Question: Like everyone I would like a flat stomach. I understand that one must remove the layer of fat first. I don't think I have much fat. If I pinch the fat near my navel and measure with a ruler it’s ½ an inch (I don't have calipers). I don't think it’s much fat (or is it?). I have been doing abs exercises regularly for two years and still have a potbelly. Are my muscles still so weak that they cannot go inward? My sister in law has more fat and doesn't exercise and her stomach naturally goes inward. Can you help me? Thank you kindly.

Answer: So many people complain of the same problem. The best exercise for your waistline is cardiovascular. This means if your goal is to lose weight, then get moving and burn more calories. Abs exercises are good to do to build core strength, but to effectively burn fat you need to get moving. Genetics may also play a role in your midline. Try to eat a healthy diet. Your goal is to accumulate at least 60 minutes of movement a day to maintain a healthy weight and 90 minutes if your goal is to lose weight. Good luck, Josie

Question: I am reluctant to go the route of cortisone shots for bursitis in my shoulder. The inflammation seems to be improving. Are there exercises that are appropriate to gain greater range of motion?

Answer: If your shoulder is improving you may not want to have a cortisone shot. Slow progression is the key to success. To increase the range of motion in the shoulder you should be warmed up before performing any stretches. Begin with a pendulum move. Stand next to a counter with one hand on the counter for support. Swing the other arm forward and back 10 times. Then perform circular motions with the arm 10 times in one direction and 10 times in the reverse direction. This will warm up and loosen the shoulder joint. You might consider asking your doctor for a prescription to have some physical therapy to get you started on a safe and effective program. Good luck, Josie

Question: What can I do myself to remedy damage done to my arthritic knees from using weights that are too heavy while strength training? Many thanks!

Answer: Slow progression is the key to success. You should ask your doctor if you could have some physical therapy to learn what exercises you should be performing to strengthen your knees. You could begin strengthening your knees with a simple exercise. Lie on your back with one leg straight and the other leg bent with the foot flat on the floor. Lift the straight leg up to the level of the bent knee and back down. Do this 15 times. When this is easy, begin adding an ankle weight. Start low and go slow. Good luck, Josie

Question: I’ve lost maybe 30 pounds within the last two months or so, with the help of "zetacap" hunger-inhibiting pill. I am down to a 29-inch waist, 144 pounds, and I am looking to start building muscle. I don't have much of an attention span and I have a wandering mind, so I do one to three exercises at a time throughout the day. The exercises I do are: Dumbbell curl until moderately fatigued (20-25 curls of a 20 lb dumbbell), three to seven minutes at 3.8 minutes per km (or mile?) at the greatest incline my treadmill (pro form) allows, leg press until moderately fatigued (20 reps), 10-15 leg curls on my healthfx gym, 10-15 leg extensions on the healthfx, butterfly until moderately fatigued (20 lbs and 20 reps), bench press off and on, because I figure the butterfly takes care of my pecs. Each exercise is done once, twice or three times a day. Is there any supplement I could take before all of my five to ten minute workout sessions, to assist in the growth of the muscles worked in that session? Is there something that would be okay to take three to five times a day? Any help would be appreciated.

Answer: You are asking many of questions that each need addressing. First, losing 30 pounds by using zetacap is worrisome to say the least, unless this is under the direction of your doctor. I would not take any supplement unless your doctor has prescribed it! The safest way to lose weight is through a healthy diet, portion control and exercise. Slow progression is the safest way to success. Strength training is an important component of fitness. American College of Sports Medicine advises that strength training should be done two to three times per week with 24 hours of rest in between workouts. This workout should include eight to ten exercises for the major muscle groups with one to three sets of 10 to 12 repetitions. If you are doing 25 reps you should consider adding more weight and doing 10 to 12 reps with proper form. I do not suggest taking any supplement before these 10-minute sessions. It sounds to me as if you are looking for the magic pill, which is a dangerous approach. Your money would be better spent by hiring a certified personal trainer and a nutritionist to help you get your eating and exercise programs on a much safer and more productive track. I hope this helps. Good luck and be safe. Josie

Question: I recently bought a workout bench that has a bench press, bicep curl and a leg exerciser. I want to know what would be the most efficient way for me to bulk up using this equipment. I am 18 years old, I have an average build and have no health problems.
Answer: The key to a successful program is to have a slow progression and perfect form. The American College guidelines for strength training are two to three times per week with a day of rest in between workouts, eight to ten exercises that target the major muscle groups, with 10 to 12 repetitions per exercise and one to three sets of each exercise. I personally like to rotate the muscle groups for each exercise to avoid having to rest 30 to 90 seconds in-between each set. Fro example chest/ back or quadriceps/ hamstrings or biceps/ triceps. Begin the workout with the larger muscle groups and end with the smaller muscle groups. This is a very effective and easy way to begin. Pick up the amount of weight that allows you to maintain perfect form, full range of motion and feel as if the last few reps are hard throughout the set. This is a great start to get strong. Good Luck. Josie

Question: I basically have no exercise routine and am over weight. I do custom drapery work for a living and most of my day is spent standing. As a result, my ankles have a tendency to swell. I also have very veiny legs, which my mother suffered from. What exercise routine (besides walking on a treadmill) would you suggest for me to improve circulation, especially in my legs and for overall flexibility? I am 59 years old and not in the greatest shape. I also just started a Weight Watcher-type program (doing it on my own). Help before I turn 60 in January!

Answer: Congratulations on your desire to get into shape. This is the perfect year to start. I am also 59 years old so I can identify with your goal before you turn the big 60! Remember that any exercise is better than none, so anything extra you do is great. I would like you to build up to 30 minutes every day on a treadmill, recumbent bike or walking. This can be accumulated throughout the day. Fifteen minutes in the morning or 15 minutes in the afternoon equals 30 minutes. This is a great way to get the circulation going and loosen up the joints. Weight watchers is a great way to learn about proper nutrition and portion control. Slow progression and consistency is the key to success. I would love to see you start some strength training as well. Stretching those stiff muscles should be done at the end of your cardio workouts when your body is all warmed up. Hold each stretch for 20 to 30 seconds without bouncing and breathe normally. I also think you should ask your doctor about your legs and see if he/she has any recommendations for you. Good luck and keep in touch. Josie

Question: Hello, I was looking for advice on what steps to take to become a legitimate personal trainer. When I search for information all I seem to get is ads for on-line degrees, which I’m sure are useless. Any information you could give me would be greatly appreciated. There is a school in Waltham with a six-month course I was considering. It is called The Personal Training Institute Thank you for your time.

Answer: To become a Personal Trained you want to get certified by a nationally recognized organization. American Council on Exercise (www.acefitness.org) is a good example of this. You can go online and order their personal training home study package. When you are ready you can take the exam here in Massachusetts. I believe it is offered at least two times per year. The Personal Training Institute is not a nationally recognized certification. You would be better off to get certified by one of the five recognized by The National Commission for Certifying Agencies. They are the American Council on Exercise, National Council on Strength and Fitness, National Strength and Conditioning Association, National Academy of Sports Medicine and the National Federation of Personal Trainers. Good Luck! Josie

Question: I'm currently working out with a personal trainer twice a week. I'm 52 years old and had bilateral hip replacement in July and December of 2000. MGH says I'm the poster child. I was hell bent on a perfect recovery and was fortunate to have found a personal trainer at my gym in April 2001 who had been a physical therapist for 10+ years! I worked out with her for one year before she left that gym. She really showed me that I could be "normal" (within my precautions)! I walk two hours per day (one back and forth to work and one during lunch break) and each day I am grateful that technology is keeping up with us! I'm okay (but just okay) with current situation, but wondering if you might be able to recommend someone else? I live in the Back Bay and work in the financial district.

Answer: You can find certified personal trainers by going online to one of the following organizations recognized by the National Commission for Certifying Agencies: American Council on Exercise, National Council on Strength and Fitness, National Strength and Conditioning Association, National Academy of Sports Medicine and the National Federation of Personal Trainers. You usually can search for a trainer in your area. Another suggestion is to ask your Doctor or Physical Therapist for a reference. Good luck. Josie

Question: So glad to have found you! Happy to report this June will be my 10th anniversary. I had a modified mastectomy and tramflap reconstruction - very successful. Now to the point. I have problems with my ribs (on the recon side) one in particular keep popping out and I am constantly uncomfortable. Most upper body exercise seems to make it worse, I was hoping strengthening my chest muscles would help stabilize them. Any advice on exercise strategies for me? I'm 54, 5'4", 140 lbs, enjoy hatha yoga, don't enjoy high impact aerobics (uncomfortable bouncing around too much) and can pretty much keep up with Denise Austin's Fit and Lite routine! Thank you. I very much look forward to your suggestions.

Answer: We have just completed writing a Book with McGraw Hill and Harvard Health Press, “Breast Cancer Survivors Fitness Plan,” which will be out this September. We have designed Flexibility and Strength Training routines for each type of surgery and reconstruction. I know the book will be very helpful for you. In the mean time we have a DVD out, “Breast Cancer Survivors Guide to Fitness” that can be ordered from www.dymnamixmusic.com. There is a wonderful day planned for Survivors on May 20th at the Westin Hotel. Contact Dana Farber for more information on this survivorship symposium. I also think that you need to go back to your Doctor to check out what is going on and perhaps you may need some physical therapy to get you feeling better. Good Luck and Hope to see you on the 20th. Josie

Question: I need some assistance. I am 30 years old, 6' 2", and weigh around 168-170lbs. I starting lifting one year ago and have put on 20lbs., which is great for me. I have defined my chest, arms, and shoulders. Recently though, I have started to lose my six-pack and have developed a "beer belly" of sorts. I do not drink beer to answer your question. How can I get back my six-pack? If this is something you cannot answer, kindly point me in the right direction. Thanks in advance.

Answer: Congratulations on working out on a consistent basis. It does sound as if you have buffed up and as you said gained 20 pounds. I believe the reason that you have lost your 6 pack is because of the weight gain. Your six-pack is still there but is now covered by some fat. I suspect that you are not doing enough cardiovascular exercise, which burns calories. At the end of the day it is calories in and calories out. So if you are consuming more that you are burning then you will gain weight and that is probably what has happened. I suggest up try to build up from 30 to 60 minutes of cardio a day to maintain a healthy weight and cut down on the intake. It is a very simple way to find that six pack. Good Luck Josie

Question: They say that you should lose no more than 1 to 3 pounds a week due to health risk and/or muscle loss. However, if my diet consists of all of my daily nutrients and protein with an extreme cardio and weightlifting workout, how could I lose muscle or be risking my health if I decided to lose up to 5 pounds a week?

Answer: Studies show that those who lose 1 to 3 pounds a week are the ones most likely to keep it off long term and also are creating a lifestyle. Those who do things in extremes usually cannot do it for long periods of time and end up gaining the weight back and even more. We suggest that you think in terms of moderation. Slow progression is the key to success. I suggest that you seek nutritional advice from an expert in the area of nutrition. Nancy Clarke is a wonderful sports nutritionist and she can be reached at Healthworks in Chestnut Hill, MA. Good luck and try to stay away from the "extremes". Josie

Question: I have been traveling and not exercising for approximately 3 months. Prior to this time, I was running and weight training. Can you suggest a plan to get back into condition?

Answer: Thanks so much for your question. It is hard to travel and keep up with your fitness routine. Now that you are back it is time to start to get back into shape. The key to success is to progress slowly and allow your body time to adapt to the intensity of the exercises. You may want to begin walking at a brisk pace for 30 minutes a day and gradually work up from there. Thirty minutes would be approximately 3,000 steps on a pedometer. To be active, your goal would be to get to 10,000 steps a day. That is from the time you get up to the time you go to bed. You can start strength training again, but probably will have to start off with lower amounts of weight. Try to train two times per week with 24 to 48 hours of rest in between workouts and gradually work up to three times per week. Remember, no one is more important than you. Take the time to get into shape. Try to schedule it into your daily schedule and make it a priority. You will be surprised how fast you can do this.


Question: I have a few fitness questions I hope you can help me with. I am a 56-year old female and am currently going through the Weight Watchers program. When I started with Weight Watchers I wanted to lose 30 pounds, and as of this week I have lost 16. I walk 30 minutes a day at least six times a week and exercise with weights about four times a week for 15 to 30 minutes. I have a lot of loose skin from my bra line down to my waist. At my age, will I be able to eventually firm this area up? What are the best exercises for this area?

Answer: Congratulations on joining Weight Watchers and losing your weight. At 56 it is very important to keep moving to maintain a healthy weight. We are also impressed that you walk 6 days a week and are strength training. We would like you to try to increase your walking to 60 minutes a day or 6,000 steps on a pedometer. This is from the time you get up to the time you go to bed. Also, you might try to strength train three times per week with 24 to 48 hours of rest in between workouts. We would like you to take some extra time to tone the areas that are bothering you. By cutting out one strength training session you can add minutes to your cardiovascular workout. As for the problem of the loose skin, hopefully the toning exercises will help. You might consider hiring a Certified Personal Trainer to help you select which exercises you should do. If the skin is still very loose then we suggest consulting with your doctor. Keep up the exercises and healthy diet and hopefully you will firm up the problem areas.


Question: A little background: I am 72 years old, 5’6” and 130 lbs. Last Spring I had open heart surgery to repair a valve; two weeks later I attended a church dinner; one month later, I attended my graduation as an English Major from Framingham State. In other words, I bounced back quickly -- yet, since then I have been dragging because of an electrical problem within the heart that hasn’t responded to medication. On January 31st, I will have a surgery to hopefully correct this. My question is: What type of exercise machine should I invest in? My treadmill is aggravating a foot problem (arthritis) that is worsening, so I was wondering about an elliptical machine – or anything else that could help me get back to my formerly strong self. My cardiologist at Brigham and Women's, a wonderful man, told me to walk. I did a lot of that up until the bad weather came, as well as a decrease in energy due to the rapid heartbeat. I'm looking forward to reverting back to my former energetic state after the 31st of January. Can you recommend exercises, a machine to have in the house, or just give me some advice? I would be most grateful.

Answer: We are so impressed with you! We understand what a frustration it must be for someone as active as you not to be able to exercise the way you want to. Firstly, because of your heart condition, be sure to have permission from your doctor before you begin an exercise program to be on the safe side. There are a few types of at home exercise equipment that we think you would like and would probably not bother your feet. My first choice for you would be a recumbent bike. This would be non-weight bearing and a comfortable and easy way to get back into shape. I just bought a Fitline from The Gymsource that also has a heart rate monitor. This would be good for you so you could monitor your heart rate. I am loving this bike and it is fairly inexpensive and easy to use. They will deliver and for a fee set it up for you. An elliptical is another great piece of equipment that is easy on the joints and feet. Please let us know how you are doing and good luck getting back into shape. You can do this, but remember that a safe slow progression is the key to success.


Question: What do you think of pilates? Personally, I love it.
Answer: Thank you so much for taking the time to write to us. It sounds like you have found a great workout for you. Pilates is an excellent program and choice when working out. You don't say if you are enjoying the mat classes or the equipment, but either way, it's working for you and that's what is important. If the time comes that you want to add more cardiovascular work to your routine, you may consider walking, treadmill work, cycling, etc. In the meantime, keep up the good work! Wishing you a happy and healthy New Year. Josie and Joy

Question: How can I get rid of a flabby stomach? I am 56 years old, starting over. I started a walking program, but it is not enough. Thank you.
Answer: Congratulations! You have picked a cardiovascular program and that is what will burn the calories and help with a flabby stomach. I have a few questions to ask you about your program. What are the frequency (how many times a week), the duration (how long do you walk) and the intensity (how fast are you walking)? These are the three things you need to think about. If your goal is to lose weight, we would like to see you walking at least 45 minute a day or 8,000 to 10,000 steps a day. A pedometer is a great way to track this. As women age, and especially after menopause, they lose muscle mass. So if it seems as if you are doing all the things you used to do and have gained weight this is the reason. At the end of the day it is calories in and calories out. It is that simple. So if you are taking in more calories than you are burning then you will gain weight. Remember the key to success in eating is moderation, healthy choices and exercise. You may also want to consider starting a weight training program to build more muscle mass and help protect your bones from the effects of osteoporosis. Slow progression is the key to success. Good Luck.

Question: I worked out for 6 months doing weight training and cardio. I lost weight and looked better, but when my friend moved away I stopped going to the gym. Now my weight is back, but I still feel muscle. Now the extra weight I gained feels flabby and it shakes in my arms and legs. I never had that problem before. I thought the muscle tone I built would go away after I stopped going to the gym. Is it still there? Why is the new fat in my arms and legs moving so much now?
Answer: We think you need to find another friend to work out with, as this seems to have worked before! If there is no one, then join a club and take some classes with other people or hire a personal trainer to kick-start your program. When you stop strength training you will lose your muscle mass in about two weeks. Yes you do still have some muscle there, but it takes attention and work to get back to where you were before. As for the flabby and shaky arms and legs, you are probably so much more in tune with your body and noticing it more. They are screaming to you to get moving again. The good news is that you can get this back and probably will find it easier than the last time. We would suggest that you start with 2 strength workouts a week and then 3x per week with a day of rest in between each workout. Try adding a cardiovascular and stretching program as well. Good luck!

Question: I'm a 40-year-old woman. I’m 5’6” tall and 122 lbs. I work out regularly (strength train) and play squash (cardio/lower body). My BMI is probably around 16 percent. I've lost a few pounds lately due to stress and lack of appetite (I'm leveling out at about 122lbs) - my appetite seems to be coming back. I've lost the weight all over, including breasts and face. I'm happy about the loss on the bottom half, but wonder how to maintain this size on the bottom portion (while continuing to tone up legs and butt), but NOT lose it in my face (I'm looking gaunt and tired). I assume there's nothing that can be done about weight loss on breasts (please correct me if I'm wrong!). Do you think I'm underweight? I'd gladly put on some weight to plump up my skin, but don't want to put on fat. I like looking trim and fit, but not tired and gaunt. Any suggestions you can offer are appreciated.

Answer: We think that the first thing you should do is get a check up with your doctor to discuss your weight loss and loss of appetite. He or she would be the best person to determine if you are too thin and help you figure out the best and safest plan. Especially if you have been under a lot of stress, you want to rule out any possible medical concerns. Breasts often get smaller as one loses weight. You can spot tone, but not spot reduce. You do strength train and play squash, which is great. We would be happy to help you get a new program going after you see the doctor for clearance. Please contact us again after you do this. Looking forward to hearing from you again in the near future.

Question: Hi Ladies, I just started a fitness program at age 58. I would like to know when you change to the next weight level with weight training machines and when you change the number of reps. Is it based on a time schedule or more of a comfort level schedule? Also, when does the stiffness go away? I’ve been at it for about a month and I’m always sore. I train three times a week. I spend half an hour on a treadmill, bicycle or elliptical machine and then another half hour weight training and about five minutes stretching at the end. Thanks for any help you can offer. I enjoyed watching your videos on the Channel 5 web site and learned a lot.
Answer: Thank you so much for asking such important questions. It sounds as if you are doing a great job and three times a week is ideal. Let me review a few simple tips that may help you. 1. Make sure that you weight train with a day off in-between each workout to allow your muscles rest and recovery before the next session. 2. In selecting the proper amount of weight for each exercise there are three important guidelines to consider. Quality of movement is the most important factor. You need to be able to go through full range or comfortable range of motion. You should be able to maintain perfect form and complete the recommended number of repetitions. If you are doing one set training then do 15 repetitions, 2-3 sets do 12 repetitions. If you can do all of these things and feel that the last few reps are somewhat hard then you have the right amount of weight. If it’s too hard select a lighter weight and likewise, if it is too easy you probably need more weight. Now lets talk about the fact that you feel very stiff. My first reaction is that you may be doing too much to fast. We like to say start low and go slow. Slow progression is the key to success. You do not need to add more repetitions. Start with one set for each major muscle group and perform 15 repetitions. That should take you 20 minutes and 10 for stretching. Then slowly progress to 2 sets and 12 reps and then to 3 sets and 12 reps. Be sure to rotate your muscle groups or allow 60 to 90 seconds of rest in-between sets if you do the same exercise 3 times in a row. Start with your large muscle groups and end with the small muscle groups. Another option is to add a stretch specific to the muscle group you just worked right after each exercise. This may help with your stiffness. Probably the most important tip is to listen to your body! If anything hurts, stop the exercise, re adjust your position and try it again. If it still feels uncomfortable then stop the exercise. Ask a trainer in your gym to review your workout to see if you are doing too much too soon. Let us know how you feel after making some small changes. Good Luck!

Question: I was very impressed by your fitness program in getting Natalie’s shoulder back to normal. Do you have any tips for someone who has been suffering with a frozen shoulder for over a year? I have gone for the standard treatments and have had two opinions, however I still cannot lift my arm over my head. If and when I do manipulate it, it aches with pain almost setting me back months. I loved water aerobics, but sadly cannot keep myself afloat. I am at my wit’s end. Any thoughts would be helpful. According to the study at the BWH, physical therapy only irritates its, but with the cold weather moving in, I feel like a wounded bird.

Answer: Thankfully, Natalie's shoulder is back to normal and she is doing great. A frozen shoulder is really painful and it sounds like you have been trying to work with your physician and physical therapist -- which is always what we recommend first. A couple of suggestions, just to keep you moving and perhaps feeling a bit better:
If you do have access to a pool, even in the winter, there are many things that you can do, even if you can't keep yourself afloat:
1. Try water walking
2. Wear a vest, or floatation device, so that you can do exercises that keep you upright and able to use your legs, core, and even arms in the range of motion you have.
3. If you are able to be in the pool, without sinking, try using your arms a little at a time (without pain) under the water
Try walking outdoors, and just swing your arms (front to back) within the range of motion that is comfortable for you. Just think of getting the blood circulating.
You haven't mentioned what has caused this situation and what your physician has told you about recovering full range of motion. This may be a good question for you to ask so that you have a better understanding of what to expect in the future. Hopefully the above suggestions will keep you "moving" without the setback of pain, and you will feel better, even if not regaining full range of motion. Wishing you well, Josie and Joy

Question: I am a 57-year-old woman with a height of 5 feet 2 inches and I weigh 150 pounds. I work out at least four times per week. I use free weights at least three times per week (biceps, triceps, back, chest, legs and abs, three sets of three different exercises) and I do cardio 20 to 40 minutes four times per week. I eat well, or at least I think I do. But I cannot drop weight around my waist (arms, chest, legs and butt look good to me!). I do take an antidepressant and somehow feel that this weight is related to this medication. Last year I went on Topamax (low dose) and lost about 10 lbs, but put the weight right back on once I stopped that medication. Do you have any suggestions? A better exercise routine? More cardio? Consult a nutritionist?

Answer: Great question! The waist/mid-section is an area that we are often asked about -- and unfortunately there's no simple answer. It sounds like you have a great exercise program and routine. Very often as women go through menopause/peri-menopause, hormonal changes also cause body changes. It's a good time to take a look at your diet, and also re-assess your exercise routine. So, perhaps we can make a few suggestions that will help.
1. Unfortunately there isn't such a thing as "spot reducing". But you may need to change your routine a bit. When we do the same exercises for a long period of time, our bodies adjust to the workload, and what at first seemed very effective, doesn't seem to work any longer. You don't say what you are doing for cardio work -- or at what intensity -- but often this is a good place to make some changes. This may be a good time to hire a trainer to help you look at your exercise routine and make a few changes that will challenge you a bit more.
2. You mentioned consulting with a nutritionist -- and that's a great idea. Again, sometimes our diet needs a change and of course, medication can also lead to weight challenges.
The really good news is that you seem to be healthy, and are on a good track for staying that way. Keep exercising and trying to eat a healthy diet. Do consider getting some help with the above suggestions. Good luck! Josie and Joy

Question: I had stomach surgery 3 months ago and have been walking and lifting 5lb weights for exercise. I am overweight and love to exercise for stress relief also. How long should I wait to do core exercises?

Answer: Congratulations on taking steps to become a healthier and more fit you! Your surgeon is definitely the one that should tell you when and what you can do for exercise. Once given the okay to exercise, it is often more helpful if you ask the doctor if there is anything you can't or shouldn't do as a result of your surgery. Be sure to ask about core exercises specifically.

We almost always recommend walking as a great choice in getting started on the road to weight control and fitness. Walk, walk, and walk some more! We aren't sure how long you've been lifting your 5lb weights, but as you get used to exercising with them, and the choices become easy, you may find you need to lift weights that are a little heavier. You may find working out in a class, or a gym, or investing in a session with a personal trainer, may help get you to a little more efficient workout and one that is a bit more challenging. Do remember that after surgery, it is important to begin slowly - and then increase your intensity, amount of time exercising, etc., gradually to be sure that you build a stronger body (and not get hurt!). We wish you well in your efforts and know that they will pay off! Josie and Joy

Question: I was wondering about running. I recently put on about 20 pounds, mostly just because I have been sitting around...but now I am back into working out four times a week isolating each muscle group: Chest, legs, arms, shoulders and back. Now I am trying to figure out what to run to lose weight and get lean muscle. I have been running/walking two miles when I wake up and then on a step machine about 1.5 miles or 20 minutes. Should I keep doing this or should I just add another ten minutes to the mid day workout on a step machine?

Answer: It sounds like you are on a pretty vigorous routine right now. We don't know how long you have been exercising, and/or how much weight you have lost. But a few things that might help you are listed below:

The cardio work is definitely going to help you burn calories - so, keep it going, just mix it up a bit.

Try the treadmill - flat, hills, fast, slower (sometimes called a "treading program" - or interval training)

Try a cycle, rowing machine, elliptical machine, etc.

Adding 10 minutes a day - mid day to your workout may be great. Just be sure not to "overstrain", get burned out, and/or set yourself up for an injury.

Cross training - choosing different activities helps prevent this.

Question: I am 68 years old, and had reached a goal weight of 136 lbs. in 2001 using Weight Watchers and regular exercise - about 30 minutes of aerobics 3 times weekly, and 20 minutes or so of strength training weekly. I had maintained that weight until last winter, when I had a blockage of the femoral artery and had to reduce my exercise routine because of leg pain. I was using an exercise bike and still doing my weight training. My weight went up by about 3 pounds. I had a femoral endoarterectomy in May. My weight went up to 142 during recuperation. Getting back to my regular exercise and my Weight Watchers food plan has not helped me get back to goal - I hover between 140-142. Any suggestions?

Answer: It sounds like you have had quite a time with surgery etc. Sometimes it is very difficult making a "break through" with our weight when we just feel stuck! When we have been doing the same exercise and eating plan for a long time our body also just thinks that things are easy, and it doesn't work as hard and doesn't burn as many calories. Maybe the following suggestions will help:

Try changing your exercise routine just a little - not sure of your aerobics, but try a different class and/or use a different piece of exercise equipment (i.e. recumbent bike, stair climber, treadmill etc.)

Try adding one more day to your exercise schedule

Try increasing your aerobic workout time from 30 minutes to 35 minutes (small amounts of increase at a time!)

Mix up your diet just a bit. Weight Watchers is a good food plan, make sure you are not choosing the same things all the time. Keep variety in your food choices as well as your exercises.

Question: I am a runner and am in good shape. I am 5'6" and 122lbs. However, my legs are somewhat muscular and larger than I want. Is there any exercise or running routine I could do to stay in good shape yet tone down to thinner, leaner legs?
Answer: It sounds like you are already very lean and working out quite a bit. A couple suggestions that may help shape your legs, more to your liking:

Try a Stretch Class, Yoga Class or Pilates Class - to concentrate more on stretching and "lengthening" the muscles of your legs.

It sounds like your legs are muscular, but sometimes changing the activity slightly - cycling, treadmill using a combination of flat and hills, etc. will help change the definition of your body

Try using the "leg" machines in your gym (if you go to a gym). Do 15-20 repetitions with a lighter weight than usual. We think of lower resistance and a higher number of reps to "shape" the muscles.

Also, do realize that genetics also pays a big role in our body shape. So, take a look at your family and see if there is a familiar pattern. Thanks so much for writing. Keep up your exercise routine, and good luck!

Question: I'm 16 years old and I’ve just started to work out (3 times a week). I’m really looking to get rid of the fat on my buttocks. I am generally quite fit. I play for a football team that trains twice a week and I have a match every Sunday. I would say I eat well. For breakfast I normally have toast with orange juice, for lunch I have ham with tuna/cheese and pickles in brown bread with a piece of fruit and a yogurt, and for dinner I have whatever my mum makes me! I’m happy with the rest of my body but my bum sticks out like a sore thumb. Can you help me?

Answer: It sounds like you are doing a good job at exercising and trying to eat healthy meals. You didn't say how much you weigh, or how tall you are, or how much you eat, but we do know that you are training hard from the fact that you are on a football team. The other thing is that you didn't say much about the training program that your football coach is using. You really can't get rid of the fat in one area of the body. Unfortunately it just doesn't work that way. But there are some things you can do that might help "shape and better define" your area of concern. If you are on a weight training program with your football practices, ask your coach to give you a workout with more emphasis on lower body exercises. Also realize that a cardiovascular workout will help you burn body fat, which in turn helps re-shape the whole body. Try running, cycling, rowing, etc. as a change of pace to your regular football workout. All should also benefit your football training. So, good luck to you. And keep up the good work!

Question: What are safe exercises for those of us who have bad knees?

Answer: The question has been asked about what exercises are safe for people with bad knees. This is a situation that many people deal with. First things first, if this is a new injury or complaint, it is a good idea to check with your personal physician to find out if there is a specific exercise prescription that you should be following, or if you need physical therapy.

For most people dealing with bad knees there are still many things that you can do. Walking is one of the best forms of aerobic activity. If you have access to a gym, or equipment, you can use a treadmill or a stationary bike. Recumbent bikes are also a good choice and gentler on your knees. Of course don't forget weight training. If you aren't sure about the leg machines, ask one of the trainers in your facility to help set you up so that you use correct form and don't put pressure on your knees. Your form and body alignment are really important and you may need to be careful about activities that have you bend your knees excessively, or have you move in a way that is jarring, twisting or causes impact.

Also, check out classes that you might enjoy such as low impact aerobics, sculpting, or body conditioning, stretch, pilates, etc. Water workout classes or swimming are also great alternatives.

The key is to listen to your body. If an exercise doesn't feel good and you think it puts pressure on your knees, then don't do it. You are the boss and know what does, or doesn't feel right for you. We hope this will give you some ideas. Good luck with your exercise program, Josie and Joy

Question: Hello Joy and Josie…I am a 46-year-old mother of two teens, am very overweight and I guess a coach potato. But I feel I am never sitting down. Errands, housework, etc., but was never "physically active". Always skipped gym class. Well now it comes time to face the music. I lifted a large load of laundry and carried it down a flight of stairs and now have a bulging disk in L4 and L5 of my back. I started physical therapy, but honestly, I need to lose weight and get in shape!! How do I exercise when I have a lower back problem? Do you have any advice on how to burn calories? Weights? HELP!! Thanks so much.
Answer: Thanks for your question. We are so glad that you have decided it is time to start getting into shape. You have to really want it for yourself to be successful and it sounds as if you are ready to get started. Slow progression is the key to success and any exercise you do is better than nothing. We want you focus on more physical activity and better nutrition. Since you have hurt you back it is very important that you get permission from your Doctor or Physical Therapist to begin an exercise program. Cardiovascular exercise is what burns the calories so we would like to see you start moving. What do you like to do? Walking is a great form of exercise and can be done anywhere anytime. We would like you to start by trying to get to 30 minutes a day. You can start with ten minutes three times a day or get up and walk around five minutes every hour, which would be 40 minutes at the end of eight hours. We love pedometers, as they are a great way to measure your activity. We would love you to get to 6000 steps a day, which would equal approximately 60 minutes of movement! Put it on when you get up and take it off when you go to bed. This is the total of your movement all day. If weight-bearing activity like walking is too hard on your back, riding a stationary recumbent bike may be a great solution. Once again, clear this with your Physical Therapist. Join a program like Weight Watchers to help learn portion control and food choices. You can do this and we wish you the best of luck. Let us know if we can help you with any other questions and also how you are doing. Good luck. Josie and Joy

Question: I am a 44-year-old woman, overweight with knee pain. I am sure the knee pain is a direct result of being overweight; therefore, I realize it is especially important I lose the weight. What type of exercise program should I start in order to lose weight, yet not cause more pain/injury to my knees? Please help!
Answer: Being overweight may aggravate your knee. That said, before starting any exercise program you need to have your knee checked by a doctor. He or she may want you to have physical therapy and also may advise you on what to do. The type of exercise programs that probably would not bother your knee would be riding a stationary bike and probably a recumbent bike where you are seated with your legs extended out in front of you. A good sensible eating plan will also help you lose weight. Weight Watchers is a good place to start. Good luck. Josie

Question: What do you recommend for a 52-year-old male that is 110 lbs overweight and looking to get my life back in order with the right kind of eating and exercise.

Answer: Thanks for the question, as it is a great one. Remember that any exercise is better that nothing. A great way to start is by walking. Try to work up to 30 minutes a day. If you cannot do this all at one time then get up and move for ten minutes 3 times per day or walk around for five minutes every hour. It is also necessary to get a good healthy eating plan. It is also a very good idea for you to get a check up with your doctor to get the clearance to start. Let us know how you are doing. Good luck. Josie

Question: I have had a stress fracture in my foot, the 2nd metatarsal, since November 2004. For some reason the fracture is not healing and since I am unable to exercise I am concerned about weight. I am 64 years old, am 5'2" and weigh 142 lbs. Is there any way I can exercise without hurting my foot?
Answer: Stress fractures definitely take time to heal, but there are a few things that you can do until you are able to put weight on your foot again: You can bicycle. Stationery bikes are perfect; especially the recumbent bikes, and they will allow you to workout, control the effort, and not place any pressure on your foot. If you have access to a swimming pool, water exercises and swimming are also a great way to workout without pressure on your foot. If you do exercise in a pool, be careful not to do any jumping or jogging type moves with your feet touching the bottom of the pool - these can still place stress on your foot. Instead, just swim, or use a "water noodle” or a kickboard to keep your feet off the bottom of the pool and still get some really good exercise. Upper body movement and exercises are also very effective in the water. Good luck - wishing you a speedy recovery from your stress fracture.

Question: What is your take on Walking Tapes? Is this something I should be doing now in the house to get me started? I do not have a stationery bike and I don't know about the gym at this point in time. Seems like my paycheck goes to too many places right now and there isn't anything extra.
Answer: Thanks for asking our opinion on walking tapes. Walking is a great form of exercise. If you like walking tapes and own one then use it. If you have not purchased one we think you should spend the money on a pedometer and try to walk outside rather than standing in one place and marching. Pedometers are fun and a great way to measure your activity. Place the pedometer on your hip when you get up and take it off when you go to bed. Count the number of steps for a few days to see what your activity level is. 2,000 steps is approximately one mile. 3,000 equal approximately 30 minutes of activity, 6,000 equal one hour and 10,000 equal 90 minutes and is recommended for weight loss. Start slow and try to add 10% each day. For example if your base number of steps is 3,000 then add 300 steps. All you need is a pedometer that counts steps and a good pair of sneakers. Find a friend to do this with you to keep you motivated and have some fun.

Question: I am a 55-year-old female, I have gained about 25lbs, I quit smoking four yrs ago and I love chocolate. I walk three to four kilos four to five times a week. I have most weight around my mid section. Will walking help me lose weight around the mid section? Please give me some advice on my problems. I am desperate.
Answer: Thanks for your question. I seem to get this same question often from women over 50! Firstly CONGRATULATIONS on quitting smoking. You have a few things going on here. Many people gain weight when they stop smoking as their metabolism slows down. Women start losing muscle mass after 40 at an approximate rate of 1/2 lb per year. This means that even if you exercise the same and eat the same you could gain about 15 lbs over that period of time. So this means it’s time to make some changes. Aerobic activities like walking, cycling, etc. are the best thing to do to burn calories and help get rid of your mid section. I suggest you buy a pedometer and put it on your hip when you get up and measure your activity for three days to get your baseline. Try to add 10 percent a day. For example, if you walk 5,000 steps one day, add 500 steps the next day. To lose weight you need to try to get to 10,000 steps a day. Start slowly and also try to pick up your pace when walking. If I asked you what four things you think you eat that make you fat, what would they be? Try to cut those four things out of your diet and think portion control. I know the first thing is chocolate -- you pick the rest. Write down everything you eat everyday for a week and you will be surprised. So move more and eat less. Find a friend to exercise with you for fun. I know you can do this, as you want it for yourself! Remember that exercise is the best medicine. Good luck. Josie

Question: I am 57 and my skin on my upper arms and my upper legs looks biscuit doughy when I bend over. Can you tighten up your skin at all or is it an age thing? I am not overweight and I walk and spin a lot.
Answer: I have so many clients with the same problem. You are not overweight and you seem to get plenty of aerobic activity, but you are not weight training. That seems to be the missing link. You cannot spot reduce, but you can spot tone. If you are in a gym where you spin, see if they offer weight training classes and try to do two to three a week with a day off for rest in-between. If you want a video we have "Fit Over Fifty Muscle Conditioning," which you can order at www.ginmiller.com. This is a 30 minute a getting started workout. Good luck. Josie

Question: What are the best sit-ups for lower abs?
Answer: We get this question a lot. Remember that your rectus abdominus is one muscle group -- not upper, middle, and lower. Some great choices are reverse curl or hip ups. Lie on your back with your legs over a stability ball and your arms over your head on the floor. Lift the ball up off the floor, bringing your hips towards your ribs. A hip up is similar to the reverse curl, but performed without a ball. Lift both legs in the air while your arms are at your sides. Try to lift your hips up off the floor. Try to do one to three sets of 15. Good luck.

Question: I am a 71-year-old female who is losing flexibility and energy and getting calf and thigh cramps for which the doctor can find no cause. How can I get motivated to get moving before I freeze up altogether? I live in a town north of Beverly and wonder how much a membership would cost for a senior who needs some personal training to get started or what can I do at home?

Answer: All of the above symptoms sound like they are caused by a lack of activity so it is time to get moving. Walking is a great way to start and can build your endurance. A good way to start is to get up and walk for about ten minutes three times a day. If this sounds like too much then get up and walk around for five minutes each hour. At the end of an 8-hour day this would equal 40 minutes. Remember, anything you do is better than nothing, so do as much as you can. This will get your blood flowing out to your muscles and make you not feel so stiff. Make sure that you drink lots of water and eat a banana a day for the potassium to help prevent cramps. We have a wonderful class for your age group at the North Shore Athletic Club in Beverly, MA that meets Monday, Wednesday, and Friday at 10am. I teach on Mondays and we would love to have you join us. This class costs $5 per session. We also have some new exercise DVD's coming out soon that would be perfect for working out at home. Keep us posted as to your progress.

Question: I've had a problem with my upper arms all my life (from the elbow to my shoulders). I'm 5'3" and weigh 129 lbs. I never go sleeveless because of my arms. They are very loose. I know they'll always be big but I would at least like to firm them up. Nothing I seem to do helps. If you have any suggestions, I would greatly appreciate it.
Answer: This is a problem that many women have. It is not possible to spot reduce, but the good news is that you can do exercises to tone this area called the triceps. A very easy exercise is to lie on your back with your knees bent and feet flat on the floor. Hold the ends of one weight in both hands towards the ceiling directly over your shoulders. Keep your elbows pointing towards the ceiling as you bend your arms bringing the weight down to where your hair meets your forehead. Slowly lift the weight and return to the starting position. Do this 15 times for 1 to 3 sets with a 30 to 60 second rest between sets. Start low and go slow. Josie

Question: I am going on 52, 5 feet tall and weigh 117 (I've lost 31 pounds since last May). I was at the gym at least 4 days a week until I had surgery on my stomach area. The incision is from the belly button down and I'm flat in that area, but the area above the belly button is not. I had a tummy before surgery and it seemed all the abs exercises didn't help. Also, my arms need help, especially the triceps. I feel my arms are blowing in the breeze and I'm very unhappy with them. I'd like some exercises to tone the stomach/abs and upper arms so that I will see results. I plan on going back to the gym this Saturday after being on disability since June 15. I like your view on what exercises I need to get results.
Answer: Congratulations on losing 31 lbs. and I am so glad that you are ready to hit the gym again. It would be great if you could get a certified trainer at your gym to give you a workout targeting your problem areas. Most gyms offer a few free sessions. Remember that cardiovascular exercise is great for your waistline, so try to do at least 30 minutes of exercise a day doing something that you enjoy. Walking, treadmill, cycling, and the elliptical trainer are all great choices. Try taking a class at your gym that offers Core exercises to strengthen your abdominals and back. For your arms, see my answer to the question above. The exercise described is a great one to help tone your triceps. Good luck. Josie

Question: I went back on Weight Watchers a year ago and began walking. Slowly, I was up to one mile every couple of days. I was to the point where I could walk that mile without feeling like I was dying when I got back to my start off point. It included some even walking, uphill walking and downhill walking.
This past December 22, I slipped off icy stairs and suffered a compound fracture of my right ankle. All the time I was home, I did great on the diet and lost 16 lbs. Didn't do much walking, though—but a lot of hopping with a walker until I could put pressure on it. Went through therapy, the whole nine yards. My foot is just beginning to feel really good after 7 months, but still swells from time to time.
My question is when can I hope to return to my mile? I know I can't do it right away, but I have "learned" to limp and am currently trying to unlearn myself from doing this. Any suggestions?
Answer: This is a great question. The quick answer is it’s time to get started again, but remember that slow progression is the key to success. I know that you want to walk, but the problem is that you still are limping and that will keep you from maintaining proper form when walking. Not having proper form can cause other problems. With that said my suggestion is to start cycling on a recumbent bike. If you cannot buy one for your home, join a local health club or YMCA. This is a great way to slowly build up your endurance and burn calories without too much pressure on your foot. When you are not limping anymore then slowly return to your walks. Good luck. Josie

Question: I am a 47-year-old female who I do believe is starting menopause. I read that exercise is really good to alleviate some of the night sweats and belly bulge I am getting. I have not truly exercised in a long time. I am 5-feet-2 and now 170 lbs. I do not want to get any bigger, but do not want to hurt myself starting out too fast or hard. Do you have any suggestions?

Answer: Having gone through menopause I do understand your issues very well. I agree with you it is time to get moving. The best way to start is "start low and go slow". Slow progression is the key to success. Remember that anything you do is better than nothing! We tell our new clients to buy a pedometer and place it on your hip. This will measure the number of steps you take every day. Measure the number of step for two days to get an idea of what your activity level is. Your first goal would be to add 150 steps a day. 3,000 steps = approx. 30 minutes of activity, 6,000= 1 hour. Since your metabolism has slowed down due to menopause you need to get moving and watch your portion control. I would love you to get to 6,000 steps per day. This is the total number of steps you take from the time you get up to the time you go to bed. Let me know how you do and remember to write down the number of steps in a log to track your progress. A fun way is to get a friend to join you in this effort! I promise walking is great medicine! Good luck, Josie.

Question: Can you recommend a good weight training and off-season workout program for basketball? Trainee is a tall lanky high school sophomore.

Answer: A high school basketball player should focus on a program specific to his or her sport. The program should combine jump training, interval training (speed training) and weight training. A good place to start is by asking the coach what he or she recommends. Most schools have pre set programs for their players. If you are unable to find a program go to www.google.com and type in basketball exercise programs and you will find many resources. Good luck, Josie.