Balancing Strength and Cardiovascular Exercise: Addressing where we are most Vulnerable?

George Will has an interesting column in today's Washington Post about Medicare. The topic of the column was Medicare and Medicaid's deteriorating financial situation due to health care costs that are increasing at an alarming rate. Will quoted outgoing Secretary of Health and Human Services Michael Leavitt as saying that Medicare's "big three hospital procedure expenses today are hip and knee replacements and cardiovascular operations with stents."
It occurred to me that preventing heart disease and orthopedic injuries will go a long ways to keep us healthy into old age. Heart disease is one of our nation's leading causes of premature death and debilitation. I am convinced that heart disease is 100% preventable with a healthy lifestyle, especially an excellent diet and at least moderate exercise. My nutritarian (Fuhrman) eating program and my love of exercise will provide me with protection against heart disease. The case that cancer is 100% preventable through lifestyle is less clear, but a lifestyle that keeps the immune system strong can provide some critical protections against cancer, especially three of the most common types that affect men – prostate, lung and colorectal cancer.
An excellent lifestyle is far and away the best way to protect against chronic disease, especially heart disease. What is debatable is the whole early detection issue. Once I was an advocate of mass screening for heart disease and cancer, but now I avoid those tests. See Should I Be Tested For Cancer: Maybe Not And Here's Why, H. Gilbert Welch, M.D., M.P.H. Also see The Last Well Person, Nortin M. Hadler, M.D.

Dr. Fuhrman wrote this on his website recently, "Unless you have a history of heart disease, or unusually elevated lipids, I think that going back and forth the doctor to make sure these numbers are perfect is a waste of time and misdirected." 


So, I am clear on my strategy to prevent heart disease and it doesn't involve running to the doctor every so often to be tested. It involves being committed to an excellent lifestyle for the rest of my life.

But what about orthopedic injuries? This is an area that I have thought much more about since my hip fracture a little over a year ago. In recent years, I have witnessed many of my friends having to endure knee, shoulder and hip surgery. Can these events be prevented as surely as heart disease? An excellent diet does help prevent and cure arthritis according to the lifestyle-oriented physicians. I assume that healthy eating is good for the joints, bones, tendons and muscles. 


Since my hip surgery and the long, painful, depressing rehabilitation process, I have rethought my exercise program. Prior to the accident on my bike that lead to the hip fracture, cycling was my main exercise. Most of my exercise was on the bike. I rode just under 8,000 miles from January 1, 2007 to December 12, 2007, the date of the accident. There were times when I worked in the gym on muscle strength and flexibility, but those times were intermittent.


Now I am trying to better balance cardiovascular training with strength training. This fall and winter I have been spending 3-4 four days per week in the gym doing bodybuilding workouts supplemented with 30-40 minutes of indoor cardio work. I ride outside 1 or two days per week. This balance may change somewhat as the weather gets better. Although I miss being outside on my bike as often, I am convinced that my total conditioning is better. The exercises that I am doing in the gym strengthen my shoulders, hips and knees. 


The silver lining around my hip fracture is that I have grown to better appreciate the need to keep my whole body in good condition, not just my heart and legs. For several months I could not walk up a flight of stairs without severe pain. Now I appreciate, more than words can describe, being able to climb stains pain free. 

I will never again take any of my muscles and joints for granted. Just maybe as I age, I can avoid the three of the biggest drains on the Medicare budget – heart disease, knee surgery and (another) hip surgery. I wouldn't be surprised if shoulder surgery is right up there at the top as well.