The Art of Aging Well: Build Strength and Muscle Tone

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Photograph of Skeeter Lifting Weight Courtesy of Trish BrakkoBrats

Photograph of Man Lifting Weight Courtesy of Paul Moore

How to Age Well by Building Strength and Muscle Tone

Guest Blog (Part Two in the Strength Training Series) by Kim Miller, American Council of Excercise Personal Trainer

Our muscles have an innate capacity to respond to stimuli by growing in size, density, and strength. Here’s how to smartly proceed in a healthy aging strength training program weeks 4-12.

Weeks 1-3 of a Strength Training Program

The first 3-4 weeks are designed to learn proper technique as well as allow the ligaments, tendons, and muscles to adjust to the increased stress that will be placed on them incrementally in ongoing weeks. These opening 4 weeks lay the foundation not only for the body physically, but for the mind mentally.

Strength Training Weeks 4-12

There are pros and cons of using machine weights and free weights. As a novice, machine weights will be a much better option in weeks 4 through 12 of your strength training program. Since this time period is primarily to build strength progressively, machine weights will offer more convenience increasing your chance of continuing your new program, as well as allow you to focus more intensely on working each muscle group rather than on correct body positioning. With machine weights, once you are set up properly, there is little room for misalignment.

Basic Machine Set Up With a Trainer

If you haven’t already hired a personal trainer to get you set up properly in each machine, then now would be a good time. At a minimum have the trainer show you the appropriate settings. You should write them down and have the trainer allow you to practice setting each machine as well as executing each machine so that he may provide feedback. This feedback will be invaluable in ensuring you will practice correctly on your own thus decreasing injury occurrences.

It will take a minimum of 4- 5 sessions with a trainer to acquire the basics. During these sessions, ask the trainer for detailed specifics on how and when to with weights and reps. A good trainer will not overwhelm you but will help you make sense of these opening 12 weeks of base strength training and will assist you in making adjustments for physical limitations.

Machines For Base Strength Training

• Leg Extension
• Leg Curl
• Hip Abductor
• Hip Adductor
• Leg Press
• Chest Press
• Lattisimus Dorsi Pull Down
• Shoulder Press
• Bicep Curl
• Tricep Press Down

Days of Training

For progressive strength gains aim for training 2-3 days per week implementing all of the above exercises in the order indicated. It will be necessary to take a day or two off in between to allow your muscles to rest.


Perform each exercise one time aiming for 10 – 12 repetitions for upper body and 12 -15 for the lower body. You should strive to use a weight that is heavy enough that by time you get to the 10th -12th repetition for upper body and 12 -15 for lower body, the muscle is moderately fatigued.

After you have been doing the upper repetitions in three consecutively training sessions then move up in weight. Most weight machines will have increments of 5 and 10 lbs. If you can at least perform 8 repetitions for the upper body, and 10 for the lower body then keep the increased weight and proceed from there.


Since your objective during this 12 week period is to gain strength primarily for healthier aging, one set of exercise performed to fatigue, according to research, is the most effective means for increasing strength. (The reason many people need to do multiple sets is that they didn’t perform the first one at maximum intensity.)

Your main priority should be to focus intently on each exercise and fatique each muscle group thoroughly. Quality, not quantity, is paramount in gaining muscle and bone strength, density, and most importantly a body that ages well!

Until the next posting, think about this, “Healthy aging may not imply living longer, but do you think it can mean living with less disease, more fun and more vitality?” If so, make just one healthy aging change in your life today.

Don’t push yourself to change everthing all at once. There’s no hurry. One change is good. We’ll work on others later. Life is good. Call if you need to. 904-501-6002

Kim Miller, American Council of Exercise Certified Personal Trainer, holds a Bachelor of Science degree in Health and Physical Education from Cleveland State University. ACE is one of the top three accreditation groups in the United States. Kim is also certified as a wellness coach with Wellcoaches. Wellcoaches has earned the coveted endorsement of the American College of Sportsmedicine.

Kim is the owner of BodySmart Inc., and has been writing a weekly health e-newsletter for over a year and a half to an ever increasing readership that extends the globe.

Last Updated May 10, 2010 by Dr. Vee

Oh, My Aching Back! (Dr. Vee Contributed to AOL Health Article)

Photograph of Golfer by Elena Weber

Photograph of Woman Exercising on the Beach by Dusan Zidar

10 Questions About Lower Back Pain

By Deborah Huso (AOL Health Writer)

According to the American Academy of Physical Medicine and Rehabilitation, 80 percent of Americans will suffer from back pain at some point in their lives, and for most of us, that means lower back pain. While a fair number of people suffering from chronic lower back pain often end up taking the surgical route, more than half of those surgeries result in no change in pain and sometimes even increase pain.

The reason, according to Mitchell Yass, physical trainer and owner of PT2 Physical Therapy & Personal Training in Farmingdale, N.Y., is that most back pain is the result of muscle weakness or imbalance.

So if you’re suffering from persistent lower back pain and seek a doctor’s advice, here are 10 questions you should ask to help get yourself on the mend, hopefully without surgical intervention:

1. What is causing my lower back pain? It’s best to rule out simple causes first. Those might include muscle weakness or spasms, spinal stenosis or disc pain, all of which can be successfully treated without surgery. Ask your doctor to give you a full physical examination.

2. What are the signs my back pain is dangerous? If you’re experiencing loss of bladder or bowel control or numbness around the anus, you may have a more serious problem, and an MRI may be necessary to diagnose the cause.

3. Could stress be causing my lower back pain? New studies have shown that lower back pain is often linked to stress. This manifestation of stress as physical pain in the body is called tension myoneural syndrome.

Craig Antell, osteopathic physician and founder of New York Rehabilitation & Wellness, says he always recommends that patients with chronic back pain who have an obvious stress factor in their lives read “Healing Back Pain” by John E. Sarno, M.D., which helps patients discover and address the link between chronic pain and mental stress.

By addressing stress, one can often relieve the muscle tension in the back that causes pain.

4. Should I use heat or ice to treat back pain? Ice will help relieve pain in the case of muscle spasm or inflammation. With chronic back pain, heat can help. Neither will treat the pain, however, but they will relieve symptoms and make you more comfortable while you recover.

5. Should I be on bed rest? Vandana Bhide, M.D., who practices internal medicine in St. Augustine, Fla., says bed rest is the worst possible prescription and can actually slow recovery.

6. Should I perform exercises to relieve and address lower back pain? Bhide recommends stretching every day before getting out of bed. While your doctor or physical therapist can recommend exercises for your specific condition, one simple thing you can do before rising in the morning is to lie on your back and pull one leg to your chest and then the other, doing each side 10 times. Then perform the same movement with both legs. Once you get out of bed, perform a cat stretch (curling and flattening your back while on all fours) 10 times.

7. Is physical therapy helpful? Physical therapy is generally the primary and most effective treatment for lower back pain, as it involves hands-on manual exercise in which a therapist will teach you exercises to address your specific pain issue. To be effective, however, you must practice the back exercise regimen at home whenever you experience back pain or to prevent it from recurring.

8. Is any over-the-counter pain medication helpful or necessary? Avoid pain medications if at all possible because they do nothing to address healing. If you need temporary relief, try ibuprofen or naproxen. Your doctor may also prescribe a muscle relaxant or steroids.

9. Should I get an X-ray or MRI? An X-ray or MRI is only necessary if your doctor has ruled out muscle weakness or spasms, bulging disc, or spinal stenosis after a complete physical examination. An MRI is essential if you’ve experienced trauma, have night pain, and or loss of bowel or bladder function, any of which can point to a severe neurological disorder or even cancer.

10. At what point may surgery be necessary, and will it help? Surgery may be necessary if you are experiencing the above symptoms, and it will help in those cases. The reason so many people who have back surgery experience no relief of symptoms is because they have been misdiagnosed. “Always make sure your physician knows the objective cause of the back pain,” says Antell. “Just treating the pain won’t fix back pain for the long-term.”

Last Updated on May 9, 2010 by Dr. Vee

Run and Eat–Race for the Taste 5K Run to Benefit EPIC Community Services

The first ever Race for the Taste 5K run was this past weekend. We had over six hundred runners and they were amazingly fast!!!! The setting was beautiful Anastasia State Park, where runners had a great view of the ocean as they ran!

The runners then had free admission to the Taste of St. Augustine, where people could sample different food items and vote for their best in category.

Thanks to Dr. Pineau and everyone at Borland-Groover Gastroenteroloy Clinic for being title sponsor. Orthopedic Associates of St. Augustine, Dr. Marema/Koppman and OB/GYN Associates of St. Augustine were other key sponsors, making this Race incredibly successful! I had fun creating and sponsoring the Runner’s bags (Featuring Ask Dr. Vee, your Holistic Medicine Expert). I also had fun (but was stressed to the max) handing out water to the runners during the race!

Local celebs who ran in the race (and were fashionably dressed to boot, and did not sweat at all despite the 84 degree Florida heat) were too numerous to list, but included Bill Abare (former EPIC Community Services President), Dr. Ram Eyyunni, Dr. Ben Pineau (and son, who runs faster than me!) and Dr. Bill Platko.

All proceeds went to EPIC Community Services, which strives to help patients and families battling addiction through Education, Counseling, Intervention and Prevention.

This year I am Vice President of the Board of EPIC Community Services and am getting on the job training from Bev Slough, St. John’s County School Board President and current EPIC Board of Directors President. Patrick Canan, former EPIC President, and local attorney, did not dress up like Elton John, but he was a sponsor of the Taste of St. Augustine.

Patrick of Gypsy Cab (yummy hummus!) and Lorna McDonald of Raintree Restaurant (yummy berry crepes) were there to help St. Augustine become more tasty.

Thanks to all the great restaurants who were there, Patti Greenough and Teresa Andrews who worked tirelessly to make the event successful!

Rebecca Romaine, was EPIC in helping mastermind such a fantastically successful race. Valerie Lee was the water gal–we are already planning on how to improve our water skills for next year (ok, yeah, garbage cans for the water cups would have been an obvious idea. Also, some of the cups were flimsy. Who knew that you had to test run the cups in advance???) Fortunately, Tara Smith-Vighetti and
Renee Wauldron were there to help pour and hand out water cups during the race!

Preparation, preparation, preparation!

Last updated April 28, 2010 by Dr. Vee

Lose Weight by Increasing Fat Burning Capacity through Exercise

How to  Increase Fat Burning Capacity For Weight Loss 

Long Distance Runner Photographed by Marco Welt


By Kim Miller, Guest Blogger and ACE Certified Personal Trainer

How can we burn a maximum amount of calories in a minimum amount of time? 

A comment from a reader who writes, “You should check the latest research on fat burning. You suggest that long slow distance (LSD) is the way to go for newbies. But that’s not what the new information says.” Well, the reader is correct, but….. read on. 

 Why Not Skip LSD Training and Get Right to the Best Calorie Burns?

If you are new to fitness, or have not been doing cardiovascular exercises such as walking, swimming, jogging, elliptical training, biking etc., then the suggested long slow distance training with minimal emphasis on heart rate intensity is used to build a base of endurance for furthering harder intensity calorie burning zones. Think of this slow long training as a necessary “evil” for furthering fat burning ability. A long slow distance base of training aids in the formation of new life changing habits, primes the muscles, ligaments, and tendons, as well as the cardiovascular system for a lifetime of increased fat burning ability and a speedier anti aging higher metabolism by reducing the occurrence of injuries, as well as the occurrence of premature overzealous training which often leads to failure. 

Fat Burning Zone Explained in Brief 

In order for a muscle to function it needs energy. There are three options that a muscle has to use fuel: 

1 Carbohydrates
2. Fat
3. Protein- only used by muscles under depleted circumstances. Consider carbohydrates and fats as the two main sources. 

When using energy our muscles use a mix of carbohydrates and fats, this is based on a number of factors, one of them being intensity and duration of activity. Fats require more oxygen than carbohydrates to burn. As a result, as exercise intensity increases and less oxygen is available, the body shifts from a fat burning zone to using carbohydrates for energy in order to maintain the activity. This doesn’t however mean that less fat is burned. In low intensity exercise the fat being used is coming from the blood stream and this was traditionally called the fat burning zone. In order to understand the whole picture though, we must look at where the source of the fat being used is coming from. 

Energy Source Paramount in Increasing Fat Burn Ability 

With increased intensity and duration of an activity, the muscles need more oxygen and energy, so our hearts beat faster to get blood to the muscles quicker. In medium intensity long duration activities the blood stream gets overloaded with work, including the job of providing an energy source to the working muscles. When looking to increase our fat metabolism, it’s necessary to get to this point of overloading our bloodstream’s energy sources. By doing this, the overloaded blood stream must turn to its own body’s muscle fat – namely the primary muscle mover’s fat (triglycerides) and glycogen (sugar) stores- which provide energy to the working body. Obtaining a state of moderate intensity training, where the body is working harder and the heart rate is being taxed at a perceived exertion of 6 out of a 10 point scale is when fat burning is amplified beyond just a simple calorie burn. To translate this into a target heart rate, achieve a heart rate of approximately 80% of your maximum heart rate and continue for duration of 20 minutes and preferably 30 – 60 minutes continuously.

How to Figure Target Heart Rate at 80 Percent 

-Take 220 minus your age.
-Multiply this number by .80.
-Your number is your THR for an increased and more efficient fat burning zone 

Fat burning can be optimized further with high intensity interval training. It’s what all the fitness magazines are writing about.  The secret lies in what is called the after-burn. It breaks all the rules applied here, but you’ll see why it’s absolutely necessary in obtaining a lean more muscular look that includes the difficult to diminish waistline. You can do it! Stay tuned and I’ll help you out. 

Kim Miller 

Kim earned a Bachelor of Science degree in Health and Physical Education from Cleveland State University. Kim is a certified personal trainer certified by the American Council on Exercise (ACE).  She is also certified as a wellness coach with Wellcoaches. 

Photograph Courtesy of Marco Welt

Last edited on April 18, 2010

How to Begin a Bone and Muscle Strengthening Program Smartly

By Guest Blogger Kim Miller, ACE Certified Trainer and Wellness Coach. 904 501- 6002

Gain Bone Strength and Muscle Tone Even if You’ve Never Trained

It’s never too late to gain strength. Our bones and muscles have an innate capacity to respond to stimuli by growing in size, density and strength. Here’s how to begin. In the beginning stages of a weight training routine, it’s necessary to take 3-4 weeks to learn proper technique while keeping the weights light.

Think of this process as setting the stage for smart progressive gains in strength, muscle tone, and muscle density. Skipping these two factors of proper technique and light weight in the initial stage increases injury occurance which is the number one reason people stop training. Don’t let this be you.

Keep the weight light enough that you can practice good form without any struggle. The temptation to increase the weight amount will be looming, but realize it is the tendons and ligaments of the body that really need sensible conditioning in these opening weeks. Be patient. Be Smart.

To Hire a Trainer or Not ?

If there was ever a time to hire a trainer it’s in the opening weeks of a weight training routine. A good trainer will show you what machines to use, how to set them up, and what weight to start with. A really good trainer will help you in those opening weeks to make sense of a routine suitable for you. This should involve asking many questions about your lifestyle, how much time you can commit to exercise, what type of job you have, past injuries, health status, motivation levels, reasons for initiating a strength program and other pertinent information that willhelp develop a plan that is suited for you and you’ll likely implement consistently.

A really good trainer will also add perspective on how best to adhere to the program and will transition you through various aspects of learning to strength train. A good trainer is well worth the money as making sense of the implementation of a strength routine is paramount when considering that most people do not continue a strengthening program for longer than a few weeks.

Going It Alone? If, for some reason you need to begin a strength program on your own, most gyms have attendants that can show you how to use the machines. There should be no cost for them to show you how to set up each machine. If you never strength trained before in your life, and you will be training on your own, have the gym’s attendant or preferably a personal trainer show you these five exercises.

Getting Started On Your Own

Leg Press- press through the heels and keep head back.

Latissimus Dorsi Pull Down-keep chest upright throughout and lean slightly back.

Chest Press- keep head back and engage chest muscles to press.

Seated Shoulder Press With Dumbells – back supported and palms facing in.

Standing Bicep Curl Against Wall- knees slightly bent and stand against wall for support.

Repetitions and Sets

Practice 15 repetitions of each exercise in the order as desribed above. Repeat this cycle one more time. Practice slowly and deliberately and use a light enough weight that 15 repetitions are not a strain.

How Often

Practice this routine 2-3 times a week for the first three weeks preferably having a day or two off in between. Increase the weights by no more than 15% each week. Remember, your goal in the opening weeks is to practice good form and allow your tendons and ligaments to get adjusted to the increased workload to come.

When you leave the gym you should feel like you could easily continued doing more. Don’t be tempted to increase your weights, repetitions or sets. This is a mistake that will ultimately increase the likelihood that you will dread going to the gym your next session. We are not just training our bodies, but we are also training our minds. It’s a process of adjustment and by honoring this you’ll increase the likelihood of making strength training a lifelong habit.

Look for part II of this series on smartly beginning a weight training routine for bone strength and increased muscle tone. Until then, keep in mind that our true wealth is in your health. Best of luck to you!

E-mail or call me for any questions you may have. I will be happy to help!

Kim Miller, Ace Certified Trainer and Wellness Coach. 904 501- 6002

Last updated April 1, 2010