Circulation, mobility and stretching exercises

The circulation, mobility and stretching exercises here are essential preparation for the main programme. These gentle, rhythmic movements, mobilisers and held stretches get your muscles, joints and reflexes awake, loosened up, warm and ready for action. Stretching is especially important if you have been sitting for a while as your muscles may have become slightly stiff. Working through the warming up section will help to ensure that you do not injure yourself and you will find the main programme more comfortable to perform.

Setting goals

We all need goals to keep us going. Think about what you want to achieve, plan your programme and chart your progress using

Always warm up and cool down.

Take pride in using the correct technique.

Move with control and good posture.

Always work at your own level and progress cautiously.

Never exercise to the point of exhaustion.

Progress each exercise week by week to maintain the load on the skeleton and ensure you get an improvement.

Work through all the recommended stages of progression.

Avoid trying to beat the clock or another person. This program is not about winning, it is about long-term benefit. Your own motivation is essential. Your bones need regular exercise for the rest of your life, not overenthusiastic bursts of physical activity at intervals.

Set aside a specific time to exercise, depending on whether you are a morning or evening person, e.g. at 1.00 pm on Mondays, Wednesdays and Saturdays. » Make sure your programme will fit in with your daily life. •k If you have not exercised for a long time, set yourself realistic goals and start at a leisurely pace.

Build up your programme over time, perhaps adding a new exercise once a month. :: If you are very short of time, do some of the exercises once a week for maintenance; this is better than doing none at all.

Warning signs

Stop exercising and seek medical advice if you experience:

Pain or discomfort

Dizziness, faintness or nausea

Shortness of breath

Rapid heart rate

Excessive sweating

Sudden feeling of exhaustion or weakness

Slow down if you are:

Feeling heavy limbed or shaky

Breathing heavily

Feeling overheated

Losing concentration

Listen to your body

It is important to appreciate the difference between working hard and overworking. If you are working effectively, you should be breathing a little more heavily than usual, feeling warm, perhaps sweating lightly and you should have a sensation of effort in your muscles.

Pain of any kind is a warning sign so never ignore or work through it. If any pain persists when you stop exercising, seek medical advice.

Getting the load up

Most of the exercises depend on the resistance caused by the pull of gravity on your body mass. Some need the addition of weights or other simple equipment to increase the resistance. This is why we refer to ‘weight-training’. Weights have advantages for bone-loading because of the stabilising muscle activity needed around the spine and hip and the variety of loading. However, they are potentially dangerous if dropped or if your lift gets out of control, so set an upper limit of 7 kg for arm lifts and 11 kg for leg lifts. Some exercises carry lower limits for safety; look for them under ‘progression’. Take care when moving weights around. A few exercises require a partner; arranging to do them with a friend will help you stick to your routine.

Daily programme

Practise good posture and pelvic tilt throughout the day.

Do lots of pelvic floor exercises.

Do one balance exercise. Vary them from day to day.

Go for a brisk five minute walk.

Climb a few flights of stairs.

Do some stretches.

Weekly programme

Aim for three 40 minute sessions a week. Choose exercises that address your current needs from among the Home Exercises or the Activities for Life. You may wish to target your hip or wrist if you have below normal BMD at that site.

The benefits for bone

The exercises are effective for increasing BMD because they cause your muscles to generate large forces in the tendons which attach them to bone. The exercises have been chosen because they were found in research studies to benefit bone at the sites which are most liable to fracture. If you do these exercises in the way they are prescribed, three times a week, they will probably increase your BMD by three or four per cent over a year, and if you are postmenopausal, they will at least prevent further bone loss. Some women have shown increases of up to ten per cent and those with the lowest BMD are the most likely to benefit.

Commitment

Bone changes slowly, so a long-term commitment is needed. Do a little exercise regularly and choose activities that you enjoy so that you will want to continue. Variety is good for your bones and helps to prevent boredom. Do not despair if the exercises take ages to do at first; you will get quicker with practice. Just like muscle, bone will deteriorate again if you stop exercising and your gains will slowly be lost.

The circulation, mobility and stretching exercises here are essential preparation for the main programme. These gentle, rhythmic movements, mobilisers and held stretches get your muscles, joints and reflexes awake, loosened up, warm and ready for action. Stretching is especially important if you have been sitting for a while as your muscles may have become slightly stiff. Working through the warming up section will help to ensure that you do not injure yourself and you will find the main programme more comfortable to perform.

THE BENEFITS OF WARMING UP

Muscles work most effectively when they are warm. They can generate more power and are stronger than when they are cold. Although you may not actually feel cold, your leg and arm muscles may be at a lower temperature than your trunk. For example, if you feel your calf muscle, you may find that the skin feels cooler than the skin on your neck. If you sit outdoors in cold weather, you may find that it is more difficult to walk when you stand up; this is because your leg muscles have been allowed to cool down in order to conserve heat for the rest of the body.

When you begin to exercise, it takes a few minutes before your blood flow increases and enough heat is generated to adjust your muscle temperature. You get hot when you exercise but only after you have been exercising for a while. The warming up exercises are designed to get your body ready before you start the main programme.

Safe exercise

It is important that you complete all of the warming up exercises in the order given before moving on to the bone-loading exercises. It is also vital to cool down, especially after vigorous exercises such as running.

Circulation The first three exercises focus on the muscles, heart and circulatory system.

Mobility The next four exercises are designed to mobilise the joints.

Stretching The last six exercises stretch all the muscle groups that you will be using for the home exercises.

Walk, side-step & march

This is the start of your programme so make it fun. Put on some lively music and enjoy the exercises. Starting your workout in this way can release tension, improve your focus and motivate you for the exercises to come.

Your movements should be gentle and your breathing should be steady. Build up the size and pace of your moves gradually; this allows the heart rate to increase steadily, making for safer and more effective exercise.

Adaptation

To help you balance, you can perform the side-step exercise holding on to a chair.

Check your pelvic tilt and tighten your abdominals. Walk on the spot, keeping your toes on the floor. Lift your arms with each step. Continue for 2 minutes.

Side-step Step to the side, transferring your weight from the ball to the heel of your foot.

March gently on the spot, lifting the opposite arm to the lifted knee. Continue for 2 minutes.

Bring your other foot in to touch the floor. Repeat to the other side. Swing your arms in the direction of the step. Continue for 2 minutes.

Shoulder & ankle mobilisers

T o perform everyday actions with ease and comfort, freely moving shoulder joints are essential. Tasks such as reaching a high shelf or serving at tennis can be difficult if you have stiff shoulder joints.

Take time and care to explore your full range of movement in each direction. Move your shoulders forward, up, back and down. Stop immediately if you feel any discomfort. Careful control and concentration on the quality of movement will improve your technique and increase your enjoyment and body-awareness.

When combined with good posture, this exercise can give your shoulder line and upper body a great shape. Slow shoulder circles are also a great way to release tension in the shoulder muscles; this is an area where many people carry tension.

Mobile ankles ensure good balance, as the joints can respond better to uneven surfaces.

Lift your front foot up by bending the knee and place your toes on the floor. Repeat this action 6 times. Repeat with the other foot. mobilisers

Shoulder Stand tall with your feet and legs a little wider than hip-width apart. Relax your shoulders and allow your arms to rest by your sides. Check your pelvic tilt and tighten your abdominals. Take both shoulders forward, then lift them up to your ears.

Draw both shoulders backward in a large arc and ease them down and back away from your ears. Repeat up to 6 times.

Ankle Stand tall, check your pelvic tilt, and tighten your abdominals. Transfer your weight to one leg and place your other heel forward.

Avoid taking your feet too far apart as this reduces your range of movement in the ankle and puts unnecessary strain on the supporting leg.

Adaptation

If you experience any pain in your lower back, or if you find it difficult to rotate without moving your hips, do the Tivist exercise seated. Remember to do a pelvic tilt before you start.

Side & twist: spine mobilisers

Mobility exercises stimulate the release of synovial fluid, the joints’ natural ‘oil’; this fluid nourishes, lubricates and protects your joint structures. They also help to keep the vulnerable intervertebral discs protected.

A supple spine absorbs impact more efficiently than a stiff spine. These exercises take the spinal joints through their full range of movement in two directions that are often neglected.

It is very important that you maintain a correct pelvic tilt for spinal exercises. Move slowly, fluently and with control. Extend the spine to its full natural range but never to the point of discomfort. Take a moment as you come back to centre each time to lengthen the spine and check your posture.

Caution

Bear in mind that each individual’s range of movement is different, so although you need to get your position as close to the pictures as possible, it is important also that you find the movement comfortable.

Lift up out of your hips, and bend slowly to one side, as far as your pelvic tilt will allow. Return to centre, then repeat on the other side. Repeat up to 6 times.

Side Stand tall with your feet and legs shoulder-width apart. Check your pelvic tilt, tighten your abdominals and bend both knees evenly.

Twist Stand tall with your feet and legs hip-width apart. Check your pelvic tilt, tighten your abdominals and bend both knees evenly. Hold your arms at chest height, resting one on top of the other.

Keeping your hips, knees and feet facing forwards, lengthen your spine and slowly turn your upper body and head to one side, as far as you can. Return to centre, then repeat on the other side. Repeat up to 6 times.

Calf & thigh stretches

Muscles are adaptable and make themselves shorter over time if they are continually in a shortened position. This frequently happens to the calf muscle in women who do not wear flat shoes or walk barefoot. Such shortened calf muscles restrict ankle movements, but regular stretching reduces the stiffness and improves mobility.

Similarly, lengthening the quadriceps through stretching improves the range of movement at the hip, transforms posture and so can help to prevent or alleviate back problems. Even if you have good posture, use a wall to support yourself, so you can focus fully on the quality of your stretch.

Stretching the quadriceps is one of the most important ways of counteracting the effects of prolonged sitting. Given today’s sedentary lifestyles, both at work and home, this is a must for us all if we are to avoid becoming chair-shaped!

Adaptation

If you find balance difficult, use a chair to do the calf stretch. Keep your back straight, your chest lifted and pull your toe up toward your knee.

Bend your front knee so that it is directly above your ankle. Press your back heel on to the floor and straighten this leg until you can feel a stretch in your calf. Hold for a count of 8. Repeat with the other leg. f ’2

Calf Stand tall with your feet and legs hip-width apart and place your hands on your hips. Check your pelvic tilt and tighten your abdominals. Keeping your toes facing forwards, take a stride backwards with one foot and place it on the floor.

Thigh Stand tall with a hand on a wall. Check your pelvic tilt, and lift your outer knee. Take hold of your ankle.

Take your leg backwards until your knee is just behind your hip. Straighten the supporting leg then increase your pelvic tilt and tighten your abdominals. Hold for a count of 8. Repeat with the other leg.

Adaptation

If balance is a problem, do the Side Stretch seated. Remember to check your pelvic tilt before you start.

Side & chest stretches

Stretching the muscles at the side of your trunk helps to maintain spinal mobility and improve your posture. It is also good for releasing tension and this exercise will help maintain the range of movement in your shoulders. Always alternate sides when performing exercises that focus on the spine, as this gives a feeling of harmony and keeps the spine aligned and the body symmetrical.

Stretching the pectoral muscles across the front of the chest is an uplifting activity in every way. Most of us experience some rounding of the shoulders when sitting at a desk or because of poor posture and with this comes a sagging of the chest and restricted breathing. Pectoral stretches transform your posture as they lift the shoulders up and back and, in so doing, strengthen your upper back. This opens out your chest and allows for deeper breathing. ii /

The positioning of your arms needs particular care when doing the side stretch.

Lengthen your spine, then extend your arm and trunk upwards. Lift, and bend sideways slightly until you feel a stretch down the side of your body Hold for a count of 8. Repeat on the other side.

Side Stand tall with your feet shoulder-width apart. Check your pelvic tilt and tighten your abdominals.

Place one hand on your hip, and lift the other upwards. > / 2

Chest Stand tall with your feet and legs hip-width apart. Place your hands on your bottom. Check your pelvic tilt and tighten your abdominals. Lengthen your spine, lift your chest and take both elbows back until you feel a stretch across your chest. Hold for a count of 8. 1 Wa r m I n g up

Hamstring &tricep stretches

The group of muscles located along the back of your thighs are among the most neglected muscles in the body, as well as the most compromised by an inactive lifestyle. Shortened, tight hamstrings can lead to restricted movement and back problems, as well as an increased risk of injury.

The hamstrings may be notoriously tight muscles but they also respond well to attention and progress will be felt swiftly. Stretching these muscles can give you a new lease of life as many actions become easier.

Caution

If you have a history of falls or persistent balance problems, use a chair for support for these stretches.

The triceps muscles are located along the back of your arm. Stretching them will ensure suppleness in the shoulder joints so that upward reaching movements can be managed with ease.

Adaptation

If you find the standing hamstring stretch uncomfortable, you can do this stretch seated. Keep your hack straight and lean forwards and upwards to increase the stretch. :ix..

Tricep Stand tall as before with your knees bent slightly. Place one hand on your shoulder and take the other arm across your chest. Check your pelvic tilt and tighten your abdominals.

Ease your raised arm up and back until you feel a stretch in your underarm. Aim to get the fingertips of your raised arm between your shoulder blades. Hold for a count of 8. Repeat with the other arm.

Hamstring Stand tall with your feet and legs hip-width apart. Check your pelvic tilt and tighten your abdominals. Lengthen your spine and transfer your weight to one leg. Slide your other foot forwards, keeping your foot on the floor.

Place both hands at the top of your weighted leg. Bend this knee as you bend forward from the hips until you feel a stretch in the back of your straight leg. Hold for a count of 8. Repeat with the other leg.

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