[unable to retrieve full-text content]

World Stroke Day is celebrated to raise awareness of an often fatal experience. Strokes can, however, be avoided. 

According to the Heart and Stroke Foundation South Africa, 10 people in South Africa have a stroke every hour. In addition, one in three South Africans suffers from high blood pressure, which is a major risk for stroke.

Suzan’s story

A stroke can literally be described as a “brain attack”, where the blood flow to the brain is temporarily cut off or limited. This causes a lack of vital oxygen and nutrients to the brain, causing cells to die within minutes.

Although not all strokes result in death, they can change lives forever. In 2010, Suzan Raphuti-Letsoalo from Atteridgeville, Pretoria, suffered a haemorrhagic stroke following the birth of her youngest child.

She spent close to a month in a coma. When she woke up, she was unable to walk, use her arms or speak. The former social worker and mother of three suddenly had to face drastic changes in her life.

As if taking care of a newborn baby wasn’t challenging enough, she also had to relearn to walk and talk during that time. She underwent intense rehabilitation – and to the great surprise of her doctors she recovered. The fact that she regained her speech and movement was a pure miracle.

Suzan was unable to return to work after her ordeal, but made use of the few resources she had to create a support system for other stroke survivors in her area.

“To me, after this ordeal, stroke is everybody’s issue right now,” says Suzan. “It’s not only an issue for stroke survivors and their families – a stroke can attack everybody and it knows no age.”

Know your numbers

Suzan’s support group is called Stroke Tamara, and aims to teach people about the dangers of a stroke and the importance of acting quickly in an emergency. In the lead-up to World Stroke Day, Stroke Tamara partnered with Angels Initiative to create and raise awareness of stroke at the Bara taxi rank in Johannesburg.

Here, people are receiving information about strokes – they can also get tested for high blood pressure, which is one of the main risk factors for stroke.

“Know your numbers – your blood pressure, your glucose levels,” says Dr Shanil Naidoo from the pharmaceutical company Boehringer Ingelheim. He says if you know that you have high blood pressure for example, you will know that you are at high risk of having a stroke and can do something about it. 

Prof Feroza Motara, Head of Emergency Medicine at the University of Witwatersrand, states that the Angels Initiative was adopted to raise awareness of stroke, not only for World Stroke Day, but to improve treatment, facilities and the capability of handling acute strokes in general.

“Ordinary citizens are essentially the ‘first responders’ when a stroke occurs. If they are able to act with certainty and speed to secure emergency treatment, we can save many lives and reduce the severity of long-term damage,” she said. 

Lower your risk

You can lower your risk for a stroke by taking the following measures:

• Follow a balanced lifestyle: eat healthy and exercise regularly.
• Get your blood pressure and blood sugar tested regularly.
• Cut out salt.
• Consume alcohol sparingly and quit smoking. 

^{Image credits: iStock and supplied}

Marelize Wilke

“Hey, Selene!” My friend is a longtime cyclist, avid bike commuter, recreational racer and not one bit shy about speaking her mind. She’s in town for some races and has a bone to pick with me.

“You write about all this cycling stuff every week, but you’ve never written about menopause. How come? It’s a bitch, you know. It would be nice to have someone talking about it.”

“Well, the cop-out answer is that I’ve never written about it because I haven’t been through it!” I tell her honestly.

But it doesn’t take more than a moment’s thought to realise she’s right: The onset of hot flashes, lousy sleep and muscle loss doesn’t sound like a recipe for cycling success.

Yet, in all the years I’ve been writing for and reading mainstream cycling magazines, I can’t recall ever seeing menopause addressed.

And to point that finger right back at myself: Though I have researched and written a great deal about menopause for women’s magazines like Prevention, I’ve never offered a lick of advice on it in the pages of Bicycling.

Time to change that. Starting now. Because when I look around the cycling community at large, from the elite racing fields to the usual shop, social, and charity riders, it’s clear that there are a significant number of women who will be, if they are not already, heading into “the change”.

Read more: Men and women are not created equal

“The Change”

That’s what menopause was called for years before we got comfortable with using words like “menopause” – the change. Which is okay, but it implies just one change – the end of your menstrual periods.

Of course, that alone is a pretty seismic change that is itself brought on by a series of changes, and it leads to a succeeding series of changes that go beyond simple freedom from feminine hygiene products.

Outside of the obvious – you’re no longer ovulating and can no longer get pregnant – the main metabolic change many women notice is body composition. As the oestrogen level drops, there’s a tendency to accumulate fat in your belly and to lose lean muscle mass. That’s a problem for a few reasons.

If you can’t maintain your muscle, you can’t produce the power to push those pedals up hills or in a paceline as hard, and you’re bound to slow down – especially if you’re also gaining body fat. Even if you aren’t a racer, gaining weight and slowing down just aren’t fun.

That’s not all. Even if you maintain your body composition, the hormone shift with menopause brings on some permanent changes in your metabolism that can affect your training and riding, as well as your overall sense of wellbeing.

For some advice on that front, I called up my go-to source for all things female physiology: exercise physiologist, nutrition scientist and fellow cyclist Stacy Sims, who has devoted about 20 years to studying these issues.

Here’s her short list of what you can do to keep on rolling strong.

Read more: 5 ways to be a better fat burner

Handle the heat

“Postmenopausal women break into a sweat later during exercise and they vasodilate longer,” explains Sims. In plain language, that means your body sends more blood to the skin to get rid of heat, since it can’t rely on perspiration to cool you.

It’s also harder for you to handle increases in your core temperature. So racing and/or riding in the heat is just plain harder.

Hydration becomes even more important during menopause and beyond. If you’re going out for a long and/or hard ride in the heat, prehydrate with a sodium-rich drink before you get on the bike. Take in at least a bottle an hour while riding and grab a protein-rich recovery drink to sip on when you’re done.

Consider also cooling yourself before exercising in hot weather by draping a cold towel around your neck. Consume ice-cold fluid during your ride if you can. And to cool down and speed recovery, dip yourself in a cold bath or pool when you’re done to help constrict those dilated blood vessels so your blood returns to your central circulation.

Speaking of heat, hot flashes are one of the hallmarks of menopause. Studies are mixed on how much exercise helps alleviate them, but most have found that active women have fewer or at least less extreme ones than those who aren’t active.

Curb the carbohydrates

You become more sensitive to carbohydrates as you enter menopause, which means you’re more susceptible to blood-sugar swings, and you actually need fewer carbohydrates overall, says Sims.

“Eat more mixed-macronutrient foods during your rides,” she says. “Aiming to get about 30g of carbohydrate per hour” – about what’s in one banana – ”on long rides is probably sufficient.”

Get particular about protein

Your body uses protein less effectively as you approach menopause and in the years after, making it more difficult to maintain your muscle integrity.

Recovery is harder, as is holding on to your lean muscle tissue. That means you need to be pickier about the proteins you consume.

“It’s essential for menopausal and postmenopausal women to lower their post-exercise stress hormones, like cortisol, as quickly as possible, since that makes you catabolic, and you can’t afford to be eating into your muscle tissue at this point,” says Sims.

That means bathing your damaged muscle fibres in essential amino acids, which helps stop the production of cortisol and promotes muscle synthesis and repair.

“You don’t want soy at all,” says Sims, noting that many women reach for soy proteins with the thought that they’re better for women. “It may help stop cortisol, but it does nothing for muscle synthesis. You want whey and casein for the best results.”

Read more: Strength train this way for maximum watts

Sims recommends taking 15g of whey or 9g of BCAAs (branched-chain amino acids) about a half hour before training. After you’ve racked your bike, get another 25g of protein within 30 minutes. If you’re training hard, get another 20 to 25g of mixed protein two hours after training and 10 to 15g before bed.

If it sounds like you’re piling on the protein, it’s because you are. You need it. And it’s still well within the 90g a day that protein researchers, like the University of Illinois’ emeritus professor Donald K Layman, PhD, recommend for active women, especially those who are also watching their weight or trying to lose a few kilograms.

Personally, I swear by 30g – sometimes more – per meal, especially when I’m doing lots of riding and racing. As a bonus: Extra protein may boost your immunity to protect you from getting sick when you’re training hard.

Ride faster and harder – sometimes

The speed and strength of your muscle contractions often decrease after menopause. You can counteract that by shifting your training to focus more on power – think intervals on the bike and strength training in the gym – and a bit less on those long, steady, and often slower endurance rides.

“Power and speed training are essential elements in a postmenopausal woman’s training arsenal,” says Sims.

Add interval workouts and strength moves to your routine: You’ll be happy you did.

Read more: 4 workouts for cyclists who hate intervals

Reclaim your sleep

Insomnia is common during menopause, as are night sweats, which can be extremely disruptive to sleep. And, of course, poor sleep quality is a double whammy, because you need sleep not only to fend off fatigue (which is common during menopause) but also to do the normal nighttime muscle repairs and recovery – and this is during a time when recovery is more difficult in general.

If sleep eludes you, Sims recommends topping off your evening dose of protein with 400 to 600mg of valerian (a herb known for its sleep-inducing properties).

“The combination helps with overnight muscle repair, keeps cortisol low (which helps keep the stimulus for developing belly fat low), and helps maintain a lower core body temperature so you’re less likely to experience hot flashes.”

Read more: Sprint intervals to get energised quickly

Just ride!

Finally, just getting out there on your bike will help alleviate some of the nagging symptoms a woman can face during this time of hormonal havoc. While there are very few studies on menopausal athletes, there is a healthy body of research on exercise’s effect on menopause. And it’s overwhelmingly positive.

In one Spanish study, the scientists asked 48 women ages 55 to 72 to either exercise for three hours a week or go about their mostly sedentary lives as usual.

At the start of the study, 50% of the women in the exercise group and 58% of the non-exercisers complained of severe menopause symptoms like fatigue and insomnia.

By the study’s end, the percentage of women with severe symptoms dropped to 37% in the active group, but rose to 66% among the non-exercisers.

The active women also reported better mood and mental wellbeing, while their non-exercising counterparts were having a tougher time mentally and emotionally.

So even if you don’t always feel like it, get out there and ride. You’ll feel better for it. And that’s something that even the change can’t change.

Finally, skeletal health is a big concern for postmenopausal women. Your osteoporosis risk rises sharply during this stage of life. Do resistance and plyometric moves at least twice a week to keep your structural system as strong as the rest of you!

This article was originally published on www.bicycling.co.za

Image credit: iStock

Selene Yeager

Chances are you’ve been told many different things about stretching over the years that seem totally contradictory.

Part of the issue is that stretching isn’t one-size-fits-all: There are different types of stretches, and what’s best for you largely depends on your body and your specific goals.

Still, a lot of confusion persists. To help clear it up, we took a look at the science and consulted Luke Lombardo, a running coach and personal trainer.

Read on as we set the record straight by debunking seven common myths.

1. You should always stretch before you start your workout

Generally speaking, it’s best to stretch while warming up your muscles, so it’s safer to go for a light jog or do some star jumps before engaging in static stretching – the kind of stretches you do while your body is at rest.

“If you have too intense of a stretch while your body isn’t warm, you could be more likely to pull a muscle,” says Lombardo.

The exception to this rule is that you could skip static stretching altogether and instead opt for dynamic stretching – meaning you’re using momentum or movement while stretching at the same time.

This kind of stretching is essentially a stretch/warm-up combo, and is best for runners. The choice is really yours.

2. Everyone should do the same kind of stretching

Stretching routines vary, and they should. Research has found that while static stretching may be sufficient for individuals looking to have a bit more flexibility for exercise such as gymnastics, dance or even spin, dynamic stretching is better for those doing exercise that involves running or jumping.

Age and gender play a role, too. Older adults may benefit from holding stretches longer. And, according to a study in the International Journal of Sports Physical Therapy, “men and older adults under 65 years respond better to contract-relax stretching, while women and older adults over 65 benefit more from static stretching.”

When in doubt, ask a personal trainer or physiotherapist for guidance.

3. Stretching will keep you from getting injured

This one is really a half-myth. Many experts, including Lombardo, say that stretching does offer some degree of protection.

“When done correctly, stretching can help reduce your likelihood of injuries because it increases blood flow to the muscles and increases joint range of motion.”

But research has shown that people who stretch aren’t any less likely to get injured compared to those who don’t.

Lombardo also notes that stretching before a workout won’t eliminate the possibility that you might pull a muscle or sprain your ankle. Additionally, stretching won’t help correct any muscle imbalances that may lead to injury, such as lazy glutes or quad dominance.

4. Stretching will increase your performance

Another half-myth here. For most typical gym-goers and recreational athletes, dynamic stretching can loosen up the body. That might very well make it easier for you to perform certain exercises, movements or hold certain poses, says Lombardo.

“It increases joint range of motion, which in turn can help your muscles be more efficient.”

The flip side is that competitive athletes might actually do worse if they stretch first: some research has found that certain types of stretching may impede some athletes, like sprinters, high jumpers or weight lifters, because they might end up overworking the muscles they need to perform at their absolute best. Worth bearing in mind before your next race.

5. If you stretched before or during your workout, don’t bother to stretch again after

If you’re in a rush, you won’t necessarily hurt yourself by skipping the stretch at the end of a workout. But if you have the time to fit it in, you should.

“Stretching post-workout will reduce muscle soreness and fatigue, as well as increase blood circulation, which can help expedite the recovery process,” explains Lombardo.

That means you’ll be able to workout again sooner.

After a workout your muscles are already warm at this point, so doing static stretches may help you reduce soreness and fatigue, says Lombardo.

For example, you may want to hold a calf stretch or hamstring stretch after going for a run.

6. You can’t over-stretch

Absolutely false. If you stretch a tight muscle too intensely, you can end up straining or pulling it.

“It is important to slowly begin a stretch and focus on lightly lengthening into the stretch during an exhale,” says Lombardo.

Don’t force anything that doesn’t feel right or that causes you pain.

Read more: 5 Stretches you should never do

7. Stretching and foam rolling are the same

Unlike stretching, foam rolling gives your muscles a myofascial release, so you can think of it as giving yourself a deep tissue massage.

“Foam rolling can better break down scar tissue in your body, which will speed up the body’s recovery process,” says Lombardo.

“It can be argued that foam rolling has all of the benefits of stretching and more as it gets deep into your fascia, but stretching will lead to greater flexibility.”

Translation: If you have the time to do both, you should! 

This article was originally published on www.runnersworld.co.za

Image credit: iStock

Amy Schlinger