PUSH-as-Rx ®™ Wellness Exercise & Fitness

The body adapts differently to different types of exercise. Aerobic, cardio, and endurance all refer to activities stimulating heart and breathing rates to provide the muscles with oxygenated blood. The oxygen is delivered by blood pumped from the heart through the arteries and returns to the heart through the veins. This explains all the heavy breathing during workouts. Aerobic exercise increases energy production in the muscle cells and blood delivery in the cardiovascular system.

Aerobic Exercise Health

The Heart

All the muscles get to rest on and off when in use. The heart is a unique muscle that pumps blood through the body that never gets time off. This is why it is important to strengthen the heart. With aerobic exercise, the heart's chamber/left ventricle gets larger, producing more blood per pump to the rest of the body. This improves cardiac output for the blood pumped by the heart per minute. When the heart is stronger, pumping more blood per beat means it doesn't have to beat as rapidly. A lower resting heart rate is associated with a reduced risk of cardiovascular disease and promotes long and healthy life.

Vascular

Each time the heart beats, blood pumps from the left ventricle into the aorta and flows into a branching vessel network. Every artery in the body provides resistance to the circulation that the heart pushes against. The resistance provided can vary, depending on overall health and health conditions.

• Aerobic exercise training reduces the workload by reducing arterial stiffness.
• Aerobic exercise increases heart rate, pushing more blood through the arteries.
• The inner wall of the arteries recognizes the increased blood flow causing the arteries to widen.
• With regular training, the arteries acclimate and become more effective at expanding with each rush of blood.
• No aerobic activity can cause the arteries to stiffen, causing circulation problems.
• Increased arterial stiffness is associated with coronary artery plaque development.
• Aerobic exercise impacts the vascular system by promoting capillary growth.
• Capillaries are microscopic vessels where oxygen diffuses from red blood cells to the muscle and other cells.
• The body stimulates a molecule called vascular endothelial growth factor to grow additional capillaries to regulate energy demand more efficiently.
• Older individuals benefit from aerobic activity similarly to young individuals.

Metabolic

Along with cardiovascular benefits, aerobic exercise increases the muscles’ energy production. The energy is produced in muscle cells primarily through an oxidative energy system. Oxidative energy production takes place within cells called mitochondria. Once blood delivers oxygen to the muscle cells, it can be used to produce energy that powers the muscles.

• Aerobic exercise training improves the muscle cells’ ability to burn fat by generating more mitochondria and enhancing functionality.
• Following each training session, the body burns more fat than usual.
• Aerobic training can increase resting metabolic rate, resulting in more calories burned.
• It can increase post-exercise oxygen consumption/EPOC, resulting in increased calorie burn after training in addition to calories burned during exercise.

Muscle

The muscles adapt from aerobic training. Muscles are made up of various fiber types.

• Aerobic exercise training primarily influences type 1 fibers, known as slow-twitch fibers.
• The name comes from the proteins responsible for their contractions.
• Relative to type 2a fibers/fast-twitch, type 1 fibers contract more slowly but have an increased capacity to contract over and over for longer.
• Aerobic training results in hypertrophy of type 1 muscle fibers by adding more slow-twitch proteins.

Strengthening the heart and making arteries more flexible directly impacts health and physical function. Aerobic exercise strengthens and trains the heart to circulate blood efficiently. Injury Medical Chiropractic and Functional Medicine Clinic can develop a personalized health plan for your needs.

Aerobic Exercise Health: Dance Workout

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Arbab-Zadeh, Armin, et al. “Cardiac remodeling in response to 1 year of intensive endurance training.” Circulation vol. 130,24 (2014): 2152-61. doi:10.1161/CIRCULATIONAHA.114.010775

Gavin, Timothy P et al. “No difference in the skeletal muscle angiogenic response to aerobic exercise training between young and aged men.” The Journal of physiology vol. 585, Pt 1 (2007): 231-9. doi:10.1113/Physiol.2007.143198

Hellsten, Ylva, and Michael Nyberg. “Cardiovascular Adaptations to Exercise Training.” Comprehensive Physiology vol. 6,1 1-32. 15 Dec. 2015, doi:10.1002/cphy.c140080

Nauman, Javaid, et al. “Temporal changes in resting heart rate and deaths from ischemic heart disease.” JAMA vol. 306,23 (2011): 2579-87. doi:10.1001/jama.2011.1826

Popel, A S. “Theory of oxygen transport to tissue.” Critical reviews in biomedical engineering vol. 17,3 (1989): 257-321.

Seals, Douglas R et al. “Aerobic exercise training and vascular function with aging in healthy men and women.” The Journal of physiology vol. 597,19 (2019): 4901-4914. doi:10.1113/JP277764

Diagnosing ankylosing spondylitis usually involves multiple tests. When doctors order blood tests to diagnose ankylosing spondylitis, an individual is experiencing worsening symptoms in their back and joints. Often, a blood test diagnosis means the doctor is looking for evidence of anything else that could be causing the symptoms. However, blood tests by themselves cannot definitively diagnose ankylosing spondylitis, but when combined with imaging and assessment, they can provide important clues that point to the answers.

Ankylosing Spondylitis Blood Test Diagnosis

Ankylosing spondylitis is arthritis that primarily affects the spine and hips. It can be difficult to diagnose as no single test can provide thorough information for a definitive diagnosis. A combination of diagnostic tests are utilized, including a physical exam, imaging, and blood tests. Doctors are not only looking for results that will point to ankylosing spondylitis, but they are looking for any results that might point away from the spondylitis results that might provide a different explanation for symptoms.

Physical Exam

The diagnostic process will begin with the individual's medical history, family history, and physical exam. During the exam, the doctor will ask questions to help rule out other conditions:

• How long have symptoms been presenting?
• Do symptoms get better with rest or exercise?
• Are the symptoms getting worse or staying the same?
• Are the symptoms worse at a particular time of day?

The doctor will check for limitations in mobility and palpate tender areas. Many conditions can cause similar symptoms, so the doctor will check to see if the pain or lack of mobility is consistent with ankylosing spondylitis. The feature sign of ankylosing spondylitis is pain and stiffness in the sacroiliac joints. The sacroiliac joints are located in the lower back, where the base of the spine and pelvis meet. The doctor will look at other spinal conditions and symptoms:

• Back pain symptoms caused by - injuries, posture patterns, and/or sleeping positions.
• Lumbar spinal stenosis
• Rheumatoid arthritis
• Psoriatic arthritis
• Diffuse idiopathic skeletal hyperostosis

Family History

• Family history plays a part in diagnosis because of the genetic element of ankylosing spondylitis.
• The HLA-B27 gene corresponds with ankylosing spondylitis; if an individual has it, one of their parents has it.

Imaging

• X-rays often serve as the first step to a diagnosis.
• As the disease progresses, new small bones form between the vertebrae, eventually fusing them.
• X-rays work best at mapping the disease progression than the initial diagnosis.
• An MRI provides clearer images in the early stages as smaller details are visible.

Blood Tests

Blood tests can help rule out other conditions and check for signs of inflammation, providing supportive evidence along with the results of imaging tests. It typically only takes about a day or two to get the results. The doctor may order one of the following blood tests:

HLA-B27

HLA-B27 test.

• The HLA-B27 gene reveals a red flag that ankylosing spondylitis could be present.
• Individuals with this gene have a much higher risk of developing the condition.
• Combined with symptoms, other labs, and tests, it can help confirm a diagnosis.

ESR

Erythrocyte sedimentation rate or ESR test.

• An ESR test measures inflammation in the body by calculating the rate or how fast red blood cells settle to the bottom of a blood sample.
• If they settle faster than normal, the result is elevated ESR.
• That means the body is experiencing inflammation.
• ESR results may come back high, but these alone do not diagnose AS.

CRP

C-reactive protein - CRP test.

• A CRP test checks CRP levels, a protein associated with inflammation in the body.
• Elevated CRP levels signal inflammation or infection in the body.
• It is a useful tool for measuring disease progression after diagnosis.
• It often corresponds with changes in the spine shown on X-ray or MRI.
• Only 40-50% of individuals with ankylosing spondylitis experience an increased CRP.

ANA

ANA test 

• Antinuclear antibodies, or ANA, go after the proteins in the cell's nucleus, telling the body its cells are the enemy.
• This activates an immune response that the body fights to eliminate.
• A study determined that ANA is found in 19% of individuals suffering from ankylosing spondylitis and is higher in women than men.
• Combined with other tests, the presence of ANA provides another clue to a diagnosis.

Gut Health

• The gut microbiome plays an important role in triggering the development of ankylosing spondylitis and its treatment.
• Tests to determine the gut's health can give a doctor a complete picture of what is happening inside the body.
• Blood test diagnoses for ankylosing spondylitis and other inflammatory conditions rely heavily on piecing together different tests alongside clinical exams and imaging.

Causes, Symptoms, Diagnosis, and Treatment

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make your own healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Cardoneanu, Anca, et al. "Characteristics of the intestinal microbiome in ankylosing spondylitis." Experimental and therapeutic medicine vol. 22,1 (2021): 676. doi:10.3892/etm.2021.10108

Prohaska, E et al. "Antinukleäre Antikörper bei Spondylitis ankylosans (Morbus Bechterew)" [Antinuclear antibodies in ankylosing spondylitis (author's transl)]. Wiener klinische Wochenschrift vol. 92,24 (1980): 876-9.

Sheehan, Nicholas J. "The ramifications of HLA-B27." Journal of the Royal Society of Medicine vol. 97,1 (2004): 10-4. doi:10.1177/014107680409700102

Wenker KJ, Quint JM. Ankylosing Spondylitis. [Updated 2022 Apr 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470173/

Xu, Yong-Yue, et al. "Role of the gut microbiome in ankylosing spondylitis: an analysis of studies in the literature." Discovery medicine vol. 22,123 (2016): 361-370.