It’s Never Too Late To Get Fit

By Dr. Elizabeth Ignacio
Interviewed by Rasa Fournier
Wednesday - December 15, 2010
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Dr. Elizabeth Ignacio
Orthopedic surgeon at Queen’s Medical Center

Where did you receive your schooling and training?

I graduated from Iolani and then went to Georgetown for undergrad, med school and my orthopedic surgery residency. Then I did a fellowship in sports medicine and knee and shoulder arthroscopic and reconstructive surgery in Los Angeles. I joined the faculty of the fellowship for about three years before I moved back home, so I’ve been here now for a little over four years.

With the holidays at hand, what’s the best way to keep children healthy and injury-free?

Primarily through exercise, whether it’s formal sports-related or just physical activity. The recommendation of the American College of Sports Medicine and the American Heart Association is ideally, at the very least for children, 30 minutes a day of some sort of physical activity, with the target being 60 minutes a day. That helps not only in terms of obesity, but multiple studies have shown that staying active and staying fit and healthy helps them socially, mentally, physically and emotionally. The way to do that is incorporating fun and activity into a child’s daily activity, whether it’s PE at school, organized sports activities, or during the holidays if they’re out of school, playing in the park. Stay away from sedentary activities like video games, mobile DSs and iPod touches. If the Christmas wish list includes, from the expensive spectrum things like Wii and the Xbox, to more economical things like getting a ball, getting a bat, running shoes, a pedometer - target the more active options. Kids are really goal-oriented; getting them into 10,000 steps a day is the ideal.

Are there different recommendations for elementary kids compared to junior high or high school?

As they get older, they tend to get more into organized sports. With pre-puberty, aerobic activities is more the focus versus post-puberty, where we can get into the discussion of the introduction of strength training. Here in Hawaii, a lot of people do single-sport specialization. The recommendation, from an injury-prevention standpoint, is engaging in multiple sports, cross training - being overall active and fit as opposed to specializing in the use just of specific muscle sets and skill sets.

Dr. Elizabeth Ignacio examines a patient’s X-rays

Any special precautions kids should take since they are so active and involved in sports?

Warm up is always very important and often taken for granted. Cool down also is very important and sometimes forgotten with post-game potlucks, for example. Protective gear is very important. As much as it might not be as cool-looking, helmets, knee braces and elbow pads reduce the risk of injury remarkably. Definitely the issue of sports specialization comes into play. In terms of overuse injury, we’re now seeing an epidemic with our pediatric and adolescent athletes. Variety is key. In terms of not just pure sports or competition, but a healthy, active child, there’s the idea of physical activity being fun and engaging, so that it is more a healthy, active lifestyle choice as opposed to primarily a sports choice or an athlete choice. It’s living a healthy, active lifestyle that will carry on into adulthood and diminish the risk of things that are quite controllable like type 2 diabetes, obesity, symptoms of arthritis as we grow older - that has to do with activity and weight. If we can get our kids to be active at a young age and have that be a part of their lifestyle, that would be ideal.

Can you touch on maintaining a healthy lifestyle and injury prevention for seniors?

From an active lifestyle standpoint, a lot of people might have apprehension about restarting, about getting active. If there’s any apprehension, they should see their physician and see what limitations they might be obligated to follow from a cardiac or musculoskeletal standpoint. Restarting, even if it’s a slow start, back into an active lifestyle definitely can add years to one’s life and add life to one’s years. It can be simple maneuvers such as getting a pedometer. Walking 10,000 steps a day is a nice target. Thirty minutes three times a week is nice to have as an initial goal. That 30 minutes might seem daunting, but it doesn’t have to be all at one workout. If you want to break up three 10-minute cardiac activities, that’s great.

People with arthritis have difficulty doing certain well-known activities such as running or walking. When you walk, or especially when you run, especially for people with arthritis in the knees, your knees don’t feel your body weight. Your knees actually feel sometimes up to six times your body weight. So keeping your body mass low helps in multiple facets relative to health and specifically with arthritis. The lower you keep your body weight, the less stress you have on your knees.

If you do, in fact, have arthritis and it’s symptomatic and it keeps you from walking as an easy activity, choose non-impact, non-weight-bearing activities such as swimming, water aerobics, yoga, Pilates, stationary bike and biking. That way you are prolonging the life of the treads on your tires - the cartilage that coats your bones, which is what’s lost when you have arthritis. These are the things that mature athletes might have to take into consideration, which doesn’t preclude them from being active and from living a healthy, active lifestyle. Making modifications can keep them active. Being active helps glucose or blood sugar control, which helps stem glucose intolerance or metabolic syndrome, and type 2 diabetes, as well as lower blood pressure, which can diminish the incidents of strokes, increase cardiac output and make your heart stronger. It can also lower bad cholesterol and increase the good cholesterol. There are multiple ramifications down the line from just maintaining exercise in one’s lifestyle.

Any final words about keeping fit during the holidays?

It’s all a lifestyle choice. It’s not about how one looks or what size pants or dress a person fits in. If you make it more a lifestyle choice, a mentality of health, as opposed to a weight-loss regimen or a diet, that would be ideal.

Rather than waiting for a New Year’s resolution, it’s reasonable to start now.

Be active, and being active will allow you to, in moderation, enjoy the food that you like to enjoy during the holidays.

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