Category Archives: Lifestyle activity

One Thing I have Never Heard a Patient Say…

walking long road

After listening to patients experiences with weight loss over the years, I can say one thing I have never heard:  “I re-gained weight, but have not changed my exercise and physical activity level”.  Never, not one patient that I can recall has reported this scenario.


Because the two tend to go hand in hand.  Lower activity level, increase weight.  I am pretty sure you know this first hand.

Now, exercise is not the magic bullet for weight loss.  Food habits have to be a main focus for weight loss success.   However, physical activity and exercise add a huge boost that is hard to beat:

1)” Wiggle room” in your food intake for the occasional slips and celebrations.

2) Maintaining metabolism, which lowers as one loses weight without doing strength training.

Certainly, a consistent activity level is not a 100%  guarantee that  you will maintain weight loss – but it is a pretty good bet.

Life, however, is not consistent.  How do we keep life from getting in the way?

  • Keep your exercise program sustainable: The quick-fix exercise programs may have great results, but if you cannot sustain it, the results will quickly fade. When setting up an exercise program ask yourself, Is this sustainable?
  • Plan A, Plan B…:  Have at least one back up plan if your scheduled exercise time is interrupted.  Schedule Plan A into your calendar.  If there is a conflict – don’t delete – reschedule to Plan B.   For example, you plan on exercising in the morning for 30 minutes, but hit the snooze one too many times.  Reschedule it to two 15 minute  bouts, one at lunchtime and one in the evening.
  • Use lifestyle activity to fill in the gaps:  Lifestyle activity is simply the amount of movement you do during your daily life.   Its about taking advantage of those moments when you can take a quick walk, dance for one song, sneak in some exercises.  It has been shown to work well for weight loss.  Tracking with an activity monitor is helpful here when your regular activity level is lowered for some reason,  such as a longer work meeting or caring for an ill relative.  Armed with the information from your activity monitor,  you can ensure you are burning about the same amount of calories by keeping your step level the same as when you are regularly exercising.
  • Use movement to manage stress:  With plenty of life stressors to go around, if exercise is your go-to remedy, you will have many reasons to keep moving.  In your body, movement is the antidote for the response to stress – so this strategy is a way to naturally work with your body to lower stress level.
  • Connect with your “why”:  Why do you want to lose weight? Keep physical activity connected to your real, bottom line reason, instead of just exercising to make the numbers on the scale go down.  Your “why” is your natural motivation.  When physical activity is connected to your own personal “why”, your natural motivation will remain.

So, while it is great to challenge yourself with fitness goals – one of the best ways to boost your odds for lifelong weight loss success is consistency with exercise.  Hows that for a challenge?

Keep Moving, Be Well,


Please share these posts with anyone you know interested in losing weight with or without weight loss surgery.  Click here to learn more about the UMass Memorial Weight Center

These weekly blogs are general guidelines. These guidelines apply to patients who are cleared by a physician for the type of exercise described. Please contact your physician with any concerns or questions. Always report any symptoms associated with exercise, such as pain, irregular heartbeats, and dizziness or fainting, to your physician.


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by | June 16, 2016 · 3:29 pm

Time to Move!

The term “sitting is the new smoking” is not an activity

“Sitting is more dangerous than smoking, kills more people than HIV and is more treacherous than parachuting. We are sitting ourselves to death.” James Levine, MD, PhD. Researcher Mayo Clinic and founder of N.E.A.T.

The human body is amazingly designed to move.  Each system works better when we move and suffers when we are inactive.  Even if you are an exerciser, prolonged sitting still puts you at risk.

This is powerful knowledge because anyone can improve health in this way.  If you can move, even in a small way, you can improve health by moving often.

Our current environment provides us with many reasons to sit and has led us to the newer science of inactivity.  Like opposite sides of the same coin, exercise physiology studies what happens in the body when we move and inactivity physiology studies what happens when we are still.  It turns out both studies are critical for understanding health.

The physiology of inactivity has discovered that when we don’t move, things start to back up in the cells. The process to deal with sugar and fats in the blood slows down or halts.  Sugar and fats in the blood accumulate and are triggers for disease.

The good news is that it does not take much movement to get the system working again. Simply moving from sitting to standing, takilifesetyle activityng a short walk, stretching – all activate the muscles’ ability to manage these triggers for disease.

Standing desks are one attempt to fix this problem, but standing still is not much better.  Imagine stagnant water, things accumulate.  Inactivity or simply stillness is the root of the problem.  We need to move to get the system working.

If you are an exerciser, no one would call you a couch potato. But…you can be an active couch potato. The chair does not care if you are an exerciser or not – stillness will cause these changes in the body despite your fitness level.

lifestyle activity stretchThe term lifestyle activity is used to describe how much we move during the day. Getting 10,000 steps a day on a pedometer all at once  does not have the same benefit as taking 5000 steps in one shot and then spreading the other 5000 out during the rest of the day.

When you are trying to lose weight or maintain weight loss add a goal for lifestyle activity in addition to exercise goals.  Often, lifestyle activity is a great first step if you are not ready to exercise yet and a great addition if you are exercising but the scale is not budging.

Bottom line – how often we move during the day is as important as how often we exercise in a week.

Keep Moving, Be Well,


These are general guidelines that apply to patients who are cleared by a physician for the type of exercise described. Please contact your physician with any concerns or questions. Always report any symptoms associated with exercise, such as pain, irregular heartbeats, and dizziness or fainting, to your physician.


by | June 18, 2015 · 2:10 pm

Reducing Weight Without Losing Weight – Part II

This is a comment a patient posted in the stretching blog last month.  I had to share her inspiring words:   I’m 8 months post gastric sleeve and have lost 172 lbs since July 2013! Been in PT since October 15, 2014 twice a week. I had to start in the pool i was so bad, but ive graduated to all office visits and I’m getting stronger by the day! I became disabled due to disk disease and got to the point we’re I sat in a recliner for 8 year because my pain became intolerable. I started PT so I could start to walk again and they found so many more problems, my knees are bent from sitting for so long so they need to be manipulated every visit, extremely painful. What I’m getting too is, stretching is crucial to my recovery program. All my muscles had become so bad from sitting that stretching them is an everyday thing for me. When my sciatic starts bothering me I have a stretch where I sit with my foot on the opposite knee stretching my lower back muscle and I’ll tell you it actually works. I have gained enough strength that I can now walk through Walmart when I was only able to use the cart for years!!! I can shower standing up, cook, clean, and none of it would have been possible without PT and the stretching and exercise I do there! I just wanted to share with you my experience and how important stretching is to my everyday recovery.

Thanks to those of you who send along some help with my car dilemma I appreciate your advice 🙂

The big point in the last blog was that how we hold our body changes our body on a cellular level – for better or worse.  And the amount of time we spend in a position has a direct impact on how much it will improve or deteriorate how our body feels. 

How we sit and stand affects everything from our joints, muscles, digestion, breathing, focus, and probably a lot more.

What did you notice last week about how you sit and stand? 

Here are some very basic and simple points to pay attention to.  As always these are general suggestions and guidelines and I trust you to do what feels best for your body: 

  • Standing as best you can, keep your feet parallel to each other (notice if your default position is with toes pointing in or out)Picture-21
  • feet under hips (not wide apart and not too close)
  • weight in heels – this is a BIG one.  (the goal is the picture on the right in red. The picture on the left in blue shows the effect of weight in the toes)when your weight is more on the front of the feet – notice what happens to the hips.  They push forward.  This puts extra pressure on the front of the feet, the knees, the front of the belly and the lower back. The shoulders and head tend to move out of alignment too.  Practice keeping your weight in your heels and hips when standing. 
  • lower back in neutral – not flat and not rounded.  There should  be a comfortable curve in the lower back and the hips should be in neutral
  • ribs facing hips – this is another big one.  Place your hand on your breastbone (sternum) – it should be close to vertical to the ground.  When we “stand up straight” the ribs tend to flare forward.  This causes strain in the back and takes the shoulders out of healthy alignment.  
  • roll the shoulders open – the inside of the elbow facing forward and shoulders and chest rolled open – Check the ribs again to be sure they did not flare forward again.   Remember….ribs down, shoulders back
  • head balanced on shoulders – ears over shoulders

Do the same when sitting just keeping feet on floor under knees. Then balance your weight on your hips so the lower back is in neutral andthCAWVYXYC move up from there with the description above.  Sitting with the back curved, like when slouching or sitting back  on a couch creates more work for the lower back. 

This is a simply way we can improve health in moments during our day.  When muscles and joints are hurting they are just letting you know they are over worked. Much of the time this is from positioning during the day. 

Posture-Before-AfterWhen pain is reduced from proper alignment, motivation to move increases.  With the body aligned properly, risk of injury with exercise is less.  So… all of this alignment awareness can lead to more movement and help with weight loss. 

Think beyond the gym for health and well-being and healthy weight. 


Keep Moving, Be Well




by | March 18, 2015 · 4:27 pm

Reducing Weight without Losing Weight

thCABPF7GPI took a car for a test drive this week. My current car is a 2004 and I have the seat perfectly adjusted so I can sit in alignment. Sitting in this 2010 car my head was pushed forward by the head rest. No matter how I adjusted the seat I could not sit with my hips shoulders and ears in alignment. That darn head rest kept pushing my head forward.

So, I asked the car salesman.   He said that not too long ago the government changed the guidelines for manufacturing car seats. They wanted to make sure that the head is on the head rest….. so they moved the head rest forward…

Does anyone see a HUGE red flag here?

Were the older cars wrong? Or, could it be that our bodies have “adapted” to our new computer working, cell phone gazing, sitting shape? Please say it isn’t so! The government, in trying to keep us safe (which I greatly appreciate), adapted the guidelines to fit this new position of our body?thCA2EI8K7

What is the big deal you may ask.

Take an object about 10 lbs.and hold it in your hands. Notice the weight. Now extend your arms so you are holding it in front of you with your arms straight. The weight did not change but it feels heavier, right?

Now think of your head (weighs about 10 lbs.) held up by your neck. With the head jutted forward those poor neck muscles are working over time. And then the back muscles need to help out.

Exercise is important. But it is only about 3% of our day if we do 45 minutes of exercise a day. The other 97% of our day is hugely thCAJSWG40important. How we hold our body during most of the day can be a breeding ground for chronic pain and injury. It can also be the breeding ground for health and well-being. It is our choice.

This week: pay attention to your body position in daily activities like driving, eating, reading, watching TV, working on a computer, brushing your teeth, talking on the phone, looking at your smart phone.

  • Notice where your head is in relation to your body.
  • Notice where you feel your weight most when sitting – on your tailbone and back, front of your hips or in the middle.
  • Notice the weight of your arms and legs.
  • Notice where your weight is on your feet when standing – on the toes, heels or in-between.
  • Which side of the body do you use more?
  • Which side do you put more weight on when sitting, standing or carrying?

Feel free to add your comments about what you notice and we will continue the chat next week…

Keep Moving, Be Well




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by | March 12, 2015 · 6:16 pm

Activity Monitors and Pedometers – The Big Picture

Patient Tip of the Week:   Every time I get up from my chair I walk around for an extra 5 minutes during my day.  It really adds up!

Over the past 10 years there has been a great fusion of technology and physical activity.  When I first started at UMass, we were so expedometercited about the new more accurate pedometers that could be worn anywhere instead of needing to be worn on the waistband.  These “pocket” pedometers were more expensive though, so challenging for all patients to obtain.  best-pedometers-1

Today we have many pedometers and activity monitors to choose from.  This latest fitness trend now provides us not only the ability to track our steps but also track sleep, calories, miles AND  brag to friends about our steps on Facebook.   

Awareness is a powerful tool and this is great progress in filling our need for more movement each day. 

 As with any trend however, some important details can get lost in the excitement.   So here is some “big picture” information about increasing daily activity and monitors:

  • The 10,000 step goal:  While 10,000 steps a day is a good goal – nothing magical happens in your  body when you achieve that amount.  Magic may happen on your activity monitor, smart phone or Facebook page – but your body just knows it moved a nice amount that day.   Considering the average person takes 2,000-6,000 steps a day, 10,000 can be a BIG jump. In reality, every extra step counts – not just the 10,000th one.  Just going from an average of 2000 steps a day to 3000 steps a day means you are healthier. So celebrate every day you make the effort to move more.   
  • How you get there matters:  If you get your steps all at once and then sit the rest of the time the body has a chance for “waste products” to accumulate and inflammation to build.  The health benefit comes from the movement breaks to keep a nice blood supply thCAFV781Pto our cells.    The point is to get us moving more often during the day, not only moving more. 
  • Is cost a barrier?  You don’t need to break the bank or wait until you can afford a $100 + activity monitor to track your activity.  Now tri-axis, or pocket or wear anywhere pedometers cost anywhere from $10-50 depending on the features.  These are accurate pedometers, small and easy to use.  The older or less expensive versions of “pendulum” pedometers that you may receive for free from your employer or health insurance are not as accurate because they need to be placed so they are level on your waistband.  It is worth the investment to purchase a tri-axis pedometer and leave the frustration behind.
  • Is technology a barrier?  Dont want to fool with a pedometer or activity monitor? – simply getting  30-45 minutes of activity split up in small bouts during your day works great.  Set an alarm on your phone or computer to remind you. Keep a tally of minutes on your calendar or food journal. Low tech but same health benefits.   
  • Is setting the monitor up a barrier? I also see many people not using their pedometer because they cant figure out how to set it up.  Just put it on steps mode and wear it all day long.  The steps will be accurate whether you put in your stride length or not.  If it has a clock mode so the steps can automatically reset at midnight, make sure the a.m. p.m. is set correctly – BIG bummer to lose all your steps for the day at noon instead of midnight!  If you have an activity monitor and it is too complicated for you, trade it in for a low tech but highly accurate pedometer. 
  • Is accuracy a barrier? Keep perspective:  Remember this tool is not perfect.  You will not get steps for certain activities and you will get steps where you didn’t take some.  If you have a pendulum pedometer (the kind that has to sit on your waistband) you will get steps when you shake it.  That does not mean it is not accurate. If it is placed correctly it will be fairly accurate.  The day-to-day awareness and striving toward your goal is more important than the accuracy.    If you are moving more during your day, you are succeeding. 

baby-walkBottom Line:  we can’t change something if we are not aware – the awareness that activity monitors give us is half the benefit.  We need reminders to move during our day and counting steps is one great way to do that.  If the social media is helpful, great – just keep in mind the ultimate goal is not to get 10,000 steps a day but to avoid prolonged sitting.  We are meant to move all day long, not just in one bout a few days a week. 

Here is how to get the most from your pedometer or activity monitor:

  1. First get your baseline steps.  The temptation is to start getting as many steps as possible once you put a monitor on.  However, this can lead to injuries and burnout caused by doing too much too soon.  Track your steps for 3-7 days on a variety of schedules ie: a few work days and a couple of weekend days.  See what your baseline average is on a typical weekday and weekend.   
  2. Add 5-10% more steps per week to your average.  for example, your average steps are 4,000 per day, the goal this week would be 4,400 steps each day.  Will you get lots of “likes” on Facebook for achieving 10% more? – Probably not.  Will your body and mind thank you by feeling better adapting to this gradual change? – Absolutely!
  3. Wear the monitor all day:  this is a tool mostly to track your non-exercise time.  Wear it all day to remind you to move more and sit less.  The steps wont rack up as quickly but again, this is a tool for promoting activity bouts all day long. 
  4. Spread them out:  Disperse the steps throughout your day as much as possible. 

Click here to go to the UMass Memorial Weight Center website and you can download a handout with more information about pedometers and a tracking sheet for the low-tech option. 

Keep Moving, Be Well




by | February 4, 2015 · 8:01 pm

Fitness beyond the “Glamour Muscles”

December 17, 2014

“For every two minutes of glamour, there are eight hours of hard work”  Jessica Savitch

I heard the term “Glamour Muscles” for the first time the other day.   (guess I don’t hang out in gyms enough – ironic huh?)

Glamour muscles are the ones people like to “show off” – the superficial abdominal muscles that make the “six pack” abs (the Rectus Abdominals), the biceps, the pectorals (chest), etc.

In this busy holiday prep week it is a great time to work the hidden but essential muscles. It does not take much time but has a big pay off. Ready for your workout:

Feet – take off your shoes and let all the joints in your feet spread out. Take a tennis ball and place it on the bottom of your foot while sittingthCABS2ECL or standing. Roll the ball under your foot. If you have ever seen a picture of the bones in your foot you can see the complexity of the anatomy of the foot.  Giving the feet some freedom without shoes and sox and spreading out the joints over a ball loosens those little joints and muscles in the foot. Spread out your toes, gently stretch the top of the foot, the bottom of the foot, the sides. Ahh…

The human foot and ankle is a strong and complex mechanical structure containing exactly 26 bones, 33 joints (20 of which are actively articulated), and more than a hundred muscles, tendons, and ligaments.” Wikipedia

Belly – When we are carrying extra weight many times we keep this area in our “blind spot” and would rather not think about it. However, holding stress in this area can create internal tension that affects organs and digestion as well as muscles of the hip and back. So, relax your belly all the way. Take some relaxing full breaths. Consciously let go of any tension there.  Imagine relaxing all of your organs in this area too. (more in a future blog on using the core in a functional way – for now let’s practice relaxing it)

Hands – Free your hands and wrists from the keyboard, driving, phone holding and texting position. The many joints in the hands need some movement just like the feet.  So, spread your fingers wide, make a gentle fist, move your thumbs in different motions. Move your wrists in circles in both directions.  If you have more time, check out this hand yoga video. thCA3UMP6S

Jaw – Notice how you are holding your jaw – another storage place for tension. These muscles of the jaw can get overworked and cause jaw pain and headaches. So simply let your lower jaw release and move away from your upper jaw. Consciously let go of tension there several times a day.

thCAJNN6N8Eyes – The muscles of the eyes can get “lazy” from only focusing up close. Go to a window or better yet get outside and look as far away as you can. Look in all direction with your eyes. Close your eyes and relax your eyelids, around your eyes, and the back of your eyes.  

All these muscles and joints need a “workout” and rest too –  possibly more than the glamour muscles because of the constant unconsciouis wear and tear they can receive all day long. Fitness is not only for the gym. True fitness is about taking care of the whole body – not just the “glamorous” parts!

Have a great week!

Keep Moving, Be Well,


Janet Huehls, MA, RCEP, CYT, CWC
Registered Clinical Exercise Physiologist, Certified Wellness Coach
UMass Memorial Weight Center

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by | December 17, 2014 · 8:44 pm

Keep Moving Weekly – Deep Cleansing

December 10, 2014

 “The body is a community made up of its innumerable cells or inhabitants”  Thomas A. Edison

 Notice the big excitement about cleansing diets?  Sounds great to clean your insides, get rid of toxins, start fresh? Especially this time of year….

I will let our dietitians address the dietary side of cleanses in a guest blog.

Did you know there is TRUE deep cellular cleansing available to you at any moment of any day?

The body is made up of a whole bunch  of cells (estimates of five to 50 trillion – give or take!).   Those cells together create organs in different systems in the body that all work together to maintain wellness.  IE: our digestive system, musculoskeletal system, nervous system, etc. 

Cells are nourished by blood flow.  Blood flow also clears away waste (or “toxins”) produced by the cells.

dirty fish tankHave you ever seen a fish tank that had not been cleaned for a while? Yeah, now you have the image – YUCK!

Now imagine the cells in your body – sitting  there at a computer, TV, vehicle – stagnant for some time.  Add some emotional stress that causes the body to put things into your blood to prepare you to react to that stress physically –inflammation increases. So does the “stickiness” of your blood. The tension of your vessels grows. The body adds some extra sugar and fats to the blood – all preparing you to fight that “tiger” (threat)  causing you the stress.  

Just like a dirty fish tank, these are the “toxins” building up in your stagnant system.  How long to you want those toxins there for?  

(Let’s just say a good dietary cleanse gets rid of “toxins” – how long until your next cleanse?)

What if you could get rid of all that “stuff” before it starts to build up and cause problems in your body’s systems? 

What if you could just prevent that build up and keep the cells nice and clear to do their real job of keeping you healthy and well. 

Well – you CAN – Right now…. At this very moment…. Are you ready???

MOVE!  Stretch, walk, breathe deep, do some chair squats, wall presses, roll your shoulders, move your hands and feet – move as much of your body you want to cleanse.

Wow, don’t you feel clean inside and out!?thCAO0PCQ1

Here is a true cleanse to try this week: 

Every half hour get up and move for 2.5minutes.  OR at least every hour get up and move for 5 minutes.  Walk, stretch, dance, do some leg lifts, squats, wall presses,  – Whatever!!! 

Lets say you did this for 10 hours of the day – that would be 50 minutes of movement!!! Better yet 10 cellular cleanses a day!!! Wow – just imagine how your body would thank you!!!

My thought is that this holiday season this is just the prescription we need – reduce the effects of stress on the body AND fit in 50 minutes of movement a day without having to take much time out of your day to do it! 

Gift-BoxSounds like a great holiday gift to give yourself. 

Who’s in with me???

Keep Moving, Be Well

Janet Huehls

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by | December 10, 2014 · 8:00 pm