Ask R7

Ironing out our differences on abs, and a few words on weird leg pain

Q: I keep reading how doing exercises to get your stomach flat can be done in the wrong sequence and will actually increase your tummy bulge instead of decreasing it. How can you tell the right sequence to do them in? I've picked out several I can do, but I'm not seeing any results. I do them twice a day, Monday through Friday, and take the weekend off.

Look at any fitness magazine or any fitness infomercial and you will know that flat stomachs are an obsession. I get a lot of questions about flatter stomachs. Much of the information is senseless hype, so I turned to Seattle fitness expert Kari Anderson and asked her to take a stab at this one. Anderson owns five Pro-Robics gyms in Seattle and has created more than 20 fitness videos, including four recent ones.

A: From a performance standpoint I believe sequencing should go from easy to more difficult. Give the body a chance to warm up and then progress.

I think it is even more important to carefully look at the exercises you choose in order to target all areas, and then also examine the quality of your work. Focusing on drawing the rib cage down toward the pelvis while contracting the abs, eliminating all momentum and doing controlled work will all help to reach strength and endurance goals.

Flattening the abdominal wall on each curl is a cue that helps my class get the most out of each curl. Most important, though, is to realize abdominal exercises will not necessarily give you a flat midsection. They will tone and strengthen the underlying muscles, but it is essential to include regular aerobic exercise in your weekly schedule to help burn extra fat the body carries. Your body is unique in where it chooses to burn its fat stores. Ab work will not target the fat-burning to that specific area.

Q: After many years of living in a car-based community, I have returned to Seattle and am trying to walk for exercise. One thing keeps cropping up to make it difficult: The muscles in the front of my lower leg along the shin become very, very tight, and it becomes difficult to raise my toes as I walk. There can be some pain, but mostly it's just very uncomfortable, since I start dragging my toes and having to lift my legs higher as I walk. I have never been a high-heels wearer, so it isn't shortened muscles (if that can even really happen) as one friend suggested. I can't seem to find a stretch that helps.

I have to walk to the bus and to work every day, so it's not like I'm couch-bound when I'm not exercising. Any ideas?

This sounded like shin splits to me, but I'm no doctor. So I contacted Dr. Christopher Wahl at the University of Washington Sports Medicine Clinic. Perhaps some of you wrestling with strange leg pains might find this useful:

A: Two things come to mind. I'll start with the one that is less common, but best seems to fit the symptoms.

1. This person might have something called "exertional compartment syndrome." The issue revolves around the "fascia" or "sleeves" that surround the muscles of the leg. In some people, those fascia are too tight. At rest, it usually isn't a problem, but as the person exercises (usually between five and 15 minutes into a brisk exercise), the muscles swell with blood and expand against the unyielding, closed compartment created by the fascia.

When the pressure in the muscular compartment overcomes the diastolic blood pressure, the swelling muscle literally chokes itself. This is manifested as tense swelling of the compartment (sometimes visible), pain and weakness. The "anterior" leg compartment (near the front) is the most common one affected. That's the one that contains the anterior tibialis muscle — the one that lifts the foot when one walks.

The symptoms usually resolve themselves 30 minutes after the exercise is stopped and the compartment pressure begins to fall.

This problem is easily diagnosed by measuring the pressures in the compartment pre- and post-exercise with a couple needle sticks. The "fix" is an ambulatory surgery to "release" the tight fascial sleeves. If the diagnosis is right, the surgery is effective about 90 percent of the time.

2. Less likely in this case is stress fractures or shin splints. These are usually caused by repetitive stress like jogging and develop very slowly (first a slight ache after a run, then pain that stops one mid-run, gradually to pain even with walking).

The difference is that it starts immediately with impact, and stops almost immediately when the offending exercise is stopped. Diagnosis can be made with MRI, bone scan or (if really bad) X-rays.

Richard Seven is a Pacific Northwest magazine staff writer. He can be reached at rseven@seattletimes.com. Paul Schmid is a Seattle Times news artist.