Cecily’s Tip for the Month 

Do more exercise than you think you need to do!

Make every activity you do in your day matter!

You can never do enough!

Osteoarthritis is also known as degenerative arthritis. It is a disease state of the joint cartilage which lines your joints and causes painful inflammation and deterioration.

Osteoarthritis, usually found in elderly people, develops mainly as a result of the continuous wearing away of the cartilage in a joint. It is very often associated with an old injury where the cartilage of the joint was damaged.

It is the most prevalent form of arthritis, characterised by pain and stiffness (especially after exercise), swelling, deformity, and/or a diminished range of motion.

Bone growths or spurs may develop on the margins of affected joints, increasing pain and decreasing mobility. There may be audible cracking or grating noises when the joint moves.

As you age, the water content of your cartilage decreases, thus causing the cartilage to be less resilient. The collagen fibers of the cartilage can become susceptible to degradation and thus exacerbate the degeneration. Inflammation of the surrounding joint capsule can also occur, though often mild. This can happen as breakdown products from the cartilage are released into the joint space and the cells lining the joint attempt to remove them. New bone outgrowths, called "spurs" can form on the edges of the joints, possibly in an attempt to improve the congruence of the cartilage surfaces. These bone changes, together with the inflammation, can be both painful and debilitating.

Some people are affected at a younger age but if you live long enough, you will definitely have signs of osteoarthritis in your skeleton.

There are 2 types of Osteoarthritis:

Primary Osteoarthritis

This is a chronic degenerative disorder related to ageing. As you age, you lose fluid from the matrix of your cartilage causing its resilience to decrease. Inflammation of the surrounding joint capsule occurs and spurs can grow on the edges of the joints.

Secondary Osteoarthritis

This is also a chronic degenerative disorder related to ageing and the changes are ultimately the same but usually more severe. It is usually associated with  previous injury, joint infection, diabetes, hormonal disorders, obesity, an inflammatory condition, ligament deterioration or various chronic diseases.,

• Regardless of the severity or location of your OA, conservative measures such as weight control, appropriate rest, exercise and the use of support devices can be beneficial.
• Regular exercise such as walking, swimming, cross trainer work in the gym or other low impact activities, are hugely beneficial.
• You have to do regular stretching/ strengthening exercises at least twice weekly.
• Weight loss will relieve joint stress and delay inevitable progression of the disease.
• Improved nutrition regarding possible ‘trigger foods’ is very important.
• You must hydrate yourself efficiently.

Cecily is a 78 year old lady, my mother. She is the mother of 7 children and has 24 grand children. She has been successful in everything she has done in her life and her motto is to ‘make every moment in your life count’!

When walking, hold your tummy tight and hold a strong, erect posture. Breathe deeply using your diaphragm and walk with intention. That way every step will count as a part of your daily exercise program!

Remember, the journey of a thousand miles begins with a single step. Exercise works the same way. Taking that first step will probably be difficult especially if you’ve never exercised. What you need to know is that it's never too late. Try not to use the old excuses not to exercise!

• Too old
• Too fat
• Too weak
• Too sick
• Too busy
• Too tired

With few exceptions, even if you're disabled or injured, you can still improve your level of fitness. Once you get going, you'll be amazed how quickly your excuses fade as you’ll be enjoying the health benefits so much! You have the goal of improving your cardiovascular fitness as well as decreasing the amount of body fat stored around your abdomen.

I give you all the help you could possibly need in The Actively Ageing ‘Kit’. You will easily be able to design an exercise program which can be endorsed and overseen by your Physiotherapist and Doctor.

Now is the time to make the change! Your diabetes will not get any better until you make the decision to change your lifestyle so DO IT TODAY!

The aim of treatment is to control your blood glucose levels and to prevent long term problems associated with diabetes--such as heart disease.

Healthy eating and exercise are the first steps to getting blood glucose levels and blood pressure under control.  If blood glucose levels are not well enough controlled with diet and exercise, anti-diabetic tablets may be necessary. Many people with Type 2 diabetes will also require insulin injections at some stage to manage their diabetes.

What Can I Do to Prevent Diabetes?

• Become more physically active
• Eat healthily (low fat, high fibre, low GI)
• Maintain a healthy waist circumference (men < 94 cm and women < 80 cm)
• Stop smoking
• Drink only in moderation

Initially insulin is still being produced by your pancreas, but it is less effective than normal. This is called insulin resistance and is an inherited characteristic made worse by carrying extra body fat.  Because insufficient insulin is available for glucose to move from your blood stream into your body cells and liver, excess glucose remains in the blood stream resulting in higher than normal blood glucose levels (BGLs).

After several years of diabetes, your pancreas may become “exhausted” and produce less insulin.

• Excessive thirst
• Frequent urination
• Feeling tired and lethargic
• Slow-healing wounds
• Itching and skin infections
• Blurred vision
• Mood swings

Research has shown Type 2 diabetes to be progressive, that is, it can get harder to control your blood glucose levels. Therefore tablets and insulin may be required to manage this disease later on. 

However, the fact is that the symptoms of diabetes may not appear until blood glucose levels are dangerously high so it is common to have diabetes and to have sustained organ damage without knowing you have it.

Diabetes is a condition where your body is unable to automatically regulate its blood glucose levels, resulting in too much glucose in your blood.

Glucose comes from foods containing carbohydrates (starches and sugars) e.g. breads, biscuits, cakes, cereals, dairy foods, fruits and some vegetables. It travels in the blood stream to your muscles and other organs where it is used as fuel. Any excess glucose goes to your liver where it is stored for future use. Glucose is your body’s preferred source of energy and your body needs it to work efficiently.

There are 3 types of Diabetes:

• Type 1(juvenile onset diabetes),
• Type 2 (mature onset diabetes)
• Gestational Diabetes (occurring during pregnancy)

The most common form of diabetes is Type 2 diabetes. 
It usually occurs in people over 30 years of age but it may occur in overweight teenagers and children with a family history of diabetes. Diabetes can be hereditary and is triggered by aspects of lifestyle such as being overweight and being sedentary.

People with Type 2 diabetes are more likely to carry excess weight, especially around the middle and have high blood pressure.  They are also more likely to have both high cholesterol levels and heart disease. This is called the “metabolic syndrome”

Unless blood glucose levels are very high, symptoms may not occur, so many people with Type 2 diabetes may not be aware they have diabetes.      
It is important to know if you have Type 2 diabetes.

Before you plunge into any kind of strength training, you must become familiar with the fundamentals of weight training techniques which will help form the basis of your exercise regime.
As a general rule of thumb, start working the larger muscle groups first, using compound movements which employ more than one muscle group to lift the weight. From here, you should progress toward the smaller muscle groups which need less energy, focussing more on isolated movements which target  particular muscles.

1. Consult your doctor prior to embarking on your strength training programme.
2. Smooth, flowing movement is essential to the safe and effective lifting of weights.
3. Set aside 5 minutes at the beginning and the end for your 'warm-up' & 'cool-down.'
4. Always pay attention to your 'form' and the safe use of any equipment you're using.
5. Controlled diaphragmatic breathing is essential for maximum efficiency.
6. Engage your 'core stabilizers'.
7. Avoid lifting too much weight too soon. You might think you are capable but you'll suffer for 2 or 3 days as a result!
8. Limit the time spent on training until your muscle bulk has built up 20 -30 mins.
9. Do 3 sets of 8 to 10 reps of each chosen exercise.
10. Spread your workouts out evenly over the week.
11. Always stretch before and between exercises.
12. Try to take your muscles through large ranges of movements.
13. Make sure you drink enough water before, during and after your session.
14. Nourish yourself with enough protein for muscle bulk development and minerals for bone strength.
15. Most of all enjoy thte feeling of improving the composition of your body!

Spend 10 minutes every day ‘marching’ around the house. This pounding on the floor will stimulate your bones to strengthen. You can break it up into 2 minutes at a time or do it all at once. You have a calendar in your Workbook so mark it off (10 minutes) every day!