For children, it can help improve their physical health. This science also benefits adults and professional sports persons as well as senior citizens in terms of revitalizing their lifestyles. They just need appropriate exercises that fit their age and other conditions.

For those who have chronic illnesses, it is also useful. For example, a person’s physical capacity may have dropped from 100 to 80-90 (per cent) due to old age, sport scientists can design a programme to help prevent more illnesses or even reverse the course by improving the patient’s physical performance to, say, 91-92 (per cent). That’s rehabilitation. Next, we will show you the state-of-the-art fitness facilities and equipment at Jin Well Being County of Thonburi Healthcare Group. The facilities have sport scientists working regularly to advice you, covering all age groups from adults to senior citizens or those with chronic illnesses. We will go over there and have a look.

Now I am at Jin Well Being’s fitness centre (in Bangkok’s Rangsit area), with two sport scientists, Khun Bas and Khun Bank, who can give professional advice to the general public as well as sportsmen and senior citizens.

First of all, please talk about the various modes of physical exercise, duration, intensity, and frequency. Generally speaking, we exercise for the strength of body  muscles and for cardiovascular or heart fitness. For muscle strength, we focus on weight training, body weight or cross fit sessions for the benefits of body mass and muscles.

Another is the aerobic or cardio exercise to strengthen the heart and cardio-vascular system. Generally, we should exercise 3-5 days or a total of 150 minutes per week to stay healthy. Each session may vary from 30 minutes to an hour to achieve the total of 150 minutes per week.

Mainly, there are two major types of exercise, one for muscle strength and the other for cardio strength. Right here, what’s the benefit of this machine?

This machine is good for the aerobic exercise or the cardio or heart fitness.

For the general public, what’s your advice on a suitable exercise programme? Basically, there are no special precautions (unless you have some medical conditions). For senior citizens, we need to check if they have chronic diseases and other conditions so that we can recommend a suitable exercise programme covering the appropriate mode, duration and intensity.

Generally, we will go for light and medium exercises for senior citizens such as Tai chi (Chinese-styled exercise)  or an aerobic exercise in the swimming pool. For cardio-exercises on a machine, the intensity is important so they should stay within Zone 2 or Zone 3, meaning their heart rate should range from 120 to 140 per minute. We can also calculate based on age like the formula mentioned by Dr Tanatip.

So we start with the maximum heart rate of 220 per minute, then minus by your age. If you are 50, that’s 170, then we aim to achieve 80 per cent of the max heart rate or about 150 per minute in this case. The machine has sensors to measure the heart while you work out.

If we aim for muscle strength, what’s your advice? First, if you’re already familiar with physical exercise, you can continue as you did before, but if you are a newcomer you need to have a physical therapist or a trainer to guide you. For those with heart disease, diabetes, or high blood pressure, what is your advice?

They will have to consult their physicians before starting an exercise programme.

Afterwards, the doctors will forward cases to sport scientists to help design an suitable exercise programme. We also need to do some tests before we start. For the rehabilitation purpose, we focus on helping senior citizens keep a good physical balance while preventing or minimizing joint and muscle problems. In some cases, we need to do a cardio exercise to strengthen the heart or prevent heart problem or improve the blood pressure.

For senior citizens with a loss of some bone and body mass, we may need some light weight training session.

There were celebrities and “fitness influencers” in the crowd that turned out last Sunday for “Wine Surfset”, at which Surfset Thailand gym trainers demonstrated how workouts might be more enjoyable over a glass of Australia’s Jacob’s Creek wine.

The sweat session at Siri House on Bangkok’s Soi Somkid took the “beer and yoga” fad one step further with exercises done on a surfboard and delectable wine at hand.

Jacob’s Creek has a new “Bring Your Australian” promotion based on Aussie pastimes such as surfing, giving people a chance to “hang ten” without having to trek to the beach.

And the “total-body surfing workout” forms the basis for techniques used at Surfset Thailand gyms.

After Sunday’s workout, guests were invited to join in an Aqua Zumba class, which is a high-energy aquatic exercise set to music.

The wines being sipped included mellow Sparkling Chardonnay Pinot Noir, dry and fresh Le Petit Rosé and sweet Sparkling Moscato Rosé, which has a light hint of Moscato grapes, berries and lychees.

The brand has seen a 300-per-cent year on year growth by emphasising the product’s distinction and positioning itself as true oral-care expert, according to a Wednesday release. Now it is launching new marketing activities, along with the Curaprox mobile application as a new touch point loaded with privileges to better serve health conscious consumers who looks for the best there is.

Ekasit Noncie, the managing director of Curaden (Thailand) Ltd, said the brand’s rise is due to Curaden envisioning a healthier world. “A world in which passionate dental professionals, clued-up consumers, and attractive, effective and safe products work hand in hand for the healthier individual.”

Curaprox operates under the Curaden AG umbrella, which was founded in 1954 in Switzerland. And Curprox has adopted this vision since 1972, in a stylish way. The company has been focusing on sharing personal care insights and promoting dentist-patient relationship in 75 countries around the world, including the past in the past two years in Thailand through an official distributor. Curaden AG has now moved forward with a joint venture deal that gives birth to Curaden (Thailand) Limited.

The main strategy is to market products by supporting consumers with facts as well as working with dentists, healthcare facilities and educational institutions nationwide. For 2020-2021, the emphasis will be on communicating the brand by fostering first-hand product experience. Those people who earnestly live their lives with quality can truly appreciate the product and its philosophy, said the release.

In retail, no direct competitor has yet existed in this market territory, but the company is adding more sales channels online that will match the lifestyle of affluent customers with special privileges and more personalised information.

The brand’s major emphasis is the toothbrush category, which comes in more than eight options differentiated by treatments, such as toothbrushes for braces, toothbrushes for primary teeth, toothbrushes for mixed dentition and toothbrushes for use after surgery or radiation treatment.

“The premium oral-care market in Thailand as a whole seems to be increasing continuously in value at least 15 per cent a year due to various contributing factors,” Ekasit said. “Advances in medical research and technology as well as manufacturing processes, increasing lifestyle-based sales channels and changing consumer behaviours prompt better responses to product innovation. Many brands are adding a wider range to their product line-up, and consumers can expect to see more products being marketed to them. So Curaprox moves forward with marketing to meet customers’ post-purchasing needs, facilitates an exchange of oral-care information and adds another convenient sales channel to our arsenal.”

Many people spend 8-10 hours in front of computer screens, resulting in stiff muscles and body aching, especially on their shoulders, neck and upper arm. We have good solutions to tackle this problem. With me today are Dr Thanathip and Archan Surasak, who is a physical therapist. 

Dr Thanathip Originally, the so-called office syndrome meant people working long hours at office with writing instruments. About 20-30 years ago, we started to use desktop computers so our sitting posture is just like this. This position is not natural as we are not built to sit for a long time in this style. For Bangkok motorists, there is also another problematic sitting posture when you are caught in traffic jams for hours. You may spend two hours daily in this position, hurting your back, neck and shoulders. 

Archan Surasak, what is your recommendation? I would like to say that a decade ago we might talk about this problem purely as an office syndrome, but today it’s different everyone has a mobile phone using it anywhere in the office or while they are commuting on the Skytrin train etc. In public places, we can see many people are busy with their personal device. Their posture while using these gadgets is not healthy and when they sit they tend to slip and lie down on the chair, with the head also bowing down while using one or both hands touching or swiping on the touch screens. I can show such a posture. It’s like this. This causes neck and shoulder aching and pains. Many sufferers have sought treatment. Sometimes, they have not got proper help. This has nothing to do with kamma. It’s just the consequence of sitting improperly. 

My advice is you have to agree the problem is caused by your own behavior. You should change your style. For those working 8-10 hours at a desk, I suggest you take frequent breaks. My advice is to get up more often, maybe not every hour, as that might affect productivity, but you should make sure you get up one plus one in the morning as well as in the afternoon. This means you routinely get up and leave the desk twice in the morning and twice in the afternoon. Altogether, you should take four breaks per day. 

Another point is that you should test if you already have the tight neck and shoulder or back problem. The screening method is simple. We can do this together. Just stand up and raise both arms to the fullest extent. Make sure you can touch both ears comfortably without moving the head. Let’s me check Khun Nop. If you cannot do it with ease that means muscles around the shoulders and neck are tight. That’s a warning sign. One more time, we are going to show you how to test the condition of your neck, shoulder and back. 

At a close look, I can see that  Khun Nop could not fully touch both ears without moving the head. There’s a gap and that’s the problem caused by muscle tightness. To do a proper test, you need to raise the arms and keep you head straightforward. Once you have muscle tightness, I would suggest that you do some brief exercise to stretch. You can do this following workout in the office next to your desk or even inside the rest room if it’s convenient. This workout takes just a few minutes and no sweating. This is aimed at loosening the muscles around the shoulders. It’s preventive and I can show you how to do it. Most people are familiar with this simple exercise when they’re in school. You have both hands touch your shoulders and then make forward and backward circles. 

Just close your eyes and imagine to use the tip of your elbows just like a big pencil to make the biggest-possible circles around your shoulders. You should do it slowly with both arms. You will feel a movement of your shoulder muscles. Move your arms forwards three times and then backwards another three times by drawing the biggest possible circles. 

Previously, I didn’t do it properly. Now I could feel a big difference. It seems to have stretched my lower back, neck and shoulder all at the same time. It’s simple and very useful. You don’t have to do it a hundred of times. Just a few times when it is convenient and do it as often as possible. Maybe 10 or 20 times or less as long as it’s convenient. One more thing when you return to your desk, make sure you sit straight even though you may slip a bit later on. By getting up more often you have the chance to be aware of your sitting position and can make a correction. Combing with a brief exercise, that’s a perfect way to take care of yourself without having to pay for anything. 

Dr Thanathip and Archan Surasak, Have talked about the office and mobile syndrome as virtually everyone now uses smartphones and many users tend to have the posture problem when using these devices for an extended period. If they are sitting they are likely to gradually slip on the chair and almost lie down. What’s the issue here? Physically, our spine is shaped like the S alphabet. When you are not sitting straight up on the chair for a long time, your spine is affected and it may deform and become like the C shape, not S anymore. In this case, you risk having a deformed spine. That’s bad and unnatural. One solution is to test yourself by raising both arms to the fullest extent over your head and if you cannot touch the ears without moving the head, then you need to stretch regularly to prevent damaging the spine and reduce aching. 

Some people could not raise their arms over the head so that’s the problem. Archan Surasak, you have other suggestions? I think we also need to be inspired to be healthy. If you want good health, it’s not on sale, you have to work out yourself. This will improve the quality of life. So stretching regularly is vital. Our body is like the car’s engine. It needs to run idle regularly to be in good shape. If you don’t start your car regularly, the battery and other moving parts will be soon in trouble. 

For human beings, we need to have a lot of physical movements to stay healthy as a sedentary lifestyle is bad for your health. For people who use mobile phones many hours a day, they risk having the damaged spine due to sitting improperly. The spine shape shifts from S to C shape as explained earlier. 

This has affected not only adults, but also children as young as 8 years old. In the older days, I only had patients in advanced age. Now, younger people and kids are also sufferers. Maybe, some kids are addicted to mobile computer games and we have pictures to show in these cases. In one case, a kid’s spine is reshaped like the C alphabet due to long hours on digital devices from smartphones to tablets etc. There was no proper parental guidance when kids use these devices. 

It seems the office syndrome has shifted over the past decades to be the smartphone syndrome and now  the digital device syndrome to cover tablets, notebooks and other devices. Now, the new styled offices are called co-working space, which is designed to accommodate the new generation of workers with additional space for physical workouts and other activities. That’s helpful. Don’t be shy and become the trendsetters. With multiple and new-styled furniture and even standing desks, that’s good. So people can exercise inside their offices.

Non-cancerous growths of the uterus that mostly commonly occur during childbearing years, uterine fibroids are found in 25 to 40 per cent of Thai women. While not particularly painful, they do cause discomfort as well as heavy menstrual bleeding and, in some cases, lead to infertility.

“Treatment ranges from medication to surgery, though that is only recommended for between eight and nine per cent of patients. Surgery comes into play when the fibroids are larger than 12 cm,” says Dr Boonsaeng Wutthiphan, an obstetrician-gynecologist at Samitivej Sukhumvit Hospital.

Dr Jacques Donnez, a professor at the Catholic University of Louvain, Belgium and a highly respected gynaecologist, was in town recently to talk with Samitivej’s doctors and provide an update on the use of the new drug ulipristal acetate (UPA) for uterine fibroids.

He began his presentation by reminding participants that the benign tumour is often found in women between the ages of 20 and 50, with age increasing the prevalence.  After menopause, the size of the myomas, as the fibroids are known in medical terms, decreases because they are hormone-dependent, with oestrogen and progesterone the major influencers of fibroid size.

The main symptom, the Belgian doctor noted, is heavy menstrual bleeding called menorrhagia which can affect quality of life.

“The second symptom, which is also important, is pressure on the bladder, which can lead to urine incontinence. And in younger women, the tumours might affect fertility,” Donnez said, adding that there are no significant differences between Europe and Asian women as the size and the localisation are more important than the symptoms. In fact, most women with uterine fibroids don’t experience any symptoms, particularly if the fibroids are small and are only detected by chance while the patient is undergoing an annual health checkup. Patients with large uterine fibroids, however, often have symptoms related to abnormal menstruation, such as heavy bleeding, irregular periods, pelvic pressure or pain, or chronic lower back pain. In some cases, fibroids growing and pressing on nearby organs can cause frequent urination or constipation. If the fibroid is particularly large and can be felt in the pelvic area, it may cause swelling of the abdomen, similar to pregnancy and, if left untreated, can make it harder for the woman to conceive or cause anaemia due to significant loss of blood. Additionally, if uterine fibroids occur during pregnancy, they may, in some cases, lead to premature birth or  miscarriage. They are not, however, life-threatening.

But while small and non-symptomatic fibroids do not require treatment, a new drug, Ulipristal Acetate, is an effective therapy for those with abnormally large myomas but do not want surgery or for whom surgery is not an option.

That’s a major step forward from even 10 years ago, when most gynaecologists would recommend a hysterectomy or, at the very least, a myomectomy to remove the tumours but not the womb. “The problem is that more and more women want to preserve the uterus

for a lot of reasons. It’s regarded as a very important part of the body because it’s responsible for pregnancy, and this has made many women reluctant to go under the knife,” he explained.

Uterine fibroids can range in size from as small as a mung bean to as large as a watermelon. You can have multiple fibroids or just one. They are fairly hard and dense in nature and can be found in almost every part of the uterus. Intramural fibroids are the most common and refer to uterine fibroids that grow within the muscular uterine wall.

They can distort the uterine cavity or uterine wall, leading to abnormalities. Subserosal fibroids are on the outside of the uterus and may project into the surrounding outer uterine tissue layer. This type of uterine fibroid is usually asymptomatic, other than perhaps

pressure on the bladder or rectum.

The last type is submucosal fibroids which are quite rare and are in such a position that, when they grow, they can push into the uterine cavity. They are usually found in the muscle beneath the inner lining of the wall and can result in the distortion of the uterine cavity, and often cause menstrual disorders.

The best option for diagnosing and monitoring the size of fibroids is high-frequency sound waves or ultrasound. This includes both lower abdominal ultrasound and transvaginal ultrasound, both of which provide accurate, precise results. There are also medications

available that provide effective treatment, allowing patients to avoid undergoing surgery.

Now, though, doctors have another weapon in their arsenal – Ulipristal Acetate, a drug in the Selective Progesterone Receptor Modulator (SPRM) class of medications with predominantly inhibitory effects on the progesterone receptor. It is currently available in 5-mg tablet form and has been approved for two main therapeutic indications: treatment of uterine fibroids prior to surgery and as a course of treatment for uterine fibroids in patients who are not eligible for surgery.

Donnez explained he prescribes two courses of UPA each lasting three months with a short break in between and that the results had been satisfactory.

“The heavy bleeding stopped, the pressure decreased and the tumour shrank. Of course, it is possible that some women will again experience heavy bleeding four or five years later, in which case we can start another course of treatment. We found that the tumour decreased around 30 per cent in volume after the first course and the second course can maximise the effect with 50 per cent decrease in volume. For the bleeding we found that it stops after six days medication,” Donnez said.

Treatment is carried out as a 12-week course. The first treatment course should start during the first week of menstruation. There should be a break of two menstrual cycles between the first course and the second retreatment course. Retreatment courses should start at the earliest time during the first week of the second menstruation following completion of the previous treatment course.

Patients who should not take the UPA medication include those who are allergic to major components or excipients in the medication, women who are pregnant or lactating, patients experiencing vaginal bleeding for unknown causes or due to causes other than uterine fibroids, patients with uterine, cervical, ovarian or breast cancers and patients with abnormal liver function or liver disease.

It will also unveil Bichup Self-generating Anti-Ageing Essence and Bichup Jasaeng Essence Special Edition, inspired by the bedroom of a Korean empress at Changdokgung Palace in Seoul.

On view are royal art pieces and traditional costumes and ornaments of the royal court. These include a Jeokui worn by the empress at important rituals such as royal weddings and a Daesamjaknorigae that decorated a woman’s hanbok outfit with coral, white jade and amber.

A highlight of the show is “Holistic Heritage Sirivannavari x Whoo”, an art piece specially designed this year by Her Royal Highness Princess Sirivannavari Nariratana.

If you plan to attend, register before October 10 for a “Bichup gift set” at https://event.whoo.co.th.

October is Breast Cancer Prevention Month and 460 women are registered to undergo the free check-ups throughout the month at the institute’s Damrong Niradura Building, director Dr Weerawut Imsamran said on accepting the donation.

Wacoal, a maker of women’s undergarments, has said it wants to encourage women, especially those in at-risk groups, to have their health checked annually.

Regular check-ups have been shown to vastly reduce mortality and increase the chances of a successful cure.

Drs Thanathip and Archan Surasak talk about physical exercise and its positive effects on every age group.

Dr Thanathip, how important is exercise in today’s internet age?

Exercise is essential for good health. Humans began as hunter-gatherers and still need a lot of physical movement on a daily basis. More people today live in air-conditioned buildings and we’re glued to our computers, maybe spending 10 hours a day in front of the screen. Our bodies have become stiff due to the long hours of sitting.

Basically, we need a lot of interval workouts to loosen stiff muscles in the neck, shoulders and other areas to stay healthy. We also need to do cardiovascular activities to keep the heart healthy, strengthen our muscles and maintain a good physical balance. We should be able to literally maintain our balance while standing on a log, but most of us lack this potential.

However, I have noticed something. When I was in medical school at Chulalongkorn University about 30 years ago, I would jog regularly in nearby Lumpini Park, and there were few other runners. Today, jogging and running are very popular, and we even see so-called “overuse injuries” resulting from excessive exercise.

On the other hand, there are more and more obese people due to improvements in oncome, the over-consumption of sugary foods and other factors. These are two extreme groups – obesity and over-exercising. There are fewer people on the middle path, so it’s like a pendulum swinging to the extreme left and right.

What do you mean by “overuse injuries”?

It means we are over-using our bodies. The people who love to exercise represent our main topic for today, those who over-excise and work out for too many hours. The other group don’t work out at all, and their overuse injuries come from working long hours in a chair, resulting in aching shoulders and upper arms. Some muscles are overused, some not at all. Overused muscles bring the risk of overuse injuries. If the injuries come from sports or too much working out, the muscle fibres will be damaged and you get aches and swelling.

Aching shoulders and upper arms are quite common and some people turn to traditional massage for relief. Is it a good solution?

In fact, we should look at the root cause. The aches could result from an inactive lifestyle. If you’re sedentary, you need more physical movement on a daily basis. That’s the real solution to the underlying problem. Professional massage might bring temporary relief, but it’s best to take frequent breaks from the computer to do brief sessions of simple exercise.

Thai traditional massage is regarded as a national treasure, but you need experts to do it properly. And massage only relieves the pain. To cure it, you need to get back to the basics – being physically active more.

Heat therapy has become popular in dealing with overuse injuries caused by improper exercise. What is your opinion?

In short, heat therapy is common among Thai people. Many people would just turn to medication and other heat methods to ease muscle and other pains. Heat therapy is common here, with many simply using balms or embrocation liquids, hot-water bags or heating pad to ease pain, but this is only superficial heat. My advice is to avoid heat therapy in the first day or two of feeling overuse injury because the heat increases blood flow to the affected area and worsens the injury. It’s better to use cold therapy initially, such as an ice bag, as long as the chill is not extreme.

On day three or four, you can use heat therapy to help the body repair damaged tissues by increasing blood circulation in the area. Some people think the more heat the better, but you have to be careful about inflammation, again by making sure the temperature is not extreme. People with chronic diseases such as diabetes must avoid extreme temperatures in coping with overuse injuries. Judge according to how you feel – If the heat becomes unbearable, just remove the source, then reapply, and so on.

Dr Thanathip, jogging and running have become quite popular in Thailand, with many running events and mini-marathons organised. Could we begin seeing more over-exercise?

Running is an aerobic exercise good for your heart, but regular runners should have a wearable gadget to measure heartbeat and other indicators to ensure a healthy session.

The rule of thumb is that maximum heart rate should be 220 minus your age. If you are 50, the max rate is 170, and you should achieve about 80 per cent of this rate during aerobic exercise. Anything higher is considered a hard-core endurance exercise while a lower range is mainly for fat burn, not for the cardio purpose.

Aerobic exercise is essential and you should do it on a regular basis, say, 3-4 times a week. If you stop, the effects will decrease in two weeks.

So we should consider our age and monitor heart rate through wearable gadgets or calculate the perfect rate by yourself. You have to pay a little for your health. Moreover, you have to work out regularly and monitor the heart rate as an indication for proper exercise level.

In terms of calories, you should burn at least 1,500 per week, or 400 calories per session if you exercise four times a week. You can burn around 400 if you run for nearly an hour.

I work on a running machine and lose 300 calories in around 30 minutes.

That means your body is fit.

However, it quite hard works out for me. If I do running outdoor, I have to adapt to the current condition. But the main subject is proper exercise.

What is your advice for avoiding overuse injuries?

Basically, you calculate the suitable duration and intensity of the exercise based on age and other factors. Sometimes you may want to achieve higher performance, but make sure you’re not going too fast or overdoing it. That’s a future topic – what to do if injured.

Dr Thanathip, can you say more about the sedentary lifestyle?

There are two major groups among the so-called Gen Y and Gen Z populations. The first are physically inactive and generally overweight or even obese. They prefer an easy-going lifestyle, eating and spending hours on digital devices. If they do exercise, it might be not enough. The others are quite strict in their diet, eating lots of veggies and low-fat foods.

Can you give advice on increasing motivation?

The first group might lack incentive to work out regularly. The most important factor is probably social. If you’re surrounded by friends who don’t exercise and enjoy eating, you’re not going to be motivated to do otherwise. Maybe you need a new environment.

Dr Surasak, what if someone isn’t motivated to exercise?

Some people need the inspiration to live longer for their loved ones, so this could be a powerful incentive for regular workouts. Some adults wish to stay healthy so they can take care of their parents in old age, while others want to exercise so that they live long enough to see their kids reach adulthood. Self-motivation is key to sustained regular exercise and helps people stick to it when they lose the will.

Many people can’t sustain their exercise habit even after they’ve spent money on equipment at home. After a brief period, the machine goes unused.

When I finished medical school at age 25, I weighed 82 kilograms. Twenty years later I was 93kg – 10kg overweight – even though I ran 2.5 kilometres every other day. It’s a challenge to keep the weight down.

Eight years ago, an in-law introduced me to biking and I spent Bt20,000 on a new bike. In the first month I did 2,000km every morning and evening and lost 7kg, the first time since med school my weight dropped. That was a big inspiration for me and I returned to running again. Today I weigh 84kg and can easily maintain it.

In short, inspiration and self-motivation are key to sustainable physical workouts.