Exercise, Nutrition, WLS, and Cooking Q & A - 2/19/2014

Since I have had my surgery, I walk about 1 1/2 miles Monday thru Friday.  The arthritis in my knees has gotten progressively worse.  Is there an over the counter medicine I can take for pain?  I am in the process of getting physical therapy to see if this will help but it hurts to walk and my entire body hurts.  What can I do to alleviate this pain?  Thank you for your answer.

Are you stretching your legs before you walk?  I find that the stretch where you grab your ankle behind you and hold it for 20-30 seconds really helps me with knee pain.  Also, if you strengthen the big muscles in your legs it takes the pressure off your knees and hips.  Here's a link for more stretches that could help your knees.

Arthritis questions are always tough for me because there really is no good one size fits all answer. Arthritis is also mild in some people and terrible in others. The real answer is to play through the pain. I almost NEVER recommend exercising in a pool, but in cases of very painful arthritis it is a good way to take the pressure off of your joints and let you get some good aerobic exercise in. As for the pain, the VSG does not really restrict you from any pain meds. I think there are probably several like alieve in combination with tylenol or ibuprofin that would help to reduce your pain to a tolerable level. I have it in my knees and I run every day. Some days the pain is worse than others but I can always push through it. When it gets to the point where I really can't take it, I take a couple days off and give my knees a rest.

The previous poster suggested stretching and while I don't think it will do anything for your arthritis directly it will help to make sure your muscles and tendons are pulling in the right places and not causing your arthritis to hurt worse. I would suggesting stretching after but if you do it before warm up a little bit first. You should never stretch cold muscles. If you find the physical therapy works, do more of it. PT is one of those things actually where more is better.

Keith - hope you are willing to answer an RNY person's question :)  Thanks for posting these - I love to read them and you have obviously educated yourself quite a bit.  My question is this: I am on a lifetime meal plan of three meals and no snacks, if I can avoid them.  On a day I don't exercise I may have 3 meals of protein, and a Premier Protein shake.  That gets me to 80 g of protein, 700 calories or less, and 20 g of carbs or less.  On a day I exercise, I do so around 5 pm...so I need a snack before I go 2 miles on the treadmill since lunch is at 12:30 and dinner is 7:30.  So around 4 or 4:30 I may have a piece of string cheese, or a shake, or a hard-boiled egg.  Any advice on the kind of food I should have before working out?  Currently I am only doing cardio but I start a gym membership on March 1st with personal training!  They may have advice too.  I am not willing to increase carbs if I can help it :)  Thanks!

Of course I am willing, I do not discriminate.

I am not crazy about the no snack part of your plan. I do subscribe to a constant flow of nutrition to your body does help to improve your metabolism. I think your non-workout day numbers look good. 80g of protein is sufficient and less than 20g is good. You don't say how much fat, but remember fat is now good, well the healthy fats anyway, so to help keep you burning body fat, you can increase your healthy fat (ie olive oil, salmon, peanut butter, coconut oil (best)) in take.

On exercise day I encourage you to hit the snacks. 30-60 (I shoot for 60 because my workout in the morning is HIIT and I don't like stuff coming up) mins before your work out eat some protein. I like shakes for this because they pass quicker and I use a hydrolized whey because it is fast digesting and ready to be used. This is also a good time to get some fats, sometimes in my shake I will include a small amount of heavy cream (grass fed when I can find it). But I always make my shakes with almond milk instead of dairy. Then 30-60 mins AFTER your workout if you are not close to a meal time, then that is a good time to eat some protein with carbs (don't go crazy here) but fast digesting carbs from fruit are good here. This will cause an insulin spike and a small rise in blood sugar but that insulin helps to carry the protein to your muscles for recovery and rebuilding. My post workout favorite is an organic brown rice cake (slow digesting carb) with peanut butter (protein and fats, some carbs) and banana slices (fast digesting carbs and potassium).

Also once you start weight training you may want to consider some protein right before you go to sleep (within 30 mins). For this I really like a slow digesting protein like casein (casein protein powder, greek yogurt, or cottage cheese). This helps to feed your muscles while you sleep and because its slow digesting it takes most of the time you sleep to get it into your body.

Also if you really want to be a good protein dooby then you really should try to get 30g of protein in within 30 mins of waking up. This helps to increase your metabolism. This is easy for me because I get up at 5am, drink a shake, and workout at 6. On days I don't workout I eat a protein bar on my way to the dog park as soon as I get up.

Thanks, Keith!  This is SUPER helpful.  Sounds like I am ok, having a shake before my workout (or a cheese stick, or an egg).  Never thought about having a "shot" of protein before bed.  I hate that plans are so different.  My NUT is pretty adamant that I should be at 3 meals total, no snacks.  I do notice that most of the people on OH do small meals and snacks.  I wish I knew definitively what is correct.  Anyway, once I start weight training I will be sure to have a bit of protein at night.

Not sure I can eat within 30 minutes of waking up ;)  I can barely open my eyes ha ha.  I eat as soon as I get to the office, however.  So normally within 1 hour and 15 minutes.  Good tip though and maybe sometimes I can eat on my commute.  I just hate eating on the go because I do so mindlessly!

Thanks again!

I am sure your NUT is just following the weight loss mantra script. And most people mean by snacks gratuitous junk food. By snack I mean small nutritious meal that supports your metabolism and therefor weight loss.

I have a question. Particularly not mine. An acquaintance asked me, and I am asking you. So, here is a person who asked me this question. What should be an ideal start for weights training exercise? This person has not done any training before. So just want to have some guidance.

Ah the classic question. There are a couple of ways to figure that out. Body builders use the percentage of a 1 Rep max. Meaning the weight at which you can only do 1 rep of whatever the exercise is. The problem is you need a spotter and its a long drawn out process.

The approach I use is to start at some weight. So for this I will assume 2 things #1 you are talking about free weights and #2 we are talking about a female of average strength considering never having trained before. So for a bench press the bar weighs 45 lbs. So I typically start with a woman with just the bar. I do spot her and I have her attempt 10 reps (a rep is one full range of motion of the exercise). So for a bench press it is starting in the up position down to the chest and back up is 1 rep. So if she can get through all 10 reps and they were very easy I will put a 10lb plate on each end (65lbs) and do the exercise again. You want to find the weight where the last rep is the hardest one you can do but still fini**** without help. That is your workout weight. You should be able to do 4 sets (a set is a set of reps). The last couple reps of the last set should be extremely difficult but not impossible (sometimes when you go up in weight that happens) but the idea is to get at least 8 reps of that last set. Now once you know that weight you should always do your 1st (warmup) set at about 10-20lbs lighter than that (in the case of bench press). Obviously for different exercises this will be different. 

Now for bicep curls I would recommend using dumbbells instead of the barbell because it is doubtful she would be able to do full sets with a barbell with no weights on it. For her I would start with a 10lb weights and again attempt 10 reps. If they are easy move up, if they are impossible move down. 10lbs is a good starting point here.

You will use the same approach for each exercise. Remember to write down the weights so you don't have to guess and try every single time.

For machines the approach is the same. Sit down pick a lower end weight and give it a try. Machine weights and free weights will never match. If you can bench 100lbs on a machine you can probably do about 75lbs on free weights. Partly the machine does some of the work and partly the range of motion is fixed on a machine and with free weights it takes extra muscle for stabilization.

There is not one correct answer here either, everyone is different. If your friend is worried about trying to find out. Have them ask a personal trainer at her gym to help her find out. Most won't charge for something like that but then also some offer an hour or so for free so thats a good way to find out too.