1. Mucho Mike Presentation Erica Axent-Hilton Amy Collett Sybil DeJonge Corrin Porter Lori Van Langen

2. Mucho Mike’s Profile  Single male  Age: 34  Height: 6 feet 3 inches (190.5 cm)  Weight: 235lbs (106.6 kg)  BMI: 29.4 (overweight)  Blood pressure: 130/90 Systolic = Pre- Hypertension Diastolic = Hypertension  LDL levels = 6 (in normal range of 4 - 6)

3. Mucho Mike’s Activity Levels  Present activity level Lifting, pulling, pushing at work ; loads trucks with building material Mountain bikes with girlfriend (Beefy Betty) Walks his dog, Mucho Mutt MUCHO MUTT

4. Mucho Mike’s Activity Levels  Past activity level Played defensive lineman on Football team Power lifted for 5 years

5. Mucho Mike’s Past Injuries  Dislocated his AC joint and tore surrounding soft tissue from football injury  Two years ago tore muscles in lumbar region and injured disc at L5-S1  Diagnosed with muscular tear in right erector spinae and a slight disc bulging at L4-L5  Has localized pain on the right side in region of muscle tear and experiences regular back pain at the end of the day

6. Family History  Intestinal and prostate cancer  Coronary heart disease  Osteoarthritis  Alcoholism (problem with both father and uncle)

7. Alcoholism  Defined as 4 or more drinks per day  Mike currently drinks 3 to 4 drinks per day (case of 24 a week)  Combination of alcohol with anti-inflammatory medications and muscle relaxants may have serious health effects

8. Medications  Prescription Medications Treated with muscle relaxants and anti-inflammatory drugs when injured his back Currently takes prescription medications for his back and shoulder pain

9. Proper Lifting Techniques Dos  Place your feet and knees at least shoulder width apart or front to back in a wide-step position.  Lean over or squat with the chest and buttocks sticking out, your back will be flat and your neck will balance in a relaxed neutral position.  Take weight off one or both arms if possible, use your hand or elbow as support on your thigh or any available structure.  Balance your load on either side if possible, or switch sides so that both sides are equally stressed.  Level the pelvis or tuck in your buttocks and suck in your abdomen, when reaching or lifting overhead.  Walk around and use backward-bending and/or stomach-lying positions before or after bending or heavy lifting. Don'ts  Lift things when your feet are too close together, you'll have poor leverage, you'll be unstable, and you'll have a tendency to round your back.  Lift with your knees and hips straight and your lower back rounded. Twisting the trunk compounds the problem.  Tense and arch the neck when lifting.  Lift and/or carry an unbalanced load.  Lift and bend too much in a short period of time.  Lift objects that are too heavy for you.  Lift heavy objects directly following a sustained period of sitting  Lift things overhead with your neck and back arched, if possible.

10. Prescribed Exercises Superman  Target area: back and abdominal muscles  Starting Position: Kneel on your hands and knees with your hands squarely supporting your shoulders and knees comfortably under your hips.  Step #1: Raise left arm and right leg off of the ground extending them evenly with shoulder and hip.  Step #2: Lower your arm and leg back to the starting position rounding your back like a cat.  Step #3: Repeat this exercise by alternating sides to complete 1-2 sets of 10-15 reps for each side.

11. Prescribed Exercises Cat Stretch  Target area: Lower back  Step #1: Get down on hands and knees with back in a natural relaxed position (don’t let spine sag)  Step #2: Keep head straight, neck aligned with spine  Step #3: Hump back-tightening abdomen and buttocks and allow head to drop all the way down  Step #4: Gradually release back and raise head to original position  Step #5: Repeat several times

12. Prescribed Exercises Back Extension  Target Area: Lower back  Step # 1: Standing or kneeling on floor with hands on hips  Step # 2:Slowly arch the lower back and stick out the chest while slightly leaning backwards  A comfortable stretch should be felt in the lower and mid back area.  Hold this position for a count of 10 seconds.

13. Outlook for Mike’s Future  Angiogram is scheduled to diagnose level of blockage  May need cardiac bi-pass surgery  Will continue follow up with exercises and increase intensity, frequency and duration