen goal. No one was forcing me to go that distance. I could have opted for a shorter run instead of no run at all. I had the freedom to alter my routine, the freedom to "turn around and come back." The important point was not how far I would be able to run on that particular day, but that I ran.

Try these tips when the cold air starts to send your motivation to exercise into hibernation:

• Alter your routine - try exercising later in the day when it is light out and the temperature is warmer.
• Switch-up your exercise program - try a new mode of exercise or change the intensity or duration of your usual regimen.
• Modify your exercise goal - allow yourself a "light" day (e.g., go for a walk instead of a run).
• Plan ahead - what type of exercise will you do when the snow starts to fall? Consider the type of equipment that you will need to help you maintain your routine throughout the cold-weather months and make sure you have it ready when the time comes (e.g., if you plan to start cross-country skiing when there is snow, get your skis now).
• Enlist the support of others - surround yourself with individuals who understand the value of regular exercise and who will give you the encouragement you need to stay the course

The beginning of cold weather tends to be an end to regular exercise for many. Changes may be needed to your "warm weather" routine in order for you to remain physically active throughout the fall and winter months. Personal goals may need to be altered. Don't fall prey to the "all-or-none" mindset. Several short duration exercises dispersed throughout the day can be just as beneficial. When your motivation to exercise is challenged, remember that it is the act of participating in physical activity that is important, not "how far" or "how fast" the exercise is performed.

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.

Have you finally decided to sign-up for that spinning class at the gym? Or, have you determined that you want to start swimming laps at your local recreation center? These are great options for increasing your activity level and improving your overall health. But, how do you know you can participate in these and similar exercises safely, especially if you have led an inactive lifestyle up to this point?

Many chronic health conditions, such as hypertension, can be "silent." That is, you can have the condition without experiencing any symptoms. If left unchecked, these conditions can put you at an increased risk for medical complications during exercise. Other health problems, such as orthopedic conditions, can be exacerbated if you participate in the wrong type of physical activity.

For many healthy adults who are interested in starting a moderate-intensity exercise program, the risk of heart attack or sudden death is low. This risk increases, however, as the intensity of the exercise becomes vigorous. The risk also increases in individuals with cardiovascular disease. According to the American College of Sports Medicine, one death per year for every 15,000-18,000 people occurs from sudden cardiac arrest that was evoked from vigorous exercise. It should be noted that the rates for experiencing a heart attack or sudden death disproportionately increase in individuals who have been previously inactive and perform physical activity to which they are unaccustomed. Because of the lower prevalence of cardiovascular disease in individuals younger than 40 years of age compared to older counterparts, their risk of sudden death from exercise is very low. The most common causes of exercise-related death for the younger population are congenital and hereditary anomalies.

How do you know if you are an individual who is at risk when you exercise or if you should see a physician prior to beginning a program? To determine this, the American College of Sports Medicine advocates a risk stratification approach to classifying individuals into three categories: low, moderate, and high risk. The level of risk is determined by the presence or absence of known chronic diseases, the presence or absence of signs and symptoms of chronic diseases, and the presence or absence of risk factors for cardiovascular disease. The category descriptions are as follows:

Low Risk: In general, individuals who fall into this category can pursue exercise safely without getting medical clearance from their physician.

• Absence of signs and symptoms for cardiovascular, pulmonary, and/or metabolic disease
• Absence of cardiovascular, pulmonary, and/or metabolic disease
• Have no more than one risk factor for cardiovascular disease

Moderate Risk: In general, individuals who fall into this category can pursue low- to moderate-intensity exercise safely without getting medical clearance from their physician, but need doctor approval before engaging in vigorous-intensity exercise.

• Absence of signs and symptoms for cardiovascular, pulmonary, and/or metabolic disease
• Absence of cardiovascular, pulmonary, and/or metabolic disease
• Have two or more risk factors for cardiovascular disease

High Risk: Individuals who fall into this category need medical clearance from their physician prior to pursuing exercise at any intensity.

• Presence of one or more signs and symptoms of cardiovascular, pulmonary, and/or metabolic disease
• Presence of cardiovascular, pulmonary, and/or metabolic disease

Because the risk for exercise-related heart attack and sudden cardiac arrest increases with age, it is advisable that women who are 55 years of age and older and men who are 45 years of age and older seek physician approval prior to engaging in exercise. A good tool for you to use to determine if you need to seek medical advice prior to beginning an exercise program or before increasing the difficulty level of a current routine is the Physical Activity Readiness Questionnaire (PAR-Q), originally developed by the British Columbia Ministry of Health and later revised by the Canadian Society for Exercise Physiology and Fitness Canada. The PAR-Q is a self-guided screening tool for individuals between the ages of 15-69 years. It asks various questions about your current and past health history. Answering the questions truthfully will help you to determine if you need a physician's approval to engage in exercise.

Exercise can be both enjoyable and safe if you take the proper precautions. To get a general idea of your risk for a medical emergency during exercise, follow the link above to the PAR-Q form and answer the questions. If you answer yes to one or more of the questions, contact your doctor prior to beginning an exercise program or increasing the difficulty level of a current routine. Share your results of the PAR-Q with your physician so that issues of concern can be addressed. If at any point in your journey to improve or maintain your fitness level you question your health and safety during exercise contact your doctor for a thorough medical screening.

Resources

ACSM Current Comment "Off the Couch and Active: When to see a Physician Before Exercising," Kohl, H.W.

ACSM Guidelines for Exercise Testing and Prescription, Eighth Edition

Canadian Society for Exercise Physiology

Thanksgiving is about 6 weeks away and now is a good time to take action against the infamous holiday season weight gain that is associated with the period that starts with this celebration and lasts through the first of the New Year. Holiday parties at work, family celebrations, and gift baskets of food from thankful clients challenge adherence to a healthful diet. Add to that the time-limiting "rush"of the holidays which not only creates stress, but often causes exercise routines to fall by the way side, and you have yourself the recipe for weight gain. Prevention is the key to maintaining your weight through the holiday season, and the earlier the start, the better.

The good news for some is that the average weight gain during this festive time is less than the common belief of 5-7 pounds. According to the investigation, "A Prospective Study of Holiday Weight Gain," published in the March 23, 2000 issue of The New England Journal of Medicine, the net average holiday weight gain is a little over 1 pound, or 0.48 kilogram. The bad news is that the results of the study indicate that this weight gain is not typically lost after the holidays.

A weight gain of 1 pound may not sound significant, but it is the cumulative effects of this gain year after year that the investigators propose contributes to the large increase in body weight seen in adulthood. Furthermore, the study noted that those subjects who experienced the greatest amount of weight gain during the holidays (about 5 pounds or 2.3 kilograms) were more likely to be overweight or obese compared to those subjects who gained fewer pounds. Considering that our nation is currently faced with an obesity epidemic, this latter finding may be applicable to a greater number of Americans now than when the study was reported in 2000.

Don't wait until the New Year to resolve to manage your weight. Get a head start at warding off the holiday weight gain by following these tips:

During the weeks prior to the holiday

• Expend an additional 100 calories per day. Walking for an extra 25 minutes at a brisk pace of about 3.5 miles per hour would result in a caloric expenditure of approximately 119 kcals for an individual that weighs 150 pounds. If caloric intake remains the same, this increase in activity over the next six weeks would result in losing over 1 pound of body weight by Thanksgiving.
• Plan. Review your calendar for the next few months. When are the holiday parties and family gatherings? Make sure you set aside time to get in your exercise. If you know you won't be able to pass up a second serving of Aunt Mable's pumpkin pie, schedule an extra exercise session to accommodate.

On the day of the celebration

• Exercise in the morning before the festivities begin. This will ensure you don't skip your exercise for the day.
• Make a post-dinner family walk a new holiday tradition. A major component of the holiday celebration is socializing with family and friends. That time doesn't have to be spent mostly with food as the focal point. Time together can be spent participating in group activities such as a round of Charades or a pick-up game of touch football.
• Eat in moderation. You don't have to skip your favorite holiday dessert to maintain your weight, just consume a smaller portion. Take extra helpings of fruit and vegetable offerings if you are still hungry (but be careful, if they are smothered in butter or other high caloric dressings you may end up packing on the pounds).
• Leave the table upon finishing your meal. Sitting in front of the food, even if you are full, may trigger you to eat more. Occupy yourself with another activity while you are waiting for others to finish, such as helping the host by clearing or washing the dishes.

During the weeks post-holiday

• Make a New Year's Resolution to maintain the exercise program you began prior to the holiday season.
• Continue to eat in moderation.

Thanksgiving may seem like a long way away, but once the holiday rush begins, you might find it more difficult to formulate a plan of action. By preparing during the weeks prior to the celebration, you will have the time to develop a few strategies which will allow you to enjoy the holiday season without putting on the extra weight.

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 New England Journal of Medicine, Volume 342:861-867, Number 12, March 23, 2000, "A Prospective Study of Holiday Weight Gain," Yanovski, J.A. et al.

The National Wildlife Federation (NWF), in partnership with the movie Where the Wild Things Are, has launched a national initiative "Be Out There" aimed at inspiring families to get up and go outdoors. Children today are the first of the "indoor generation." Electronic forms of entertainment, such as computers and video game systems, have kept them indoors and "detached" from the natural world.

On the "Be Out There" website, the NWF states that children are spending more than 6 hours/day engaged with electronic media, decreasing their time spent outside by more than 50% compared to previous generations. Growing up indoors has its consequences. Lack of creativity, impaired concentration, decreased classroom performance, poor social skills, aggression, decreased physical activity, and increased risk for obesity have been linked with a greater time spent indoors.

Connecting with the natural world through outdoor play enhances the mental and physical health of children and can improve their performance in the classroom. Interaction with the out-of-doors fosters creativity, decreases stress, reduces symptoms of Attention Deficit Hyperactivity Disorder (ADHD), and increases physical fitness. The "Be Out There" initiative advocates that parents provide their children with a daily "Green Hour" during which they have unstructured play outdoors. This time spent connecting with the natural world can occur in any green space such as their own backyard, the woods, open fields, and local parks.

Many communities have nature centers that offer programs to help children (and adults) connect with nature. The Lloyd A. Stage Nature Center in Troy, Michigan offers the Jr. Naturalist Club, an award-winning program, for children ages 4 years through the 5th grade. The Jr. Naturalist Club meets once per month through the school year, and for one week in July. Stacey Yankee, the Nature Center Manager at the Lloyd A. Stage Nature Center, states that the nearly year-long program is designed to allow children to explore and experience the outdoors during the different seasons. They can see how the natural world changes as the seasons change.

Yankee notes that the hands-on activities of the Jr. Naturalist Club program are age-appropriate and tailored to the abilities of the children. Each month has a different theme with projects designed to engage the children with the natural world. This month, the children had the opportunity to make apple cider by using the apple press to grind the apples. Pond studies and the use of insect sweep nets are a few examples of the many nature-connecting activities available to the Jr. Naturalist Club member.

According to Yankee, the Lloyd A. Stage Nature Center, which is 100 acres with 2 miles of walking trails, is [a little bit of] "Up North right here in Troy." For families who have little yard space or very few trees on their property, this is an important asset of the city. Yankee states that the Jr. Naturalist Club program allows the children to "witness all that nature has that they can't get in their yard at home... [a way] to connect with nature and to feel what it is like to be in the woods." For more information on the Jr. Naturalist Club, and the other programs offered by the Lloyd A. Stage Nature Center, call (248) 524-3567. The Lloyd A. Stage Nature Center is located at 6685 Coolidge Highway in Troy.

Join the "Be Out There" initiative this weekend and take a walk in the woods, a place that my daughter describes as "The Outdoor Funhouse."

Resources

The National Wildlife Federation

Stacey Yankee, Nature Center Manager at the Lloyd A. Stage Nature Center, 6685 Coolidge Highway, Troy, Michigan, 48098; (248) 524-3567.

Are you tired of pounding the pavement by yourself? Join a running club! At the mention of individual sports, running may be one of the first athletic pursuits to come to mind; but, for many, it offers a valuable social network and much needed camaraderie on long runs that could otherwise be lonely when done solo.

Beginner and seasoned runners alike can benefit from a membership to a running community. Many running clubs offer several different group runs to meet the various running levels of members, so beginners need not feel intimidated. One such club is the Your Pace or Mine Running Club in Rochester, Michigan which was formed by John Hodgson and Jen Keuten in December, 2006. According to club member Joe Terranova, "Our running club is great....We basically take all speeds, our motto is 'no runner left behind.' We always try to not let anyone run alone, and everyone is very supportive of each other and we've become great friends."

Whether you are interested in training for a race or just want to run to improve your overall health and fitness, running with a group undoubtedly will keep you motivated to achieve your running goals. According to Terranova, "I would never be running as much as I do without the club, and I definitely would not be doing more marathons. I trained alone for one in 2004 and won't do that again. The only bad thing is that I get sucked into a lot of races due to peer pressure. But it's all fun."

What are the benefits of joining a running club?

• Support - sharing a similar interest develops a sense of community. Fellow runners offer words of encouragement to keep you going during training runs and races.
• Accountability - it is easier to stick to your exercise routine when you know a group of people are waiting for you.
• Networking - many friendships and business deals have evolved from members conversing during group runs.
• Improved fitness/performance - mentorship from seasoned runners who are eager to share their running strategies (as well as a little healthy competition among members) can lead to improved running times.
• Safety - running with a group may help to protect against an assault; and, can be life-saving if a personal medical emergency should arise during the run.

What does a running club membership typically provide?

• Group runs that usually take place on weekend mornings, but some are scheduled during the workweek (often in the evenings).
• Social events, picnics, potlucks, post-run get-togethers, etc,.
• Club newsletters/emails
• Online forums
• Information on upcoming races
• Training information/seminars
• In some cases, discounted race entries, club race shirts, and store discounts on running gear

Whether you are interested in speed workouts or training for a marathon, joining a running club can provide you with many benefits. To find a running club near you, contact the Road Runners Club of America, a national organization of over 980 running clubs. To join or learn more about the Your Pace or Mine Running Club in Rochester, Michigan visit www.yourpaceormine.com.

Resources

Road Runners Club of America

Your Pace or Mine Running Club, Rochester, Michigan

"Benefits of Group Running" by Christine Luff, about.com Updated February 22, 2009

Regular exercise has an important role in the treatment and management of diabetes. In general, the physical activity recommendations for healthy individuals apply to those with diabetes. That is, at least 150 minutes (preferably 300 minutes) of moderate-intensity aerobic exercise per week. The exercise program should also include strength training and flexibility exercises two to three times per week. Because variations in your exercise program may be needed based on your form of diabetes (e.g., type I versus type II), the severity of your disease, and the type and schedule of your medications, you should consult your health care professional prior to initiating an exercise routine.

Some special considerations associated with exercise and diabetes of which you should be aware include:

Hypoglycemia - low blood sugar (a blood glucose level <70>

• shakiness
• irritability
• lightheadedness
• rapid heart rate
• nervousness/anxiety
• excessive or abnormal sweating
• chills
• weakness
• tingling/numb sensation of the mouth and fingers
• headache
• hunger
• blurred vision
• confusion
• seizures
• unconsciousness

Active diabetics who are at a greater risk for experiencing exercise-induced hypoglycemia are those individuals who:

• Take insulin or medicine that lowers blood sugar levels (oral hypoglycemic medication)
• Exercise during the peak action time of their insulin dose
• Exercise for a prolonged period
• Exercise harder than usual
• Skip a meal or eat a meal that is too small
• Delay eating a meal
• Consume too few carbohydrates
• Have a cold or other illness
• Are under stress

Blood Sugar Monitoring - Know how your body's blood sugar level responds to physical activity. By checking your blood sugar level both before and after exercise you will be able to adjust your workouts accordingly. Your health care professional will provide you with a target value that is appropriate for you. Here are some general guidelines to follow:

• If you plan to exercise for an hour or more, consume an additional 15 grams of carbohydrate before or after exercise.
• If you intend to exercise vigorously, consume an additional 15-30 grams of carbohydrate (may need to be done every hour, discuss with your health care professional).
• If your pre-exercise blood sugar value is between 80-100 mg/dl, you are at risk for exercise-induced hypoglycemia. To prevent it, you should consume carbohydrates and wait for the value to increase before you begin exercising. A general rule-of-thumb to follow is the "15-15" protocol. That is, ingest 15 grams of carbohydrate and wait 15 minutes. Then retest your blood sugar. This procedure should be repeated until you reach your target number (as recommended by your health care professional).
• If your pre-exercise blood sugar level is at or above 300 mg/dl (or a fasting value above 250 mg/dl with ketones in urine for type I diabetics), exercise can cause the level to go even higher and, therefore, should be avoided until the value has been lowered.

Exercise Safety Precautions

• Wear your medical identification tag or carry your medical information card
• Exercise with a partner or in a medically supervised setting to protect yourself in the event of an emergency
• Carry a fast acting carbohydrate snack, such as life savers or graham crackers, with you while exercising in case you experience low blood sugar
• Drink plenty of water before, during, and after exercise
• Wear appropriate, well-cushioned footwear, especially if you have peripheral neuropathy
• If you are on insulin, inject it into your abdomen, not exercising limbs, to lower your risk for hypoglycemia
• To reduce the risk of nocturnal hypoglycemia, avoid exercising before bedtime (hypoglycemia can occur several hours after exercise). If you must exercise before bedtime, increase your consumption of carbohydrates.
• Exercising at the same time of day may reduce the likelihood of a hypoglycemic event
• Avoid vigorous exercise if you have retinopathy to reduce your risk for developing a detached retina

Know your own body and how to manage your symptoms when it comes to exercising with diabetes. To ensure your exercise program is safe and meets your needs, you should consult your health care professional to develop a routine that is appropriate for you. Make a copy of this article and take it along with you to your appointment to discuss issues of concern.

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

American Diabetes Association

ACSM's Exercise Management for Persons with Chronic Diseases and Disabilities, 1997

ACSM's Guidelines for Exercise Testing and Prescription, Eighth Edition

This morning I ran in the Brooksie Way Half Marathon, my first half marathon road race ever, and the first road race in about 16 years in which I have participated. I did not decide to run in this race until a few days ago and I did not formally train for it. I chose to approach it as just another exercise session, not a competition.

Motherhood has changed my perspective. I realize now that the experience in and of itself is what life is about, not the outcome. I chose to use this race experience to reminisce. The race began and ended on the campus of Oakland University (OU), my alma mater.

Upon my return to OU, I was reminded of my time as a Graduate Assistant and how concerned I was as to whether I would be able to get a job in my field of study. Interestingly, part of the race course took me near the house of a former co-worker (from that job I feared not getting). I used to visit her often. She was my support during the time my husband and I had difficulty conceiving.

I continued to reminisce as I passed each mile marker of the race. Two portions of the race, the Clinton River Trail and the Paint Creek Trail, were paths on which my husband and I have taken our children (the ones I feared not having) for family walks.

I find it interesting to see how the different "paths" followed in life interconnect to make one journey that takes you onto the trails of the future. Each path has the potential to bring you to a crossroad that becomes a turning point in life, the experience of which shapes your character.

I successfully finished today's race, 1st for my age division and 3rd female overall with a running time of 01:29:08, an accomplishment that I hope has become a turning point that will direct the future path choices of my children. A lesson for them that no matter how old you become, you never stop striving to experience life.

A very cold me waiting for the race to begin.

A picture my son took of me crossing the finish line.

Shocked, but excited, about the results of today's race.

My children, the real "trophies" in my life.

The Award Ceremony after the race.

Forty-six million Americans, about 1 in 5, report being diagnosed with arthritis by their doctors, according to the Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP). This number is projected to increase to 67 million by the year 2030, limiting the activity levels of more than one-third of the adults affected by the condition. The May 1, 2009 issue of Morbidity and Mortality Weekly Report (MMWR) reports that an analysis conducted by the Centers for Disease Control and the U.S. Census Bureau revealed arthritis to be the most common cause of disability in the United States.

Over 100 different rheumatic conditions and diseases fall under the arthritis category. Osteoarthritis is the most common form, affecting approximately 27 million adults in 2005, according to the NCCDPHP. The Arthritis Foundation defines osteoarthritis as "a chronic condition characterized by the breakdown of the joint's cartilage... the breakdown of cartilage causes the bones to rub against each other, causing stiffness, pain, and loss of movement in the joint."

Osteoarthritis, also known as osteoarthroses or degenerative joint disease, most commonly effects the knee, hip, low back, neck, and hand joints. Common symptoms include pain/stiffness in the effected joint after extended periods of inactivity (e.g., upon waking in the morning after a night's rest) or after prolonged use (e.g., a day of yard work).

Risk Factors for Osteoarthritis

• Physical inactivity
• Overweight/obesity - heavier body weights are associated with an increased risk for the development and progression of osteoarthritis of the knee joint (3 in 5 people who are obese are at risk for developing knee osteoarthritis)
• Joint and/or nerve injury
• Overuse of the joint
• Genetics/heredity
• Age - the incidence of arthritis increases with advancing age, with approximately 50% of adults 65 years and older reporting doctor-diagnosed arthritis
• Gender - women are at a greater risk for developing arthritis (28.3 million women are affected compared to 18.1 million men)

Diagnosis of Osteoarthritis

• Positive medical history and physical exam

Prevention and Management of Osteoarthritis - Treatment options are based on the severity of the symptoms. The goal is to decrease pain and improve joint mobility. Your doctor may recommend:

• Medication, such as non-steroidal anti-inflammatory medicines, to reduce pain and swelling
• Weight management
• Joint protection/avoid joint injury (e.g., avoid high impact activity)
• Supplementation with glucosamine and chondroitin sulfate
• Surgery
• Exercise

The Role of Physical Activity in the Prevention and Management of Osteoarthritis

The role exercise plays in reducing your risk for conditions such as heart disease, stroke, and diabetes is well known. However, arthritis can be a barrier to exercise due to painful joints and the fear of triggering pain. Fortunately, when the proper mode and technique of exercise is performed, physical activity can help to keep your joints flexible, reduce joint pain, improve function during day-to-day activities, boost mental health, increase muscular strength, help to reduce and maintain body weight, and enhance quality of life. To improve overall health, it is important for you to learn how to successfully incorporate exercise in to your life.

General Exercise Guidelines for Individuals with Arthritis - exercises should be matched to the severity of the arthritis, the joints effected, and to physical capabilities

• Engage in activities that are low impact, such as bicycling, swimming, and walking
• Warm-up prior to and cool-down after exercise, for 5-10 minutes each, to minimize pain
• Avoid activities that result in increased joint pain that lasts longer than 2 hours after exercise
• Participate in flexibility and range of motion exercises
• Perform strength training exercises, particularly of the muscles surrounding the effected joint (isometric contractions, as opposed to weight lifting, may be required initially)
• Exercise during periods of the day when joint pain is least severe
• As fitness/ability improve, duration, rather than intensity, should be increased because pain may limit the achievement of higher intensity levels
• Alternating periods of exercise and rest may be beneficial (e.g., walk for 5 minutes, rest for 2 minutes)
• Several sessions of short duration throughout the day may be more tolerable than one session of a longer duration

If you are interested in learning more about how you can maintain an active lifestyle in the presence of arthritis, the Arthritis Foundation, Michigan Chapter, is offering a free informational program, "Arthritis in Motion: Sports, Exercise, Play and Arthritis," this coming Tuesday evening, October 6, at the Mt. Clemens Community Center. According to Kara Dorda, Manager of Community Education for the Arthritis Foundation, Michigan Chapter, this event will feature presentations by local Orthopedic Surgeon, Wayne M. Gunkle, DO, Sports Psychologists John Pietrofesa, EdD and Cathy Pietrofesa, PhD, and Physical Therapist Kim Smith, DPT.

Topics to be addressed by the presenters will include:

• Common forms of arthritis
• Diagnosis
• Treatment
• Prevention and management strategies such as how to break the pain cycle and protect your joints
• How to create a fitness program that meets your personal needs.

Dorda states that the evening starts at 5:30 p.m. with light refreshments. Presentations begin at 6:00 p.m. and last until 8:30 p.m. Time will be alloted for questions and answers. Dorda notes that registration is required and still open. Call 1-800-968-3030 to reserve your seat today. If you call after hours, you may leave your name, number, and email address. Information can be faxed or emailed to you. The event is located at the Mt. Clemens Community Center, 300 N Groesbeck Hwy, Mt. Clemens, MI 48043.

If you are unable to attend the October 6th program, a similar event will be offered on Thursday, October 22, 2009 at Oakwood Southshore Medical Center, Nasir Auditorium, 5450 Fort Street, Trenton, MI 48183. Call the 1-800 number above to reserve a spot.

Information on both events is also available at www.arthritis.org/chapters/michigan.

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 Arthritis Foundation

The Arthritis Foundation, Michigan Chapter

Centers for Disease Control and Prevention National Center for Chronic Disease Prevention and Health Promotion

ACSM's Guidelines for Exercise Testing and Prescription, eighth edition

ACSM's Exercise Management for Persons with Chronic Diseases and Disabilities, 1997