1. Prescription for Change MUCHO MIKE Prescription for Change MUCHO MIKE Presented by Duncan, Phil, Bryce, Jesse, Morgan & Mike

2. Introduction Physical ProfilePhysical Profile –Age: 34 –Height: 6’ 3’’ –Weight: 235 –Body Fat: 31%

3. Intro Continued Health HistoryHealth History –Past back injury –30lbs gained in last 2 years (no exercise/bad diet) –30lbs gained in last 2 years (no exercise/bad diet) –Shoulder injury –Non adherence –Booze (alcoholism in family) –High blood pressure 130/90 –High Cholesterol, LDL, low HDL –Angina and family history if coronary heart disease

4. Intro Continued… Social Support SystemSocial Support System –Girlfriend (non-commonlaw) –Mucho Mutt (sedentary dog with arthritis

5. Client Objectives/Goals Weight loss of 30lbs over 8 monthsWeight loss of 30lbs over 8 months Increase energy levelsIncrease energy levels Lower blood pressure to normal 120/80Lower blood pressure to normal 120/80 Reduce pain and improve functioningReduce pain and improve functioning Reduce alcohol IntakeReduce alcohol Intake

6. Mucho Mike’s Beliefs Fewer meals lead to weight lossFewer meals lead to weight loss Truth: More meals/smaller portions is healthier Carbohydrates are fattening (Atkins)Carbohydrates are fattening (Atkins) Truth: Complex Carbohydrates provide long- lasting energy. Alcohol is not a barrierAlcohol is not a barrier Truth: Empty calories, reduced motivation Job activity justifies intakeJob activity justifies intake Truth: Strength training burns less calories than aerobic activity

7. Physical Prescription Hot morning showerHot morning shower Aerobic Activity (submaximal)Aerobic Activity (submaximal) Light Stretching EveningLight Stretching Evening Preventive strengthening exercisesPreventive strengthening exercises

8. Exercise Prescription Back Stretches Mat/Floor StretchesMat/Floor Stretches Hold Each Stretch 10-20 secondsHold Each Stretch 10-20 seconds Starting Goal of 3 times/weekStarting Goal of 3 times/week Cat StretchCat Stretch Pretzel StretchPretzel Stretch Lying Crossover TwistLying Crossover Twist Hamstring StretchHamstring Stretch Low Runner’s LungeLow Runner’s Lunge

9. Aerobic Exercise Week Days: walking with girlfriend and dogWeek Days: walking with girlfriend and dog Every night about a half hour after dinnerEvery night about a half hour after dinner 30 – 45 minutes30 – 45 minutes light intensity, walking so you feel comfortable talkinglight intensity, walking so you feel comfortable talking Weekends: swimming with girlfriendWeekends: swimming with girlfriend Approx. 30 minutesApprox. 30 minutes

10. Exercise Prescription Lower Back & Abdominal Strengthening Stability Ball ExercisesStability Ball Exercises 10-12 Reps10-12 Reps Starting Goal of 3 times/weekStarting Goal of 3 times/week Pelvic TiltPelvic Tilt Back ExtensionsBack Extensions Alternating Leg LiftsAlternating Leg Lifts CrunchesCrunches

11. Ergonomic Applications When pulling a cart:When pulling a cart: –Face the object squarely –Keep your back straight –Bend your knees slightly and pull in a smooth motion. When pushing a cart:When pushing a cart: –Stay close to the load –Don’t lean forward –Use both arms

12. Ergonomic Applications Loading TrucksLoading Trucks –Get help with heavy lifts –Avoid Twisting and bending while lifting –Reaching and lifting –Use Co-workers to lift awkward objects

13. Ergonomic Applications Note use of proper shoes to avoid slippingNote use of proper shoes to avoid slipping Rotate “heavy” or repetitive jobsRotate “heavy” or repetitive jobs –Use breaks to divide up “heavy” work Pace yourself to avoid fatigue when doing heavy work for a long period of time.Pace yourself to avoid fatigue when doing heavy work for a long period of time.

14. Dietary Recommendations Beat the binges and starves….Beat the binges and starves…. - Eat Breakfast - Eat Breakfast –Spread caloric intake throughout the day Reduce alcohol intakeReduce alcohol intake - Move to light beer - Reduce from 3 to 2 per night CoffeeCoffee

15. Stress Management Relief of Chronic PainRelief of Chronic Pain Aerobic ActivityAerobic Activity

16. Preventing Relapse Prepare for problematic situationsPrepare for problematic situations –Develop methods to cope with them Locker SnacksLocker Snacks –Help with avoiding binging Pre-planned recreation with Girlfriend/MuttPre-planned recreation with Girlfriend/Mutt - Will help to avoid drinking all the time after work Adherence to ExercisesAdherence to Exercises –Slips shouldn’t lead to quitting

17. Motivation Health RealityHealth Reality -Family health issues -Risk of Heart and Vascular disease -Back and Functional problems Exercise and Diet improves thisExercise and Diet improves this Relationships – Girlfriend, Mucho MuttRelationships – Girlfriend, Mucho Mutt Efficacy – previous successesEfficacy – previous successes