welcome to in good shape here's what's coming up. stand up paddling healthy exercise for everyone. keep moving while working out helps many people with asthma . and staying active with cardiac problems exercise helps the heart. and here's your host dr constant but. this is so exhausting. but you may ask yourself why is this guy running around with a straw in his mouth that's because this is what it feels like when you exercise with asked me. so it's no wonder that working out with us doesn't

sound like any fun. ok. but you should work out because working out is like medicine for us. and not only them. one disease heart problems back pain joint pain there's one treatment that works better than any medication that you ever get it's an exercise. that what is the right to take well i don't know but the spot physician fernando de mayo does and i will be. welcome to in good shape. to be sure that's true. but the answer from.

you know if you don't use it you lose it and i am not talking about your credit card i am talking about your body. for a long time the golden rule for heart patients was to take it easy but nowadays we know the opposite is true a proper training can strengthen your heart and ease your symptoms and more right. today tossed in bed 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 created a market i was involved in lots of projects where i had to give my all and sacrifice a lot 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 thorsten 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 part clima fired a warning shot as you called. the 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 that though it took around 3 months until what he said clicked for me. but still 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 paid off within a year he's lost 20 pounds. short it's a must not when i go to the supermarket my shopping cart looks like a visit to the farmer's market the right diet is key to losing weight in a healthy way but the funny also needs regular exercise tossed in tart has profited from his workouts. stick armado on the 1st sets the heart learns to work more economically on the resistance the heart experiences what's called the after load is reduced and you can measure it levels of stress hormones like adrenaline in the body which are at higher levels if you. hard as weak can be reduced by working out and you just. tossed him on his doctor suggestion to exercise more. the cardiologist also gave him useful training tips. and you managed but if

a patient 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 time then you'll need to lower the tempo on the way back lungs on the holes it's ideal to go for half an hour and even if when you get but you feel like you can't take another step. it's all going to come in. tossed and has now even set up a small gym in one of his rooms where he exercises with friends and neighbors. during a year of working out his heart stronger and in general tossed and then feels like a new man. and i'm meeting fernando de niro he's a specialist in sports medicine here at the park british 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 so 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 a cleats 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 very convenient and also very important for how to patients whose heart is weakened but when i think about my practice and my patients many of them very afraid if they're suffer from heart disease 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 is exactly the same that happens with your skin it's going to roll all the and if you have a sore and it is much worse but if you stop exercising you cannot avoid it it's

going to improve it's going to be better and you are going to feel better you are 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 jesus is kind of lazy and they just want to get some tablets and but exercise and sports is working the same like pills and doing exercises 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 scene they take the drugs they take because for example they need much less than before therefore exercise is not only moving it is a menace in it is

a treatment and it 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 meat off of the heart patients than to sit down and to watch. what's 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 start exercising and of course the secure and they do not know what to do and that is the role of the sports doctor or 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 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 disorder 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 hard to disease and hard to take in total strengthen the 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 will 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. 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 moving 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 that i go 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. 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 it 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 up thick because i wouldn't have known how to deal with it at home either i should or shouldn't do it was really tough.

consulted orthopedic specialists pain therapists and physiotherapists she tried copping 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 slipped disc but didn't think an operation was necessary he knew or didn't have a pinched nerve because she had. drank than sensation in her legs he thought the pain came from bad posture. first. if we don't find any neurological loss of function we still have to be cognizant of the slow 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. 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 liberations 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 disk material in the affected area. and that means that you have a herniated disk but no more symptoms. i'm kind of symptomatic near the water now once again pursues all the activities she enjoys and wonderful is it's such a wonderful feeling to be free of pain. a great feeling and your shoes. to a crook now days 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 the joints are made for if you don't you see 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 ache 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. too few it's exactly

the same and you can orientate yourself following the pain if you heart's after a 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 would come. sports activities are good for a joint so 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 it's not necessarily good for patients it can also be harmful that every activity the is good for your joints and is good for your body for example rather than

a bike or walking or swimming or dancing even is very healthy and is going to improve the function of the joints and if they are injured it's going to get better you're 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 use whoa to stay with the sport 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 you're like the time it's thinkable that with the time you're going to avoid it on 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 it's more likely that you are going to persist and you are going to mind pain 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 it off your chest. in good shape you're a weekly health show on d w that covers many aspects of health care we look at what's new in medical treatment nutrition and fitness and beauty we discuss these topics and we're specialists and offer you opportunities to pose your own questions so get in touch

. when asthmatics 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. the 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 of people who have a small often begin avoiding exercise it's a natural reaction physical activity puts more stress on the lungs. when asthma patients start exercising the lungs have to work harder more air needs to go in and out and healthy people the bronc expand naturally during exercise that's not necessarily the case with asthma patients their broccoli can constrict meaning they're out of breath faster. it was diagnosed 10 years ago in emergency situations she could inhale cortisone but that wasn't enough to keep her asthma under control. as if it wasn't there for 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 but new medications have made the symptoms more treatable and thanks in part to her daily exercise regime who hasn't had any major episode. lately. the exercise has definitely helped how often do you need the inhaler now that after the nigga i must only be for exercise exercising with us mark david of mine has been doing it for years whether during training or out on the dance floor or sports student enjoys working up a sweat. but that hasn't always been the case david has had asked most since childhood physical education classes at school were hard on him. after the teacher would sometimes just throw a ball into the middle of the room and all the other kids would run after it and

they were able to even though they had more on guard. i often had to stop set down and use my asthma spray for. exercise has become a form of therapy for david the fitter he becomes the less chance he has of having an asthma attack he's just gone through a stress test to determine exactly how hard he can work out. we measured the v o 2 max or the maximum oxygen intake that can improve significantly through exercise we also did lactic performance diagnostics so that we can now find his most efficient training level and. to train efficiently david should wear a heart rate monitor that can warn him when he's overdoing it he has to pace himself to keep from putting his lungs and muscles under too much strain. because learn to love exercise too and i'll go cycling 3 times a week she never feels out of breath anymore and that's done wonders for her

quality of life. this summer was something special and every sea was dotted with people on board with trying to enjoy their way forward. this is aptly called standup paddling it may look funny but it's a great 4 body workout. stand up paddle leg or s.u.p.t. for short is great for young and old border so they say to find out if that really is the case 3 absolute beginners to the sport are trying it out under the guidance of personal trainer year ago to get started you need a good sense of balance decent stamina and of course basic swimming skills and the type of board you choose is also important 6. i'm sticking with it once and beginners should start with a relatively large and wide board that makes it easier to keep your balance and

a board that's tempered towards the front it's best if you've never been on one before. because then it's easier to steer practicing on dry land helps you get a feel for it. after the final it's easier to keep your balance if your legs are spread a little so 1st will get into the safest position lean forward and put your hands on the board nothing can really go wrong in this stance and if you're feeling uncertain on the water then return to this position. from the kneeling position and look forward place one foot in front of you then the next time and slowly stand up . now comes the tough part trying it out on the water going out of line and. standing up is easiest when the board is already in motion when it's gliding slowly forward. after a few minutes the s.u.v.

beginners have gotten used to the wobble at all managed to stand up. to the. it's easier than i thought not really that hard at all. that's right. your balance is tough and paddling isn't all that easy either. boss it's fun but you have to get used to it at 1st it feels very wobbly. the instability is part of what makes standup pedaling a full body workout generally deeper layers of muscles can't be tactically trained they're only activated by intense stimulation like having to keep your balance on a wobbly board and the paddling part of the exercise uses other muscle groups. your pardon steve paddles with an extended arm that's important to remember you don't want to just use a few muscles you want to activate your core and that's. that improves strength

coordination and stamina. and there are lots of ways to make the workout more challenging and more intense. let it come and you can always change boards and use a smaller narrower one and once you're feeling secure on the board you can start doing a few exercises or even try out and yoga moves. also. so to sum up stand up purpling isn't only fun but also trains your muscles conjure spirits and improves your sense of balance a sport for one and all. that said 1st a day see you next week in toronto then excuse me. see you next week and then let's all try to stay in good shape. see.

the fun. though there is one of germany's most popular tourist destinations the region's incredible variety of landscapes make it a paradise for those seeking a more active holiday fellas like me to get a lot of exercise and while i'm here and while i'm at it i want to find out the ways in which the coronavirus endemic and climate change are affecting tourism here

in the uk tradition. is one of nature's wonders. one of its mysteries really alive. the sunken national park. every year the return to spotlight why. researchers from germany are trying to find out the. nation of the food. 60 minutes on d w. we know this is a scary time for the coronavirus is changing the world changing our lives

so please take care of yourself keep your distance and wash your hands if you can stay at home we're d.w.p. are here for you we are working tirelessly to keep you informed on all over platforms and we're all in this together run together and we'll make it through the main stage usage everybody in the stacy space a woman stay safe is released instances. over the world. over and over. today i'm in the very in southern germany are more precisely metro but

a small bavarian town nestled in the alps.