for a long time the golden rule for heart patients was to take it easy no days we know the opposite is true and proper training can strengthen your heart and ease your symptoms and the right. to date tossed invent is passionate about exercise but he hasn't always been for years the computer expert put all his energy into his work and there was little left over for health shops if you i was involved in lots of projects where i had to give my all and sacrifice lots of my free time i was always on the go and i forgot to take care of myself. that lifestyle had an impact at one point tossed and weighed 146 kilos his body mass index was over 40 in other words he was morbidly obese that put lots of strain on his heart then his cardiologist clima fired a warning shot as you call. pumping function is reduced considerably yours is at 36

percent 55 percent is considered normal. but the doctor also trying to encourage boston by telling him he could take back control of the situation explaining that exercise and weight loss improves heart function some of it or more of the it took around 3 months until what he said clicked for me. but i suddenly pulled up one day during a walk and thought from this moment on i'm going to take responsibility for my health. and you have. tossed and began watching what he ate and started to weigh himself every day that's a big step for people who suffer from impaired heart function they have to monitor their weight constantly on the advice of his doctor tossed and also changed what he ate laying off fatty roasted meats and switching to a mediterranean diet he and his wife now cook with lots of vegetables and healthy oils and it's pay. within a year he's lost 20 pounds. secured it's

a must not when i go to the supermarket my shopping cart looks like a visit to the farmers market the right diet is key to losing weight in a healthy way but the body also needs regular exercise too often tart has profited from his workouts. each time i don't this is what's the heart learns to work more economically just on the resistance the heart experiences what's called the after life is reduced. and you can measure it levels of stress hormones like adrenaline in the body which are at higher levels if your heart is weak can be reduced by working out and you just. tossed him following his doctor suggestion to exercise more. the cardiologist also gave him use have training tips. and human rights information never even goes for a walk then i suggest going for a brisk one and then paying attention to how worn out you feel during and after you

should always stop if you have the feeling you can't go on. then you'll need to lower the tempo on the way back runs on the holes it's ideal to go for half an hour and even if when you get back you feel like you can't take another step and. it's all going to come in that. tossed and has now even set up a small gym in one of his rooms where he exercises with friends and neighbors. your year of working out his heart stronger and in general tossed invent feels like a new man. and i'm meeting fernando de meo he's a specialist in sports medicine here at the spot is on ted's park bridge thanks for having me today you offering certain groups for heart patients so how connectivity improve the heart well the heart to some muscle like your apps or your biceps and when you work out they grow they improve their function they are better exactly the same happens with the heart if you start exercising your heart is going to grow and

it's going to be more able to carry out any activity for example if you can play at the heart of athletes and people who do not exercise the heart of one athlete can be 50 percent larger than of people who do not carry out any exercise and of course that this is very convenient and also very important for how to asians whose heart is weakened but when i think about my practice and my patients many of them very afraid if they're suffer from a. yes very afraid to do some training so do they need to be afraid. you have to confront then with the option if you do not exercise what's going to happen with your heart it's exactly the same that happens with your skin it's going to roll all the and if you have a sore on it is much worse but if you stop exercise and you cannot avoid it it's going to improve it's going to be better and you are going to feel better you're going to be able to carry out more exercise and you have to decide if they're

afraid of it the option is clearly the best thing sometimes maybe they just say that they are afraid because it's just kind of lazy and they just want to get some tablets and but exercise and sports is working the same like doing exercise is much better because with each pill you can have one effect for example you can't reduce the blood pressure or you can reduce the blood sugar or you can improve the mood but with exercise you can achieve all these goals at the same time and what we observe frequently is that patients who start exercising they have to reduce the net is in they take the drugs they take because for example they need much less than before therefore exercise is not only moving it is made this in it is a treatment and you can't replace or at least compliment other therapies and what role does that play what kind of sports and exercise we do with your indifference

even prefer not to talk about sports because it's it means the rules and you are playing what they prefer to talk to the total of patients is exercise we are exercising the whole day for example when you take when you go for a walk or you arrive your bike you are exercising and you do not associated with sports but if you move if you are very active if you use every minute every minute just to use your body it's going to. improve its function and it's going to eat much later for the heart patients than to sit down and to watch sports on t.v. and is there something like a perfect do in which you would prescribe exercise yes it is and it is very important for patients after a heart attack for example we recommend patients to start exercising 10 days after a heart attack and that's not a mistake telling that 10 days after a heart attack patients should stop exercising and of course they are insecure and

they do not know what to do and that is the role of the sports doctor or of the cardiologist to tell them to find out what they can do what is appropriate for them what they like and direct command to write it down like any medicine and any other threw up the recommendation of how do you motivate your patients to get started it's very easy because in other diseases for example if you have a pneumonia and the patients x. ask himself a soup what could i do differently there's nothing that you can change but if you have a heart attack or any heart is sort of you can change your diet you can stop smoking you can start exercising and that is something that the patients realize when they get sick and they find out well if i change my lifestyle if i start exercising for example i can avoid further complications and i'm going to feel better and to do much better well that is the highest motivation that i can offer my patients who

just spoke a lot about heart disease and heard to take in total strengthen muscles of the heart but there are other diseases like orthopedic diseases like for instance lower back pain there are a lot of pills and medications that would help and a lot of surgeons of their would like to operate on those kind of patients but i promise you there's something better. to cook works in an office where she spends much of the day at her desk but she can still do something for her back problem she makes a point of getting out of her chair and move. around frequently and she watches her posture. and now she's back to her old fitness programme she can even go for runs. it was sensational to go jogging again i had to start slowly just a couple of kilometers at ago but now i'm up to 8 again and very proud of that. initially thought she would never run again m.r.i. clearly showed a slipped disc in the lumbar region of her spine. in

the early stages after a herniated disk you would logically have a phase of rehabilitation and go slow and then you would start with the strengthening exercises of. flashback to november 26th buthe was experiencing pain throughout her lower back sometimes it spread to her left leg sometimes up into the back of her neck she tried to alleviate it with rest heating pads and stretching exercises that grew worse when she sat for longer periods the only thing that helped was pain medication but only briefly. it was overwhelming but i didn't want to get written because i wouldn't have known how to deal with it at home either but i should or shouldn't do it was really tough. consulted orthopedic specialist pain therapists and physiotherapists she tried copying and even infusions nothing helped the pain didn't go away she was at the end of her

rope work was torture surgery seemed the only option she decided to try one more specialist and went to see christoph he confirmed the slip disc but didn't think an operation was necessary he knew or didn't have a pinched nerve because she had strength and sensation in her legs he thought the pain came from bad posture. just when i don't know if we don't find any neurological long. function we still have to be cognizant of the slip because it may be relevant to the treatment but it may not be the focus of the problems. in this clinic or back problems that doctors and physiotherapists give patients with acute herniated disc pain killers so they can keep moving with these the only important thing is to keep the nerves from growing you're at it with regular exercise improves circulation keeping the nerve cells in the spinal disc provided

with nutrients which helps the healing process a lot of patients here practice every day movements that many are now scared to attempt along with exercise they learn more about their condition. the disc prolapse happened but it's not an issue the body can reabsorb the disc material in the affected area. and that means that you have a herniated disk but no more symptoms. to me. now once again pursues all the activities she enjoys. it's such a wonderful feeling to be free of pain. it's a great feeling and your shoes if your. daughter could learn how dares to run for longer and longer stretches what she's learned in the course of the past painful months is that baby in her back was the wrong approach.

especially when it comes to pain like glow big pain or joint pain people think that exercise may be harmful to the joints so how do we know that exercise is more helpful than harmful because exercise is exactly what the articulation of the joints are made for if you don't use it they are going to last function that is exactly the same with any body function if you stop playing the piano or the evening you are going to do it with the time exactly the same happens with the joints if you do not use it they are going to lose its function and they are going to 8 when you finally start to move so what's a good rule of thumb when to exercise and when perhaps not to exercise well it is important because too much exercise can harm the joints and as i said to few it's exactly the same and you can orientate yourself following the pain if you hearts after the workout or even worse during the workout you are doing too much or too sal and that if you feel well during the workout and after wards or even if you

have pain before you start exercising and it recedes during the exercise that is a very good indicator that you are doing the right thing and that is also good for your joints so what kind of movements what kind of sports activities are good for joins well i prefer not to say sports because it implies the rules and you are trying to win something and you are competing with other people and that is a nice difference between exercise and sport exercise implies moving just using your body just using your joints and the other. not necessarily good for patients it can also be harmful that every activity the wood for your joints and is good for your body for example rather than a bike or walking or swimming or downsizing even is very healthy and is going to improve the function of the joints and if they are injured it's working to get

better you are going to suffer less pain and you are going to increase your mobility and is there anything we should avoid you should avoid over stress over exercising that means if you start exercising start with small steps something that you know that you can do and avoid activities which you cannot control for example playing games with the ball you cannot decide how many meters you have to jump to catch the ball for example but if you decide to start running or driving a bike you know exactly what you are doing you know exactly which movement you are carrying out and that is something that you can control much better do you have any tips for all of us hope to stay with the sport how to be consistent in your training it is important to have an environment which also motivates you to exercise more if you to spain for stressful or your like to time it's thinkable that with the time you are going to avoid it and your want to stop exercising that

if you have an nice room or if you meet nice people if you have an agreement with other persons to exercise regularly when that is more likely that you are going to persist and you are going to mind paying your rhythm and your exercise program thanks so much for this talk. so working out helps in a lot of conditions but there is something else you could do just to write it all down to get a futurist. in good shape your weekly health show on d w that covers many aspects of health care we look at what's new in medical treatment nutrition fitness and beauty we discuss these topics in depth with specialists and offer you opportunities to pose your own questions so get in touch . when asthmatics 3rd themselves physically they can suffer from shortness of breath or coughing but exercise

nonetheless is important but it's very important to find the right dose for you. an active life without any restrictions until recently that from a little more than a dream for. she suffers from asthma and has always struggled with attacks that sometimes come daily. to thing that starts with a coughing fit that i can't control and it can grow so strong i eventually start throwing up the air wants in but the coughs and mucus need to come out and at some point i can't breathe anymore then i have the feeling that something heavy is sitting on top of me right here. any physical exercise could trigger the painful attacks eventually called one even grew afraid to walk or climb stairs but the more she rested the more trouble she had breathing. it was caught in a vicious circle people who have a small often begin avoiding exercise it's

a natural reaction physical activity puts more stress on the lungs. i ask when asthma patients start exercising the lungs have to work harder more air needs to go in and out in healthy people the bronc expand naturally during exercise that's not necessarily the case with asthma patients their brockie can constrict meaning they're out of breath faster with. gordon was diagnosed 10 years ago in a budget see situations she could inhale quarter but that wasn't enough to keep as much under control. i just wasn't there at the end when we saw ms sontag for the 1st time she was incapable of physical activity so we set out to adjust her medicine tailoring it more to her needs we also got her back up and more active she started exercising 1st going for walks then bike rides that all helped improve her symptoms. last more can't be cured.