Health experts say the current Covid-19 situation in the country is not favourable for social gatherings even for welcoming the New Year.
“Current active cases have exceeded 21,000 and daily numbers are close to 2,000. We should not expose ourselves to any risk of infection,” said Universiti Putra Malaysia medical epidemiologist Assoc Prof Dr Malina Osman.
“We should also not strain our healthcare system further.”
The conditional movement control order (MCO) was eased for the sake of the country’s economy, and not for engaging in big social crowds or family gatherings, said Dr Malina.
She advised the public to continue to comply with SOP, as the vaccine was yet to be made available locally.
“Hopefully the vaccine will reach our country soon. Singapore has started the vaccination for their frontliners today (yesterday) and their cases are much lower compared to us, we have to be more consistent and vigilant against Covid-19.
“Or we can expect early next year to be markedly different from our neighbouring country,” she said.
Universiti Malaya professor of epidemiology and public health Prof Dr Sanjay Rampal said for the next few weeks, it was important to do two things.
“First, avoid being in congested and confined areas for prolonged durations. It may be hard at times to maintain the minimum 1m physical distancing but we have to.
“Second, there may be a need to maintain a social circle for longterm emotional and psychosocial support, but avoid a large bubble, and restrict mixing across networks,” he said.
For New Year celebrations, Dr Sanjay suggested that the public usher in the New Year by staying at home.
Large gatherings, if any, should be held in big, open spaces while practising physical distancing, he said, adding that the location should have sufficient amenities to promote good sanitation and hygiene.
Medical Practitioners Coalition Association of Malaysia president Dr Raj Kumar Maharajah concurred that celebrations should be held in open areas with good ventilation to reduce the probability of getting infected.
Dr Raj said air conditioned and closed spaces without good ventilation posed a risk to people.
“Malaysians can celebrate in open areas by observing the SOP laid out by the Health Ministry. Use your face mask, observe social distancing, and wash and sanitise your hands regularly,” he said.
Going into the new year, Dr Raj believed there would not be “total freedom”.
“There will still be restrictions for the whole of next year. Hopefully, the vaccine can ease that for us. However, let’s remain positive and hope for the best,” he said.
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A ‘Body Mind Powerbank Station’ class being held over Zoom.
TWO humanitarian non-governmental organisations are jointly holding free online classes on techniques to alleviate stress.
The Art of Living (AOL) Malaysia and International Association for Human Values (IAHV) will hold the classes, themed “Body Mind Powerbank Station”, to teach participants the proper stretching and breathing techniques that can assist people in dealing with anxiety, especially those induced by the Covid-19 pandemic and movement control order.
The classes are 20 minutes’ long and will be conducted via Zoom every Wednesday to Friday between 8pm and 9.30pm.
AOL Malaysia president Sundaresh Aw Yang said the techniques would help calm minds.
“The MCO has disrupted many lives, resulting in sleep disorder, anxiety, lost of concentration and increased anger that take a toll on the body.
“This programme, started in October, will help participants to relax and improve their energy, ” he said when contacted.
“Normal breathing will see about 20% of the oxygen we inhale go to our lungs.
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“Through the techniques to be taught in the classes, we can bring it up to about 70% to 80%.
“People who are angry will breathe heavily and in short breaths. Those who are happy will breathe lightly, long and deep, ” he added. Aw Yang said with better breathing, it would also help improve quality of sleep.
He said the techniques were started by AOL founder Ravi Shankar from India in 1981.
“It can help people to be more positive and have a peaceful mindset, ” he said, adding that there were 156 AOL centres globally and 50 in Malaysia.
IAHV president Tan Boon Yang said he had been practising the techniques for 15 years and found it to be beneficial.
“People commonly advise us to rid ourselves of anxiety and not be angry, but fail to guide us on how to do so.
“I had depression and the techniques have helped me to manage my anxiety, ” he said.
“I am now actively involved in humanitarian efforts.
“The techniques are very simple and I hope it can work for others too, ” he said.
He added that IAHV was a global organisation found in 25 countries, with its branch in Malaysia registered in 2012.
Some like them big, some like them small, but either way, the size of your calves can tell a lot about your health.
MEN take pride in having them big, but women want them slender.
It’s a skeletal muscle group that’s difficult to bulk or trim, even though it’s one of the most used in daily tasks.
If you’re unsure which muscles these are, I’m referring to the calves.
Genetics and anatomical structure play a significant role in how the muscle is shaped and how large it can grow.
The calves comprise of two main muscles: the outer gastrocnemius (known as the calf belly with two “heads”, i.e. medial head and lateral head), and the underlying soleus, which is the smaller of the two.
Together, they are responsible for bending the ankle joint upwards (dorsiflexion) and straightening it to point your toes (plantarflexion).
These two muscles taper and merge at the base of the calf muscle, and attach to the heel bone (calcaneus) via the Achilles tendon.
During walking, running or jumping, the calf muscles pull the heel up to allow the body to propel forward.
There is also another small muscle that runs beneath the gastrocnemius and soleus, called the plantaris.
It has a short belly and a long, thin tendon that connects to the Achilles tendon.
Functionwise, the plantaris muscle assists the gastrocnemius, but not significantly.
In fact, in 10% of the population, this muscle is completely absent.
Bigger or smaller?
Basically, the size of your calf muscles is determined by how far your heel bone (calcaneus) projects backwards, i.e. its length.
The longer this bone is, the smaller your calves.
In one 2011 study, researchers studied individuals of similar height, weight, lower limb length and foot length, and discovered that the ones with shorter calcanei had bigger calves.
Meanwhile, those with longer calcanei had more slender calves.
They also looked at the muscle recruitment patterns and found that people with shorter heels and big calves were using their medial gastrocnemius muscle more than the lateral gastrocnemius muscle while walking.
In contrast, those with longer calcanei had more evenly distributed calf contractions.
People with skinny ankles (small girth) will not be able to build bulk in their calves, although they have a lot more agility than their counterparts with thicker ankles.
Sprinters generally have bigger calves due to the extraordinary amounts of explosive power required to sprint short distances.
Long distance runners, on the other hand, tend to have slender, toned calf and leg muscles.
In fact, the calves in animals that move fast are practically non-existent.
Sausage legs
There is no ideal or normal proportion for the calves and ankle – it depends on what is beautiful to the eye.
Aesthetically, we are all wired to desire ankles that are smaller than the calves.
However, there is a condition where the ankle is just as thick or slighter thinner than the calf, making the lower leg look like a cylinder.
This “cankle” – a combination of the words “calf” and “ankle” – is not a medical term, but a word made popular in 2001 when Jason Alexander’s character in the movie Shallow Hal used it to criticise an overweight woman’s lower leg, saying, “It’s like the calf merged with the foot, cut out the middleman.”
When you have cankles, you’ll find it hard to differentiate the calf from the ankle. Some people call this “sausage legs”.
Women are more prone to this as it seems to run in the female line, with mothers, sisters and other female relatives tending to have the same lower leg shape.
Unfortunately, there is just so much you can do to alter it through natural means besides losing the fat that is covering the ankle.
Sometimes, however, these cankles are due to medical conditions like excessive water retention, kidney disease, bad sprains and surgery.
The calves are prone to tightening and cramping, especially after a workout, so be sure to stretch them out.
If your ankles remain swollen over a long period, do seek medical advice as it could be the sign of something sinister, like heart failure.
Managing those muscles
If you’re genetically predisposed to having big calves and don’t want to bulk further, the best you can do is to scale back on high intensity, skipping, plyometric and heavy weight-bearing exercises as they contribute to hypertrophy or muscle growth.
Also, don’t walk, hike or run up on an incline (e.g. hills or uneven surfaces) as these activities force your calf muscles to work harder.
They will definitely get stronger, but could also get bigger.
Instead, stick to running on flat surfaces.
To build your calf muscles, there are only two types of effective, yet simple exercises: heel or calf raises with knees straight (for the gastrocnemius) and with knees bent (for the soleus).
Start with one set of 12-15 repetitions with your feet parallel first.
Then turn your feet out (toes pointed out or away from the body) for the next set.
For the last set, turn your feet in. This forces your muscles to work from different angles.
To target the soleus muscle, repeat the entire sequence seated, perhaps with a light dumbbell on your thighs.
Do three sets, but only with your feet parallel.
You may not see noticeable bulk, but you’ll see some tone and more definition.
Stretch and soak
The calves are prone to tightening and cramping, especially after a workout, so be sure to stretch them afterwards.
The simplest way to do this is to stand at the edge of a step and place the balls of your feet on it.
Keep your legs straight (use the wall or railing for support) and reach your heels to the floor until you feel the stretch in your calves and Achilles tendon. This stretches your gastrocnemius muscles.
To stretch your soleus, do this with one knee bent, then repeat on the other side.
In addition, you can try soaking your lower leg in warm, salt water for 15 to 20 minutes before patting dry with a towel.
Then, apply some oil or lotion to self-massage the calves using stroking motions towards your hip.
Depending on your preference, you can use your fingers, palms, heel of your hand or knuckles.
Strong pressure reduces tension and pain in your muscles, while using a light pressure is more relaxing, especially before you retire for the night.
Benefits in all sizes
Fret not if your calves are big because there are some health benefits associated with it, according to a 2008 study published in the Stroke journal.
Apparently, regardless of age, gender, body mass index (BMI) and other vascular risk factors, those with bigger calves have fewer fatty deposits known as plaques built up in their arteries, thus lowering their risk for stenosis, carotid artery disease and strokes.
Researchers suspect this may be because big calves give the body another place to store fat that could cause problems when they’re floating in the bloodstream.
At the same time, people with bulky calves could also be more prone to non-alcoholic fatty liver disease as the calves act as a proxy for fat deposits.
In a 2013 study in the Journal of Physical Therapy Science, researchers concluded that the smaller a person’s calves are, the higher their resting heart rates might be.
In general, high resting heart rates, or anything above 100 beats per minute, have been linked to an increased risk of death, regardless of physical fitness.
A normal resting heart rate for adults ranges from 60 to 100 beats per minute.
A lower heart rate at rest implies more efficient heart function and better cardiovascular fitness.
So, all is fair whether you have big calves or small.
On that note, here’s to a brighter 2021!
By Revathi Murugappan, who is a certified fitness trainer who tries to battle gravity and continues to dance to express herself artistically and nourish her soul. For more information, email starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
Experts: Govt should launch awareness campaign to be transparent on safety
To allay concerns brought about by anti-vaxxers, health experts suggest that the government come up with a campaign to educate Malaysians on the safety of Covid-19 vaccines. The National Council on Islamic Affairs has given the go ahead for inoculation.
Health experts are urging the government to come up with a vaccination awareness campaign now to alleviate public fears and concerns over the Covid-19 vaccine with the arrival of the first batch by February.
Universiti Malaya expert virologist Prof Dr Sazaly Abu Bakar said through a campaign, the government should explain how the vaccine actually works.
“What we do not want is the ripple effect after this in which not only the Covid-19 vaccine is affected but also vaccines for other infectious diseases which we have been using for eons.
“Anti-vaxxers are trying to sow distrust on vaccines. It is not just about the Covid-19 vaccine but their aim will be affecting all the other childhood disease vaccinations which is not good,” he said when contacted yesterday.
He explained that a vaccine can only enter the country after the National Pharmaceutical Regulatory Agency ( NPRA) approves it although the government has made allocations to purchase the vaccine.
“The vaccine cannot be brought in and distributed to the people until the NPRA has verified that it is safe to use.
“The rakyat should not be concerned about all these other issues that are non-scientific, non-science-based and non-data-based. What the rakyat should know is that there are different platforms for different vaccines.
“This is good because that means the government is giving us the option of choosing which vaccine we want to take eventually as there are people who are allergic to certain components of a vaccine. Maybe when one vaccine is not suitable, another one is suitable,” he said.
So far, the Health Ministry had implemented a nationwide survey to gauge the interest of Malaysians in getting the Covid-19 vaccine.
It was also announced that Prime Minister Tan Sri Muhyiddin Yassin would be among the first to take the vaccination.
Universiti Putra Malaysia medical epidemiologist Assoc Prof Dr Malina Osman said proper policy and regulation is needed to handle vaccine skeptics and anti-vaxxers.
“Once we have bold scientific evidence on the effectiveness and safety of the vaccine, the gazettement under the law should be carried out to disallow those who have no authority to talk against the vaccine, and there should also be provision on an appropriate punishment for those who talk ‘nonsense’ about the vaccine,” she said.
“In the Muslim community, the issue on whether the vaccine is halal or not have been raised by those who reject the vaccine. This group provides isolated evidence against the decree by recognised religious scholars towards acceptance of the treatment from the Islamic point of view,” she said.
Prof Dr Moy Foong Ming, from Universiti Malaya Faculty of Medicine’s Department of Social and Preventive Medicine, concurred that a vaccination campaign should be set up while also being transparent on the safety, side effects and efficacy of the vaccine.
“The government should be transparent on the safety, side effects and efficacy of the vaccine. The total uptake and among subgroups of vaccination should also be presented to the public.
“The media should publish equally on information of the efficacy and safety as well as the side effects of the vaccine.
“Clear explanation of why the side effects happen, who are the high-risk groups and what are the chances of a side effect that will happen should be presented to alleviate people’s fears,” she said, adding that relevant government agencies should address religious concerns.
Dr Moy added that highlighting the fact that “all vaccines and medicines have some side effects, including Covid-19 vaccine” should be emphasised to the public.
The calves are prone to tightening and cramping, especially after a workout, so be sure to stretch them out.
