drric hiking for health 2011 (slide share edition)

Hiking for Health?!?

We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

“The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet, and in the

cause and prevention of disease.” ~Thomas Edison

Sedona

Enrique Saguil, MD

• Family Medicine West Suburban• Sports Medicine St Joseph• Medical Acupuncture UCLA• Integrative Medicine AZCIM• Yoga Teacher The Chopra Center• No affiliations with REI or Whole Foods Market• In Private Practice in Arlington Heights, IL• Author of Running Behind (release date 8/2012)

Take a Hike!!!

Q: What is the usual thing to look forward to with a doctor visit?

A: Praise or scolding, then a suggestion to lose weight, and follow up for another visit.

(Note: like a Mercedes dealership, with enough visits, we will eventually find something major, only problem is you can’t trade in your body!)

The First Health Approach

We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

Your TeamRic Saguil, MD

Jason Gruss, MDTom Jordan, RD

Katrina Christie, LCPCJennifer Green, NDJoe Musolino, DCAmy Iaquinta, DCNick Nowicki, DC

Emery Paredes, PTCourtney Day, EPYu Zhu, MD China

Mike Blumberg, LCPCAimee Weber, EP

You

nutrition

movemen

t

We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

First Health Associates

2010 S. Arlington Heights RdLL Suites

Arlington Heights, IL

Ric Saguil, MD

Now look at exercise/prevention.

• NOT COVERED ON INSURANCE• Your on your own (run/bike/swim)• Most of us -“school knowledge” of exercise,

(which could be dangerous) ….“leagues?”• If it was so good, why didn’t we stick with it last

new years resolution?• No place that’s close enough, cheap enough,

new enough or fast enough….but what about your neighborhood?....or backyard!!

Elk Grove

Swimming

Excellent for joints,Good for lung capacity

Limited by place and climateWatch skin conditions

Watch asthmaWatch shoulder injury

Biking

Good for jointsGood nature contact

Good to help “green living”Watch back/neck

Watch walletWatch speed/coasting

Running

Long developed community activityCan be done by any age

Addictive (positively-chi running)Watch the lower extremities

(Shoes!)

Yoga!

Ancient artPopularity high, lots of places

Low injury riskExcellent at cultivating relaxation response

Excellent flexibility/power/balance Detoxing

Still Growing with multiple styles

El Junque

Exercise Myths

1. You have to work up a sweat2. You have to work up to 4 minute miles3. You have to see gains fast4. Shoes are all the same5. Drink when you get thirsty6. You can have a heart attack….+/-!!!

Walking Stats and “gettin sweaty”

MET’s (cal/kg/hr):Sitting for this lecture= 1 METHiking= 6-7 MET Jogging 12min/mile 8 METBike 10-16 mph 6-10 METSwimming fast 6-10 MET

4 min mile=15mph5 min mile=12mph10min mile=6mph12min mile=5mph15min mile=4mph20min mile=3mph25min mile=2.5m/h

Adapted from Compendium of Physical Activities. Ainsworth, BE et al. Medicine and Science in Sports and Exercise. Vol 25, Pg 713 (1993) and Vol 32, S498 (2000).

Hiking

Forest Preserves are tax supportedThe fastest hikers burn as much as the slowest joggers

Slowing down can bring awareness to the rhythm of natureMoving away from technology cultivates the relaxation response (kids!)

Less chances for strain and overuse injuryWatch solitude (injury, dehydration, disorientation)

Watch animals

Equipment

• Shoes/Clothing• Packs• Map• Poles • Protection (think kids)

Shoes/Clothing

• Know your feet (pronator/supinator)• Get some assistance (foot doc, sports doc, ex

phys, running store, REI team member)• Choose shoes to match the foot and plan • Add an orthotic but plan on break-in• Choose clothing that wicks moisture and

protect from seasonal elements and the type of hiking you will be encountering….

Feet

• Pronators

• Neutral

• Supinators

Word of caution• Break them in………..if you find “hot spots” as

you were them at home, co-op member get to return without question or hassle! (Try that at Dicks Sports)

• Minimus running…..adapt slowly please!!

A Quicky with DrRic

• Having flat feet is ok (check out kids at a pool)• Adults get flatter with time and weight• Heel strikes on pavement can send shocks

back up the spine especially with poor posture • Proper shoes can dissipate the shock• “Gellin” can make cheaper shoes comfy• Proper socks for cushion, comfort and

absorption

Sundance

Poles and Packs

Poles good for heavy packs or arthritic knees/backs

Poles and arms take advantage of more muscle for work

A Quicky with DrRic

• Poles can “extend” your distance• 90 degrees at the elbow• Choke down as you go up• I like to “crutch it” as I go down• Keep your back straight! Pack or “Bare-Back”• Please tell the kids to use their back packs

properly or get combo backpack/coasters

Clothes to keep core temp stable

• Vents/pit zips• Moisture wicking• Detachable extremity• Light • Compressible (if long trips)• Flexible but durable

A Quicky with DrRic

• Shoes/socks - Jacket - shirt - pants – underwear (in descending order of importance)

• Or for just starting – shoes/socks and a light jacket

• Hats • More advanced – a puffy, windbreaker, rain

proof, pants to match, gators for brush, cover for the backpack, balaclava.

Spring Valley Nature Sanctuary

Shade and Air (just as important as clothing!!)

wrong

right

right

wrong

Sweat rate

• Depends on environmental condition (ambient temp, humidity, wind velocity)

• Clothing (insulation and moisture permeability)• Intensity of physical activity • Usually about 1.0-1.5/h (about 2% decrease in

body water/h if 150lb)• At 5%, gastric emptying reduced 20-25%• Sunburn retards skins ability to dissipate heat

Dehydration

• Athlete sweats 1-2 L per hour (33-66oz)• 2% water loss can impair fine motor skill and

judgement• At 104*-105*, altered cognition.• At 106*-107*, delerium,stupor, coma. (Marathon, Ironman)

• Suggestions are: carry 4 liters per day but it varies…

“That’s Hot…….

Carriers

Volume

4L= +/- 8.8lbs

Multiday trips???

That’s heavy baby!

2L

½ gallon or 1.89L

0.6L 0.35L 0.24L0.5L

Don’t forget the salt

A Quicky with DrRic

• 4-6 ounces(0.11-0.18L) every 20 minutes or ½ Liter/hour• Can’t trust thirst sensation (unless 2% fine

motor skill/judgement not important for the hike)

• Timing important for deep forest preserve or national park (ie Half Dome=14hours)

Starved Rock

Protection

Check shoe/clothes for hitch hikers!

DANGEROUS!!

!

A Quicky with DrRic

Aron Ralston -127 hours

Timing of hikes

• Weather.com• Weather.gov• Sunrise/sunset• 1-3 times a week for 30-60 minutes (30+minutes to achieve RR)• Or add resistance to burn more calories (depending

on your indivi resting metabol rate)• Diabetics can increase to 5x week for glucose control• Hypertensives can use breathwork twice a day

A Quicky with DrRic

IN

IN

OUT

OUT

Inhale/Exhale hiking exercise to cultivate “The Relaxation Response”

Devils Lake

RR

My ultimate reason for hiking it using nature to lower blood pressure, clear the mind, increase serotonin and encourage positive gene expression

Looking for the next level?

• Pick a spot that’s calling to you• Research the terrain and the challenges• Prepare local, add resistance, time your “summits”

to dovetail your schedule• Work on flexibility and region specific strength• Cross train/cross fit/personal programs• Nutritional assessment to “sync” with training• Seek guidance on how to develop a personal

training regime from knowledgeable people

Research

• Price• Time away• Seasonality• Difficulty level and goal setting

Loop Trail

One Way

Advanced training

• Increase in speed or resistance• Cross training (endurance and altitude work)• Flexibility is a universal improvement any

sport

Nutritional enhancement

• Standard American Diet is lacking in nutrient• In all cases of disease, poor nutrition is a

contribution• In many cases of performance plateau,

nutritional depletion is a contribution• See a registered dietician/sports nutritionist

Keeping Healthy = Think outside the BOX

• Maintaining low BMI Hiking• Eating properly (Andy Weil’s “Antiinflammatory Diet”)• Cultivating the Relaxation Response Hiking• Exercising Hiking• Sleeping 6-8 hours Hiking• Community/group tx (Dean Ornish says it helps)

….if you need help with the above, just ask my team at FHA!

First Health Associates

• Protection (long-term) is ultimately making a lifestyle change with education/guidance in

………..diet/movement/neutralizing stress.• Not one size fits all, sometimes “Steps” are necessary to

improve outcome while under the care of a qualified team.

We pride ourselves on developing a personal program with a multidisciplinary approach

to a sustainable lifestyle change.

FHA’s Steps of “Kaizen”

In making a change, everyone starts and ends at a different step, we help you get to the next one…..

………Hiking is another way to step up!

Starved Rock

10/1/11 2013

Take a Hike!!!!

We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

Next Lecture:Whole Foods Market Schaumburg

Initiating the First Steps to a Lifetime of ChangeSeptember 24th, 2:00 pm Call WFM

QUESTIONS?

COMMENTS?CONCERNS?