We’ve all done it. I’ve pointed to the top half of my abs to show a client where my “upper abdominals” ended and where my “lower abdominals” began. The truth is I just didn’t know any better at the time. That didn’t make me a bad person or even a bad trainer; it just meant there was something I wasn’t quite sure about. So where do the upper abdominals end and the lower abdominals begin? The answer is a lot simpler than you might think.
Abdominal muscles are differentiated between upper and lower by which part of the torso they move. Upper abdominals depress the ribcage and curl the thoracic spine into flexion (your upper torso), while lower abdominals control the pelvis (your lower torso). All abdominal muscles work together to provide stability to the midsection. However, exercises like posterior pelvic tilts and crunches are not the same in regards to recruitment patterns. A crunch, when done properly, is an exercise that primarily utilizes your upper abdominals (internal obliques and the rectus abdominus). The posterior pelvic tilt, when done properly, is an exercise that primarily utilizes your lower abdominals (external oblique muscles).
What about rotation? Rotation is primarily a function of the abdominal obliques with secondary assistance from a variety of other core stabilizers and movers more intrinsic to the spine. Pure rotation is a function of synergistic contraction between both upper and lower abdominals (internal obliques and external obliques) with stabilization provided by the transverse abdominus and the rectus abdominus. The external obliques are used on the side opposite the rotation while the internal obliques are used on the side the rotation is towards. Pure lateral flexion is a function of both the internal and external obliques working synergistically on the same side. In this case the quadratus lumborum is also at work.
Application
Axe chops (from left to right) primarily engage the external obliques on the left and internal obliques on the right. Axe chops (from right to left) will primarily engage the internal obliques on the left and the external obliques on the right. This is one simple way to ensure your client’s upper abdominals don’t become over developed compared to their lower abdominals. We see this muscle imbalance in our office weekly in low back pain patients even though it is easily prevented.
Thank you Chris Ostling PT, DPT for your assistance with this installment
Tuesday, April 27, 2010
Monday, April 26, 2010
Consult Before Exercise?
You hear it all the time; “Consult a physician before beginning an exercise routine”. It’s the smart thing to do. You are doing your diligence to consult a physician. But does your physician have a good understanding of what it really means to exercise? Chiropractors, Medical Doctors, and physical therapists are great resources for a variety of ailments. They attend years of schooling to gain a vast education regarding their field of study so that you can have piece of mind when soliciting their advice. Unfortunately, in those years of schooling, it is rare that these doctors are properly educated on exercise techniques. They are hardly exercise physiologists. It is important to choose carefully which professional’s advice you seek when considering an exercise program; they don’t all have the experience necessary to give you specific enough advice.
While this does not always hold true, the first thing to consider about your physician of choice is; does he or she exercise? If the person with whom you are consulting does not exercise regularly, how are they going to relate to you when questions arise regarding your workouts? Understanding the body’s physical response to exercise is one thing, but to understand the experience as an active participant is something totally different. It is okay to ask your doctor if he or she exercises regularly. Tell them you would like to start exercising and that you need someone with exercise knowledge and experience to provide you with the proper advice as to how to go forward with your routine. Also, let your doctor know that it is important to you that you understand how to get the results you expect from exercise. This statement is important because it lets a responsible doctor know that if he or she does not have experience writing exercise programs, his or her best advice is to refer you to someone who does.
Exercise is about much more than just lifting weights and getting your heart rate up. It is imperative that you practice proper form while performing various exercises. It is also important that you do not recklessly elevate your heart rate. Sometimes, working harder is not working smarter and it can be counter productive. As a dually licensed Chiropractor and Personal Trainer, I provide for my patients exercise programs following an extensive fitness assessment. It is impossible to prescribe exercises to a patient without a thorough assessment of their baselines. For many patients who truly want to pursue a lifestyle change for fitness, I often refer to credible Personal Trainers in the community who I know can handle the four to five day per week commitment they will need. Don’t be afraid to talk to a personal trainer at your local gym after you have clearance from your doctor to exercise. Ask the trainer about his or her qualifications; a good question to ask is, “who are you certified through?” ECITS, NASM, and ACSM are all credible certifications to listen for. Ask them if they have experience with someone like your self. Find out if the trainer knows how to accommodate for your injuries before enlisting his or her services. Trainers should be excited to answer your questions, if they seem disinterested, expect the same kind of attention during your training sessions.
Personal Training can be expensive, and maybe you can’t afford it. Asking a trainer’s advice on a gym floor is free. If a trainer in the gym is not with a client, it is in your interest to ask them any questions you might have, and it is in their interest to answer you.
Hopefully you now have a better understanding of who you should consult when considering a lifestyle change towards fitness. You have made a great decision and I commend you on it. Now protect yourself before you start. Ask the right questions to the right people, it will help you set goals and expectations. Remember, if it was easy, we would all be fit. You are doing the right thing by starting an exercise program. Just make sure you get the proper advice. If you have any questions or comments regarding this topic please feel free to contact me at my email, drsean@islandchiropractic.net
While this does not always hold true, the first thing to consider about your physician of choice is; does he or she exercise? If the person with whom you are consulting does not exercise regularly, how are they going to relate to you when questions arise regarding your workouts? Understanding the body’s physical response to exercise is one thing, but to understand the experience as an active participant is something totally different. It is okay to ask your doctor if he or she exercises regularly. Tell them you would like to start exercising and that you need someone with exercise knowledge and experience to provide you with the proper advice as to how to go forward with your routine. Also, let your doctor know that it is important to you that you understand how to get the results you expect from exercise. This statement is important because it lets a responsible doctor know that if he or she does not have experience writing exercise programs, his or her best advice is to refer you to someone who does.
Exercise is about much more than just lifting weights and getting your heart rate up. It is imperative that you practice proper form while performing various exercises. It is also important that you do not recklessly elevate your heart rate. Sometimes, working harder is not working smarter and it can be counter productive. As a dually licensed Chiropractor and Personal Trainer, I provide for my patients exercise programs following an extensive fitness assessment. It is impossible to prescribe exercises to a patient without a thorough assessment of their baselines. For many patients who truly want to pursue a lifestyle change for fitness, I often refer to credible Personal Trainers in the community who I know can handle the four to five day per week commitment they will need. Don’t be afraid to talk to a personal trainer at your local gym after you have clearance from your doctor to exercise. Ask the trainer about his or her qualifications; a good question to ask is, “who are you certified through?” ECITS, NASM, and ACSM are all credible certifications to listen for. Ask them if they have experience with someone like your self. Find out if the trainer knows how to accommodate for your injuries before enlisting his or her services. Trainers should be excited to answer your questions, if they seem disinterested, expect the same kind of attention during your training sessions.
Personal Training can be expensive, and maybe you can’t afford it. Asking a trainer’s advice on a gym floor is free. If a trainer in the gym is not with a client, it is in your interest to ask them any questions you might have, and it is in their interest to answer you.
Hopefully you now have a better understanding of who you should consult when considering a lifestyle change towards fitness. You have made a great decision and I commend you on it. Now protect yourself before you start. Ask the right questions to the right people, it will help you set goals and expectations. Remember, if it was easy, we would all be fit. You are doing the right thing by starting an exercise program. Just make sure you get the proper advice. If you have any questions or comments regarding this topic please feel free to contact me at my email, drsean@islandchiropractic.net
Monday, April 19, 2010
Exercise Injury Prevention, the Proper Warm-Up
If you exercise even semi-regularly, the chances are you know someone who warms up improperly. It is also likely that you see that someone in the mirror every morning. The fact is, if you know that a warm up is necessary before exercise, whether you are performing it correctly or incorrectly, you are way ahead of the proverbial game. So, what are you doing wrong? Well, there are two major mistakes people make when warming up before a workout or an athletic event.
One common workout warm up mistake that people make is typically made by men. As a chiropractor who worked as a certified personal trainer for the last six years, I have seen literally hundreds of men "warm up" by performing one light set of a given exercise before progressing to full weight. The fact is this technique should be used as the very last step in the proper warm up.
The most common mistake that I see in the gym regarding a warm up is made by men and women alike. It's the cardio warm up. People who make this mistake come into the gym and hop on a bike, a treadmill, or an elliptical. They move for five to ten minutes to build a sweat, and then they get off and jump right into lifting weights. The fact is, again, this technique has a place in the warm up. The mistake is that alone this cardio warm up is really only the first step.
Put simply, the term "warm up", is poor word choice. I prefer to call it "readiness drills". The purpose of readiness drills is to acclimate the body to the tasks you are about to ask it to accomplish. Let's use baseball as an example. If you ever attended a Major League game and you got there early enough to watch the players go through readiness drills, you would watch the players start their days by running slowly. The purpose of running slowly is to gradually increase blood flow, thus increasing body temperature. Once the muscles have become more flexible from the increased blood flow, players build towards top speed without risking injury. After they have acclimated themselves to running straight, you would see these professionals start moving in all directions that their body could possibly be asked to move during the game. They used the same slow progression of effort to progress to full speed in all aspects and skills involved in a game. You should be doing the same thing. A typical day of readiness drills for my patients and clients include a multitude of exercises including a cardio sweat, body squats, ball slams, pushups, and pull ups. Depending on the exercise program or sport of the day, more specific tasks are used as well.
Your readiness drills should reflect what your workout plans to accomplish. Step one, build the sweat, this is for the cardiovascular and muscular systems. Step two, move the body without extra weight in ways it will be asked to move when you exercise. This is for the nervous system. Step three, lift light weights and build up to your heaviest weight of the day for a specific movement gradually. This brings everything together. Now you are ready to exercise. A typical day of readiness drills should take between 10 and 20 minutes. The changes your body undergoes due to the readiness drills lasts only about 20 minutes once you begin resting. Keep this in mind when you exercise.
For information regarding Chiropractic care and training offered at my office check out my website.
www.islandchiropractic.net You can make an appointment request right form the web!
One common workout warm up mistake that people make is typically made by men. As a chiropractor who worked as a certified personal trainer for the last six years, I have seen literally hundreds of men "warm up" by performing one light set of a given exercise before progressing to full weight. The fact is this technique should be used as the very last step in the proper warm up.
The most common mistake that I see in the gym regarding a warm up is made by men and women alike. It's the cardio warm up. People who make this mistake come into the gym and hop on a bike, a treadmill, or an elliptical. They move for five to ten minutes to build a sweat, and then they get off and jump right into lifting weights. The fact is, again, this technique has a place in the warm up. The mistake is that alone this cardio warm up is really only the first step.
Put simply, the term "warm up", is poor word choice. I prefer to call it "readiness drills". The purpose of readiness drills is to acclimate the body to the tasks you are about to ask it to accomplish. Let's use baseball as an example. If you ever attended a Major League game and you got there early enough to watch the players go through readiness drills, you would watch the players start their days by running slowly. The purpose of running slowly is to gradually increase blood flow, thus increasing body temperature. Once the muscles have become more flexible from the increased blood flow, players build towards top speed without risking injury. After they have acclimated themselves to running straight, you would see these professionals start moving in all directions that their body could possibly be asked to move during the game. They used the same slow progression of effort to progress to full speed in all aspects and skills involved in a game. You should be doing the same thing. A typical day of readiness drills for my patients and clients include a multitude of exercises including a cardio sweat, body squats, ball slams, pushups, and pull ups. Depending on the exercise program or sport of the day, more specific tasks are used as well.
Your readiness drills should reflect what your workout plans to accomplish. Step one, build the sweat, this is for the cardiovascular and muscular systems. Step two, move the body without extra weight in ways it will be asked to move when you exercise. This is for the nervous system. Step three, lift light weights and build up to your heaviest weight of the day for a specific movement gradually. This brings everything together. Now you are ready to exercise. A typical day of readiness drills should take between 10 and 20 minutes. The changes your body undergoes due to the readiness drills lasts only about 20 minutes once you begin resting. Keep this in mind when you exercise.
For information regarding Chiropractic care and training offered at my office check out my website.
www.islandchiropractic.net You can make an appointment request right form the web!
Thursday, April 15, 2010
Bending Your Knees to Lift... Just the Beginning
You have heard it before. “Bend your knees when you pick that up or you’ll hurt your back.” Well, that’s true, to a degree. The fact is though, simply bending your knees is not enough to prevent low back injury.
The reason chiropractors, physical therapists, and personal trainers alike advise bending your knees is because they do not want you to put stress on your low back. The thought is that bending your knees will shift the stress from the back to the knee, but this is not always true. Don’t get me wrong, you should always bend your knees when lifting, but there are other things that must be done as well.
To understand what you need to do to protect your back, you will first need to understand some basic bio mechanics. I promise to keep it very simple. You have 24 vertebrae sitting directly on top of one another that make up your spine. Your spine rests on top of a bone called the sacrum. The sacrum is positioned directly in between two bones called the pelvic bones. In between each of the 24 vertebrae and where the spine meets the sacrum is a disc which you have probably heard of before. While the vertebrae and the sacrum are bones, the discs are made of cartilage and fluid that is structurally not much different than a jelly doughnut; they are hard on the outside and soft in the middle.
Simply put, those vertebrae work together like a spring when you bend over. Imagine bending a spring back and forth over and over again. While that spring might be very strong at first, over time, it would weaken and eventually break. Most commonly with bending, the injury is to your disc. Imagine squeezing a jelly doughnut on one side, all the jelly would squirt out the other direction. This is a simplified example of a bulging or herniated disc. So how do we prevent this from happening?
The answer is very simple. Your back shouldn’t move. Your vertebrae shouldn’t be asked to bend on one another. Discs should not be squeezed on either side. The best way to prevent this is by bending from the hips and the knees at the same time. In case if you weren’t clear on where your hips are, they are the place where your legs attach to your pelvis. Run your hands down your sides, the first bone they come in contact with is the pelvis, as you continue to move your hands down towards your feet you will feel two large round bones, those are your hips. When lifting large, awkward objects from the floor, it is often advisable to drop to one knee in order to get the object off of the floor. For smaller objects or for objects that are located in an elevated position, bending at the hips and knees is advisable.
The first important point when lifting objects from below your hip height is the most simple. Stand close! I mean really close. You want the object that you are about to lift to be located as close to your legs as is possible. The closer the object is to your legs, the less it stresses your spine. Also, to avoid twisting, make sure whatever you are about to lift is directly in line with your belly button at all times.
Avoiding twisting when you lift...
Next comes the pelvic tilt. I give my patients a visual aide for this movement. You want to visualize yourself breaking a sheet of glass with your butt. Imagine that you are standing directly in front of a glass window, and you want to break it without bending your knees. You will have to thrust your butt backwards which will create a very stable arch in your low back. Once you have shifted your pelvis in this manner, your focus should be to continue to squat while reaching backwards with your butt as if you were hovering over a public toilet. Pairing the pelvic tilt with the squat will enable you to lock your lower back from any movement and thereby protect it from any injury! This will take practice to perfect, which is why I recommend to my patients that they practice the squat without weight daily.
So let’s recap. The first step in lifting an object is to stand close to it and make sure it is right in line with your belly button. The second step is tilt the pelvis forward to lock the low back. The third step is to squat while reaching your butt backwards the whole time as if hovering over a public toilet. If the object is too large or too low to squat down to, drop to a knee before lifting. My last piece of advice in regards to lifting is very easy to remember. If it’s too heavy, get help with it!
Every day people hurt themselves performing activities that should not cause them any pain or discomfort. If your form while performing these activities is perfect, you significantly reduce your likelihood of becoming one of these people. I recommend that you practice this technique a few times without any weight before you attempt to lift any objects in this manner. At first it will feel strange and unnatural. Give it time. You will quickly begin to take notice of how much better your low back is feeling, and you will be able to attribute that improvement directly to your new lifting technique. I wish you the best of success with this lifestyle change on your way to better health.
Forward any questions regarding this article to drsean@islandchiropractic.net
Dr. Sean Pastuch, D.C.
The reason chiropractors, physical therapists, and personal trainers alike advise bending your knees is because they do not want you to put stress on your low back. The thought is that bending your knees will shift the stress from the back to the knee, but this is not always true. Don’t get me wrong, you should always bend your knees when lifting, but there are other things that must be done as well.
To understand what you need to do to protect your back, you will first need to understand some basic bio mechanics. I promise to keep it very simple. You have 24 vertebrae sitting directly on top of one another that make up your spine. Your spine rests on top of a bone called the sacrum. The sacrum is positioned directly in between two bones called the pelvic bones. In between each of the 24 vertebrae and where the spine meets the sacrum is a disc which you have probably heard of before. While the vertebrae and the sacrum are bones, the discs are made of cartilage and fluid that is structurally not much different than a jelly doughnut; they are hard on the outside and soft in the middle.
Simply put, those vertebrae work together like a spring when you bend over. Imagine bending a spring back and forth over and over again. While that spring might be very strong at first, over time, it would weaken and eventually break. Most commonly with bending, the injury is to your disc. Imagine squeezing a jelly doughnut on one side, all the jelly would squirt out the other direction. This is a simplified example of a bulging or herniated disc. So how do we prevent this from happening?
The answer is very simple. Your back shouldn’t move. Your vertebrae shouldn’t be asked to bend on one another. Discs should not be squeezed on either side. The best way to prevent this is by bending from the hips and the knees at the same time. In case if you weren’t clear on where your hips are, they are the place where your legs attach to your pelvis. Run your hands down your sides, the first bone they come in contact with is the pelvis, as you continue to move your hands down towards your feet you will feel two large round bones, those are your hips. When lifting large, awkward objects from the floor, it is often advisable to drop to one knee in order to get the object off of the floor. For smaller objects or for objects that are located in an elevated position, bending at the hips and knees is advisable.
The first important point when lifting objects from below your hip height is the most simple. Stand close! I mean really close. You want the object that you are about to lift to be located as close to your legs as is possible. The closer the object is to your legs, the less it stresses your spine. Also, to avoid twisting, make sure whatever you are about to lift is directly in line with your belly button at all times.
Avoiding twisting when you lift...
Next comes the pelvic tilt. I give my patients a visual aide for this movement. You want to visualize yourself breaking a sheet of glass with your butt. Imagine that you are standing directly in front of a glass window, and you want to break it without bending your knees. You will have to thrust your butt backwards which will create a very stable arch in your low back. Once you have shifted your pelvis in this manner, your focus should be to continue to squat while reaching backwards with your butt as if you were hovering over a public toilet. Pairing the pelvic tilt with the squat will enable you to lock your lower back from any movement and thereby protect it from any injury! This will take practice to perfect, which is why I recommend to my patients that they practice the squat without weight daily.
So let’s recap. The first step in lifting an object is to stand close to it and make sure it is right in line with your belly button. The second step is tilt the pelvis forward to lock the low back. The third step is to squat while reaching your butt backwards the whole time as if hovering over a public toilet. If the object is too large or too low to squat down to, drop to a knee before lifting. My last piece of advice in regards to lifting is very easy to remember. If it’s too heavy, get help with it!
Every day people hurt themselves performing activities that should not cause them any pain or discomfort. If your form while performing these activities is perfect, you significantly reduce your likelihood of becoming one of these people. I recommend that you practice this technique a few times without any weight before you attempt to lift any objects in this manner. At first it will feel strange and unnatural. Give it time. You will quickly begin to take notice of how much better your low back is feeling, and you will be able to attribute that improvement directly to your new lifting technique. I wish you the best of success with this lifestyle change on your way to better health.
Forward any questions regarding this article to drsean@islandchiropractic.net
Dr. Sean Pastuch, D.C.
Tuesday, April 13, 2010
Getting Ready for Activity: Stretching... The Truth
Take yourself back to gym class. you're standing there reaching down and stretching towards your toes, sneaking peacks around the room to see how flexible your peers are, The whistle blows and it is time to start breaking into teams and playing the game of the day. After all, you are all stretched out now, so athletic activity is safe. Or is it?
Unfortunately, the act of stretching statically, which many of us consider common sense for injury prevention, is simply ineffective before athletic performance. Any time we exercise, there is a definite objective, a goal towards which we are striving. When we stretch, the goal is typically to "get loose" or to "warm up" before athletic acivity. Static stretching is the act of stretching a given muscle and holding it for an extended length of time. Contrary to much common belief, this type of stretching is not an effective way to warm up. In fact, static stretching before athletic activity can hinder performance. So why do we still do it?
In the past, it was believed that static stretching allowed muscles to lengthen, thus giving the athlete more range of motion through which he or she could move without risking injury. The latest research however is saying otherwise. Recent research has shown that static stretching will not improve range of motion. It will however allow an athlete to move further through a range of motion without experiencing pain. In exchange for this pain free range of motion, the athlete's performance is negatively effected. While it defies common sense, this claim is easily explained. There are advantages to limiting range of motion in athletics, and there are advantages to experiencing pain when this range of motion is exceeded. I'm going to use a sprinter to further illustrate this example. World class sprinters do not stretch their hamstrings past the range of motion that they use in competition. The reason is preservation of a principle called the elastic component of muscle. The elastic component of muscle defines a given muscle's ability to lengthen and shorten without injury. When we stretch a muscle statically, we reduce its elastic component. Let's go back to our sprinter. The most successful sprinters are the ones who generate the most force between their foot and the ground with each stride (provided the force is generated in the direction opposite of that the runner wants to move). Most of this force is created at the gluteals and the hamstring muscles, as they are the strongest extensor muscles of the leg. Maintaining relatively tight, or short hamstrings ensures that the sprinter's leg will fire into extension with the most force possible.
To understand this principle, picture a rubber band. The tighter you pull a rubber band, the more force is snaps back with. However, if you took that same ru bber band and held it in a stretched position for 30 seconds like we do our muscles, the ability to snap back with any significant force would be greatly reduced. Your body understands this principls; it is one of the reasons pain is experienced when we ask our bodies to work at high levels in expanded ranges of motion. The pain we feel in our muscles is experienced as a protective mechanism.
You might be wondering what you should do before athletics now if you shouldn't be stretching. In my next blog I'll talk about the importance of a proper warm up. Or as I call it, readiness drills.
I look forward to your questions and comments regarding this blog post.
Unfortunately, the act of stretching statically, which many of us consider common sense for injury prevention, is simply ineffective before athletic performance. Any time we exercise, there is a definite objective, a goal towards which we are striving. When we stretch, the goal is typically to "get loose" or to "warm up" before athletic acivity. Static stretching is the act of stretching a given muscle and holding it for an extended length of time. Contrary to much common belief, this type of stretching is not an effective way to warm up. In fact, static stretching before athletic activity can hinder performance. So why do we still do it?
In the past, it was believed that static stretching allowed muscles to lengthen, thus giving the athlete more range of motion through which he or she could move without risking injury. The latest research however is saying otherwise. Recent research has shown that static stretching will not improve range of motion. It will however allow an athlete to move further through a range of motion without experiencing pain. In exchange for this pain free range of motion, the athlete's performance is negatively effected. While it defies common sense, this claim is easily explained. There are advantages to limiting range of motion in athletics, and there are advantages to experiencing pain when this range of motion is exceeded. I'm going to use a sprinter to further illustrate this example. World class sprinters do not stretch their hamstrings past the range of motion that they use in competition. The reason is preservation of a principle called the elastic component of muscle. The elastic component of muscle defines a given muscle's ability to lengthen and shorten without injury. When we stretch a muscle statically, we reduce its elastic component. Let's go back to our sprinter. The most successful sprinters are the ones who generate the most force between their foot and the ground with each stride (provided the force is generated in the direction opposite of that the runner wants to move). Most of this force is created at the gluteals and the hamstring muscles, as they are the strongest extensor muscles of the leg. Maintaining relatively tight, or short hamstrings ensures that the sprinter's leg will fire into extension with the most force possible.
To understand this principle, picture a rubber band. The tighter you pull a rubber band, the more force is snaps back with. However, if you took that same ru bber band and held it in a stretched position for 30 seconds like we do our muscles, the ability to snap back with any significant force would be greatly reduced. Your body understands this principls; it is one of the reasons pain is experienced when we ask our bodies to work at high levels in expanded ranges of motion. The pain we feel in our muscles is experienced as a protective mechanism.
You might be wondering what you should do before athletics now if you shouldn't be stretching. In my next blog I'll talk about the importance of a proper warm up. Or as I call it, readiness drills.
I look forward to your questions and comments regarding this blog post.
Monday, April 12, 2010
Welcome
Welcome to my blog! I look forward to providing you with some insightful information regarding self improvement and the reclamation of your mind and body. I'm a Chiropractor in Hicksville, it's a town on Long Island in New York. For the past six years I have been working as a certified personal trainer, and early this year I opened my very own private chiropractic practice. On this blog I plan to field questions regading health topics. If I can't answer them, I'll be honest and let you know that I'm the wrong guy to ask. If I can answer them, I promise your questions will be answered thoroughly. I've been working to better myself every day since I realized that I had the choice to do so. I hope that my experiences and my education can help you with your endeavors. I'll wait a day or two for some response to this initial blog to generate and I'll evaluate what direction you want me to start heading in. If I don't get sufficient responses, I'll start with talking about exercise options alternative to the gym.
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