But who always has access to bright light for reading? Everyone blasts music from time to time. And I know I've never hit the "eight glasses" benchmark. So we decided to expose the truth behind some of these sayings in this month's feature (Health cliches). We couldn't address all of them, but we got into the facts and fiction for some common health sayings and discovered which ones truly are important for healthy living.

When you have your health sayings straight, you can adjust your thinking in other areas, starting with exercise. The first — and most difficult — step of any routine is making it a part of your schedule. Once you've got that down, it's time to focus on your form. Two local professional trainers offer their expertise, nailing down the proper form in a handy visual guide for exercisers at every fitness level (Good form). Proper body positioning can ward off pain and prevent injury and will give you the maximum health benefits.

After refining your routine, complement exercise with a healthy diet. But eating healthy doesn't mean you have to give up flavor for nutrition. Use spices and oils to give a different kick to your meals, instead of using a ton of salt or high-calorie dressings (Spices and oils).

And in between all this health talk, I've always got an eye on my calendar. March usually kicks off the thaw from winter weather, but many of us want to escape to warmer temperatures right away. Keep our list of spring vacation necessities handy while you're stocking your suitcase (Six essentials). And don't forget the sunscreen!

Wishing you well,

Jessica Sipperley

CITIZEN PATRIOT | GEORGIA RHODES

"Drink eight glasses of water a day."

This often repeated statement just doesn't hold water. "There are tons of medical sites that push the wisdom that you must drink eight glasses of water a day," says Dr. Bruce Bigelow, a family doctor in Jackson. "I can't find an authoritative source that tells us exactly why that quantity is picked."

Bigelow points out while high fluid intake is important for the kidneys to remove waste and regulate fluids in the body, the "fluid" you drink doesn't necessarily have to be water. Any kind of juice, milk or other beverage fits the bill, as long as there is not much caffeine (a weak diuretic) or alcohol.

"Many medications can build up in the body and are more likely to cause side effects if you are dehydrated, so a high fluid intake makes many medications work better and more safely," Bigelow says. In addition, some fruits and vegetables, such as watermelon and tomatoes, contain high concentrations of water, too — up to 90 percent.

Registered dietitian Christine Huff recommends reading, "Water: How much should you drink every day?" published by the Mayo Clinic and available at www.mayoclinic.com/health/water/NU00283. The article says factors such as exercise, the environment, illness and other health conditions or pregnancy or breast-feeding can influence your individual need for fluids.

So, how can you know you're getting enough fluids if you don't follow a specific regime? If you rarely feel thirsty and you produce about six cups or more of colorless or slightly yellow urine, the Mayo Clinic would say your fluid intake is probably adequate. But if you're concerned about your fluid intake, talk to your doctor.

"Don't go out in the cold with wet hair. You'll get sick."

This saying is all wet. If wet hair in chilly temperatures gave you a cold, wouldn't everyone in Antarctica be sneezing and coughing year-round? According to Bigelow, colds are caused by viruses caught from others, not from cold weather. The best way to prevent a cold is to minimize physical contact with others and to "obsessively wash your hands," he says.

To prevent colds at any age, Bigelow says, children should have lots of physical contact with others, especially at ages 1 to 5 and older, to help build a strong immune system. Each virus will cause the body to develop antibodies, creating resistance in the future.

"Eating fried food gives you zits."

It's possible this food fallacy cropped up because acne typically starts in adolescence, and it's not uncommon to see teens eating burgers and fries. If you go by the saying, "You are what you eat," then consuming greasy foods leads to greasy skin, and then acne. Right? Wrong.

According to the American Academy of Dermatology, acne is not caused by food — greasy or otherwise. Other foods, like peanuts, cola and shellfish, have been blamed for acne flare-ups, but there is no scientific evidence proving food causes or worsens zits. If a person with acne notices a certain food seems to cause problems, the Academy suggests avoiding it. But overall, the wisdom is to eat a healthy diet and see your dermatologist for proper treatment of acne.

"Cracking your knuckles causes arthritis."

Nope, it's not all it's cracked up to be. The "popping" sound is created by the bursting of a gas bubble trapped beneath the lubricating capsule of fluid covering the knuckle. Researchers at the Johns Hopkins Arthritis Center say there is no evidence to support that cracking knuckles causes any joint damage such as arthritis. There have been reports of injury to the ligaments around the joint or dislocation of tendons, which attach muscle to bone, according to the center. But the injuries were treatable, with no permanent damage. Researchers also cited a study that found many years of habitual knuckle cracking may cause reduced grip strength compared to non-knuckle crackers.

If it's not knuckle cracking, what causes arthritis? There are two major categories of arthritis: Rheumatoid, or inflammatory, and degenerative, known as osteoarthritis. While the jury is still out on the exact causes, researchers believe there is likely a genetic predisposition for both types.

Degenerative arthritis, the "wear-and-tear" variety, is linked to aging and excessive mechanical stress, which may accelerate joint damage. For example, genetically predisposed older obese individuals may be more prone to arthritis in the knees.

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"Sunscreen is just for fair-skinned people."

Darker skin contains more melanin to protect against sunburn-causing UVB rays, but it does not defend against deadly cancer-causing UVA rays. Regardless of skin color, if you are exposed to the sun, even from a car or bus window, you need sunscreen every day, all year. The American Cancer Society recommends a sun protection factor (SPF) of 15 or higher. Look for a broad or multispectrum sunscreen containing such ingredients as avobenzone, oxybenzone, mexoryl, zinc oxide and titanium oxide for the best protection.

If you're already using sunscreen regularly, note the expiration date. Most sunscreen products lose their effectiveness after two or three years. You need about 1 ounce (or a palm-full) to protect yourself from head to toe, and obviously less if only your face, ears, neck and hands are exposed. Reapply every two hours if you are exercising or swimming, because no sunscreen is 100 percent water- or sweat-proof.

Children are especially vulnerable to sunburn because their skin contains less melanin. The American Cancer Society recommends keeping babies younger than 6 months old out of direct sunlight and protected with a hat and clothing.

And there's a beautiful bonus to sunscreen: Skin that has been protected from ultraviolet rays retains more of its elasticity, which translates into fewer wrinkles, better skin tone and fewer "sun spots."

"Reading in dim light will ruin your eyesight."

CITIZEN PATRIOT | GEORGIA RHODES

As far as other eye-related myths, Serino says wearing someone else's eyeglasses will not ruin your eyesight, and using reading glasses, especially after age 40 when most of us need them, will not make you dependent on them.

"Loud music will damage your eardrums."

As tough as it is to hear, several factors can damage nerve cells in the inner ear and cause hearing loss, including heredity, some medications, aging and some illnesses, according to the Mayo Clinic. Chronic exposure to loud noises, such as booming music, is a big contributor, too.

Cranking up the volume on your personal listening device isn't the only culprit. Occupational noises related to farming, construction or factory work can damage your ears. Recreational noises that are potentially dangerous include listening to loud music, shooting firearms, snowmobiling and motorcycling. Even mowing your lawn with unprotected ears puts your hearing at risk.

Noises in the 30- to 80-decibel range — from a whisper up to sitting in heavy traffic or turning on a garbage disposal — are considered safe. Sounds in the 85- to 110-decibel range put your hearing in the "risk range." Noises like a jet engine at takeoff (140 decibels) are in the injury range. Sounds at 90 decibels are the maximum allowed by law during a standard eight-hour work shift.

Hearing damage is irreversible, but taking precautions to protect your ears can reduce the risk of hearing loss. On the job, protect your ears with specially designed earmuffs or earplugs. Away from work, wear hearing protectors if you snowmobile or hunt. And turn down the music, especially when listening for long periods of time.

The idea that gyms are only for bodybuilders or super jocks is a thing of the past. People of all shapes and sizes use fitness centers and programs to get in better shape. But the most important part of using gym equipment is not how much weight is being lifted or the number of repetitions. The first step to using any machine is the right form. Proper body positioning is critical to get the best workout and prevent strain or pain in the body.

"Good form is very important," says Cindy Chrisman, a certified personal trainer at Powerhouse Gym, 1901 Horton Road in Jackson. "If your form is not good, your workout won't be effective. It's always a good thing, as a trainer, to come in and see, 'Oh, look how good their form is.' "

To help gym-goers everywhere, BHJ asked Chrisman and Sandy Darling, another Powerhouse trainer, to demonstrate proper form for popular gym exercises.

Chest press with dumbbells

CITIZEN PATRIOT | DAVE WEATHERWAX

• Keep the elbows in line with the shoulders, and don't let them fall below the bench.

• Push the dumbbells up with the arms.

• Bring the dumbbells together at the top.

• Lower the arms with control.

• Keep the back flat along the bench.

Lat pull-down

CITIZEN PATRIOT | DAVE WEATHERWAX

• Bring the bar down in front of the chest, not behind the head.

• Pull the bar with the elbows, not with the hands.

• Arch the back and lean back slightly, to make it easier to pull the weight into the chest.

• Bring the bar to the starting position with control.

Lunge with dumbbells

CITIZEN PATRIOT | DAVE WEATHERWAX

• Keep the head level and look forward.

• Make sure the back is straight.

• Step forward with one foot. Keep the foot flat on the ground.

• Lower the body straight down and rise in the same way. The thigh of the forward leg should be parallel with the ground.

• Push the weight through your heels when you come up. Point your toe up in your shoe to make this easier, Darling says.

Squat with bar

CITIZEN PATRIOT | DAVE WEATHERWAX

• Keep the chest open and up.

• When going down, don't push the knees forward. Instead, act like you're sitting down in a chair.

• Push the rear back.

• On the way up, keep your weight in your heels.

Side lateral lift

CITIZEN PATRIOT | DAVE WEATHERWAX

• Lift the dumbbells up and away from the sides of your body, creating a straight line with the arms.

• When lifting the dumbbells, stop when the elbows line up with the shoulders.

• Bend the knees slightly. "Don't lock (your knees) because then you put friction into the muscle instead of the joint," Chrisman says. "You're already working the muscle."

• On the way down, don't let your arms drop. Bring the weights down slowly.

Bicep curl

Demonstrated by Darling

• Keep the elbows slightly in front of the body.

• Bend the knees slightly.

• Curl the arms, bringing the weights up in front of the body.

• Make your movements smooth, and always keep the arms in line with the body.

Tricep rope pressdown

CITIZEN PATRIOT | DAVE WEATHERWAX

• Stand with the legs apart, knees slightly bent.

• Pull the handles to chest level.

• When pulling down, pull the handles apart; when coming up, bring handles back together.

• The whole time, keep your elbows glued to your sides.

Treadmill

CITIZEN PATRIOT | DAVE WEATHERWAX

• Move the arms up and down, not across the body, which could strain the back.

• When moving the arms up, the hands should line up with the chest.

• Move your feet in a heel-to-toe motion. "You want to push off the ball of your foot," Chrisman says. "This will bring you forward."

• These tips apply for both walking and running.

Stairstepper

Demonstrated by Darling

• Do not hunch over the machine. Keep your body straight and tall.

• Keep the head in line with the spine.

• Look ahead, keeping your gaze at eye level.

Sit-ups

CITIZEN PATRIOT | DAVE WEATHERWAX

• Support the back of your head with your fingertips. Do not interlock your fingers.

• Pretend a string is pulling your chest straight up, Chrisman suggests. "The biggest thing is remembering to lift with the chest, not the chin."

• Exhale on the way up and inhale on the way down.

• Keep your feet flat on the floor.

Things to remember

Chrisman and Darling emphasize a few rules of thumb for every type of exercise:

• Pull the belly button toward the spine, tightening the abs.

• Don't hold your breath. Make sure to exhale in the exertion motion of the exercise — whenever you're activating the muscles the most. "That's huge; that's a really big deal," Darling says.

• Remember body alignment, keeping the shoulders, hips, knees and ankles in mind.

• Focus on maintaining your form, not the amount that you can lift. "By the last couple of repetitions, you should be feeling a struggle, but you don't want to be losing your form," Darling says.

• Don't add weight too quickly — go in 5-pound increments. You shouldn't have so much weight that you can't control it on the way down.

• If you are working one side of the body, make sure to work the opposite side, too.

CITIZEN PATRIOT | ERIK HOLLADAYTim Welsh of Jackson participates in a Spinning class at Jackson Community College.

Consider it amped-up stationary cycling.

Spinning is a high-charged aerobic workout that tones leg muscles and can build strength. It burns some serious calories — as many as 600 in a 40-minute class — and strengthens quadriceps, hamstrings and gluteus in the rear, as well as the "core," which includes abdominal and lower back muscles. It also isn't too tough on the joints, says Amy Herrick, a certified Spinning instructor who teaches classes at the Allegiance Health Wellness Center.

"It's low impact," she says. "It's a great lower body workout."

Spinning was created in 1989 by cyclist John G. Goldberg as a way to train for races, but classes grew to include anyone looking to get in shape. The bikes are specially designed with a fly wheel that is weighted or belt-driven to provide adjustable resistance, Herrick says.

Spinning is now trademarked, so only certified instructors can use the word to describe their classes. However, gyms may offer similar cycling workouts with different names.

Instructors offer participants a simulated ride that takes them through a variety of terrain. Stationary cyclists do simulated "hill climbs" with heightened tension, as well as runs or sprints that pick up the pace.

At first glance, it may look like an activity reserved only for fitness buffs, but Herrick says anyone can do it. She encourages those who join her class to set the resistance or the speed of pedaling to what is comfortable for them.

"People say 'I've seen those Spinning classes, they're ruthless,' but everyone can do a Spinning class and everyone can go at their own pace," she says.

Loretta Merrill, 72, of Napoleon Township has been participating in the classes for more than a decade and says she enjoys trying to keep up with her daughter, Michelle Woods, who teaches the classes at a handful of local gyms. "I've had fun with it," Merrill says.

Those who decide to try it should make sure to bring plenty of water and wear stiff or supportive shoes and comfortable clothes, Woods says.

"It's a fun-filled 50- to 60-minute bike ride, and it's choreographed to music," Woods says. "It's a great way to get a great workout in a short period of time."

Where to go

Check out local Spinning classes at these fitness centers:

Jackson YMCA, 127 W. Wesley St., 784-9622

• Mondays and Wednesdays: 5:45 a.m., 12:10 and 5:30 p.m.

• Tuesdays and Thursdays: 8:30 a.m. and 5:30 p.m.

• Fridays: 8 a.m.

• Saturdays: 8 a.m.

• Sundays: 12:30 p.m.

Members must purchase a $14 card to take classes, or pay $3 to drop in. Nonmembers pay $8 to drop in.

Jackson Community College, Victor Cuiss Fieldhouse, 2111 Emmons Road, 796-8455

• Mondays and Wednesdays: 5:30 to 6:30 p.m.

• Tuesdays and Thursdays: Noon to 1 p.m.

• Saturdays: 9 to 10 a.m.

Allegiance Health Wellness Center, adjacent to the hospital at 205 N. East Ave., 788-4867

• Mondays, Wednesdays and Fridays: 5:15 a.m. and noon

• Thursdays: 4:30 p.m.

• Saturdays: 8 a.m.

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Before these culinary advancements, there were spices and oils. A spice is an "aromatic vegetable substance, in the whole, broken or ground form," excluding items usually seen as food, like onions and garlic, according to the Food and Drug Administration. Using spices is a calorie-free way to bring out the flavors of food. In a similar way, swapping dressing or sauce for oil is a healthy move.

Add just a pinch ...

Spice availability in the United States increased 41 percent from 1995 to 2005, according to the United States Department of Agriculture. The popularity of spices has risen locally as well. Denene Vincent, founder and executive chef at Le Chat Gourmet in Eaton Rapids, is debuting a cooking class focused on spices in April.

"I've had so many people inquire about it — how to store spices, how to use spices," Vincent says. "You will never walk down the spice aisle or look at spices the same way again after you come to this class."

Vincent teaches students how to produce spices in classes regularly. "It's all part of healthy cooking — keeping things as pure as possible," Vincent says.

Some of the most widely used spices include vanilla bean, ginger root, nutmeg, sage, rosemary, parsley and pepper. Shoppers can combine spices to make seasonings. For example, popular seasonings in Vincent's classes are a cajun seasoning, with cumin, paprika, chilies, garlic, onion powder and cayenne, white and black peppers; and a jerk seasoning, made with nutmeg, allspice, cinnamon, black pepper and garlic.

Both flavorings would go well with chicken and can include herbs as well, based on tastes. Vincent also suggests experimenting with different peppers and using juniper berries with game-oriented dishes, like duck and venison.

"When you're doing different types of cuisine, look at some of the things that are indigenous to that culture and its food," Vincent says. "It's such a learning lesson. It's so much fun."

Although we would be inclined to think salt is a spice, due to its partnership with pepper, it doesn't make the cut. Salt is a chemical compound, and too much of it can cause high blood pressure, which can lead to heart attack or stroke, says registered dietitian Robin Shear, who practices in Brooklyn.

"Spices can expand people's sense of taste without the negative side effects that salt can have," Shear says. "(A spice) brings up natural flavors of food, rather than masking it with the flavors of salt."

Making a switch to a spice can reduce calorie intake as well. Add red chili flakes or pepper to marinara sauce instead of salt. Or, use cinnamon in place of sugar to flavor unsweetened applesauce, Shear says.

"Over time, that would be a small change that could actually add up to a significant savings," Shear says.

... or a splash

Vincent uses oils in every class, especially extra-virgin olive oil. Canola oil also is a healthy pick, Shear says. These oils contain monounsaturated fats that are good for the heart.

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"Balsamic vinegar would be my No. 1 choice," Vincent says. "Put the vinegar at the bottom and slowly add the oil, whisking constantly so they don't separate."

Oil-based dressings are more nutritious than those that are cream-based, but in any case, dressing should be used in moderation. Shear even recommends using some type of oil over fat-free dressings.

"Nutrients are better absorbed in the body with the oil, especially fat-soluble vitamins, like A, E, D and K," Shear says. "It's all about the portion size."

On the Web

To sign up for Le Chat Gourmet's spices class, or for more information about classes, visit www.lechatgourmet.com.

For more ideas on pairing spices with your favorite dishes, check out suggestions from the Culinary Cafe at http://www.culinarycafe.com/Spices_Herbs.

In our dine-and-dash society, convenience often trumps nutrition in meals. Even when we try to make good choices, these foods can be rich in processed ingredients and other stuff that's not very healthy.

For a little help to find the healthiest foods out there, BHJ went to some local experts. Organic grains, fresh fruits and vegetables and a tiny grain called flax seed are items area health store owners say are truly healthy. Reading nutrition labels and the way you prepare your meals make a big difference, too.

Great grains

Bread is a staple in everyday eating, but whole grains make the healthiest loaves. Walt Shuberg Jr., owner of Natural Health Foods Inc., 1090 Jackson Crossing, and Walt's Health Food & Specialty Shop, 102 W. Michigan Ave., recommends checking the label to make sure whole grains are included. For example, sprouted grain bread does not include any processed ingredients and contains enzymes, which provide energy. Shuberg carries Food of Life Sprouted 7 grain bread at both stores.

Another grain that offers a variety of health benefits is flax seed, which Shuberg considers his "hottest grain" right now with his customers. This seed is either brown or gold and has a nutty taste. Flax seed is an excellent source of fiber and omega-3 fatty acids, Shuberg says. These fatty acids have been shown to lower risk of heart-related issues, including heart attack, according to the National Institutes of Health. Flax seed oil is on the market, and you'll get the omega-3s but no fiber.

Flax seed contains potassium, magnesium and protein and is low in saturated fat. In addition, flax seed helps the heart, provides good oils for the skin and lubricates joints, Shuberg says.

Flax seed can be added to bread, oatmeal and organic grains. Shuberg says some of his customers have put flax seed in fruit juice, milk, soup, salads, baked goods and even coffee beans.

Get picky about produce

Fresh fruits and vegetables top any list of healthy foods. Fruits and vegetables are packed with vitamins, minerals and other essential ingredients. Plus, they offer tons of enzymes, boosting energy levels, and don't fill you up with processed ingredients, Shuberg says.

If eating vegetables sounds bland and unappealing, Barbara Gawron, co-owner of Nature's In Herb Shop, 108 N. Main St. in Brooklyn, says it is OK to add seasoning or make a dip to add some flavor. For instance, adding a little peanut butter to celery.

"As long as you don't go off the deep end with several processed ingredients," Gawron says. "The better nutrition you have, the higher your energy level will be. You will be capable of doing more, because your body has more to work with."

Although all fruits and vegetables have nutritious value, there are some that rise above the rest. Cranberries and blueberries are loaded with antioxidants, for example. Shuberg says spinach or romaine lettuce offer more nutrients than iceberg lettuce, which is mostly water.

Label lingo

When Gawron takes a peek at food labels, she always remembers her motto: "If you can't pronounce it, don't eat it."

"Keeping chemicals out of your body is the best thing you can do," says Gawron, who has a background in nutrition.

Aside from mysterious labels, you also should avoid prepared meals that advertise "Just add water!", because they have high amounts of processed ingredients — ingredients that have been changed in some way from their raw states. Processing allows food to be preserved, but vital vitamins and minerals can be lost. Processed foods can include additives, or substances that lack nutritional value. Cooking from scratch is the best choice, Shuberg says.

Cooking from scratch can be difficult for some, because of the amount of time involved. But a simple meal, such as a Caesar salad, can be a quick-yet-healthy option. Shuberg says he chops up a chicken breast and adds some celery and onions to his salad.

"Everyone has things to do on their plate each day, but sitting down to a good meal is very important," he says.

Here are some tips for smart grocery shopping, from eBrandAid.com:

• Speed read the front label. Manufacturers use the front label to entice shoppers to buy their products, which means more than likely, the wording is pure advertising jargon.

• Go to the ingredients list. Manufacturers list ingredients in order, from most to least.

• Look for words you can't pronounce or terms that sound like something from your ninth-grade chemistry textbook. This will be another clue there are chemical additives that might be harmful to your health.

• Scan the Nutrition Facts label. This is where you'll find the amounts of nutrients you're getting based on the ingredients list.

Whole grains play a major role in reducing the risk for many health problems, such as ...

• Heart disease

• Stroke

• Type 2 diabetes

• Several forms of cancer

• Gastrointestinal problems

To make sure you're really getting whole grains, check the ingredients list for the words "whole" or "whole-grain," says Michael Lackman, a registered dietitian at Allegiance Health. "Cracked wheat," "wheat flour" and "stoned wheat" labels do not guarantee that a product has whole grains.

"Try to make at least half of your daily grain servings whole grain," Lackman says.

Mention the word "vitamin," and the next thought likely relates to health. Vitamins are good for everybody, and healthy foods are stocked with them. But the most difficult part of vitamin consumption is keeping tabs on what each vitamin does for the body, especially with 13 vitamins to remember. Riboflavin, or vitamin B-2, is one of eight B-vitamins humans need in their diets.

What is riboflavin?

Riboflavin is a water-soluble B-vitamin that's essential for metabolic processes, normal cell function and energy production. It also assists in maintaining the body's supply of other important B-vitamins, such as B-3 and B-12, as well as iron, zinc and folate.

Which foods are rich in riboflavin?

Organ meats, such as calf's liver, crimini mushrooms and spinach, are considered excellent sources of riboflavin, according to the U.S. Food and Drug Administration. Other good ways to pack more riboflavin include eating almonds; eggs; milk; and lean meats, like beef tenderloin; plus fish, soybeans, whole grains and yogurt.

According to researchers at the Mayo Clinic, people who eat healthy diets rarely need a riboflavin supplement, but it is often found as part of a multivitamin.

How much do I need?

Based on the Reference Daily Intake value from the FDA, the Institute of Medicine at the National Academy of Sciences recommends 1.3 milligrams of riboflavin for males 14 and older. Females 14 to 18 need 1 milligram daily, while women 19 and older need slightly more — 1.1 milligrams. The need for riboflavin increases with pregnancy (1.4 milligrams) and breast-feeding (1.6 milligrams).

How do I know if I'm not getting enough?

Telltale signs of a possible riboflavin deficiency include a sensitivity to light; tearing, burning or itching sensations in and around your eye; soreness around your lips or tongue; cracking skin at the corners of your mouth; and peeling skin around the nose. More serious health problems include anemia, dermatitis, weakness or swelling of the tongue or throat. People with chronic illnesses, the poor, the elderly or those with alcohol dependencies are more susceptible to riboflavin deficiencies.

If you suspect you may be riboflavin deficient, ask a health-care professional for an evaluation.

Our bodies can only absorb so much riboflavin, so any excess comes out in urine. There is no danger of riboflavin overconsumption.

How do medications affect riboflavin?

Birth-control pills, the antibiotic tetracycline, some antidepressants, alcohol and anti-malarial and anti-gout drugs are known to decrease riboflavin availability in the body.

Sources: The Mayo Clinic (www.mayoclinic.org) and the George Mateljan Foundation (www.whfoods.org).

CITIZEN PATRIOT | ERIK HOLLADAYDarin Ditzel of Jackson works out doing incline barbell presses at Pro's Gym in Vandercook Lake.

Putting many people in the same area provides a haven for germs. Beyond a minor cold, a more serious health condition has been getting heightened attention. Methicillin-resistant Staphylococcus aureus (MRSA) is a type of bacteria that causes skin infections. MRSA is especially dangerous because it is resistant to several antibiotics, including methicillin, penicillin and amoxicillin.

"I'm not saying that people shouldn't be worried about staph, (but) most infections are pretty mild and can be contained," says Dr. Suzanne Bradley, an infectious disease specialist at the VA Ann Arbor Healthcare System and University of Michigan Health System. "In emergency rooms, 95 percent of infections will be the types that doctors see all the time."

A common bacteria

About 85 percent of MRSA infections were found in health-care settings, according to 2005 data from the Centers for Disease Control and Prevention. Methicillin-susceptible Staphylococcus aureus (MSSA) was the common strain in the community, Bradley says. "In the last couple of years, we've started to see MRSA in patients who had absolutely no contact with the health-care system," Bradley says.

"The good news is most of the people that have those kinds of infections do well," Bradley says.

However, infections can become severe with the onset of staph or bacterial pneumonia, which is more likely during flu season. With a typical flu virus, people generally start to feel better after about a week, Bradley says. But if staph or other types of bacterial pneumonia set in, the flu-like symptoms return after a brief period of improvement.

"Staph pneumonia can be pretty serious business, even if it's not MRSA," Bradley says. "If you start feeling sick again, you need to get to a doctor right away."

Staph bacteria occurs naturally in humans, creating difficulty in completely preventing infections, Bradley says. About 10 percent to 20 percent of the human population chronically carries staph bacteria, typically in the nose. However, people can go through their whole lives without being aware of the existence of significant staph bacteria, Bradley says.

"When you're dealing with a bacteria that's a normal part of human flora, it makes it really hard to control," Bradley says. "That's why people have focused on trying to find a way to make a vaccine to boost immunity, so that people won't get sick. We haven't shown that we can prevent infection."

Passing it on

Failure to wash hands in between patients is a major catalyst for spreading staph infections in health-care settings, Bradley says. Staph also can be spread if medical equipment has not been cleaned properly.

In the community, staph infections can occur through skin-to-skin contact, entering the body through open wounds or sores. Using the same towels, razors or touching the same surfaces in locker rooms or fitness centers can facilitate the spread of staph infections as well.

"I think for most people, using plain soap and water is fine," Bradley says. "Using an alcohol-based hand rub is good. I think the bottom line is just do it, and do it often."

Exercise machines are major areas of shared contact. Cleaning in between uses greatly lessens the likelihood of spreading bacteria among members, Bradley says. At both Pro's Gym and Snap Fitness, cardio and resistance machines, as well as weight equipment, are sanitized by the staff and patrons throughout the day.

"Anything that anybody touches is cleaned, wiped down from head to toe," says Holly Flickinger, assistant manager and trainer at Pro's Gym, 202 E. McDevitt Ave. "Usually, all of our members are very good about after using a machine, (then) wiping down all the pads."

In addition to cleaning machines and equipment, Snap Fitness, 1527 Horton Road, provides hand sanitizer to its members. Owner Bob Pringle says no health problems have been reported at the gym since its opening in October 2007. "Really, (the machines) are cleaned on a constant basis," he says.

The real risk

Although staph infections are nothing new in the athletic realm, the likelihood of catching a cold or a virus in a fitness center is higher than contracting a staph infection, because staph does not set in as quickly, Bradley says.

"With the flu, within 48 hours, you're sick. It's very difficult to prevent the flu without taking the vaccine," she says. "With staph, it's going to take a little longer to develop and cause problems, so you have a chance to intervene."

In 2007, staph bacteria made local news when a string of infections, ranging from non-severe to MRSA, hit several area schools, including Grass Lake and Hanover-Horton high schools. When these break-outs occur, the increased attention often causes people to panic, Bradley says. Although staph infections can become severe, simple steps can be extremely effective in keeping staph infections at bay, Bradley says.

"I think we just have to go back and re-address some of those habits that people used to emphasize to prevent infections — keeping surfaces clean, washing your hands, covering your mouth when you cough, those kinds of things," Bradley says.

Nothing beats winter blues better than a healthy dose of sand and sunshine. This cold weather is wearing out its welcome, and if you're lucky enough to have some vacation time for spring break, you've been counting down the days until your trip. But before you head for warmer climates, consider this handy list of practical take-alongs to ensure your time away is the best it can be.

Sunscreen

The American Academy of Dermatology recommends an SPF of 15 or higher, regardless of your skin color. True, those with fairer skin need to be extra conscientious, but anyone with skin needs to protect it — especially those parts that haven't been exposed to the sun for months! Don't forget your back, the tops of your feet, tips of your ears, back of your neck and your scalp.

One other thing — just because you got a pre-trip "base tan" at a local tanning salon doesn't mean your skin is protected from harmful rays. You still need sunscreen. If the thought of donning a swimsuit in your winter white skin makes you go pale, slather on a sunless tanning product for a week or so before you go.

Hat

Be it wide-brimmed (3 inches or more) or even a baseball cap, a hat will help to protect your face from some degree of sun exposure, and reduce glare as you gaze down the beach. And for beauty-conscious folks, less squinting in the sun means less potential for lines between the eyes, crow's feet and blotchy, discolored skin.

Sunglasses

Yes, they're a fashion statement, but chosen properly, they also can protect from damaging UVA rays. Watch for this label when you're shopping for shades.

Walking shoes

Sure, flip-flops are fine for poolside, but nothing's worse when you're seeing the sights and all you can think is, "Get me out of these shoes!" Make sure the shoes you take are comfy and supportive, and don't take any brand-new sneakers or sandals. Walking around Cancun with blisters on your feet is nothing to write home about.

Water shoes also are an excellent idea to protect your feet in sand, rocks and whatever's under the water, especially since you haven't walked outside barefoot in months.

Refillable water bottle

Sure, in Michigan we're still drinking hot cocoa and coffee to stay warm. But when visiting a warmer climate, it's more important than ever to stay hydrated to protect against heat exhaustion, cramps and heatstroke. Plus, water actually helps your body cool itself. Keep your plastic water bottle and use it multiple times, or pack your own insulated water bottle, available at outdoor or sporting goods stores.

First-aid kit

You can purchase a prepackaged kit once you reach your destination, or assemble one yourself. Just make sure you pop these American Red Cross-recommended first-aid essentials into your beach bag or glove box:

• Sterile gloves

• Sterile bandages

• Antibiotic wipes and ointment

• Burn ointment

• Band-Aids

• Thermometer

• Eye-wash solution

• Tweezers

• Pain reliever

While you're at it, consider packing insect repellent, antibacterial hand sanitizer, anti-itch lotion, and Benadryl or Claritin for allergies.

Weekly:

MONDAY:

• Strength Training, 9 a.m. and 5:30 p.m., Allegiance Women's Health Center, 3305 Spring Arbor Road. Call to register: 768-4377.

• Light Walking with Stretch and Balance, 10:15 a.m., Allegiance Women's Health Center, 3305 Spring Arbor Road. Call to register: 768-4377.

• "Drums Alive," 5:15 p.m., One Jackson Square, 11th floor. Call to register: 768-4377.

• "Rockin' Yoga," 6:30 p.m., One Jackson Square, 11th floor. Call to register: 768-4377.

TUESDAY:

• Pilates, 8 a.m., Allegiance Women's Health Center, 3305 Spring Arbor Road. Call to register: 768-4377.

• Get on the Ball, 8:30 a.m., One Jackson Square, 11th floor. Call to register: 768-4377.

• Flex, Stretch and Balance, 9 a.m., Allegiance Women's Health Center, 3305 Spring Arbor Road. Call to register: 768-4377.

• Aerobics, 11 a.m., One Jackson Square, 11th floor. Call to register: 768-4377.

• Fusion, noon, One Jackson Square, 11th floor. Call to register: 768-4377.

• Prenatal and Postpartum Pool Exercises, 1:30 p.m., Jackson YMCA, 127 W. Wesley St. Punch cards must be purchased at Allegiance Women's Health Center, 3305 Spring Arbor Road. Call to register: 768-4377.

• Line Dancing, 5:30 p.m., One Jackson Square, 11th floor. Call to register: 768-4377.

• "You Can Do Yoga!", 5:30 p.m., Allegiance Women's Health Center, 3305 Spring Arbor Road. Call to register: 768-4377.

• Jazzercise, 5:45 p.m., Jazzercise Center of Spring Arbor, Village Crossing Mall, 7851 Spring Arbor Road. Call to register: 750-4847.

WEDNESDAY:

• Sunrise Gentle Yoga, 6:30 a.m., Allegiance Women's Health Center, 3305 Spring Arbor Road. Call to register: 768-4377.

• "You Can Do Yoga!", 8 a.m., Allegiance Women's Health Center, 3305 Spring Arbor Road. Call to register: 768-4377.

• Cardio Mix, 9 a.m., Allegiance Women's Health Center, 3305 Spring Arbor Road. Call to register: 768-4377.

• Gentle Arthritis, 11 a.m., Allegiance Women's Health Center, 3305 Spring Arbor Road. Call to register: 768-4377.

• Gliding, 12 and 5 p.m., One Jackson Square, 11th floor. Call to register: 768-4377.

• Power Walk Express, 5:15 p.m., Allegiance Women's Health Center, 3305 Spring Arbor Road. Call to register: 768-4377.

• Yoga/Fusion, 6 p.m., One Jackson Square, 11th floor. (Both men and women welcome.) Call to register: 768-4377.

• Tai Chi, 7 p.m., Essential Energies, 915 Airport Road. Call to register: 796-8060.

• Zumba, 7:20 p.m., One Jackson Square, 11th floor. Call to register: 768-4377.

THURSDAY:

• Cardio Mix, 8 a.m., Allegiance Women's Health Center, 3305 Spring Arbor Road. Call to register: 768-4377.

• Flex, Stretch and Balance, 9 a.m., Allegiance Women's Health Center, 3305 Spring Arbor Road. Call to register: 768-4377.

• Aerobics, 11 a.m., One Jackson Square, 11th floor. Call to register: 768-4377.

• Fusion, noon and 5:15 p.m., One Jackson Square, 11th floor. Call to register: 768-4377.

• Prenatal and Postpartum Pool Exercises, 1:30 p.m., Jackson YMCA, 127 W. Wesley St. Punch cards must be purchased at Allegiance Women's Health Center, 3305 Spring Arbor Road. Call to register: 768-4377.

• Pilates, 5:30 p.m., Allegiance Women's Health Center, 3305 Spring Arbor Road. Call to register: 768-4377.

• Jazzercise, 5:45 p.m., Jazzercise Center of Spring Arbor, Village Crossing Mall, 7851 Spring Arbor Road. Call to register: 750-4847.

FRIDAY:

• Pilates, 9 a.m., Allegiance Women's Health Center, 3305 Spring Arbor Road. Call to register: 768-4377.

• Gentle Arthritis, 11 a.m., Allegiance Women's Health Center, 3305 Spring Arbor Road. Call to register: 768-4377.

• Zumba, noon and 5:30 p.m., One Jackson Square, 11th floor. Call to register: 768-4377.

SATURDAY:

• "Drums Alive," 8 a.m., Allegiance Women's Health Center, 3305 Spring Arbor Road. Call to register: 768-4377.

• Jazzercise, 8:30 a.m., Jazzercise Center of Spring Arbor, Village Crossing Mall, 7851 Spring Arbor Road. Call to register: 750-4847.

Bi-weekly:

• Smiles on Wheels, mobile dental hygiene, Jackson County Human Services complex, 1715 Lansing Ave., Room 116. Clinics held 8:30 a.m. to 3:30 p.m. on the first and third Monday of each month for those without a regular dental office. 740-5620.

• Smiles on Wheels, mobile dental hygiene, Jackson County Human Services complex, 1715 Lansing Ave., Room 005. Clinics take place 8:30 a.m. to 3:30 p.m. on the first and third Friday of each month for those without a regular dental office. 740-5620.

• Walk-in hearing and vision clinic, 1 to 4:30 p.m., Jackson County Health Department, 1715 Lansing Ave., Room 211. Free hearing and vision tests for the general public. Clinic takes place the first and third Friday of the month. 788.4395.

Monthly:

• Alzheimer's Caregiver Support Group, 2 to 3:30 p.m., Hillsdale Senior Services Center, 320 W. Bacon, Hillsdale, 517-437-2422. Respite care available on site. Group meets the first Monday of the month.

• Alzheimer's Caregiver Support Group, 6:30 to 8 p.m., John Ganton's Countryside Retirement Community, 3637 McCain Road. 787-4150. Group meets the second Tuesday of the month.

• Male Caregiver Discussion Group, 7 to 8:30 p.m., Immanuel Lutheran Church, 1505 W. Michigan Ave. 782-6081. Group designed for husbands, sons and partners of someone with Alzheimer's. Group meets the fourth Tuesday of the month.

• Alzheimer's Caregiver Support Group, 1 to 3 p.m., Department on Aging, 1715 Lansing Ave., Ste 672. 788-4364. Group meets the first Thursday of the month.

Special events:

• "Women Under Construction," retreat, March 7, 7:45 a.m. to 5 p.m., Trinity Wesleyan Church, 620 Robinson Road. Paulie Heath will be the featured speaker and performer. $30. 750-2654.

• Colorectal Cancer Update, March 11, noon, Allegiance Women's Health Center, 3305 Spring Arbor Road. Guest speaker will be Molly Burchett, community program representative for the American Cancer Society. $5 or free with Perks program. Call 888-335-7241 to register.

• Understanding Endometriosis, March 18, noon, Allegiance Women's Health Center, 3305 Spring Arbor Road. Speaker will be Therese Curtis, BSN, RN. $5 or free with Perks program. Call 888-335-7241 to register.

• "Sleepless in Jackson: Sleep Hygiene," April 23, 7 p.m., Ella Sharp Museum of Art and History Community Room, 3225 Fourth St. Presented by Allegiance Center for Women's Health. Guest speaker will be Gregg Patten, MD. Free. Call 768-4377 to register.

• "I Love You, You're Perfect, Now Change," musical production, April 30 at the historic Gem Theater in Detroit. Bus will leave O'Neill Drive Kmart parking lot at 5:30 p.m. Hosted by Allegiance Center for Women's Health. $55 for nonmembers, $50 with Perks program. Call 768-4377 to register.

• "Just Breathe!", a retreat for finding balance and managing stress, May 9, 9:30 a.m. to 4 p.m., One Jackson Square, 11th floor. Hosted by Allegiance Center for Women's Health. Retreat features a gentle yoga class, creative journaling and group interaction. Cost is $40. Call 768-4377 to register.

Red Cross Offerings:

• Adult CPR/AED. 4-hour course. $40.

• Adult CPR/AED, Infant and Child CPR, and First Aid. 8-hour course. $65.

• Adult, Infant and Child CPR/AED Review. 4-hour course. $35.

• Infant & Child CPR and First Aid. 6-hour course. $45.

• CPR/AED for the Professional Rescuer. 2- part, 8-hour course. $75.

• CPR/AED for the Professional Rescuer Review. 4-hour course. $40.

• Infant and Child CPR. 4-hour course. $40.

• First Aid. 3-hour course. $30.

• Baby sitter's Training. 6-hour course. $50

• Bloodborne Pathogens: Preventing Disease Transmission. 2-hour course. $10.

All classes take place at the American Red Cross, 3425 Francis St. Stop by or call 782-9486 for details on class dates and times or to register. You also may go online to www.redcross-scmichigan.org.

Jackson YMCA Offerings:

• Aerobics. Classes range from beginner to advanced. $14 per month for members. $8 per one-time class for non-members.

• Aquatics. Preschool, youth and adult swim classes are available. $20 per session for members, $40 for non-members. Lap swim, open swim and water aerobics programs also offered.

• Gymnasiums. Two gymnasiums offer a variety of programs and open gym opportunities. Hours are 5:30 a.m. to 9 p.m. Monday through Wednesday, 5:30 a.m. to 10 p.m. Thursday, 5:30 a.m. to 9 p.m. Friday and 7 a.m. to 5 p.m. Saturday.

• Martial Arts. Both Tae Kwon Do and Aikido are available. Adult Aikido classes are 6 and 7 p.m. Tuesdays, 7 p.m. Thursdays and 10 a.m. Saturdays. Youth classes are 6 p.m. Thursdays, and 9 and 11 a.m. Saturdays. Tae Kwon Do classes are 5:30 p.m. Mondays, Wednesdays and Fridays. $28 per month for members, $38 per month for non-members.

• School Programs. Several educational programs are offered, including arts and crafts, music and story time, gym games and swimming. Preschool and home-school offerings are available.

All activities take place at the Jackson YMCA, 127 W. Wesley St. Call 782-0537 for more details on dates and times or to register. You also may register online at www.jacksonymca.org.

CITIZEN PATRIOT | SCOTT STONERAl Earle, 90, returns a serve while playing tennis recently.

"I'll play tennis as long as I am able," Earle says. "I love the game. It's a game you can play all your life."

Earle first picked up a racquet at age 7 and moved into more intense competition in high school and college. He won the title in the 65-and-older age group at the Jackson County Super Seniors Tournament on Aug. 30, 1987, as a 69-year-old singles competitor.

Now, he plays a couple times a week with friends and hones his skills with private lessons. Earle took some time to tell BHJ the story behind his dedication and why his passion for tennis isn't fading.

Be Healthy Jackson: When did you get interested in tennis?

Al Earle: I've been playing since I was 7 years old. My dad's house was right next to a tennis court. In high school and college, I took care of the tennis courts at the clubhouse. During tournaments, I had to be there to line the courts.

BHJ: Did you play at the high school and college levels?

AE: I played at Boonton High School in New Jersey and High Point College in North Carolina. I had a (college) scholarship for football and tennis. I was No. 1 in singles and doubles. After college, I played on an adult team.

I like singles better, even though at my age, I should be playing more doubles.

BHJ: Where did you play when you moved to Jackson?

AE: I've lived in Jackson since 1979. I joined the Jackson Racquet Club when I came here. I'm sorry they closed that tennis court; it was beautiful. It's now a warehouse. I played at least two or three times a week.

Now I play once a week in the winter at (Craig) Calderone's farm with Jack Adams, Lionel Miller and Grace Miller, and one or two times a week in the summer. The Middle School at Parkside is the best place to play. They have all new tennis courts.

BHJ: Do you always play with this group of four?

AE: The four of us play every Saturday morning, usually from 8 to 10. In the summertime, we play with other people.

The thing is, nobody my age plays tennis anymore. They don't have tournaments for my age group. Sometimes, I play against younger kids.

BHJ: You take private lessons with Calderone every so often. How do these help your game?

AE: I guarantee you when I take lessons with Craig, I am 50 percent better. As I get older, it gives my tennis a lift. It makes me sharper. Every time I take a lesson, for the next two weeks, I feel on top of the world. We work on getting the swing down, bending the knees ... and my net game. My net game is my weakest part.

As a kid, I never took lessons from anyone. I taught myself how to play. My big weapon was my serve. That's what they talked about, but I'm not sure if that's true today. (Laughs)

BHJ: Have you ever been in any major tournaments or seen professional tours?

AE: No, I wasn't competitive the way they are today. Calderone's kids, they are tennis all-stars. The velocity of their serves is unreal.

BHJ: Did you have any professional players that you followed when you were younger?

AE: Oh, (Pete) Sampras. There were a lot of really great players in that time. One of my favorite players was Chris Evert. And Jim Connors was a real fighter. He was short, but he was a fighter. He really played a great game.

BHJ: Have you ever had to stop playing because of injury? Broken a bone? Sprained an ankle?

AE: No. I have been lucky. I have played with people who have had serious injuries. I was in the service for four or five years. I was in England during World War II, and I wasn't playing tennis then. But that's it.

BHJ: Why is it important to you to keep playing?

AE: I play for the recreation. A lot of kids give it up, but I think it's a game you can play forever. (He knocks on the table.) Look at me — I'm 90, and I'm still playing singles.

To simplify this process, the Smart Choices program will label foods that meet certain nutritional standards. The label, set to hit grocery stores by the middle of the year, will include the number of servings, the calories in one serving and a green checkmark.

Who developed this program?

The Keystone Center, a nonprofit group that seeks solutions to public health issues, developed the Smart Choices program.

"Many manufacturers currently display their own 'better-for-you' front-of-pack symbols, but the nutritional standards for these symbols vary from product to product," writes Brad Sperber, director of the Health and Social Policy Practice Group at the Keystone Foundation, in an e-mail. "The intent is to provide one simple communication for the consumer — regardless of which brands they buy or places they shop."

How does a food product get a label?

• Smart Choices standards were set by the Dietary Guidelines for Americans, the Food and Drug Administration, data from the Institute of Medicine and other nutritional research.

• Foods with Smart Choices labels must have low amounts of Nutrients to Limit.

• Total fat: [?] 35 percent of calories or [?] 3 g per serving

• Saturated fat: < 10 percent of calories or [?] 1 g per serving

• Trans fat: 0 g (< 0.5 g per serving)

• Cholesterol: [?] 60 mg per serving

• Added sugars: [?] 25 percent of total calories

• Sodium: [?] 480 mg per serving

• People usually need more Nutrients to Encourage in their daily diets. These nutrients include calcium; potassium; fiber; magnesium; and vitamins A, C and E. Foods with a Smart Choices label will have 10 percent Daily Value of at least one of these nutrients.

• Food Groups to Encourage are supported by the Dietary Guidelines for Americans. A food product with a label must have at least 1/2 of a serving of one of the following: fruits, vegetables, whole grains or fat-free/low-fat dairy.

• Only certain products must meet the Nutrients or Food Groups to Encourage criteria to get a label. For more information, visit http://smartchoicesprogram.com/nutrition.html.

What about beverages?

• A Smart Choices beverage must meet the Nutrients to Limit standards.

• Then, calories per serving come into play:

• If a beverage has between 20 and 40 calories per serving, it must contain at least one Nutrient or one Food Group to Encourage.

• If a beverage has between 40 and 60 calories per serving, it must contain at least one Nutrient and one Food Group to Encourage.

Could food products in all stores have Smart Choices labels?

• Food retailers can voluntarily be a part of the program.

• Several companies have said they are likely to participate, including Coca-Cola, ConAgra Foods, General Mills, Kellogg Co., Kraft Foods, PepsiCo, Unilever and Walmart, Sperber says.

• Details about the Smart Choices governing body are still being discussed, Sperber says, and consumers can expect to see the label in stores by the middle of this year.

Source: http://smartchoicesprogram.com.

With the cold weather that awaits every time we step outside, it's tempting to hole up inside and hibernate, storing thoughts of exercise with memories of warmer times.

But being active shouldn't depend on the temperature. This winter, use tips from area fitness enthusiasts and brave the cold outside or try a new class inside (Snow Excuses). You don't have to go sprinting through the snowfall; in fact, shoveling the driveway burns quite a few calories. Plus, exercise makes us feel more energized, which can be an even bigger bonus if the weather is cold and gray.

While some of us may struggle with the motivation to continue exercising in the winter, there are athletes of all ages working tirelessly to overcome sports injuries and get back in the game. In this issue's feature on sports medicine (Sports Medicine: Getting back in the game), we meet some local athletes and the professional therapists who share a dedication to recovery and a desire to return to top fitness form.

And after burning all those calories, don't dive into leftover holiday treats — instead, replenish your energy with nutritious choices. We know a salad is a great pick, but with all the toppings out there, it's easy to go overboard with calories. Use our guide to make a healthier salad, starting from the lettuce up to the dressing on top (Healthiest salad toppings).

Of course, no January would be complete without thoughts of change. But New Year's resolutions often cause more stress than they're worth. We've looked into ways to set realistic goals, because changes don't have to be monumental (Make resolutions stick). Taking small steps, each and every day, is the ideal way to start living healthier.

Wishing you well in the new year,

Jessica Sipperley

CiTIZEN PATRIOT | DAVE WEATHERWAXConor Sullivan, a student athlete at Lumen Christi High School, throws a ball at a trampoline while balancing on one foot as he works on rehabilitating his ankle at Orthopaedic Rehab Specialists.

As clinical director for Orthopaedic Rehab Specialists West, 2136 Robinson Road, Klump works with patients as a physical therapist and an athletic trainer.

CITIZEN PATRIOT | NICK DENTAMAROPhysical therapist Brandon Klump stretches Larry Brugger's knee at Orthopaedic Rehab Specialists, 2136 Robinson Road.

So, how does sports medicine differ from more general forms of physical therapy? Let's let the expert explain:

"Sports medicine has a more focused goal," Klump says. "Most of the time, we see patients that are unable to compete as a result of their injury and their singular focus is to return to their sport. Our job is helping them accomplish that goal as quickly and safely as possible.

"In this environment, we also have to help ensure that the athlete is ready to compete both mentally and physically. We must help them regain the confidence in their injured body part as well as push them from a fitness standpoint to minimize the risk of further injury.

"In a general practice or with patients not involved in a specific sport, the approach must be much broader. We have to focus on all aspects and planned uses of the injured area and increase the use of function to allow them to perform those activities without pain and as safely as possible."

Working for results

Successful treatment often relies on a shared commitment to physical therapy, from both the athlete and the professional. At Allegiance Sports Medicine, each patient gets an evaluation, and then begins therapy sessions tailored to the specific injury, says Jill Williams, an athletic trainer. But whether an athlete has twisted a knee or tweaked a shoulder, the pattern of the treatment program has the same basic ideas.

"At the beginning, we're focused on strength and decreasing any inflammation they have," Williams says of Allegiance's patients. "Once we get their pain and their inflammation down, then we would add the strengthening (exercises). We work a lot on core conditioning and core stability."

For example, an athlete with a knee injury would start out with range-of-motion exercises, Williams says. Then come the strengthening exercises, and exercises that are sports-specific, for a certain sport or position.

"We usually end with ice, to decrease any inflammation," Williams says. "I would say we use ice on over 90 percent of our patients after they come in, until they can complete exercises without inflammation or pain."

And athletes are always given exercises to do outside of therapy. Doing the at-home exercises is crucial, Williams says, and often contributes to a smoother recovery.

"We usually see patients twice a week for a half hour at a time, and obviously we're not going to be able to correct what their deficit is in an hour per week," Williams says.

One key deviation from this pattern comes with back injuries, Williams says. In these cases, she says, trainers use more manual therapy techniques, physically working on the muscles and loosening the area of injury.

For Klump, the payoff comes from seeing a person enter the clinic in a lot of pain with limits on his or her everyday life and watching the person return to all activities without pain.

A high school athlete anxious to get back on track, Conor Sullivan, 17, has had an excellent experience with Orthopaedic Rehab so far. "They are kind, polite, respectful to all their patients, and perhaps most importantly, they are knowledgeable and successful at what they do — heal and return," Sullivan says.

But the reality is, returning to a beloved sport is not the case for every athlete. Klump says it is difficult to see a patient work hard, do everything he or she is asked of and still not get the intended results. On the sports medicine side, he explains, it is tough to initially set a "return-to-sport" goal that is realistic, and then not achieve it due to some type of complication.

"It is even worse when I have to tell the athlete that they aren't ready to return to their sport. It can be tough to deliver bad news," Klump says.

CITIZEN PATRIOT | ERIK HOLLADAYMarco Grbesa, center back, watches Hannah Rose, 14, left, and Ashley Kakowski, 14, practice taping the feet of freshman basketball players Richard Mallory, 14, and Gary Pool, 14.

A learning experience

Marko Grbesa of Lansing is a certified athletic trainer for the Jackson High School Student Athletic Training Program. In its eighth year, the program is open to all Jackson High students. The goal of this program is to provide the students with a firsthand look at sports medicine. Students learn by observing a sports medicine professional and by performing basic skills, such as taping and first aid. Grbesa also gives the students various homework assignments and quizzes.

Currently, there are 12 students in the program, but Grbesa says he had as many as 16 in the fall. Students enter the program on a volunteer basis. The numbers vary due to sports interests — some students only want to work with certain sports — and whether interested students are tied up with their own athletic commitments. Sports assignments are then selected based on seniority — first within the student training program, and then based on class level.

First, students take a class after school with Grbesa and learn basic taping techniques, stretches and first aid. After passing this class, they are then allowed to perform what they learned on the athletes who may need it. Students in the program are responsible for attending all practices and games for their respective sports, in order to assist the certified trainers. The students also are responsible for travel with their teams, record keeping and reporting any new injuries to Grbesa.

Training to be a trainer

Klump advises someone with an interest in sports medicine to spend some time observing different areas within the sports medicine spectrum. These professions can include specialty physicians and surgeons, athletic trainers, physical therapists and coaches.

"First, I would want them to make sure that it was right for them, and they aren't just interested in it because it involves sports and they love sports. I love watching and competing in many different sports. However, it is a much different thing to be at a game covering an event and be responsible for medical care than it is watching as a fan," Klump says. "Lastly, I would warn them that information is always changing and this area requires a lot of continued learning in order to make sure that your knowledge base remains current."

These challenges offer a stimulating career choice for someone who is passionate about sports, science and helping athletes perform at peak levels. To become a certified athletic trainer, a person must graduate with a four-year degree in a sports-medicine-related field, such as kinesiology or athletic training. The field depends on the college, Grbesa says. At the college level, after observing sports-medicine techniques; taking basic classes, such as anatomy and physiology; and completing a written application, along with an interview, people must apply for athletic-training programs. According to Grbesa, a program can attract up to 100 to 200 applicants, and only accept about 10 to 20 of these people.

In these programs, students take specific athletic-training classes and get on-the-job experience as trainers for the school's sports teams, Grbesa says. Once someone earns his or her degree, the next step is taking a national exam, given by the National Athletic Training Association Board of Certification. Passing this exam garners official certification and entry into the sports-medicine career field.

Sports medicine takes patients

Be Healthy Jackson wanted to find out what it's like to be on the receiving end of physical therapy for a sports injury. Three athletes — a multi-sport high school student, a semi-pro baseball pitcher and an avid snowboarder — provide the inside scoop.

MEET: Conor Sullivan, 17, a junior at Lumen Christi High School, Jackson

Sports: Football, track and intramural basketball

Injury: Knee tendonitis. Sullivan wrenched his knee in an early football game and the injury wore on with wear and tear during the season. He also separated his right shoulder when he landed wrong after making a catch and being tackled. On top of that, Sullivan has a high ankle sprain involving a separation of ligaments as a result of a tackle during a game.

BHJ: How have you benefited from the therapy so far? Can you see a real difference?

CS: Without therapy, I could not have played in every game, especially at the level that I was expected to perform.

BHJ: What is the biggest challenge of therapy?

CS: The biggest hurdle in therapy is making the time for it and waiting for the therapy to kick in. The time it takes to heal injuries, especially when you aren't staying off of them, seems endless. I am a typical 17-year-old with little patience and always a ton of things I'd rather be doing. It is hard to stay off your injuries and not be involved in what you love most in life.

BHJ: When do you think you'll be "good to go"?

CS: I hope to continue therapy to be able to have my ankle at 100 percent for indoor track in three weeks.

BHJ: What is your ultimate goal once your body is in better shape?

CS: To have successful indoor (and) outdoor track seasons and start training and lifting for football next season, and to improve my speed and agility.

MEET: James Cawley, 45, Jackson

Sport: Semi-professional baseball pitcher for Kosters and Devries out of Grand Rapids, among others.

Injury: The most recent injury was to his right shoulder. Cawley believes it began a year ago last November while pitching in a baseball tournament in Florida. He did not seek medical attention until this summer, when the lack of strength, control and increase in pain while pitching caused him to contact his orthopedic surgeon. Therapy started six weeks after his surgery in September 2008.

BHJ: Why did you choose Orthopaedic Rehab Specialists?

JC: My daughters suffered several athletic injuries, and ORS was always there to assist in recovery, so when I injured my shoulder there was no question where I was going to go for physical therapy.

BHJ: How have you benefited from the therapy so far?

JC: After surgery, my arm was placed in a sling for six weeks so I had little use of my right arm. When therapy started, I could not brush my teeth or wash my hair with my right arm. I am on the fourth week of therapy and my range of motion is starting to come back. The normal arm movements like reaching to start the car and putting on my belt have returned.

BHJ: What is the biggest challenge of therapy?

JC: How much time it is going to take to become healthy again and return to what you used to do. In your mind, you have to think about the little improvements and stick to the program that is developed for you even if results are slow.

BHJ: When do you think you'll be "good to go"?

JC: I was told that some of that is up to me and the work that I put into therapy, but I believe it will be between nine to 12 months before I am good to go. I have recovered from several different sports injuries and this one has been the most difficult. My desire to compete and the support of my family have been instrumental in returning to the sport I love, not to mention the physical therapists that push, pull and encourage me every day.

BHJ: What is your ultimate goal once your shoulder is in better shape?

JC: I have played semi-pro baseball for a team out of Grand Rapids since 1989 and the manager called to see how the surgery went. He wanted to know if I would go with his team to a baseball tournament in Phoenix next fall, which is about one year after therapy started. Bob Devries, my manager, and I have gone to this tournament several times and he would like to return one more time with this team and then retire from baseball. Nothing would please me more than to be able to pitch for him one more time.

MEET: Kristan Dumbauld, 22, Rives Junction

Sports: Snowboarding, running

Injury: In May 2008, Dumbauld was outside playing tag with a 2- and a 5-year-old and injured her knee.

BHJ: What is the biggest challenge of therapy?

KD: Getting my balance back on one leg.

BHJ: When do you think you'll be "good to go"?

KD: At times, right now, and others never. I just have to keep reminding myself of my goals and my dreams.

BHJ: What is your ultimate goal once your knee is in better shape?

KD: Snowboarding. It's really difficult (to wait) and tempting to just jump in and go boarding. This summer, I wouldn't mind trying wakeboarding. I look forward to going into therapy. It does make it easier on the therapist when you have your own goals.

Jessica Sipperley contributed to this story.

Sports medicine strategies ... for life

Dr. David H. Janda of the Institute for Preventative Sports Medicine in Ann Arbor reminds athletes of the importance of the pre- and post-participation warm-up before heading out on the field, the court or the rink.

Janda recommends 10 to 15 minutes of warm-up exercises, followed by another 15 minutes of stretches to prepare the body to play and prevent injuries. "It's true whether you're a weekend warrior to a student athlete," Janda says.

After participation, spend another 15 minutes stretching while the muscles are at their warmest, because it prepares your body for the next time.

For more on how you can prevent sports-related injuries, visit the Institute for Preventative Sports Medicine's Web site at http://www.noinjury.com.

JACKSON CITIZEN PATRIOT FILE PHOTOWomen work out on a circuit training program at Curves in Jackson.

When it comes to fitness, circuit training offers an individual a chance to "cross-train" your body. You're working your muscles, your heart and your lungs with alternating exercises and stations to build strength and endurance in one training session. With its many benefits, it's easy to see why so many Jackson gyms offer this form of total fitness training.

Components of circuit training

Training sessions focus on nine to 12 strength and aerobic/anaerobic exercises or stations. Johnny O's Fitness Club, 2136 Robinson Road, Suite 4, offers 14 stations in its circuit. There are seven machines with jogging or step stations in between to maintain an elevated heart rate.

Exercisers can use these independent circuits or improvise their own circuit-training routines with machines and weight-lifting activities, possibly using the help of a trainer to get the most beneficial workout. Either method should concentrate on building strength, toning muscles, burning fat and improving endurance.

In order to reduce stress on joints and tendons, training sessions should include a high number of repetitions with reduced weights. The idea isn't to "bulk" up like serious lifters who use heavier weights, but to tone and strengthen the muscles.

Ideally, there should be little or no rest between exercises or stations. Circuit training is all about staying on the move.

Nate Gunterman, fitness associate at Johnny O's, reminds beginners and those who already do circuit training regularly to mix up their routine. That's where the cross-training comes in. Do not stick with a regimented routine; instead, alternate your circuit order, stations and exercises on consecutive days. Gunterman recommends changing the number of repetitions per machine and the amount of time spent on each.

"Otherwise, you plateau," Gunterman says. "Your body gets too used to the routine and you don't progress."

Why try it?

Circuit training improves aerobic conditioning, strength and fat-burning abilities simultaneously. Most circuit trainers do it three times a week with a rest day in between. Gunterman said a person could do the training in as little as 10 minutes for the full circuit, depending on the number of repetitions at each machine. That's what you call an efficient fitness routine!

Circuit training also ...

• Offsets fatigue

• Keeps boredom at bay due to the variety of exercises and routines

• Improves posture

• Enhances muscle balance

• Lowers blood pressure, increases HDL (good cholesterol) levels and reduces risk of heart disease

• Elevates strength, stamina and endurance

• Tones muscles and increases lean body mass

• Offers versatility because it can be done in as an individual or a group in a variety of places — outside, at home or in a gym

• Increases bone density to ward off osteoporosis

• Boosts resting metabolism, resulting in more calories being burned throughout the day

Where to go in and around Jackson

• Curves, in Jackson, Brooklyn, Grass Lake, Michigan Center and Somerset Center, www.curves.com*

• Fit Zone for Women, 2103 W. Michigan Ave., 788-6888, www.FitZoneforWomen.com*

• Johnny O's, 2136 Robinson Road, Suite 4, 750-3800, www.gantons.com

• PACE Yourself Fitness Center, 7851 Spring Arbor Road, Spring Arbor, 750-1690**

• Planet Fitness, 2020 Holiday Inn Dr., 784-5551, www.planetfitness.com

• Powerhouse Gym (program created with trainer assistance), 1901 Horton Road, 879-4684, www.powerhousegym.com

• Pro's Gym, 202 E. McDevitt, Vandercook, 796-2337, www.prosgym.com

• Snap Fitness (by class), 1527 Horton Road, 782-1001, www.snapfitness.com

*Women only

**Separate circuits for men and women