HEALTH FARMING
( By Dr. Krishna Murari Modi )

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1-Physical Fitness: A Personal Responsibility

Agility, endurance, flexibility and strength are the test of fitness. A combination of qualities that enables a person to perform well in vigorous physical activities leads to physical fitness. Healthy people may be physically unfit because they do not exercise regularly. Good health and physical fitness are the same. Individuals who are physically fit tend to be slenderer and develop greater resistance to disease and recover faster if they do become ill. They are more alert and relaxed. Physical fitness is a personal responsibility. Most people are physically unfit because they simply do not get sufficient exercise. The years between adolescence and middle age are the peak period for physical fitness. Habits that aid physical fitness include getting enough sleep eating properly, receiving regular medical and dental care, and maintaining personal cleanliness. Health can harmed by overeating or eating the wrong kinds of food; smoking; drug abuse and excessive alcohol. Fitness during childhood influences fitness as an adult.

Exercise

Which is the most "expensive time" spent in the day’s routine?

Is it earning livelihood? Is it the time you spend for religious duties or listening to religious discourses? Is it the time you spend for recreation in a club or a cinema hall?

Is it the time you spend doing social work or carrying out duties for your community?

The answer is : the time you spend on exercise.

Life is too fast. Everybody is on the run. Nobody seems to give a thought to his health. It is high time we said : STOP - THINK- start your exercise today. Push yourself, discipline yourself to do exercises every day for just one month and then you will get into the habit. It must become a second nature to you. Then all the doors of happiness will open, you will live and enjoy every moment of it. The history of exercise goes back to man thousands of years.

In the third century B.C., Brahmin physicians believed chiefly on natural therapeutics (including exercise) for different parts of the body. An ancient book called "Mallayudha" mentions the scope of exercise and refers to the cure by manipulation if something goes wrong while doing strenuous exercises. Believes of the Indian system of exercise like wrestling, Dand Baithak, Mugdar etc find courage from Hanuman and they pray to him for strength.

"Cong Fou" of ancient China was a series of ritualistic postures and motions prescribed by priests for relief of pain and other symptoms of ailments. Ancient Greeks had their God of Health ("Aesculapius") shrines built all over. There were in fact temples of health. The entire nation including their Kings, used to worship at these temples and keep their bodies fit, trim and beautiful.

The word exercise has taken its origin from the Greek word ascetis. An ascete was the man who exercised his mind and body. They considered the man in his entirety (I’homme tout entire) and emphasised that the mind and body were inseparable. They did exercises to develop their body, listened to good music and went to dramas to cultivate their mind. Those who exercised only to win a prize (althlon) were called athletes. Most of the exercises were done in a state of complete undress. The Greek work for nude is Gymnos, exercise performed in the nude was called gymnastics. Hippocrates, the father of modern medicine, said "the wasting of the fleshy parts" is the greatest in those cases in which the patient keeps the limb up and does not exercise it. Those who practice walking have least atrophy.

Frequent and rapid walks were recommended by him to reduce obesity. He ordered a cautious approach when resuming strenuous exercises after prolonged rest. Getting up early after delivery and walking about following child birth is not a new idea. Primitive people practiced it. In modern times we have come back to the idea of early ambulating and postpartum exercises to strengthen the abdominal wall.

Russian author, SP Bodkin, advocated breathing exercises for those who have suffered a heart attack so that they will not feel short of breath on slight exertion. Facilitation has been instituted as an adjutant to strengthen weakened muscles particularly in hemiplegics. They are useful for regaining control of voluntary muscles. People know how you look, you know you feel. By exercising, your appearance will improve, your sagging abdomen will sink in and your muscles will bulge. Your personality and gait will improve. There will be lightness in your step. You will feel like a new, youthful person.

Your endurance will grow, you will have feeling of well being, your mind will become more alert, you will have less nervous tension. A person has pulse rate of 72 beats per minute. If you take a short run or do vigorous exercise you will feel short of breath, and may not be able to run longer. The pulse at this stage may reach 140/mt. If you exercise regularly the pulse rate will gradually come down. In a week, a month, 3 months, one year you will note a marked reduction of pulse rate at rest. If you take a run or do vigorous exercises you will be able to run a longer distance or do exercise for a longer time before becoming breathless. This means that you are capable now of putting in more hours of work without getting tired. You will not feel fagged out or exhausted at the end of the day. Still a lot of energy will be in reserve for you to enjoy life, since you have become more vibrant, energetic and ready to suck the honey of life.

Most heart attacks and strokes come in the period of emotional stress. This may coincide with a set back in business or even while watching a tense world cup. During stress a hormone, called adrenalin, is secreted in the blood. Due to it, the pulse rate rises, blood pressure shoots up, blood becomes more viscous and blood sugar rises.

If you have been exercising regularly, you can cope up with all these stress signals. Exercising the heart can help you to cope up with emergencies much better. Exercise will make your heart stronger, it pumps out more blood with every pulse beat. The coronary artery of the heart muscles has many branches which are linked profusely by capillaries. During an emergency as the pulse rises, more bloods is pumped, all the capillaries open up and so there is no chance that the heart will have a lesser oxygen supply leading to its failure. The capillaries open up and the blood pressure will not shoot up high. When you exercise the sugar in the blood is burnt up and you are equipped better to cope up with such an emergency.

The blood vessels of a person who exercises, will have fewer fat deposits. Even if the coronary artery of such a person is blocked by floating fat, the heart will not be affected by lack of oxygen. This is possible because of a profuse branching out of coronary arteries and plenty of blood supply through the capillaries in the heart wall. Enough supply of oxygen will be maintained and the heart will not be infarcted.

The food you eat is either used, stored or discarded. When you fill up the petrol tank of a car, it overflows when full. If you eat 2,800 calories every day and use only 2,400 calories in routine work, 400 calories left will be stored. When you keep on storing what is left out, the unused energy, you start gaining weight. You will gain 1 lb. If you store about 4,000 calories. When you exercise, the fat is Converted into muscles, muscles are heavier than fat, so by exercises you may gain weight instead of losing it. But you will feel better and look better. The best way to reduce weight it to combine exercise with less calories in diet.

An old saying, " You are as old as your joints" From the feel to the head, a human being has many noiseless, flexible and strong joints. The arches of feel have great flexible, strength and suppleness. They carry the entire weight of the body from place to place, tirelessly. A series of small joints in the spine is the most important of them all. Due to their flexibility one can bend, twist or turn and still keep the strength and control over it. These joints become stiffer as you advances in age. You can remain young as long as you can keep your joints flexible with the help of exercise. Yoga exercises (Asanas)are the best for the mobility of the spine. Yoga strengthens the nervous system. The spine is like the battery of your body. If in use, you will keep it flexible. It makes you feel young and keeps all other functions of the body in a firm condition.

Learning Asanas with the help of a book sometimes can be dangerous. You are benefited by Asanas only when the "asan" or your sitting posture is correct while doing it. This is why it is always safer to learn Asanas from a good teacher. I do not recommend shrishasana (Head stand). People who can benefit from Shirshasana are only those who have good health. The weak will benefit the same by doing sarvang asana (Shoulder stand). If you spend 20 minutes a day doing the below mentioned Asanas you can remain disease free.



  1. Sarvangasana (Shoulder stand)
  2. Matsyasana (Fish pose)
  3. Halasana (Plough pose)
  4. Bhujangasana (Cobra pose)
  5. Shalabhasana (Locust pose)
  6. Dhanurasana (Bow pose)
  7. Pashchimottanasana (The forward bend)
  8. Ardha Matsyendrasana (The twist)
  9. Savasana (Corpse pose)


  • You need to exercise your:




    1. Shoulders and arms
    2. Abdomen and the back
    3. Legs
    4. Heart
    5. Lungs; and
    6. Blood vessels

    When we exercise, the respiration deepens and the heart rate increases. The circulation of blood increases due to increased heart rate. More oxygen is supplied to blood due to increased respiration. More blood, carrying more oxygen, reaches all parts of the body. Thus all the organs receive more oxygen, more nutrition from the circulating blood and more waste products are also carried away by this blood released by different organs of the body. Thus through exercises the general health of the body starts improving.

    During exercises, the muscles go on contracting and relaxing. The muscles constitute almost half of the total body. When they contract all the blood contained in them is expelled out. When they expand all the blood gushes in. The repetition of this process strengthens the muscles. The blood circulation is increased not only by muscular activity but other parts like the nerves system, the blood vessels, heart, lungs also play a role. The nerves supply to the wall of the heart and the blood vessels stimulates them to empty out more completely. Thus the heart vigorously pumps out more blood and the pulsating blood vessels carry it to different parts of the body, the minute branches of the blood vessels called capillaries which normally remain closed, open up. The blood reaches the most remote areas of the body also. A great deal of carbon dioxide is eliminated in this circulating blood by different organs. When this carbon dioxide reaches the lungs, it stimulates the lungs. The rate and depth of respiration increases. This increase in respiration helps increase the rate of exchanges between carbon dioxide and oxygen in the lungs. So increased demand by the body for oxygen is met and more waste carbon dioxide produced by the more active body is eliminated through the lungs.

    The lymph flow increases. The lymph which is a carrier for digested food works for the elimination of the body’s waste products. All the organs of elimination like the skin, kidney, bowels start functioning with a better capacity to cope with extra amount of work load. The skin becomes more active, the pores open up and more perspiration takes place. This, apart from eliminating urea, works as a cooling tower. The body which is getting hotter by doing exercises is cooled down by perspiration.

    The kidney gears itself up during exercises. The demand for water increases, you feel thirsty and more amount of urea and waste is eliminated in the urine. Thus the kidney becomes more active during exercises. The bowels are cleared more efficiently. If constipated, you get a clear motion. This happens due to the massaging effect on small and large bowels by the contracting abdominal wall. Diaphragm does a similar job from the top. The intestine has better peristaltic movements thus pushing the content of the bowels forward.

    So all the four great channels of elimination - skin, kidney, lungs and bowels work more efficiently and cleans the body from inside. It is better cleaning work than the one done from outside by taking a bath. The digestion and assimilation of food improves by exercise. Increased circulation helps in a better distribution of digested food. During exercise more nutrition is required. Old cells break down and new cells are formed. So in a way body is renewing itself all the time. For building up new muscles, material for building up cells is required. The body demands more food. Appetite increases. The liver and the pancreas are massaged by the diaphragm. The diaphragm is vigorously depressed and elevated by expanding and contracting lungs. The secretion of liver and pancreas increases and so more amount of digestive juices are available to digest the food. Thus by exercises the appetite increases and food is digested and assimilated better.

    The old muscle cell break during exercise, they are eliminated, new muscle cell are formed. These new cells are larger and stronger. The new muscle cells produce less fatigue poison called lactic acid. These cell are efficient and put less load on the eliminative organs of the body. The connective tissue tendons which connect muscles to bones get renewed. They help in improved muscle action.

    Through better circulation and more pull by contracting muscles, the bones become firmer, joints stronger and flexible. Stronger bones and flexible joints help in the smooth functioning of joints.The heart benefits by exercise. As the contraction and relaxation of the heart muscles are vigorous during exercise, these muscles are exercised and become stronger. The pumping capacity of the heart increases for two reasons:



    1. due to stronger heart muscles; and
    2. better nerve control

    The heart keeps on beating from birth till death. It does an enormous amount of work. The work done by the heart of a young man of twenty five in twenty four hour is enough to fit six tons of weight to the height of one foot. The heart does this job without tiring itself out. The beats are controlled by nerves which are not controlled consciously. There are yogis who can control their heart system through concentration. They can reduce their heart rate at will and even stop it for a few moments.

    The lungs receive more blood from the exercised heart. As more blood comes to lungs it has to purify faster and return it to the heart. For this purpose the breath comes faster and deeper. The lungs get adjusted to exercises. They expand more. The chest expansion becomes greater and new lung cells are formed. Lungs become bigger, more elastic so the capacity of the lung to take in more air improves. The intercostal muscles get developed, the ribs are raised higher during inhalation. Thus the capacity of the lungs increases. This can be noted by measuring the chest after breathing in and out. After doing exercises the girth of the chest gradually increases following inspiration (breathing in).

    Fatigue

    We have a good check fatigue to guide us. It works as a safety value as a limit to exercise. We can gauge the amount of exercise we should take for best results. Beyond that we begin getting fatigued. When we run or do exercises the breath becomes deeper. There is frequent bringing in of more oxygen into the lungs, which gets absorbed in the blood. Carbon dioxide form the blood gets eliminated in to the air while we breathe out. This increase in breath is called "second wind". If we keep on exercising, the oxygen supply and nutrition reaching the muscles compelling the body to discontinue the activity. Even after we stop doing exercise, the heart continues to beat faster and we still keep on breathing heavily till the 3worst of toxins are eliminated. This is known as acute fatigue and is quite uncomfortable for the body. It passes off gradually. The general fatigue will pass off in a few hours or after a night’s sleep.

    capacity and skill increase. This is known as training or conditioning. The level of training can be gauged by measuring the oxygen consumed and the lactic acid accumulation. A simple method has been devised. An efficient circulation of blood in a trained person is characterised by a slow rise in the pulse rate during exercises and a prompt return to resting condition after exercise. The pulse rate during severe exercise goes upto 140/mt. Five minutes after stopping the exercises it should come to normal. The pulse rate is also affected by emotion. This very simple test and can be used easily by any person. The test of physical fitness is a sure pointer to cardiovascular fitness.

    Among older people, the effect of training can likewise be demonstrated. During exercise the oxygen consumption increases, the pulse decreases progressively, but it is slower than in a young person.

    The fatigue is affected by following factors:



    1. Emotional stress: The relations you have with you superior or co-workers. A tense relationship can tire you faster.


    2. Temperature. In higher temperature, fatigue comes faster than in cold weather.


    3. Light. Less light tires us more easily.


    4. Noise. A noisy atmosphere tires faster.

    In an occupation where intellectual pursuits are involved, additional factors can affect a person.



    1. Basic interest. If you like doing your job, you will feel less tired doing it.


    2. Diverting the emotional factor. If you home life is congenial, if you take more interest in things around you, will feel less tired.


    3. Motivation influences. If you are rewarded for good results and get your promotions at the right time or when they are due to you, your efficiency is better.

    In exercises done for one month discernible changes occur. An increased supply of oxygen leads to better muscle metabolism. Glycogen depletion is much less from the muscles.

    If training is done for at least five months the muscle glycogen storage will increase by two and half times more than before the exercise started. A person who is exercising should be particular about his diet. He should take a high fat diet especially when he is young and growing. This will increase, the storage of glycogen in the muscles. The muscles can work for a longer time. The glycogen metabolism also slows down. This further reduces the speed of depletion of glycogen from the muscles.

    A high carbohydrate diet is not suitable for such a person because the total glycogen depletion takes place much faster and so they feel tired more rapidly.


    Age and Exercise

    Many people believe that exercise should be done only in childhood. The life process benefits all ages, though the type of exercise may differ. For children, games are the best, because they are interesting and every child likes to play. Children who get involved in studies and neglect games, should be encouraged to play games. If it is not possible then they should be coaxed to doing exercises. If the child plays a game where only legs are exercised then he should be taught exercises for upper parts of the body also. When a person completes his studies start doing exercises to keep fit throughout his life. This can be supplemented by games or gymnastics whenever possible.

    When a person approaches his fortieth birthday, he is at the peak of his productive period. He is too busy and comparatively richer, he is too busy to exercise and eats rich food. At this age the bodily function starts slowing down. Circulation of blood becomes sluggish, there is tendency to become obese and joints will start getting stiff. At this age, exercise is most important. It will slow down the ageing process. He can play badminton or golf which is comparatively less strenuous. If you have been strenuous exercises can be done during your middle age. But if you are going to start exercising after a long lay-off then you have to do so slowly.

    Amount of Exercise

    At the age of 60, this will depend more on the condition of your body. A few can still do a strenuous exercise if they have been regular. For others a brisk walk to keep the circulation going is good enough. Keep winding your body clock with the aid of exercises so that it will keep on running smoothly. If you have frail health then go slow and do simple exercise. In old age, the body is like a fatigued machine. It is difficult to start it, but gradually it goes on working smoothly.


    Motherhood and Exercise

    Exercises during pregnancy, lactation and menstruation should not be discontinued. Exercises during pregnancy keep the abdominal muscles firm and help for a painless and easy delivery. They can be modified in the last few weeks of the pregnancy. A few day’s rest will be necessary after delivery. Exercises done during lactation will keep the body in shape. During menstruation, exercises can be continued. If bleeding is profuse they can be modified.


    When to Exercise

    You should exercise any time of the day, when you are free. If you have a choice, the afternoon time is the best. After a day’s work the flexibility in the joints is more, so the exercise can be done easily.

    You can do them in the morning. At this point of time, the joints are a little stiff and the heart has slowed down after the night’s rest. You may do a little warming up before you start doing a strenuous exercise. There should not be any tiring of the body. For you will not be left with energy to do the day’s work.

    It can also be done before retiring to bed. It will refreshing for those who do mental work. Those who exert physically during the day it will be very refreshing, but do not forget to take your meal 2 hours before doing exercise. Do not take a heavy dinner.

    If the routine of work gives time for exercising twice a day, do some exercises in the morning for additional little exercise in the evening will give a full quota of day’s exercise.

    Exercises should never be done close to meal times. Vigorous exercises should be done atleast half an hour before or two hours after the main meal. When food is taken, the blood goes to the digestive organ and the nerve energy is diverted to it. If exercises are done just after a meal, the blood and nerve energy will be diverted to muscles and digestion will be impaired. It is better to give the body on e task at a time and then it functions better. If you want to do light exercises like walking or playing golf you can do it just after a light meal of curd and salad or soup and toast or fruits. But if you feel uneasy even after such a sparse meal follow the rule of half an hour after meals.


    Rest Day

    You need not exercise 365 days of a year. Take a day off every week, but do not keep on increasing the off days. Do not do extra exercise the next day if you have missed a day of exercise. If you have missed it for a week, do not think that it requires some rituals to start it again.


    When not to Exercise

    A useful weapon can be misused if you are over-enthusiastic. Do not exercise when you are ill. Rest is the best cure during illness. Stop there and then if you feel pain during or after exercises or if you have inflammation of certain joints give some rest for healing. You may feel sore the next day after exercises, this may happen when you are a beginner or over enthusiastic, take rest for a day and you will recover.

    If you are weak or too tired avoid active exercises you can take a passive exercise in the form of massage. Avoid exercises if you have a strain or a torn ligament. Rest for few days and you will come out of it. A few stretching exercises are permitted to keep up the mobility.


    Go easy on Exercises

    Start with exercises which are easy to perform. If you start with strenuous exercises to get quick results you will be disappointed. When you start exercises you will develop soreness, sprains or strain in your joints. Take few days’ rest. These are not permanent and they will pass off. Do not over exercise, do not use all your surplus energy for exercise, it may be destructive.


    Slow and steady wins the race

    Select the right exercises, do them properly and for a limited time. You can increase your exercises once a week. Know your limit. Always be sure that exercises you are doing can be done easily.

    Overdoing or underdoing exercises is bad. If you do not feel any increases in the strength or girth of your muscles steadily probably you are underdoing your exercises. Test yourself and you will know how far you can go.

    Start with 5 minutes of exercises if you are a beginner. The speed and the pause between exercises will determine what exercises are to be taken. You will be surprised to find out how much you can do in five minutes.

    You may increase your exercise time by two minutes every week do not exceed 2 minutes. This time is carefully chosen to keep you fit for physiological needs. The rate of exercises can be slowed or increased. If you feel you have not done enough exercise you can increase the speed till you feel exhausted. Select your exercises. Exercises done in a reclining position need more exertion than while standing. You can choose a special apparatus to exercise if you require support. If you are keen on muscles lay stress on muscles then keep on increasing the resistance.


    How to Exercise

    Bending upto a certain point is easy, beyond this point you feel tension in your muscles and if you still go further you will feel pain. Do you exercises upto the point of tension. If you keep on doing exercises the mobility of the joints goes on increasing. The point of pain becomes the point of tension in a few days and gradually you can still go beyond this point without pain.

    This principle has been used in exercising the patients with stiff joints passively. Movement and pain are indirectly related. A patient has more when the movement in the movement in the joint is less. With the help of exercises as he increases his movement, the pain goes on decreasing, ultimately he becomes pain free. If the movement is done upto the point of pain, the muscles become tense in protective response and desired result will not be achieved.


    Speed

    Do not exercise in a haphazard and careless manner. Exercises should be done carefully, gracefully and at the right speed. When you do exercises, do them with all concentration. At every moment your mind should know what your body is doing. You should not do exercises as a punishment. Enjoy doing them. You may do exercises along with music or select the right exercise for a particular time.

    Combine your exercises with breathing. It will enhance their good effect and do them when you are relaxed. Even a slight tension causes waste of nerve energy. Exercises should not be completed at a single go. After each exercise relax for a while. This will help your exercising muscles fill up with blood and circulation will equalise in all parts of the body. It will help the lungs to catch up and clear all fatigue poison from the blood.

    Alternate your exercise with games, boating or swimming to keep the interest alive. You can alternate exercise with yoga asana. Do exercise for one day and yoga asana the next. Yoga asanas make the body healthy and nerves strong.


    Sleep and Rest

    If exercises are important, so is rest. In fact both should alternate. After rest, you will feel energetic and this energy should be utilised for doing exercises. It is constructive for the body. If you do not utilise it either it is wasted or the body stops generating it.

    During rest, the body eliminates waste material, builds new cells and repairs the old ones. When you feel tired you must rest. If you have done the right amount of exercises you will get up fresh after a restful sleep in the right. The requirement of sleep differs for different people. Many can do with six hours others may need 8 to 10 hours. If you know to relax well, relax before your sleep, your requirement of sleep will reduce.


    Physiology of Exercise

    A strong and well built is a great asset in life. It helps to face adverse situations and to achieve greater heights in your professional career and day to day activities. A well worked out system of routine activity with an intelligent diet can lead you to higher attainments and help overcome mental and emotional difficulties and bring happiness from within.

    Better health and great physical power can be acquired by exercises and an adherence to certain rules. It does not come naturally as you grow to maturity. What is the most important factor in building a beautiful body and superb health? Food, what we eat is important. Food provides energy for daily work, helps in growth and provides vitamins and minerals which help us maintain good health.


    Breathing

    It is one of the most important factors required for building up the body. We can live without food for days, without water for a few days, but we cannot do without air even for five minutes. Pure air is an important factor for body building. Open up the windows in your bed rooms. Be sure there is fresh supply of air day and night. People are unnecessarily afraid of a draft. They think that a sudden cold will happen only if the body is weak and the body has less vitality.

    More and more people are regulating the temperature, humidity and ventilation of the room through air conditioners. At least, it helps in proper ventilation.


    Exercise and Growth

    We know that 50% of the body is made up of muscles. Proper exercise must be taken for their proper growth and development. When man exercises his body, he becomes muscular and when a woman exercises her body, it helps to become more rounded and curvaceous. Nature has made the woman’s body in such a way that muscles do not grow in the same way as the man’s muscles. Beauty and charm of a woman are greatly enhanced with exercises, and so is the case with the male counterpart.

    Many people think that better health comes from something unknown. This is not correct. It is clear now that superior health can be achieved by anybody who is prepared to make an effort and a small sacrifice.

    Many people seem to have more body energy and prolonged youth. This comes when they are lucky to have inherited it from their parents. They seem to abuse and misuse their body and still keep themselves healthy. They are, in fact, spending the vitality from their forefathers. But their progeny may have to pay the penalty. If we study the lives of people who had a long existence, the secret of their longevity is found in their diet and daily exercises. Women grow old much faster than men, because, by and large, men keep themselves more active.

    Many brain workers will say that they do not have time. It is not true. When you exercise you have a strong heart, strong stomach and so your brain also gets better nourishment. A strong mind, in a strong body. What exercise we do is not rally important. You choose an exercise and do it regularly, but, remember, it takes years to build a beautiful body.


    Walking is the Best

    Not everybody has gymnasium in the vicinity. The private ones are expensive. Still, if one cannot afford to go to a gym, the best alternative is to take a walk, a brisk walk or go jogging. This can be regulated according to age and strength. If you are sad or depressed, walk and walk deliberately and you will come out of your depression.

    If you have a problem or an emotional strain, get out of the house and go for a walk and you will be able to solve it. Walk and you will have time to think. Understand your problem and plan your strategy to make life better. Remember do not talk while you walk. Walking is an interesting activity. You may choose a different route every day, it will bring you in contact with nature, you will be able to see, feel and know it better. You will make many new friends and it will give you a feeling of sharing in human activities.

    It is good for old and middle aged people. Youngsters should make more strenuous exercises or jog vigorously. They should participate in games.


    Exercises for women

    Exercises for women are more important then for men. They gain strength and beauty. If they are strong, they impart strength to their children. If they are weak their children will be weak. Failing marriages can be traced to weakness in the body and low vitality. The failure in marriage will be less if the woman is more alive, more supple and bubbling with health.

    Swimming is a good exercise. In swimming every part of the body is exercised as you are free to move in all directions like a bird in the air. You are will exercise the things to make them slimmer and rounded. By doing exercises for breast, they can be made firm, bigger and rounded. One’s height cannot be much increased, but a better physique, an improved posture can give the impression of better height. A beautiful woman creates the impression of beauty by her physique, good posture, brightness in her eyes, fresh skin colour and the way she carries her body.


    Nerve and Exercises

    In modern life, man thinks he is working hard. Yes he does so but often without involving much physical activity. All kinds of modern conveniences make for a less energetic existence. A car restricts walking, an elevator makes stairs superfluous, mental work takes all the time. In fact new gadgets and conveniences have brought about a sudden change in man’s habits. Man was used to cutting wood, carry water and live under primitive conditions. Physical labour was involved at each step. A body used to hard work will not enjoy to be suddenly doing sedentary work. Sedentary habits put an unnatural pressure on the body. It is then that we are prone to nervous breakdown, insomnia, headaches and nervous ailments.


    Exercises and Businessmen

    Several businessmen will say, " I have no time for exercises". Exercises are as important as eating and sleeping. Businessmen who have taken to walking or golf are finding a wonderful release for their tension.

    If you do not have the time to take care of your most valuable possession - your body - then you will have plenty of time for being strapped to the sick bed and slowly planning for your funeral. If you look after the body well you will tend to be more ambitious, determined and energetic.

    A car needs an oil change, a regular supply of petrol and water and regular tuning. Your body is more sophisticated machine than that of a car and it deserves better care.


    Exercises to keep fit

    Selected exercises which could be done in twenty minutes with small rest periods are listed:

    1. Toe Touching
    Stand erect, feet together arm at side. Take a deep breathe. Raise head, breathe in deeply breathe out slowly as you go down. Touch the floor out side left foot, come up little and down again to touch floor between feet, and touch between feet once more. Come up and touch out side right foot. If you can not touch just move in that direction. Hold your breathe when you come up to the starting position. This exercise will strengthen your back and abdominal muscles. Start with 5 and go up 20 or more.

    2. Lateral Bending
    Stand erect, feet about thirty centimeters apart, left arm extended over head, bent at elbow. Breathe in deeply. Keeping the back straight bend sideways to the right and slide your right hand along the right leg as far as possible and at the same time press to right with left hand. Come up a few centimeters and press to right again. Breathe out as you come down. Hold your breathe coming back to starting position. Same way repeat to left. This exercise will help to trim things and waist. Start 5 and go up to 20 or more.

    3. Knee Raising
    Stand erect, feet together arm at side. Take a deep breath. Raise the left knee as high as possible, holding just below knee and shin with hands. Keep your back straight throughout. Breathe out slowly while raising the leg. Hold your breathe while coming to starting position. Repeat with the right knee. Do it five times and go up to 20 or more. It will help you abdominal and thighs muscles.

    4. Arm Circling
    Stand erect, feet about thirty centimeters apart. Swing both arms in circular motion clockwise. Breathe slowly and deeply throughout. This exercise will help arm muscles and to lift your breasts. Do it 20 times and go up to 50 or more.

    5. Squats
    Stand erect, feet slightly apart. Take a complete breathe in. Sit down to lowest possible level while breathing out. Raise your heels when you sit down. Hold your breathe while coming up. Repeat 10 times and go upto 30 or more. You can do the same exercise more effectively also by not raising your heels.

    6. Leg Raise
    Lie on back on hard surface. Arms on your side. Raise both the legs together without bending the knees as far as you can, and slowly try to achieve the right angle position, lowering and raising the legs slowly. Breathe in while in relaxed lying position, breathe out while lifting the legs, hold your breath while lowering the legs. Do it 5 times and go up to 15 or more. A good exercise to reduce your paunch.

    7. Sit Ups
    Lie on your back on a firm surface. Keep arm on your side. Legs straight and together. Keep your back as straight as possible and move to a sitting position. Slide hands along the legs during this movement, finally touch the toes. Breathe in while lying down and breathe out while coming up and touching the toes. Do not push yourself too hard while going to touch toes. Gradually you will do it better. Keep feet on floor, in the beginning, if necessary hook them under a chair. Five times and go up 20 or more. This is good for your bulging abdomen

    8. Slide Leg Raising
    Lie on your side, leg straight lower arm stretched over head along floor, top arm used for balancing. Raise upper leg as far as possible. Do not push too hard. Gradually your leg will reach a perpendicular position to the floor. Do half the number raising right leg. Breathe in while lying down. Breathe out while raising the leg, hold your breathe while bringing your leg down. Do it three times on each side and go up to 20 or more. This is a good exercise to reduce hips and thighs.

    9. Side Leg Overs
    Lie on your back, legs straight and together, arms stretched side ways at shoulder level. Raise the left leg to a perpendicular position, drop it across body and try to touch left toes with right hand, raise leg to a perpendicular position and return to starting position. Repeat the same movement with right leg. Keep body and legs straight throughout and shoulders touching the floor. Breathe in while lying down and breathe out during raising the legs and taking it across. Hold your breathe till you come to starting position. Do it 3 times with each leg and go upto 10 above. It is good for your thighs and hips.

    10. Chest And Leg Raising
    Lie flat on the floor, face down, arm on your side. Take a deep breathe in, raise your head, both shoulders and legs at the same time as far as possible. Keep legs straight. Breath out slowly as you raise your chest and legs up, hold your breath as you bring them down. This is good exercise to strengthen your back. Do it 5 times and go up to 12 or more.

    11. Push Ups
    This is the well known India "Dund". Lie on the floor facing down, hands under shoulders, palms flat on the floor. Straighten arms, lift the body and raise hips to highest point. This is the starting position. Then the head travels slowly down in the direction of the arm and after the nose has reached the floor level, then chin and chest are brought to the same level. Continue in an arch till final position when arms are fully extended, and the whole spine goes in a backward arch. Take a deep breath in, in the staring position and breathe out slowly during the movement. This is a difficult exercise and to make it easy the hands can be placed on higher level than feet. Start with 3 and go up to 6 or more. This is a good exercise to strengthen your arms, chest and back.

    12. Jogging, Half Knee Bends
    Simulate to run in one spot raising your feet at least 15 centimeters from the floor. After 1 minute of spot running do 10 half knee bends. Start with hands on waist feet together, body erect. Bend at knees and hips, lowering body until calf and thigh form a angle of about 110 degrees. Now jump as high as 15-20 centimeters and land on straight legs. Repeat it 10 times and do stop running for 1 minute again. This combination will break your monotony and will be more effective. Do slow deep breathing while doing these exercise. 3 minutes to 6 minutes or more.

    Let me add one short exercise to be done in the course of the day; 6 to 10 times a day. It is good to trim your paunch. Tense your muscles of abdomen, hold it for 6 seconds and hold your breath. It will help your tummy to reduce.

    Exercises are of three types:

    Constitutional, Developmental, and Corrective or Therapeutic.

    Constitutional
    They strengthen vital organs and increase their activity. They are not strenuous. Can be done by people of all ages and of all occupations. They include -



    • Walking
    • Free hand exercise
    • Light games
    • Deep breathing
    • Dancing
    • Singing

    Developmental
    To develop muscles of the body to improve strength and specially for the young and not essential for every body. They include-Exercises with an apparatus



    • Weight lifting
    • Resistance exercises
    • Strenuous games

    Corrective or Therapeutic
    They are taken in the case of diseases like those of the heart, chest, arthritis, vascular diseases, flat feet, spinal curvatures, pigeon chest, knock knees etc.

    We will discuss exercise to be done in the case of :



    • Heart
    • Chest
    • and Arthritis

    Heart
    The use of physical exercises by physicians in caring for patients with heart diseases has greatly increased in recent years. There are two types of exercises - Isotonic and Isometric Isotonic exercises are those involving movement with muscle exertion like walking, jogging, running, cycling and swimming. These lead to a rise in the pulse rate rather than blood pressure.

    Isometric exercises exert muscle force but no movement takes place. They evoke an increase in the blood pressure and smaller increase in the heart rate during exercises of hand grip, climbing steps, resistance wheel, rowing machine etc. They are more useful for cardiac patients. They produce cardio vascular distress which is physiologic and rapidly reversible.

    The blood pushed out with every heart beat called stroke volume, increases 4-5 times in a normal person when he progresses form rest to maximum exercises. The oxygen consumption increases form 10-12 times in a normal human being during maximum exercises.

    We will deal with two diseases of the heart



    • Angina pectoris
    • Myocardial infarction

    In angina pectoris, the arterial supply to heart muscles called coronary arteries are either narrowed blocked. The heart muscles will become ischaemic as external physical load increases during exercises.

    In both cases the medical management in almost the same. Of course, in myocardial infarction initially 8-12 weeks of complete rest is given so that infarction may heal up, then gradual activity is started.

    For cardiac rehabilitation the known factors should be decreased



    1. Elevated blood cholesterol
    2. Cigarette smoking
    3. Physical inactivity

    Regular physical exercises will prevent further progression of coronary atherosclerosis (narrowing due to fat deposit in the coronary wall). It has been found that the incidence of heart diseases is much lower among bus conductors than the less active bus drivers.

    There have been research studies that have been conducted to more active during work or leisure time is less compared to among those doing a similar activity but in a sedentary sort of way. The first step in the conditioning programme for heart patients is to do an exercise test. It will determine the intensity and duration of the prescribed exercise. The usual procedure is for the patient to maintain the highest conditioning heart rate at 80-85% of the measured maximum of symptomatic heart rate. This gives measurable benefit in 10-12 weeks. Exercise testing should be done every 3 months. Later on every six months. The exercise prescription is updated after the new test. Following points should be remembered:



    • It should be safe
    • It should be supervised by a physician
    • Each patient must be guided individually
    • The patients must tame their won pulse rate and report any excessive rate or unusual symptoms.

    At least five or six mechanical devices should be available for the tests like stair steps, bicycle, rowing machine, resistance for 4 minutes, at the end of which the heart rate should be taken as the target heart rate level. After two minute’s rest, the patient can repeat the same exercise or move on to other exercise. Two minutes rest. Then each of the group rotates to other station or device. This pattern should continue five or six times. Over exercising can cause harm.

    Chest or Pulmonary Diseases
    The value of breathing and general exercises, as an adjunct particularly in treating of asthma, bronchitis, emphysema, etc. has been recognised . Patients are consistent and generous in their praise for the relief provided. Physicians with long experience put their faith in stressing the benefit provided by theses exercises.

    Before we make an attempt to do the exercises, we should be made aware of the elastic property of the lungs and the thoracic wall (chest wall). The lungs resist change in their shape because of their elastic property. In the normal state the inclination of the lungs to empty is opposed by inclination of thoracic wall to fill. A stiffer lung will empty to a smaller volume and the rigid chest wall will hold the lung at bigger volume.

    The lung volume established passively by the elastic properties is the functional residual volume of lung, normally varying around 3000ml. It is important to note that this is the volume to which lung will return passively. A change of lung volume away from functional residual volume requires active muscular effort. The contraction of the diaphragm decreases thoracic pressure and thus increases the lung volume, Simultaneously by compressing the abdomen it increases abdominal pressure.

    The action of the diaphragm is to produce inspiration which means drawing in of breath. It is also active while vomiting and in defecation. The external intercostal muscles help in inspiration. The internal intercostal muscles help in the expiration. In the quiet tidal breathing, the diaphragm moves approximately 1.5 cm in the standing position and little more in the supine position. The rib cage increases 1 cm. while standing and 6cm in supine posture. Anteroposterior displacement is greater than lateral. While breathing to the maximum volume (deep breath) the rib circumference increases by 8cm. The anteroposterior diameter by 3cm, lateral diameter by 1.5 cm. The maximum diaphragmatic execution is 10cm. The linear displacement of diaphragm accounts for approximately two third of changes in the lung volume.

    The drawing in of breath or inspiration, is achieved by the development of intrapleural pressure varying from 6-10 cms of H2O below the atmospheric pressure in quiet breathing, 50-60 cms of H2O in deep breathing. The intra pulmonary pressure is also below atmospheric pressure by about 3-4 cms of H2O in quiet respiration and more in deep breathing. Two forces oppose the changes in the lung volume. First the elastic property which determines the distensibility of lung and thorax.

    The second is the resistance of the airways developed in common pulmonary diseases due to bronchial muscle constriction, with muscle congestion and hypersecretion. In the presence of bronchial disease, the increased resistance of distal airways lowers the pressure in proximal airways, so they are more easily compressed.

    Thus an increased airway resistance, even closure, is readily produced by overactive expiratory efforts. Less forceful expiration may force more air. The oxygen consumption of respiratory muscles increases over ten times in respiratory diseases due to extra put in by the muscle. Any exercises with attempts to produce higher minute volume is jeopardised. This is because the extra oxygen (O2) absorbed might, at least theoretically, be consumed by expiratory muscles in their increased effort.

    Tissue destruction reduces the elastic property of the lung tissue. The tendency of the chest wall to distend leads to hyper-ventilation of the lungs. The mechanical or microbial threat to airways are dealt with in part by the secretion of the muscle and by cough reflex mediated by vagus nerve.

    Lung Function Test
    A simple test may be indicated. The lung function test enables the physician to know whether there is an obstruction to the air flow, but not whether the patient has lung cancer. It helps:



    1. To give a measurable assessment of the patient’s disability.
    2. To follow the progress of the disease.
    3. To try to differentiate the possible causes of breathlessness.

    Vital Capacity
    This is the amount of air expelled by maximum voluntary effort. In a normal person about 3/4 of air in the lungs is expelled in the first second and within 3 seconds all of it is expelled out. In a diseases lung there may be obstruction in the air passage. Therefore, the amount of air expelled in the first second will be much less. If the air expelled in one second is as much as 70% of the tidal volume, the lung under scrutiny will be normal. If it is less than this, it will be due to obstruction in the airway passage.

    This test should be repeated after a few weeks to measure if there is noticeable improvement. The maximum expiratory flow can be measured by a peak flow meter. This portable instrument directly measures the peak flow rate which is otherwise reduced when there is obstruction of the airways.

    Pathological anatomy
    In asthma as the lungs usually remain quite normal, a minority patients ultimately develop emphysema. In bronchitis there is hypertrophy of mucous glands in the trachea and bronchi with high proportion of goblet cell which produce excessive mucus which obstructs the passage. In bronchial diseases there may be obstruction with or without infection leading to more severe consequences or abscess formation.

    General Exercises
    The sufferers of asthma and bronchitis should be given a simple programme of exercises. They should walk1/2 to 1km. initially and increase the distance gradually as the health permits. This can be combined with simple free hand exercises or exercises with steps, cycle with a meter or a tread mill. They should preferably walk instead of moving in a car if the distance is short.

    Patients respond to these exercises favourably. Their confidence increases. Their tolerance for exercises goes higher. With this improvement, they will experience a fall in the heart rat during exercise. Even those who have severe form of disease can increase their exercise levels and oxygen uptake by twenty percent.

    Breathing Exercises
    Breathing exercises are a great help in ‘retraining’ in breathing. We should be realistic in assessing the effect of these exercises:



    1. Breathing should be relaxed. This way the opening of the airways is increased.


    2. Clearing of the airways can be enhanced.


    3. A patient will become confident that he can withstand breathlessness. He can also participate in normal day-to-day activities.


    4. Stress should not be given after strengthening the respiratory muscles, as their excessive use will compress the airways and increase breathlessness.


    5. A proper and efficient use of the respiratory muscles and accessory muscles is indicated so that the oxygen used is much less.


    6. By increased expiration the hyperinflation of the lungs can be reduced, so that during inspiration lungs are not fully stretched.


    7. An increased diaphragmatic exertion with reduced thoracic movement will reduce the sensation of breathlessness.


    8. An altered pattern of respiration changes the distribution of inspired air, so that the gas exchange is better. We use same exercises for asthma, bronchitis and emphysema. They are few with certain variations adopted in several parts of the world. We have tried to include all the good points from these many exercises.

    Air of treatment


    1. Physical and mental relaxation.
    2. Acquiring good posture
    3. Lower rib respiration
    4. Increase of diaphragmatic respiration.

    Patients should have confidence in the therapist. They should be taught individually and later he may join a group. When he does these exercises in a group, he will be encouraged by others and will feel more confident and put in better effort.

    Relaxation
    It is most important for a patient with asthma and emphysema to relax. These patients are always tense, nervous and exhausted because they are all the time making a continuous effort to avoid suffocation.

    If you watch these patients carefully you will find many signs of tension. They may have tremors in the hand, their eyes may twitch when closed, they may have a short movement pattern in their chest region as they are all the while conscious of their breathing. They may show more movement in the upper chest, shoulders, neck and spine especially when they are being seen. This tension and these wasteful movements unfortunately use up a lot of energy.

    For these patients relaxation is very important. If they are relaxed, then only can they learn to breathe more efficiently and in the right sort of way. A patient should be told about these wasteful movements and also be taught the intricacies of abdominal breathing. He should be told that proper breathing will be less taxing and will reduce the attacks of breathlessness. These new methods are not short term methods, but should be used permanently.

    At the time of an attack he should give more attention to these new methods and he will be benefited by the new knowledge. These patients should be provided with a happy and congenial atmosphere at home. They should also adopt a happy-go-lucky attitude. When patient is taught to have relaxation, an atmosphere of silence must prevail. He should be made to lie down comfortably with his head and knee supported an a pillow and the arm resting comfortably.

    He should be taught the difference between tense and relaxed muscles. Tense them for a short period and relax them for a linger period. This should continue till he knows how to relax them completely. This should be done in the muscles of the arm, shoulder, neck, face, chest and abdomen. These tensions in the muscles can be measured, and we can know about their success. The patient can also take the help of a machines called biofeed back, and the patient can watch himself how much relaxed he is and it helps him in further relaxation. When the patient has learnt this of relaxation, he is ready for exercises. He starts with stretching and relaxing short muscles of shoulder and upper chest. Various rhythmic and swinging exercises designed for the purpose are carried out along with respiration.

    Breathing Exercises
    Do breathing exercise in the morning or evening when the stomach is empty. You can do them just before your morning exercises. Deep breathing is important. It can be done standing, sitting or lying down. Standing position gives advantage of freedom for muscle movements.

    Stand erect, arms on your side, exhale slowly and deeply, bend your neck, bring your shoulders forward and contract the abdomen. You will find that you can further exhale more air. This is called forced exhalation.

    Now start breathing in slowly, expand the chest, abdomen and straighten the neck. Do not hold the abdomen. To inhale a little more, lift your chest further, retract the abdomen a little and extend the neck. You will able to draw in a little more air. This is called forced inhalation. Stop for few moments at the end of exhalation and inhalation.Do it 4 times and go up 10 or more. To make it more effective and interesting, add arm movements.

    Stand erect, bring the arms in front and at shoulder level. This is the starting position. Start breathing in slowly and deeply and simultaneously bring the arms back and extend you neck. Pull out the chest and abdomen. This will help you to draw in more air than you usually do. Hold the breath for a movement and then start exhaling slowly, bring down your arm to your side and straighten your neck. Exhale as much air as you can, pause for a moment and start again.

    You can move your arms in a different direction. Stand erect, arms on your side. Keep the back straight. Start slowly breathing in, raising the arms and heels. Do not forget to expand the chest and bulge out abdomen. Hold the breath for few moments and start breathing out slowly and reverse the journey of the arms and heels. Hold the breath for few movements and start it again.

    Flat Feet
    When the arches of the feet are flattened, the patient feels pain while walking. This can be congenital or. Congenital is seen in children an can be corrected by plaster cast. Acquired flat look normal, when held, but when the person stands up they get flattened. The foot points laterally when the child walks. The knee also points laterally, that means that the entire leg has rotated at the hip joint.

    Most of the deformities are produced during the first four months, when the child is too young to turn young to turn over. In whatever position the child is placed, just after birth, it knows its position of comfort. The child is placed in the frog position, the leg becomes fixed in outward rotation. Another deformity occurs in the feet. Stretched muscles become weak and contracted muscles become powerful.

    Exercises



    1. Sit in a vajrasan position. It will lengthen the tendoachilles tendon (the most prominent tendon at the back of the heel).


    2. Walk on lateral border of feet.


    3. When standing shift your weight on lateral border of feet.


    4. While walking, keep the position of feet right.


    5. Picking up objects from the toe. The child should sit on a low chair and pick up a marble with the toes and put it in a container left for left feet and right for right feet.


    6. Stand on a large book or stair trying to grasp the edge with the toes.


    7. Sit in a chair and turn the feet down in and up.


    8. Stand on the lateral border of the feet. He may need to hold on to something to keep the balance.


    9. Stand on the pigeon toe and try to raise yourself on the toes.


    10. Stand in front of the wall about 1 1/2 feet away pigeontoe position, heel firmly touching the ground, go forward and touch the wall with your chest. You should feel a pull at the back of your heel and calf muscles. You can adjust the position of the feel if you don’t feel the pull or your heels are raised as you go forward. Teach the child to walk keeping feet straight in front of him.

    Arthritis

    For treatment of arthritis, rest and exercises play a great role if given discriminately. Rest when the condition is acute and there is a lot of pain. Exercise when the condition is chronic and the pain has minimised. We will deal here with three types of arthritis.



    1. Rheumatoid
    2. Osteoarthritis
    3. Infective arthritis

    Rheumatoid arthritis can be acute sub acute or in chronic stage. Exercises can safely be started in chronic rheumatoid arthritis, osteoarthritis and when supuration has stopped in the infective arthritis. An acute stage is reached when the pain is acute the joint is inflamed. Rest is important.

    Such patients need a lot of reassurance. This should be given generously. These patients should be treated with confidence, the message will reach automatically to the patient and he will know that he is in the right hands. The acuteness will pass off to chronic stage in 3-4 weeks. These patients should be handled carefully to prevent deformities. These arise due to bad posture in the acute stage.

    They should be provided with a firm bed. On a wooden bench a thin cotton mattress should be good enough. It should not be sagging in the middle. The foot can be placed against a padded board to prevent foot drop. A pillow under the knees should be avoided. Only one thin pillow should be given in the night. The arm should be held close to the body and with the elbow flexed. The position of the arm should be changed frquently. The inflamed and acute joint can be supported in a splint. The swelling reduces much after and the patient gets relief in pain much faster. The splint should be removed 2-3 times a day for exercises.

    The deformity in ankylosing spondylitis generally occurs due to bad posture during sitting and lying down. It often happens when a person sleeps with high pillows in the bed and is propped up with pillows in the back. Gradually the curvature and the restriction of movements of these patients goes on increasing. They should try to sleep on a hard bed with a thin pillow. They should try to sleep on the back and in front without any support for a few minutes. They should always sit on a straight back chair and should keep on exercising even with some bearable pain. This way they can stop or slow down the oncoming deformity, can have more movement and pain will be much less.

    These joints can quickly get stiffened and lose mobility if not cared properly. Even from the onset of the disease when the pain is acute, a gentle local joint movement should be started for a short period once or twice a day. The patient should be encouraged to do exercises himself, or with joints supported by the therapist. The movements should be done gently and not be forced. An increase of pain after exercises indicates an excessive amount of motion. In the next session it should be reduced.

    The muscles around the affected joint should be voluntarily contracted and relaxed by the patient by moving the joint called static exercise, done 2-3 minutes every hour. This will prevent wasting, otherwise the splinted joint starts wasting quickly and the rehabilitation and recovery take longer. As the patients condition improves, exercises must increases but not too rapidly otherwise a relapse may occur.

    Sub Acute Stage
    When swelling and pain have subsided and active measures will not cause a relapse the patient will be sub-acute stage. Now gradually exercises should be increased but overindulgence may cause a relapse. The patient can reduce his period of rest. The splint can be removed for longer periods or kept during the night only. If the patient improves, swelling subsides, body temperature becomes normal. Erythrocyte sedimentation rate (ESR) comes down and anaemia improves.

    Patient should stop before excessive fatigue sets in. Gradually with the exercise of the joints, mobility will increases. A patient must exercise on his own and can do a few exercises assisted by his therapist. The patient can sit in a chair and do exercise, he can stand and do exe

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