“A good quote cuts right to the point, just like a skilled surgeon”
J. Brellier

It’s been said that “a spoonful of sugar helps the medicine go down”. I tend to agree. Over the years I have lectured numerous times around the country and around the world. I have always found it useful to use quotes to help drive home my message of health. As a result, I have a huge collection of health, fitness and wellness related quotations that, to me, have a special message within. These quotes range from great scientists to great presidents. Spiritual leaders to comedians. Hippocrates to Grouch Marx and even Miss Piggy.

FitQuips are a collection of quotes with a brief commentary by me about what I believe is in that quote that is important for your health and your life. Sometimes body, sometimes mind, usually a little of both. I also finish with a brief FitTip which is meant to be an action step for you to incorporate in your life immediately and improve your health.

FitQuips are my way to deliver a health message and sometimes health news in what I hope will be an entertaining manner. It’s my “spoonful of sugar” that not only helps the information go down but I believe it makes it stick!.

We know there is no shortage of health information out there, yet are we any healthier as a result? I believe the delivery medium can impact the message and inspire action. I learned from Gary Trudeau the power of creative message delivery through an unlikely medium. With his Pulitzer Prize winning Doonesbury cartoon, Gary Trudeau was able to impact more people that many of the best written editorials in the most influential newspapers. He delivered the same message but in an entertaining format that stuck. I hope FitQuips are not only fun, but motivational, inspirational and help you positively change your life. I welcome any feedback.

FitTip

A FitQuip a day keeps the doctor away. Take one and see.

What is history, but a fable agreed upon?
Napoleon Bonaparte

In the Da Vinci Code, we are told that “history is always written by the winners”, implying that our history books may contain more editing and revisions than we would like to imagine.

One history many of us would like to rewrite, given the chance, is our Family Health History. When your doctor asks questions about diseases or conditions that run in your family, he or she is not just being polite and making small talk, but rather gathering information that could be very important to your present or future health. When it comes to health, history tends to repeat itself.

As we unravel the genetic code and learn more about the role of genetics and how your body is programmed to function and malfunction, it becomes clear that this is an area that needs to be explored as part of almost every medical encounter. Predisposition to many diseases is passed on, sometimes to every generation, and sometimes it will skip generations.

It is not only important for your doctor to climb your family tree with you, but you too should ask your relatives about your family’s health issues as far back as anyone can remember. You may uncover things that are critical to you and give you the head start you need in preventing lightning from striking twice in the same family.

Gathering health information can sometimes be a challenge. Some families are notoriously secretive about matters of health (often cultural), and in cases of adoption or broken non-communicating families, getting health information can be as difficult as cracking the Da Vinci code itself.

We all know that diabetes, heart disease and certain cancers run in families, but we are learning that so many more conditions can be part of your genetic makeup. Believe it or not, conditions like arthritis, back pain and even the predisposition to certain knee ligament injuries can now sometimes be blamed on your parents! – or their parents. Also there are more and more genetic tests available that can be performed to assess your risk of developing a variety of conditions. This is something you can explore with your physician.

The future of medical technology and breakthrough treatments actually include genetic manipulation or gene therapy to prevent or cure many common conditions. Designer Genes to the rescue.

So, my best advice, other than to choose your parents wisely, is to learn as much about your family health history as possible, and then research and practice all the preventive measures that are appropriate for you.

FitTip

Learn from the past to assure a healthy future. Family matters in more ways than one.

“I saw the angel in the marble and carved until I set him free”
Michelangelo

Your body is constantly remodeling itself. Constantly changing, for better or for worse. This internal and external renovation is not a random process out of our control. On the contrary, we have a direct influence everyday on the final product. In fact, it’s more of a work in progress and it’s never too late to aim for an upgrade.

Two critical elements in the sculpting process are lifestyle ones that are under your direct control. With you as the artist, exercise is the chisel, and the foods you choose, the raw materials.

Exercise is a powerful stimulus that causes predictable specific changes in your body including structural, hormonal and biochemical ones. Yes, remodeling even takes place at the cellular level. The overall result is very positive for your body both internally and externally. A stronger, healthier, more resilient you.

Your exercise program needs to include three key components: cardio; strength; and flexibility. Cardiovascular or aerobic work is for the most important muscle in your body, your heart. Strength training is an essential part of the sculpting process. It goes way beyond what you might see on a bodybuilder with their obviously strong muscles and exterior. Strength training rebuilds body from the inside out improving the structure and durability of your bones, tendons, ligaments and so much more. Flexibility training or stretching gives you the elasticity you need for ease of movement. And don’t forget to work your core- it is the center of your fitness universe!

Food is not only an important fuel but also can have either positive or negative effects on your system and your frame. Your choice either way. Learning to make the right food choices involves being smarter about both the quality and quantity of the things you put in your mouth. Learning more about good carbs and friendly fats, staying well hydrated with water, and realizing once and for all that extreme diets don’t work, not for the long run.

Perhaps Jack La Lanne said it best: “Exercise is King. Nutrition is Queen. Put them together and you’ve got a Kingdom.”

So much of how your body functions, thrives or fails is under your direct control with your lifestyle choices. For example, 70% or more of premature deaths are lifestyle related and preventable. Exercise and nutrition are cornerstones but other factors like genetics, stress and luck also play some role. All of this can be seen vividly in amazing exhibits like BODY WORLDS. I strongly recommend that you visit this extraordinary exhibit if the opportunity arises. It will change the way you treat your body- like the priceless work of art that it truly is.

FitTip

Help your body re-invent itself- more durable than ever- with the right exercise and food choices. Make the sculpting process work for you.

“I’m a gym member. I try to go four times a week, but I’ve missed the last… twelve hundred times.”
Matthew Perry (RIP) as Chandler on the TV show “Friends”

With the holiday season winding down, many are looking ahead to getting back in shape, or staying in shape, through the winter months ahead. After all, it will be springtime before you know it. Many will be hitting the trails or roads and joining gyms, in search of a better body. Maybe you’ve even gotten a personal trainer as a holiday present.

For those who have not been exercising and are committed to starting a program, I applaud you. It is the single best gift you can give yourself. It can also be very challenging.

The key is to find a program you like, and one your body tolerates well, and stick with it- no matter what it takes!

For those of you who are starting out after a long layoff, or if exercise is new to you, it’s important to avoid those common mistakes when starting an exercise program. Also, if you are really out of shape, overweight, or have medical issues, check with your doctor before starting up.

The 5 most common mistakes individuals make when starting an exercise program are:

• Too much too soon – Many try to make up for lost time by going at it with a vengeance. While I love that “start-up” enthusiasm, it’s also important to remember that exercise is a powerful stimulus, which benefits your body in many ways, but your body needs time to adapt to the new stresses and strains being placed on it. So go slowly at first.
• Follow the “10% Rule” – Never increase your exercise routine (i.e. the amount of miles you run or the amount of weight you lift) more than ten percent per week. This avoids overuse injuries and the overtraining syndrome.
• Lack of balance – Try not to pick only one activity. Embrace cross-training to get more overall balance for your body. Remember there is no single perfect exercise that covers all aspects of fitness so it pays to mix things up. Also, in general you should not be doing the same exact routine every single day (although walking and stretching can usually be done safely every day). Each week try to incorporate aerobic (cardiovascular) activities, weight lifting and stretching. Unidimentional (i.e. one activity only) workouts can create imbalances that can be a set up for injuries. Also, a variety makes things less boring. When you first start out, it’s fine to pick one activity, but as the weeks go by, be sure to add more overall balance to your program by adding the other above mentioned components.
• Pick an activity that’s right for your frame – Musculoskeletal (i.e. muscle, bone and joint) problems are so common that you may need to modify your routines to accommodate that bum knee, sore shoulder or low back that goes out more than you do. Check with your trainer or physical therapist (if you have one), or your orthopaedic surgeon who can help you stay fit and pain free. Fitness shouldn’t be a pain!
• Fuel up –  So many are trying to both lose weight and get fit at the same time. There’s no question that exercise should be an essential part of any weight loss or weight control program. The mistake that is commonly made is that in an effort to drop pounds, starvation (i.e. inadequate calories) becomes part of the plan, and that will interfere with optimal workouts. Food is your fuel for exercise so learn to make good food choices rather than starving yourself. Breakfast is especially important so look for a high quality carbohydrate one, like oatmeal or cereal with a banana. Also be sure to drink plenty of water (at least 8 glasses a day) to remain adequately hydrated, since fluid needs go up with exercise.
• Stick with it – Exercise is not easy but it should be fun. There will be times when you may want to pack it in, especially when the novelty wears off. There will always be a handy excuse available. Dropout rates are tremendous so don’t be a casualty. Don’t give in and remember you are creating a lifetime habit, so thing long term.

If you can avoid these few mistakes, your path to fitness should be much smoother. Believe it or not, even those who have been exercising regularly for years fall prey to these common exercise errors. With a little effort, they are easily avoided.

FitTip

Mistakes are part of any new endeavor. We all make them. But learning from others’ past errors is always a better choice than experiencing them yourself.

“The two biggest sellers in any bookstore are the cookbooks and the diet books. The cookbooks tell you how to prepare the food and the diet books tell you how not to eat any of it”.
Andy Rooney

With the holiday season in full gear, many of us will indeed be out buying books- always a great gift. Another thing that many of us will predictably do is pack on a few unwanted, unneeded pounds.

There is a popular myth that most Americans will gain 5–10 lbs over the holiday season. Recent research has shed some light that may help you shed some pounds, rather than gain, this holiday season.

Scientists have recently found that most of us actually gain only about 1 lb between Thanksgiving and New Years. Before you celebrate and reach for the eggnog, consider that fact that most who gain do not lose that pound or so, and over the years they do add up leading to an expanding waistline. Those who are already overweight or obese are more likely to pack on even more holiday pounds, making their situation worse. Only about 10% of us will gain more than 5 lbs.

Researchers also found that those who were most active were less likely to beef up, again underscoring the importance of exercise in weight control. Also, those who reported being “less hungry” were less likely to gain weight.

I am convinced that you can enjoy the holidays, including many of the wonderful foods, without packing on unwanted, and rarely lost, pounds. Here are some strategies that really work in beating the holiday weight gain game:

• Stay active – Exercise everyday. In recent studies those who were most active were least likely to gain weight. This is especially important if you are adding extra daily calories.
• Eat a good high quality breakfast – Breakfast is the “pace-car” for your daily metabolism. Individuals who regularly eat breakfast tend to be thinner and also consume less calories later in the day. Oatmeal or a high grain cereal with bananas is a great start.
• Don’t skip meals or starve yourself – So many try to “undereat” during the day especially if there is a holiday party later-the result is party overeating, especially high calorie, high fat foods. Instead, eat healthier, low calorie meals during the day (try a low fat yogurt with granola and an apple). At the party, start with some veggies or salad to fill you up a little before hitting the buffet table.
• Water water everywhere – Drink 8-10 glasses of water a day and totally skip the sodas especially if you planning other sweets at dessert time.
• Limit you alcohol intact – Also avoid the higher calorie alcoholic beverages like eggnog. Again, drink lots of water.
• Be a “picky eater” – Your food choices will make or break your success. Do eat, but be smart about it.
• Portion control – Moderation is the key to enjoying the many tasty holiday foods and snacks. Be mindful about both the quality and quantity of the foods you are eating. Remember, “a minute on your lips, a lifetime on your hips”.
• Join a gym – Ask Santa for a gym membership, or give one to someone you love. Better yet, go together. It’s a gift of health that can last a lifetime.

With a little bit of planning and touch of will power you can easily get to the New Year feeling good about yourself and how you have taken steps to improve your heal

FitTip

Plan ahead for both a happy and healthy holiday season.

“Today, there’s much more contact — but a lot less communication.”
N. DiNubile, MD

When I was a kid growing up in downtown Philly, getting a black eye was a cool right of passage. Now, blackberry thumb is the hip ailment that is growing in popularity — same for iPod finger.

Blackberry thumb and iPod finger are overuse-related tendinitis in the hand that occur from repetitive thumbing and finger use with small handheld devices that have grown exponentially in terms of popularity. Even my somewhat technophobe big sister sends me messages from all over the globe.

In the past, when video games just hit the scene, we saw “nintendonitis.” Similar ailments are now seen in the thumb and other fingers in those who peck away at laptops, not known for their good ergonomics. Instant messenger addicts get “texting tendinitis” and cell phone junkies have “numb thumb.” Carpal tunnel syndrome too is on the rise. With new technology comes new ailments.

Fortunately, these problems are usually not serious and do respond to some simple measures including avoiding the handhelds for a few days and taking Advil or Aleve. Ice or heat and some stretching help as well. If symptoms persist, see an orthopaedic specialist who can make an accurate diagnosis and get you started on a treatment program.

My best advice is to try to prevent it completely by taking frequent breaks and stretching regularly. Think of it as a rest stop on the information superhighway. Try these simple exercises every hour of high-tech hunting and pecking:

• Shake your hands out, then open and close your hands fully ten times, like making a fist.
• Put your elbow straight with your hand open in front of you with your fingers pointing up and your palm facing away from you like a policeman signaling “stop”. Gently pull back on your fingers. Hold 10 seconds and repeat.
• Next, with your elbow still fully straight, reverse your hand and wrist so the fingers are pointing downward- pull your palm downward towards you. Hold 10 seconds and repeat.
• Shake things out again and massage your palms, wrists and forearms.

These simple exercises can go a long way in keeping you healthy. Even yoga has been shown to be effective in preventing many of these common repetitive strain ailments. Better yet, pick up the phone to make direct contact with your friends and colleagues — or is that too passé? IM me your thoughts.

FitTip

Remember contact is not communication, and communication is not understanding. Don’t let your daily contacts fall short- strive for quality interaction, especially with those who are important to you.

“All the world’s a stage and most of us are desperately unrehearsed”
Sean O’Casey

Practice makes perfect. This is true not only on stage and in sports, but also in sales, surgery and every field where humans excel. The great ones understand the work that goes on behind the scenes. For every minute Michael Jordan spent on the court, he spent an hour in the gym or training room preparing his body for the work to come. Add another hour or so on the practice court, honing his skills and shots. No wonder he made it look so easy.

Practice can also occur without leaving home- even sitting still with your eyes closed in your lazy-boy. Visualization is a mental dress rehearsal where you picture yourself going through the process or activity, all the way to your desired and optimal goal. You then play the tape over and over in your head- a sort of active goal oriented meditation. It actually works, and translates into improved performance at showtime, when the real-life situation presents itself.

I have done this for many years and believe it has helped me succeed in a variety of circumstances. For me, it actually started in the late 1950’s with my backyard basketball court. My dad, Alfred (amazingly ahead of the times in many ways), had me practice shooting baskets at first without the ball then with the ball-both times picturing the exact arc that the ball would follow into the basket, as if it were contained in a long curved tube… swoosh! Picture it happening, and then let it happen. 20 years later I heard sports psychologists describe the same type of “visualization” techniques. As an avid tennis player, I was also re-introduced to the concept when I read the classic The Inner Game of Tennis by Timothy Gallwey. It really struck a cord with me, about the role of mental preparation and rehearsal in achieving success. He has similar books for both golf and skiing, both of which have helped many.

So practice can take on many forms and all are helpful. The best surgeons takes courses that simulate what they need to do technically. They also think things through, in detail, including possible complications, each and every time before entering the OR. Top sales people do sales training and are prepared for anything. Athletes and actors- we know they practice and rehearse. Legendary tennis coach Nick Bollettieri, who has worked with, and created more top players than anyone, says “no one becomes a successful player without paying the price in practice”. Harry Hopman’s tennis advice applies to all of us, no matter what your racquet is- “the practice court should be used more to practice weaknesses than strengths”. So, as they say, practice, practice, practice.

FitTip

Follow Virginia Wade’s advice: “spend more time preparing and less time regretting”

“It’s not the conditions, it’s the decisions.”
Mountain-climber / expedition saying

Why do we do the things we do? What drives our behavior? Is it our circumstances and situations or is there an internal compass at play? Usually it’s a bit of both. When things get too busy at work or home, often your workouts suffer. Higher stress, comfort food and overeating can set in. Clearly our environment has an influence, but usually our rational thought processes drive things. Or do they? Interestingly, our decision making process isn’t as simple and straight forward as you might think. So much happens beneath our own radar when choices, conscious or subconscious, are made.

In his fascinating book Blink, Malcolm Gladwell (author of best-seller The Tipping Point) dissects the mechanism by which we make every day decisions in “the blink of an eye”, something that is constantly at work in daily life. He explores the process of “rapid cognition” and how the “adaptive unconscious” plays in. Parts of your brain start thinking, analyzing and making decisions before you do- and way before you are even aware of it. He applies the “blink” concept to relationships and marital success, ER physicians’ accuracy in making a heart attack diagnosis, unbelievable behavioral similarities between stock traders and army field generals and so much more. You come to realize that rapid decisions with little information can often be better than ones following a long period of information gathering and rational thought- and that the “blink” rapid stuff drives a good bit of our behavior. Which brings me back to health.

Life is full of choices and many of these daily choices determine the level of health you enjoy, both present and future. Activity levels, food, snack, and beverage choices, getting regular checkups and timely medical care when needed, all add up. Making good quality everyday choices is what often makes the difference between health and disease, feeling good or feeling bad and ultimately whether you enjoy a long active productive life or not.

I believe that many of the subconscious, “blink of an eye” processes are in play here and the more you learn about them the better you will be at making them work for you, not against you, in all aspects of life. Malcolm Gladwell says, “I think its time we paid more attention to those fleeting moments. I think that if we did, it would change the way wars are fought, the kind of products we see on the shelves, the kinds of movies that get made, the way police officers are trained, the way couples are counseled, the way job interviews are conducted and on and on–and if you combine all those little changes together you end up with a different and happier world”.

FitTip

Forget the conditions, and learn more about your decisions. Check out Blink.

“I’m not afraid to die. I just don’t want to be there when it happens”
Woody Allen

Not long ago, Terri Schiavo was the news – morning, day and night. It was the main topic in homes, offices and schools across our country. One unfortunate woman, in a hospital bed in Florida, polarized our nation without even being aware of her influence. She sparked heated debate with each side strongly convinced of its stance, usually set in stone. Despite the differences with deep political and religious roots, agreement was made on one important issue. Virtually every stakeholder agreed that each individual should make their own end of life decisions. Those critical decisions should be clear, documented and adhered to.

Living Wills have been around a long time but they never really caught on. Not until Terri Schiavo. Living Wills basically are written specific instructions on how you want physicians and other healthcare professionals to treat you (i.e. what heroic measures they should or should not take) if you were to become permanently unconscious and terminally ill. Most individuals know exactly what they want or don’t want to endure in this type of unfortunate situation-they just never take the time to write it down. Everyone should have a Living Will or advanced health-care directive. Everyone. It should be done now, rather than waiting for an illness or catastrophic event. It’s not just for the sick or elderly. Also, it’s not only for you, but for your family. Just think of the awful war that raged around Terri Schiavo. Believe it or not, similar end of life issues and discussions occur in virtually every hospital in our nation, everyday.

Since Terri Schiavo, interest in Living Wills has exploded, with exponential growth of these legal documents. Perhaps that will be her legacy. Although she could not speak, her message was clear. Still only 20–40% of adults have one. In the business of life, this is every bit as important as your mortgage, car lease, employment agreement, or if you’re flying high enough, your golden parachute.

To learn more about Living Wills, talk to your doctor and/or an attorney specializing in this area. Also go to agingwithdignity.org and review their “Five Wishes” form which helps you navigate some of the tough end of life issues. The AMA provides useful information and some great links to relevant materials.

Woody Allen, who often contemplated his own mortality, also said “I don’t want to achieve immortality through my work, I want to achieve it through not dying”. Terri Schiavo achieved immortality through her long struggle and ultimately her passing. She has and will influence how we live and how we die for years to come.

FitTip

In both sickness and in health, life and death, a little planning goes a long long way, and throughout the continuum of life you should always be in charge of your healthcare.

“A chain is only as strong as its weakest link”
Old Proverb

Lately I can’t go to the gym without someone coming up to me looking for advice because in their efforts to remain fit and active they have hit a roadblock. Something hurts- a sore knee, achy shoulder or bad back that goes out more than they do. Ditto for my practice where I have seen a significant increase in exercise related ailments. I should give out orthopaedic frequent flyer miles.

I’m an orthopaedic surgeon specializing in sports medicine who has also had a life long interest and commitment to exercise. What I have learned over the years is that the far majority of exercise related ailments are preventable with some simple measures. That is why I wrote FrameWork- Your 7 Step Program for Healthy Muscles, Bones and Joints (Rodale Press 2005).

Exercise is essential for maintaining optimal health and being sedentary is just not an option, yet many individuals run into difficulties in their quest to be fit. Just about anyone can get into trouble, from young, fit and seemingly indestructible, to older and somewhat “beat-up”. We all bring “weak links” to the gym or out on the field. I‘ve learned this from working not only with my sports medicine patients but also athletes at the highest levels, including professional and Olympic. I have also learned the harder way, personally. A high school football injury that came back to haunt me, and a more recent low back issue.

The human body does, and will, breakdown, especially when often pushed to the break point. Some of us are more vulnerable than others. Musculoskeletal ailments have surpassed the common cold as the #1 reason people seek medical care in this country. It is no wonder for many, that workouts can be a challenge. Also, as Arnold Schwarzenegger so wisely said in the FrameWork forward, “I have really come to appreciate how the body is a dynamic, ever-changing structure that is different at different times. At 30 you need a different approach to fitness than when you were a teenager”. His workouts have evolved with him and even the Terminator himself has had to visit the repair shop. So, how can you be more durable, with less risk of breakdown? FrameWork offers 7 easy steps that can benefit everyone, young and old.

In FrameWork, I outline a comprehensive plan for optimal health and durability. In Step 1, a unique self-test (take the interactive on-line version of the self-test) asks the question “are you built to last?” and finds your individual “weak-links” (we all have them). These “weak-links” or points of vulnerability may be old injuries or ailments, suboptimal nutrition, genetics, lifestyle, workout design, mindset and more. They are like hidden land minds, just waiting to be found, waiting to rear their ugly heads and put you on the sidelines, rather than in the game. Step 2 thru 7 allow you to customize a program for your unique frame (based on the self-test and your own history) focusing on balanced workouts, frame-friendly nutrition and the important role of recovery and mindset. The program combines healing and restorative methods from the worlds of rehabilitation, martial arts, and yoga in a way never presented before. A “troubleshooting” section teaches you how to prevent, treat and safely work (out) around the “Top 20” sports medicine ailments from tendinitis and knee problems to back pain and pinched nerves. I also offer and insiders view of safely navigating the healthcare system, including a look into the very promising future for those with stubborn musculoskeletal issues. Most importantly, I use stories, drawn from my experience treating many wonderful athletes, entertainers and my many patients to help you better understand, and listen to your body- so that you can extend the warranty on your frame and it will be there for you when you go the distance.

Check out FrameWork (click here to purchase) and you won’t regret it. In fact, your frame will love you for it.

FitTip

Find your “weak-links” and get a body that’s “Built to Last”.

PS- Read what’s being said about FrameWork- Testimonials and advanced praise.