Originally posted on January 8, 2011 with revisions on April 12, 2017.
Well, it’s nice to see that it only took a few days to spark some interest in my special Scoliosis Management class, which is Pilates on the Mat and Professional Equipment. This class comes up every so often as a Workshop. And I’ve gotten support from local Chiropractors and Osteopathic Physicians for my work. Even a Neurosurgeon who performs spinal surgeries.
My last workshop in February, 2017 attracted a bunch of new faces, including a visitor from the Chicago area, who only got to attend one of the 4 sessions. So she booked a couple of private lessons and even filmed the last one, for her personal use. Stay tuned for more!
My personal Story – who gets taller at age 40? I did!
In brief: I was diagnosed with Scoliosis at age 10 and started having chronic pain at age 19. During stressful times like exams, I was downing handfuls of Ibuprofen and getting massages, just to survive. And for years experienced very one-sided sports injuries. Right hip, right knee, right ankle, right foot. Left shoulder. It all makes sense now.
I found Pilates in my 30s. In about two years of daily practice, I changed my spine. Dr. Chip Abbadessa looked at the xray in 2009 and said, “Are you telling me that you used to have Scoliosis? Look at this…” Thanks, Dr. Chip! And yes, I got close to an inch “taller.”
I no longer have those constant headaches and pinching pain between the shoulder blades -- and no longer floored by spasms in the low back that would happen with seemingly no warning. My weight didn’t really change, but I feel much lighter on my feet, can reach higher, and haven’t been this flexible since middle school. (Keep in mind, I became a long distance runner in middle school, and running tends to decrease flexibility. I also got lazy about stretching at age 18). I felt “old” at 25 and feel “young” and bouncy now, at 47. OMG. I’m 47. Well my goal is to be bouncy at 97.
DISCLAIMER: This blog is not intended to diagnose, treat, or cure a disease. This blog is also not intended as medical advice or services, and you should not ignore any medical advice to the contrary. Nor should you fail to get medical advice or treatment if you are experiencing a health episode. Please get a diagnosis from those licensed to do so, such as a Physician. I cannot give guarantees or estimates as to how long it would take to see measurable results. I only have my own personal experience and those of clients working with me. Their information is confidential.
Here are some answers to questions fielded so far :
1. Q: What is Scoliosis? A: It’s categorized as an abnormal curve of the spine , which can be anywhere from mild to severe. If you want to see some extreme xrays, you can go onto Facebook and see some of the groups listed under Scoliosis. It may be deemed medically advisable to have a surgery. That is between you and your Physician. Some cases are so severe that it can affect the vital organs. Such as breathing.
But it’s so much more than just that. Scoliosis affects the entire body – the feet, the knees, the hips, the shoulders, the arms, you name it. Even if it’s a mild case, there is still an effect. If your therapy has only been focusing on the spine, that is only part of the picture. Spinal surgeries will not address what has been happening in the pelvis, knee joints, feet, etc., nor the muscle imbalances that have developed from being a certain way for a long time. I’m grateful to have shared ideas with a local Neurosurgeon who said that I gave him cause to think about some of the methods used in spinal surgeries which are part of the protocol (affecting the Psoas Major muscle), and therefore, what may be useful to patients after they recuperate from surgery. http://scoliosissystems.com/scoliosis/scoliosis-affects-the-entire-body/
2. Q: What causes Scoliosis: A: It’s often unknown . Theories abound, including: injury; viral infections; structural abnormalities at birth; muscular imbalances that accumulate over time (especially with one-sided sports like GOLF or TENNIS); spinal degeneration with age, and uneven development during puberty. Many people are diagnosed during puberty, while others ‘develop’ abnormal curves in adulthood. The condition is generally diagnosed by xray. http://www.mayoclinic.org/diseases-conditions/scoliosis/symptoms-causes/dxc-20193699
3. What are visible signs of Scoliosis? A. Uneven shoulders and hips. One leg appearing to be “longer” than the other. Do a slight forward-bend and have someone run their fingers along the spine to detect a lateral curvature, or a “rib hump.” If your loved one has these signs and also complains of discomfort, I highly recommend making an appointment with your Doctor for an x-ray and diagnosis, especially to see if there are any complications. Hey, here’s a great website article with photos: https://medlineplus.gov/ency/article/001241.htm
4. Q: What are the risks of having Scoliosis? A: There are quite a few. Here are some:
a) According to Stott International in 2011 (now Merrithew Health and Fitness), about 75% of women with Scoliosis age 65 and over have an osteoporosis fracture in the spine . One could infer that the abnormal curve plus gravity puts unusual pressure on the spine. Here’s an article about osteoporosis fractures being often in the spine. http://orthoinfo.aaos.org/topic.cfm?topic=A00538
b) Often, Scoliosis comes with chronic pain — the more severe the curve, the more likely the person will experience pain in his or her lifetime. From age 19, I had a lot of back pain which wasn’t helped by all those hours slouched in front of the computer and hunched over books (English major, Law School, yay); and it usually got really bad during exams. From my mid-20s, I had a lot of chronic pelvic pain. All this pain went away within the first couple of months of daily Pilates, but it wasn’t just from attending classes. It was also because I spent a lot of time improving my posture and really getting “deep into” my body and feeling whether the spine was articulating or “stuck,” and really understanding my unique combination of muscular imbalances, and issues with my overall posture. https://www.healthcentral.com/article/scoliosis-deserves-special-consideration
c) Severe cases of Scoliosis can cause problems with the organs — for instance, development of the lungs, trouble breathing, and so on. In this case, surgery might have to be the answer. For a very complicated case, I’d be happy to provide referrals for Physicians and Licensed Physical Therapists. http://www.abilityconnectioncolorado.org/infantilescoliosis/how-scoliosis-impacts-the-body/
d) We have heightened chances of sports injury, with imbalances in the hip and shoulder. We may lean more to one side of the body. Muscles designed to stabilize joints don’t do their job properly. Muscles also get used for purposes that aren’t their original “design,” which then limits mobility and flexibility. This sets up a vicious cycle of over- and under-use, and the end result is often a chronic sports injury. In my many years of running, I noticed that the injuries all occurred on the right side of the body, including: an inguinal hernia, shin splints, ankle sprains, stress fractures in the foot and tibia (lower leg), and Iliotibial Band Syndrome. Interesting article: https://www.laserspineinstitute.com/back_problems/scoliosis/causes/sports/?source=Google-DSA-Conditions-PPC&cpao=7776&gclid=CKfquqqck9MCFRRufgodVGgMjg
5. Q: Can medications help with Scoliosis? A: Well -- Not really, except mask the pain. If the doctor prescribes pain medications -- that will lessen the sensation, but it will not target the root cause. And the curvature could worsen as you age (with degeneration of spine and disks). In the case of osteoporosis, specific medications may help prevent bone loss, but they won’t improve the curvature that exists -- and apparently they don’t reduce fracture risk, since the biggest risk is falling. Meds also come with side effects. That said, talk to your doctor about all options and risks, then decide together . http://articles.mercola.com/sites/articles/archive/2010/01/28/did-merck-trick-you-into-buying-fosamax-with-an-imaginary-disease.aspx
6. Q: What can help with Scoliosis? A: I have seen great results from a combination of Chiropractic or Osteopathic work and muscle re-training for mild to moderate cases; and it may also benefit you to get myofascial release, or Rolfing. Before embarking on a new program, you should get a professional assessment. An xray will let you know if you have spinal degeneration or other complications. A posture/alignment analysis will help you understand your muscular imbalances. With that, you have a road map for your wellness plan, which may also include therapeutic massage, and exercise that is kind to your body.
If you have a severe and/or complicated case of Scoliosis, or had a spinal fusion surgery, you may need physical therapy instead. At the very least, you will need medical clearance. I highly recommend doing that before embarking on any fitness program anyway -- especially if you are experiencing chronic pain or undergoing pain management therapy.
7. Q: Will Yoga in a very hot environment improve my Scoliosis? A: If you want Yoga – then choose someone truly experienced in therapeutic Yoga to help you —even better if the program is developed by a specialist, such as a Physiotherapist. If you do find someone with proven results, then I would be very enthusiastic. As for now, it sure seems as if hot Yoga comes with a high rate of injury. The extreme heat allows us to stretch beyond our normal capacity, so we really have to be careful about using the proper muscles to stabilize the spine. Frankly, I’m not enthusiastic about hot Yoga. And if the teacher has little understanding about anatomy and physiology -- go find someone else. Look for someone who advertises that specialty, with verifiable results. In my personal opinion, Yoga Therapy in normal room temperature is a safer option.
8. Q: What do Scoliosis Management lessons involve? A: Very specialized exercises on the Mat, Reformer, and Cadillac, as well as changing the way you breathe, sit, stand and walk. To make meaningful changes, you must devote a little bit of time and energy to yourself every day, whether in the studio or at home. There is a huge emphasis on Osteopathic Sciences. The mental attitude is also highly focused — I give a lot of feedback from what I see with my eyes, and I also provide lots of cues, often hands-on. Be prepared to hit plateaus and brush off the frustration. The body will not always do what you want. Stay calm. Focus. Communicate between mind and body to note what you feel, how a particular movement feels today, and compare it with how you felt last week, last month, etc. My program also involves exercises which were devised by a physiotherapist and other specialists. And it includes modifications of Pilates exercises, because the standard exercises may encourage imbalances rather than help. Yes -- especially on the Reformer.
9. Q: So how can I attend the Scoliosis Management Workshop? A: We start with a quick phone call and then meet in person with a "beginner's assessment," which takes one hour and is generously priced for you. That will help me to include exercises that are appropriate for you, and to help provide you with a network of support. I often do these workshops in conjunction with Physical Therapy businesses, Chiropractors, and Osteopaths.
You'll also see the advantages of doing one or more private lessons to have a bunch of exercises to take home, tailored for your unique body/mind.
It is always a great idea to consult your Physician before embarking on a new program. For otherwise healthy individuals with a mild to moderate case of Scoliosis, who already work out, who are not suffering from sharp or shooting pain, or muscle spasms, then we can start with the beginner's assessment. If you do have those symptoms, I would refer you instead to your Physician and to consider Physical Therapy. With a serious case of Scoliosis or something more complicated like a Stenosis (narrowing of the spinal canal), or Spondylolisthesis (forward slippage of a vertebra), you must first get medical clearance and instructions from your Physician, and it would be a good idea to consider Physical Therapy -- I can provide a list of great therapists.
10. Q: How long will it take to improve my spine? A: There is no easy answer. Scoliosis is something that we will need to work on for life. We have unique bodies, different ages, varying jobs which tax our bodies accordingly (desk work, manual work), different diet and lifestyle habits, and widely divergent levels of ability to commit to muscle reconditioning (time, finances, etc.).
11. Q: Will Insurance cover this class? A: No. If you would like Insurance to cover your sessions, I will refer you to a fantastic Manager who will be able to answer your questions about how to get a Prescription for Physical Therapy from your Doctor and how to find out if your Insurance Company will agree to cover it.
12. Q: Can I take your class while receiving Physical Therapy or other treatments from someone else? A: That is up to your Physical Therapist and Doctor. If they allow it, then welcome! Keeping in mind: you may be doing specific exercises in Physical Therapy that are different, with different “cues”; and you may have specific limitations from your Physician. If their directions seem to be in conflict with my Method, then please -- either finish their sessions first, or have specific written instructions from them to me. I want to work with your team.
Do you have any other questions? Please contact me through my website.
Okay, hopefully I got your attention from that title! I found some interesting food for thought, after a colleague mentioned her frustation at exercises systems (including Pilates) becoming closed systems and limiting growth.
You're right -- this isn't exactly a Pilates photo, but this is how I felt about being compelled to teach something that was outdated and not resonating with me. It was a struggle in futility. So I simply moved to another studio which allowed me to teach as I wanted, rather than be required to teach exactly as everyone else taught, when I was disagreeing with the concepts/cues taught about Anatomy, Alignment, even Breathing. A few years later, that Brand caught up with the times, and changed many things -- and I'm so very thankful for that.
A. The original Pilates came from an older understanding of the human body; and one cannot dispute that in almost 100 years, modern science has embraced far more advanced concepts about Anatomy, Physiology, and Kinesiology.
1. We used to have this view just 20 years ago, that muscles connected only to tendons, and that bones connected to bones through ligaments. Well, that is just not accurate. We now understand that ligaments also connect to muscle.
2. We also used to think that ligaments could not regenerate when they were damaged (as compared to tendons and muscle). That is also incorrect today (look up Prolotherapy).
3. We also never even thought about Fascia 20 years ago, and now it's the rage in the fitness and wellness industry.
a. We used to teach that muscles pull, that they shorten and lengthen.
b. Now, we are understanding that muscles may not shorten and lengthen all that much, and that it's the Fascia that's changing. That instead of looking at the human body as having several hundred muscles, that we should instead view the human body as one continuous piece with multiple compartments. (Look up Thomas Myers).
Everything is changing. Rapidly .
B. Moreover, when Joseph Pilates first started teaching, people for the most part led more active lifestyles, with far different lifestyle habits (no cell phones or laptop computers, no drive-thru fast food establishments, and so forth). Moreover, if you look at Joseph Pilates's old videos, you'll see some which leave you questioning whether everyone was moving safely. I'm thinking of one in which he was actively pulling a man's head. Ouch. At any rate, their daily habits were different from ours nearly 100 years later. Our bodies have changed, and so have our needs.
C. As the years went on, Pilates changed from men's fitness, and became synonymous with dance, because it helped dancers heal their bodies from injurious training (which isn't the most sound idea in the first place, but it is a beautiful art).
1. For decades, the field was dominated by dancers who became teachers, and they taught for their own niche market.
2. Nowadays, Pilates is embraced by a much larger community. With the aging populations; surgeries for major joints like knees and hips (requiring more physical therapy); sedentary lifestyles leading to back pain; and of course emerging scientific discoveries, it became advantageous to modernize Pilates and take another look at whether we are doing truly healthy exercise in this country. And to suggest injury-preventive training, as well as rehabilitative, corrective work.
D. An unfortunate development in Pilates was that the discipline became littered with dysfunctional cues based on dysfunctional dance aesthetics. (For example, pressing down the shoulder blades, sucking in the belly at all times, not letting the ribs "pop" when you lift the arms, get taller as you twist the spine, and so forth). Let's take some of these dysfunctional cues and look at them:
1. Keeping the belly sucked in at all times. There are so many things to challenge here:
a. Breathing. Functional, healthy breathing requires that we use our Diaphragm properly, in a way that allows our organs to move the way they're supposed to. That means, letting the belly pooch out, so that the organs move. If you don't do that, then you don't let the Diaphragm go all the way down and fill the lungs properly. This is an easy test.
* Breathe in and let the belly button pooch out. Feel how much you can fill the lungs. Take an exhale, and notice how you feel.
* Now KEEP THAT BELLY BUTTON SUCKED IN. Try to take an inhale. You can't fill the lungs so well, can you? How do you feel mentally? I rest my case.
b. Keeping the belly sucked in at all times was thought to help support the low back. HOWEVER, this will make a person constantly "grip" their abdominal muscles, and produce a weak Psoas Major . A, muscle which directly touches all of the lumbar vertebrae and disks (uh oh, that's the low back), connects to the Pelvis, and also the leg. A muscle which is critical for walking, sitting, standing, and all manner of movement. Oh yes, time to toss out that cue altogether.
2. "Knitting in the ribs at all times, don't let them pop."
a. This is especially dysfunctional when you do spine extension. In an ordinary, non-dancer type person, this will make back-bending a physical impossibility. At best you might go a little bit past vertical. The ribs change when the spine changes, and vice-versa. If you don't let the ribs change, then the spine won't change. It's just common sense. If you want to test me on this, try it out.
b. This cue will also limit range of motion in the shoulder. At the end-range of arm-reaching up into the air, the human skeleton does a little spine extension. So go back to what I said in (2)(a), above. Then try this little experiment.
* Reach your arms up in the air and let the ribs "pop." See how far back you go.
* Now KNIT IN THOSE RIBS AND DON'T LET THEM MOVE. Now try raising your arms and see how far they go.
3. "As you twist the spine, get taller and taller." Well this is just anatomically inaccurate. And it could cause an injury.
a. If you actually did lengthen the spine as you twisted it, you would damage the spine and the spinal cord, which is part of your Central Nervous System.
b. Thankfully you cannot do that. It just isn't how your Facet Joints work in the spine. And, it's a mathematical impossibility, based on the curved shape of the spine.
4. "Slide the shoulders down and back." While this may be intended to tell people not to "shrug" their shoulders, this is a potentially injurious cue.
a. Just try this experiment to see how this cue tends to reduce range of motion with arm-reaching:
* Reach your arm up in the air, without thinking of anything else. Note how high you went.
* Now, SLIDE THAT SHOULDER BLADE DOWN AND BACK. DON'T LET IT BUDGE. And now try reaching the arm up in the air. That's possibly worse than knitting in the ribs. How did your neck feel doing it that way? Ugh.
b. I see a lot of people who misconstrue that well-intentioned cue and "fix" their shoulders, and contract muscles that need to stretch.
c. And if you need further convincing, both Pilates and Yoga are questioning this dangerous cue: http://www.yogajournal.com/teach/alignment-cues-decoded-draw-shoulders-down
Thanks, Eric Franklin, for bringing ALL of this to the forefront years ago! He really opened my eyes, starting in 2010. We were learning about really up to date scientific research, as well as some classic research from the early 1900s that had gone mostly ignored. And a lot of this research raised serious questions about whether Pilates as an industry will need to undergo another dramatic paradigm shift. Including the rehab side.
E. Modern Pilates was not perfect, either. I had long been aware from my days as a Pilates teacher-in-training that what we learned was debated.
1. We didn't hear that in regular teacher training -- although I questioned from time to time, the information I had been hearing in basic teacher training. It conflicted with what I understood in the human body from massage school and from massaging people. I ended up hearing about the debate from their leading physiotherapist at the time, booking private lessons from her, and taking a specialty course that she had been teaching. A year later, a leading Physical Therapist took over the course and came up with a new manual, explaining in more detail what was really going on in the human body. Yet, basic teacher training was still teaching the wrong information! At least at that time, that was the case.
2. So this led me, out of curiosity, to do some research. Apparently, all this modern approach to Pilates started in the late 1990s, after a pair of researchers named Hodges and Richardson published studies about the role of certain muscles in the abdomen and trunk area, and relieving back pain. From there, Core Stabilization/ Core Training exploded within the Health and Wellness industry everything from weight lifting to physical therapy focused on a little abdominal muscle called the Transversus Abdominis
3. While I still have yet to find a definitive retraction, I did find an intriguing article by Hodges in 2008 admitting that its not as simplisitic as once thought. Now thats quite notable, considering that so many people are still acting as if its Absolute Truth. I also found some other articles that are either pro- or against- the ideas we preach about core stability. One asks if its pure stupidity. Yikes! And one article in particular punches holes in all the muscle testing. . .
http://e http://www.alexanderschool.edu.au/the-alexander-technique/articles/76-core-stability?catid=25%3Asports rikdalton.com/media/published-articles/dont-get-married/
I'm not looking at this as if all my previous study of Pilates was a waste (certainly not). I don't need to throw away several years of study. In fact, I'm more than happy to entertain multiple approaches and use the ones that work. Who knows what the scientific research will uncover in the next 20 years? I change with the times and bend like the green bamboo. Or the palm tree in the breeze.
Every few months, it seems that some new weight loss plan, pill, or shake arrives in the market, and perhaps millions of people are moved to try it. Especially when someone triumphantly reports losing a significant amount of weight and going down several pants sizes in a short time, with no exercise!
Is this health ?
Some are even marketed as network marketing. I was once curious about an MLM in 2000 but didnt think much of it after a few meetings. How many times can someone hear eat all the pizza, fries and ice cream you like; take the fat blocker pills, and energy pills; and still lose weight.? Yuck. It just didnt resonate. Well, and then there was a widely publicized news report of the founder dying a month later, from a drug overdose. It just sent me running. And as well, the energy pills had Ephedra, which became a banned substance. I remember looking at boxes of unopened product and threw them all away. Blah.
I was later, in 2012, drawn to another MLM mainly because of a great friend who had an amazing idea about doing fitness videos with other friends in the fitness industry. Now that MLM did stress the importance of balanced eating and exercise, which was great. However -- ummm -- I just really didn't like the product, it didn't taste good to me. And after a couple of months, I couldn't lie to myself. I went back and looked at the things that I wrote back several months earlier and nodded.
So, I am not at all for weight loss shakes. Here's why:
A. The things that always raise personal red flags are artificial sweeteners, Sucralose,and Stevia in the ingredients. I realize its in there because most people looking to lose weight crave the very sweet taste, but they dont want the calories or simple carbs. However, they all have negative health effects.
1. Sucralose is literally sugar combined with chlorine, which I've known for the past 18 months, thanks to a local Naturopath. Heres an article on it, as well as Aspartame. http://www.wnho.net/splenda_chlorocarbon.htm
2. Views are mixed with Stevia. http://www.kitchenstewardship.com/2011/09/22/a-sweet-sweet-summer-what-are-the-facts-on-stevia/ . I just really cant stand the flavor of it. Two of my friends felt sick and got headaches after having a drink with it. And so did I.
B. I believe whole-heartedly in a real food diet which retrains unhealthy thinking and teaches people to be independently successful. Weight management is hard work. Keeping it off for life involves a change of life to make it work. My metabolism is better now than it was in my 20s.
C. Diet clubs and plans
have some initial success. But the long term success is grim. I'm sorry, but it just is. http://www.bigfatfacts.com/
And who hasn't seen those TV shows which pit people in a battle to see who could lose the most weight in a relatively short time? Unfortunately, a lot of them regain weight and/or apprently suffer negative health effects as a result of their ordeal. http://www.dailymail.co.uk/femail/article-2927207/We-fat-Former-Biggest-Loser-contestants-admit-cont...
C. The other thing is: I have a hard time believing that one can lose fat with a weight loss program, without exercise. And by that I mean, body fat percentage. Because fat percentage and activity level are pretty good indicators of health and potential risks. http://www.kellicalabrese.com/Articles/combining-diet-with-exercise.html
The following have been well-recognized for decades now...
1. Most diets without exercise end up with loss of lean muscle, water, even organ tissue; and their body fat percentage can grow higher, even if the weight goes down.
2. As a result of weight loss by calorie restriction, the metabolism ends up compromised and holds onto body fat even more tightly. So, if someone falls off the wagon so to speak and gains weight, they gain back a lot more fat. One need only look at well publicized figures to recognize how easy it is to fall into the yo-yo cycle. This fat storage is apparently built into our DNA. Our ancestors faced periods of famine and also trekked by land and sea to populate new areas, so they had to be efficient to survive. Can I do this with even less effort, less energy expenditure? Sure, I'll lower the metabolism so I don't have to eat as much. Sorted.
3. When people are claiming to lose fat, are they talking about measurable, documented fat percentage loss? Or are they just looking at a change in the scale, or the loss of pants sizes and assuming that its all fat? The most reliable measurement of fat percentage is the hydostatic tests. The next most reliable are calipers if done correctly. Those hand held biomechanical impedence things are wildly variable. Like by 4-5 percentage points.
And related material:
Pardon me for getting really steamed, but it really irks me to see advertisements that promise that you'll get "fit" in only 30 days, whether its a pill or a workout.
What a load of . . . well I'm going to use my internal editor to not use the words I'd like to use right now. In this case, Im steaming about a health club advertising a 30 day, 7 days a week Boot Camp. Sounds like a perfect opportunity to get a stress fracture, inflexible joints (including spine), and perhaps a knee injury. Especially for those folks 30 and over.
Fit in what way?
Perhaps someone who goes all out for 30 days will lose a few pounds. But there is no way that the body can maintain such a punishing regime. It's a recipe for an overuse injury, which could manifest within the 30 days or after.
And when (not if) that injury hits, it will sideline you and cause the usual collateral damage: (1) Weight gain often happens, (2) Frustration, depression, lowered self-esteem, (3) Some people give up; (4) Others may develop eating disorders, particularly women; (5) Still others return to exercise before they have finished healing and set up a chronic injury/pain situation.
7 days a week is never recommended for us normal folks, unless its some kind of flexibility training. (Now that would fall within the guidelines of the Aerobics and Fitness Association of America). The people who might fall outside of that are ELITE and YOUNG athletes. But even then, I've seen Cirque du Soleil/Shanghai Circus acrobats hobbling about with ice packs strapped on to this and that body part, getting right to work. And I have also seen elite dancers in some constant state of pain. (Which is why Im so enamored with the Franklin Method®, especially for these folks!)
Well then, we normal folks ought to be taking at least one day of rest per week AT THE LEAST. If you find yourself feeling stiff or developing pain, your body is giving a clear signal to slow down, and figure out whats going on.
Fitness is a lifestyle, its not something you can obtain quickly. There are many facets to physical fitness including core strength, flexibility, balance, coordination, and control. Then, there is overall health which includes your energy level; blood work (HDLs, blood sugar, all that good stuff); emotional and mental health; diet (yeah, we cant make up for the pizza, fries and beer with a big workout and nothing but broccoli the next day. Dont laugh, I knew plenty of friends in college who did that every weekend).
And if you are new to exercise, or took a long hiatus because of life circumstances, you deserve to treat yourself well. Start with a doctor checkup to rule out any cautionary measures and jump joyfully into some brisk walking, swimming, or other low-impact exercise. Grab a friend. Take in an appropriate level Pilates or Yoga class. Learn proper body mechanics to prevent injury.
Whenever I see people hobbling about and saying how great their workouts have been, I want to cringe. Want some Ibuprofen with that?
Wouldnt you like to experience instead, that workout in a more joyous, elastic, energetic way and go back to feeling as if you were a kid again? If so, call me; and if Im too far away I can most likely find someone in your area.
Anyway, thats my rant for today. Im totally against get-thin-fast and get-fit-fast regimes. Do it the old-fashioned way: with patience, and focus -- and retraining the brain to think healthy for life. Your body and brain will love you for it.