300516 Keeping your shoulders flexible and pain free part two

300516 Keeping your shoulders flexible and pain free part two

A brief reintroduction to keeping your shoulders pain free continued from last week, just in case you may have missed it during your busy day.

If you have shoulder pain, and if your doctor has cleared you to exercise that area, here are a few tips that many find to be helpful in alleviating their shoulder discomfort. According to physical therapist (PT) Alex Petruska, a senior PT in the Sports Medicine Center at Harvard affiliated Massachusetts General Hospital, the focus in getting pain relief is on three goals:

  1. Increasing your range of motion (ROM)
  2. Strengthening the muscles of the shoulder
  3. Stretching the ligaments and muscles to keep them limber

Standing shoulder stretch

Carefully do this exercise, because due to the leverages involved, it can to put a lot of tension on the shoulder.

  • Start out either standing or sitting with one hand holding onto the top its opposite shoulder. For instance, if you were starting to stretch your right shoulder, your right hand would be on the top of your left shoulder.
  • Hold the arm of the stretched shoulder parallel to the floor with the hand touching the opposite shoulder, take the other hand, and gently push the elbow towards the stretched shoulder. You will feel an immediate stretch in the shoulder of the bent arm.
  • Hold the stretch for 10-15 seconds and release, go to the other side and repeat the sequence 10 times.

Side lying rotations

If you have access to any weights this does not require heavy ones, 1-5 pounds may be enough depending on your strength level. In some cases, contrary to popular opinion, more is not better. This is an external rotation movement. It strengthens one of the four small rotator cuff muscles and you do not need heavy weights while doing so.

  • Lie on your side with one arm bent to 90 degrees, elbow resting on the waist. Some people advise placing a small towel on the waist to keep the elbow up a bit.
  • From this position, slowly, but not glacially slow, raise your hand in a semicircle towards the ceiling. Keep the elbow on the waist during the full movement.
  • Both sides should have the same ROM. If not, work on getting them equal.
  1. Increasing your range of motion (ROM)
  2. Strengthening the muscles of the shoulder
  3. Stretching the ligaments and muscles to keep them limber

Wall walks stretch the muscles and tendons thereby helping to keep them limber.

  • From a short distance away from the wall, face it either sitting or standing. Standing may be a better option.
  • With both hands on the wall in front of you, use your fingertips to walk up the wall. The closer you get to the wall the more difficult this becomes.
  • Go as high as you can and hold for 10-15 seconds.
  • Repeat 10 times.

Another way to do this is to stand, either facing, or with your back to the wall.

  • With your straight arms next to your hips move your arms in a semicircle up over your head. Maintain constant contact with the wall during this motion.
  • Go as far up as possible, hold the top position for 10-15 seconds, and then lower your arms back down and start over.
  • Do this 10-15 times.

Now it is up to you to help protect your shoulders by doing some of these exercises several times a week until they feel stronger and pain free.

290516 Knowing your numbers – blood pressure

290516 Knowing your numbers – blood pressure

High blood pressure is commonly referred to as the silent killer because unless it is extremely high there are no outward symptoms or signs.

High blood pressure is a contributing factor to:

  • Strokes
    • Very high pressure can cause a break in a weakened blood vessel, which then bleeds into the brain. This can cause a stroke. If a blood clot blocks one of the narrowed arteries, it can also cause a stroke.
  • Eyes
    • Continuous or high blood pressure can in time cause blood vessels in the eye(s) to burst or bleed. Your vision may become blurred or otherwise impaired. This can result in blindness.
  • Arteries
    • As people age, the arteries throughout the body harden, particularly those in the heart, brain, and kidneys. High blood pressure is associated with and is a direct contributor to these stiffer arteries. This in turn, causes both the heart and kidneys to work harder to do their job of keeping the body healthy.
  • Kidney
    • The job of the kidneys is to act as filters to rid the body of wastes. Over time, high blood pressure can narrow and thicken the blood vessels of the kidneys. Once this happens the kidneys filter less fluid. This causes waste to build up in the blood. At this point, the kidneys may fail altogether. When this happens, medical intervention is necessary and treatment in the way of dialysis or a kidney transplant are distinct possibilities.
  • Heart
    • A major risk factor for heart attack is high blood pressure. Throughout the body, the arteries bring oxygen-enriched blood to the heart muscle. Without enough oxygen in the heart, chest pain, known as angina, can occur. If this blood flow back to the heart is blocked, a heart attack results.
  • Congestive Heart Failure
    • High blood pressure is the number one risk factor for congestive heart failure (CHF). CHF is a serious condition in which the heart is unable to pump enough blood to supply the body’s needs.

Therefore, it’s important to know whether not you have high blood pressure. And the only way you know this is to have your blood pressure checked.

Blood pressure is both measured, and displayed with two numbers. The first number is a systolic this is the highest pressure in the arteries when your heart beats. The second number is the diastolic pressure. This, the lowest number, is when your heart is resting between strokes.

The ideal blood pressure is under 120 over 80. Anything above these two numbers is either pre-hypertension or hypertension. A blood pressure level of 140/90 mmHg or higher is considered high blood pressure. About two-thirds of people over the age of 65 have high blood pressure.

If you have had your blood pressure checked and it is between 120/80 mmHg and 139/89 mmHg, then you have prehypertension.

280516 Adaptations to Training

280516 Adaptations to Training

If an exercise routine is correctly planned and properly adhered to, then improvements in physical strength will result as the body adapts to the load. Exercise is one method of making the body accustom itself to handle the imposed training loads.For adaptation to take place, the following must be given strict attention to during both the planning stages and the implementation of the plan afterwards.

The stimulus magnitude, more commonly referred to as the overload



Individualization-The stimulus magnitude

The correct amount of stimulus or overload brings about positive changes in the athletes physical state. This load must be greater than what the body is normally accustomed to for a positive change to take place. There are two ways to manage the adaptation process. One is to increase the intensity or volume, and the second is to select different exercises .Training loads are divided into these categories:

Stimulating-the magnitude of the load is above the neutral level which allows positive physical changes to take place.

Retaining-also known as the neutral zone as the body is just maintaining its present condition

Detraining-too much of a good thing causes a deterioration in performance, the functional capabilities in the athlete or both the performance and functional abilities.

230516 Keeping your shoulders flexible and pain free part one

230516 Keeping your shoulders flexible and pain free part one

If you have shoulder pain, and if your doctor has cleared you to exercise that area, here are a few tips that many find to be helpful in alleviating their shoulder discomfort. According to physical therapist (PT) Alex Petruska, a senior PT in the Sports Medicine Center at Harvard affiliated Massachusetts General Hospital, the focus in getting pain relief is on three goals:

  1. Increasing your range of motion (ROM)
  2. Strengthening the muscles of the shoulder
  3. Stretching the ligaments and muscles to keep them limber

He goes on to suggest doing the following five exercises, with supervision until you know how to do them correctly.

Behind the back ROM, exercise

  • Begin this with your right hand behind your back. Keep the back of your hand against your lower back or belt.
  • Now reach around with your left hand and gently pull the right hand up towards the left shoulder. Go slowly and be gentle when doing this stretch. Due to the leverages involved, it has a tendency to put a lot of tension on the shoulder.
  • Hold the top position for 10 to 20 seconds at a time. Do the stretch on each side ten to fifteen times before moving onto the next exercise. Stretch only to a point of mild discomfort.

Keep your shoulders flexible with the overhead stretch

Keeping the muscles and tendons of your shoulders flexible, helps make daily activities easier to do. Here is a good, but easy stretch to start your day out with each morning.

If you have difficulties getting down or getting up from the floor, you can do this one in bed or standing. The latter, in my humble opinion, is the best way to do this because you can a larger range of motion.

  • Start out by lying on your back and holding onto a small towel or even better yet, a short piece of elastic material to keep tension on the muscles in the shoulder during the stretch.
  • Your hands should be about shoulder width apart.
  • Begin with your arms straight, hands at the waist, holding onto and attempting to spread the towel or elastic material. Now, in a slow gentle motion raise them up toward the ceiling and lower them back behind your head, still keeping your arms straight.
  • When standing up, try to move your straight arms further behind our head each time. A good gauge of how far you are moving them is to stand with your back to a wall. Step away from the wall a few paces and see if you can still touch it. The farther out you go, the more your ROM will be. Do this stretch without pain.

Shoulder extensions increase the strength of the shoulder muscles that help control the shoulder blade.

  • Stand with your arms straight and your back touching a wall.
  • Push against the wall with your arms while keeping your elbows straight.

Hold the tension for 10 to 15 seconds ten times.

More next week.

The bench-press by Daniel Pare, Canadian strength coach

The bench-press by Daniel Pare, Canadian strength coach

The bench press is one of the most popular exercises out there and still, one of the most poorly performed one. There is more to pressing the barbell up than one may think!

Many trainees are just not doing the exercise properly. Here are a few tips on positioning yourself before beginning to make sure that everything is in line to push from floor to ceiling. The barbell should go down to your chest and then pushed back up in a straight line. This rarely happens.

The elbows should be under the barbell and they usually are not. Often times they flare out to the side in a most dangerous position relative to the shoulders.

Let us look at some of the muscles involved in bench-press. We have the chest which is a given, then we have the triceps, the abs, the legs and less we forget, the back.

Take a moment and look at your Gray’s Anatomy book, where do the Latissimus dorsi (lats) muscles of the back originate from and insert?

The answer is very simple it originates from the lower part of the spine and up to mid back and inserts to your humerus bone, the bone of the upper arm near the shoulder joint. When the abs and lats are strong, you will notice now that your elbows will stay under the bar. The lats must be strong and ready to work. Here are a few exercises to consider for strengthening them:

  • The chin up,
  • The lat pull down,
  • The deadlift and
  • The bent over row

Make sure that you are doing each of these exercises with proper form and technique. For example, when doing the chin up, your chin should come up to touch the bar without letting your body swing on the way up or back down.

If you cannot do that then, trade it for lat pull down. With the lat pull down, the line of pull is very simple; keep your elbows pointed down to the floor. This means no leaning back. If you lean back, you lose the effectiveness of the exercise and the lats are not working up to their full potential. Some of you will be very surprised at how little weight you can actually do on this exercise when doing it properly. Be consistent and persistent and you will get stronger lats that will ultimately improve your bench press.

The deadlift is also a great exercise to strengthen the lats. Remember though it is not the stiff leg deadlift or the Romanian deadlift (RDL). It is the simple plain jane deadlift.

The bent over row is also an excellent exercise. Make sure to keep your torso strong and tight as you bring the barbell up. Keep your elbows coming up and slightly back towards your lower rib cage. This is the reverse motion of the bench-press. You want the barbell to touch the lower part or your rib cage. Remember, we are working on a bigger bench press, so make sure you get your back stronger.

210516 PRISE method of training

210516 PRISE method of training- Quality, not quantity, makes all the difference when it comes to diet and exercise

According to the Duke Medicine Health News , the quality of the diet and exercise counts more than quantity. They preface the statement by saying that different modes of exercise including aerobics, resistance training, sprinting intervals, stretching, yoga, and Pilates when coupled up with moderate amounts of protein used during the day “has multiple health benefits… written in a study published in the Journal of Applied Physiology May 16 2013.”

The study examined the PRISE program of multiple exercise methods and more daily protein intake.

As a side note, the protein intake of 20 to 30 g taken four six times a day is right in line with recent recommendations for the older population who have a reduced ability to absorb and utilize protein.

These multiple health benefits include lower abdominal fat as well as overall body fat, an increase in lean muscle mass along with optimal blood glucose, blood pressure, and insulin numbers.

A brief look the PRISE program

This program, designed to take advantage of the many exercise modes, provides an alternative to the many one-sided exercise and fitness routines now in vogue within the health clubs, studios, and hardcore gyms.

The concise definition of PRISE is:

P designates protein, R is resistance or strength training, I means interval training, S is for stretching, and the Eequates to endurance activities.

The authors of the study state the best outcome was the fact that all of the participants continued to be enthusiastic about the program, even four months after the study ended. The research scientists noted that none of the participants were bored, exhausted, or injured during the entire four months of their training.

The participants biographic details

This was a small group of fifty-seven men and women aged thirty-five to fifty-seven. Every one of them were either obese or overweight with an average BMI of 28.6 and average body fat percentage score of 36.6. Not only did they have unhealthy high body mass index and body fat numbers, they were exercising less than sixty minutes per week! Additionally, within the past ten years none of them had been doing any resistance training at all.

Each of the people in this study, now separated into three groups, ate 60 grams of whey protein daily. Group 1 was sedentary, group two did intense resistance training four days a week, and the third group did a multitude of different modes of exercise. The thirds ones exercise schedule included strength training, endurance training, Yoga instructor demonstrated and led stretching, and sprint intervals.

The outcome differences between the groups were significant. The people in the third group experienced the biggest health improvements. These included losing the most weight, large reductions in their abdominal fat and waist circumference, and better blood glucose numbers. Furthermore, they had the largest increase in lean muscle mass percentage when compared to the sedentary and intense resistance trained other two groups.

The other two groups also showed healthy improvements, even the sedentary ones taking the 60 grams of protein each day. One of the main doctors involved in this study, Dr. Paul J. Aciero, FACSM, FTOS, a professor at Skidmore Colleges Health and Exercise Sciences

Department and Director, Skidmore’s Human Nutrition and Metabolism Laboratory…. stated that “increasing the amount of protein in the diet to as much as 35% will tend to decrease total and abdominal fat
According to a recent article in the Duke Medicine Health News , the quality of the diet and exercise counts more than quantity. They preface the statement by saying that different modes of exercise including aerobics, resistance training, sprinting intervals, stretching, yoga, and Pilates when coupled up with moderate amounts of protein used during the day “has multiple health benefits… written in a study published in the Journal of Applied Physiology May 16 2013.” The study examined the PRISE program of multiple exercise methods and more daily protein intake.

This is a deceptively simple program.

  • The first step is to start increasing your daily intake of protein, in small 20-30g amounts, 4-6 times spaced throughout your day. Naturally speaking, if you are very active and larger, this amount could be even higher as long as you don’t have kidney issues. Overall, it works out to about 1.2-1.6 g/kg of bodyweight or .6-.8g/lb of body weight.

Resistance training 2-3 times per week doing:

  • Push ups, bicep curls, front side and rear raises, triceps extensions, squats, lunges, Bulgarian split squats, floor presses, rows and curl ups (not crunches) using a basic set of barbells, dumbbells, elastic material such as tubes, bands, medicine balls, or bodyweight calisthenics for 3-4 sets of 8-12 repetitions for each exercise.

Interval exercises

  • Fast to slow walking to fast, sprint intervals, rope skipping fast to slow to fast, bicycle riding, jogging, stationary bike, elliptical riding…just warmup, hit it hard and then back off until your heart rate returns to a more normal state and then hit it hard again for several bursts at a session.


  • Follow the advice in these good stretching books such as those in Bob Andersons’ Stretching and Brad Walkers’Ultimate Guide to Stretching & Flexibility – Handbook or enlist the aid of a qualified fitness professional, or physical therapist to guide you through the many available stretches.


  • Keep your heart rate around 60-80% of your max heart rate (220-age=MHR) for 60 minutes several times a week. Work up to the minutes if you are not used to exercising for long periods.

This also works well for those of us who have beat our bodies in the gym for a long time and need a break from the high intensity training. Try it for 2-3 weeks and then get back into the heavy strength training again after this rejuvenation period is finished.

Quantity still has a huge influence on the outcome as it has been demonstrated time after time that more exercise, certainly above the minimum recommended daily amounts, invariably leads to better results. As long as exercise is not over done to the point of developing into a body dysmorphic disorder. Read more here:http://www.mayoclinic.org/diseases-conditions/body-dysmorphic-disorder/basics/definition/con-20029953

Duke Medicine Health News September 2014 Vol. 20, No.9



Duke Medicine Health News September 2014 Vol. 20, No.9


160516 Steps to a happier and healthier you

160516 Steps to a happier and healthier you

If you are happier, you normally are healthier and vice versa. Getting there is not too difficult, it just takes a bit of effort to improve your well-being.

According to Dr. Ronald D. Siegel[1], 40% of what determines our happiness is directly under our control. Contrast this with the findings that a mere 10% of our happiness has anything to do with an outside event either good or bad.

“It’s not events, but our responses to events that determine our level of well-being,”[2] Dr. Siegel says. He went on to suggest these steps that you can take to improve your emotional and physical health.

  1. The first and most important step to take is to be happy-just like the song says. Remember, “It’s not events, but our responses to events that determine our level of well-being.”[3] You control the majority of your own happiness with your responses to what happens to you.
  2. Live in the moment, not in the past or future but right now. If you fully embrace the present activities, the enjoyment they bring is increases. This makes you less likely to be thinking or worrying about things in the past or future. Make the most of the moment.
  3. Keep a daily diary of things you are grateful for, things you have enjoyed doing, of people you liked spending time with…each of these promotes positive feelings, improves your outlook, optimism, satisfaction with life and increases your connections to others. The cycle continues onward.

Now that you have several ideas for becoming happier, we are moving onto the physical part of getting healthier. Once again, the resource is from the Harvard Medical School, this time from Dr. Edward Phillips who is the founder and director of The Institute of Lifestyle Medicine. He also is the faculty editor for Simple Changes, Big Rewards, one of the Harvard special reports.

Total health, both mental and physical, is a combination of the two. The better your mental health, the better will be your physical health, and vice versa. If you are presently engaging in poor habits then your health will suffer. By making efforts to change these unhealthy habits, you will be improving your overall health.

Dr. Phillips says, “two thirds of all illness is the result of our lifestyle choices.” Obviously, two thirds of illness is a large part of our health makeup and one that needs attention if we are to become healthier. His advice now follows.

  1. You must take the responsibility for your health. This means not only seeing your doctor on a regular basis but also following their advice. Getting the necessary regular exams, screenings, and tests included in this aspect of being responsible for your own health.
  2. Use your personal strengths to improve your health, for example use the discipline of your personal habits, or make use of the skills of your profession to improve your life. Create great tasting meals from basic ingredients by experimenting with contents. Do something different with your exercise program. If you run, then change your course, add weight to a backpack, find some hills, but change it up. On the other hand, if you lift weights then drastically change the routine around by increasing the reps into much higher numbers than you currently use. Alternatively, lower the rep numbers and increase the intensity up into the 85-100% range for lower number of sets.
  3. Make small changes in your goals so you see progress each week. Pick out a goal that you know for a fact you can accomplish. One such goal, if you are not already doing any cardio workouts, is to start with doing a cardio exercise for 5 minutes each day.
  4. Keep track of what you do with a logbook. A daily diary is useful in keeping track of your moods, the food, and drink you have each day, your exercises, and whatever else is important to you.
  5. The daily benefits you begin to notice will spur you on to even better habits that will most defiantly improve your health.

Each of one of these suggestions is simple to follow and easy to track. By incorporating them into your lifestyle, they will begin the remaking of you into a healthier person.


[1] Dr. Ronald D. Siegel of the Harvard Medical School, an assistant clinical professor of psychology and faculty editor of Positive Psychology, a special health report from the school.

[2] Dr. Ronald D. Siegel of the Harvard Medical School, an assistant clinical professor of psychology and faculty editor of Positive Psychology, a special health report from the school.

[3] ibid

150516 Running and losing weight

Running and losing weight

The following is my answer to a question regarding the inability to lose weight even though this person was running an average of three miles per day.

Stay with your exercise programs and don’t use the fact that you are exercising to eat or drink more than necessary. Just because you are running 3 miles and lifting weights does not mean you can pig out at the Golden Corral or drink a large Starbucks as a reward. Instead, the reward is a healthier body free of excess body fat and more lean muscle mass.

You will not be able overcome poor eating with exercise. Think how long it will take to exercise off one doughnut, milkshake, or whatever else you may have a hankering for that may not be healthy or nutritious.

Start a written log of all you eat and drink. Keep at it for at least 3-4 four days and then look at what you are ingesting. There will be areas that are not that healthy, nutritious, or simply extra stuff that you could stop eating or drinking.

Weigh yourself every morning after getting up and after going to the bathroom in the same clothing.

Reset your ability to interpret the hunger signals and those that alert you to being fed enough without going overboard on the eating and drinking. Contrary to what your parents and other adults may have told you growing up, you do not have to or need to finish everything on your plate to help the starving children somewhere else in  the world.

Keep up with your water and if you feel like eating something start with an apple or a glass of water, wait for ten minutes and reexamine the need to eat or drink.

Some studies have shown a complete day of fasting tends to drive the weight down followed by moderate eating and drinking as before the fast began.

As for the calories, some have found that by adding a zero to the end of your current weight (142+0=1420) you arrive at a minimalist calorie figure divided up into 4-5 meals per day. This may be too severe but by keeping track of your weight and how you feel, it could work well for you.

You can safely lose 10% of your current body weight per week without tapping into your muscle stores. Therefore, in your case, at 142, you could be losing about 1.4 pounds per week. Of course, there is some point where this will stop working because there won’t be any more fat to cut. This is a ways down the road. When you get to around 134-136 simply stabilize and decide if this is a good weight for you without torturing yourself to maintain it. Once you find the way for you to lose weight, cutting for the contest will be a piece of the proverbial cake and can be accomplished within 2-3 weeks prior to the meet in March.

In my experience, the best thing that worked for me was to weigh daily, log, pay attention to what I was eating, use smaller plates, tune into my hunger and pre-satiation signals, and ask what the food or drink was doing to help me reach my goal of 200 pounds.

Start with these first and see where they take you. Stay with it for at least a month. By the end of the month, I suspect your weight will be into the mid 130’s.



140516 Accommodation to Strength Training Programs

140516 Accommodation to Strength Training Programs

Accommodation to training is the second part of the adaptation process. If the same load and the same set of exercises are consistently used time after time the body soon adapts, and then stops making progress.

“This is a manifestation of the biological law of accommodation, often considered a general law of biology”. According to this law, the response of a biological object to a given constant stimulus decreases over time. By definition, accommodation is the decrease in response of a biological object to continued stimulus. In training, the stimulus is physical exercise.”

Inefficiency results due to the accommodation law if standard exercises and training loads are used over long periods. Training stimulus MUST vary in order to be beneficial.

This training stimulus must be as specific as possible to the sport or activity one is training for in both muscular coordination and physiological demands. A high transfer of training results when using specific exercises during the training session. However these two requirements present problems for the elite athlete. The training has to be variable to ovoid accommodation and yet stable enough to satisfy the demands of specificity.To avoid the staleness that accompanies accommodation, qualitative and quantitative alterations are made to the plan. Quantitative changes are those changes made to the training loads. Qualitative differentiation results in the selection of different yet specific exercises.

Elite athletes require broad qualitative changes to their programs to remain on top of their sport.

090516 Acetaminophen safety

090516 Acetaminophen safety

The season of colds, coughing, and flu bring on an increased use of acetaminophen, which is one of the ingredients in Tylenol and other over-the-counter medications for controlling pain and fever. Accidental overdoses of these products end up with thousands of people admitted to the emergency room each year.

According to the Harvard Men’s Health Watch, 600 and more products contain acetaminophen and inadvertently combining these products can push you into the danger zone. Each dosage, no matter where it came from, adds up. You must be careful not to exceed the daily limits otherwise you risk damaging your liver.

As previously mentioned acetaminophen, helps control pain and fever. It does not reduce inflammation. Nonsteroidal anti-inflammatory drugs (NSAIDs) help control inflammation. In those individuals who cannot tolerate NSAIDs, due to the irritation these drugs sometimes cause to the stomach and intestinal lining, acetaminophen is tolerated. Thus, an individual attempting to control chronic pain, such as in older adults, may be tempted to use more than the recommended dose per day.

The problem arises when this dosage is exceeded because acetaminophen has a much and narrow wonder of safety when compared with ibuprofen and naproxen. This is not to minimize the danger of NSAIDs because they too can make you sick but it just takes a larger amount of these to reach a dangerous overdose. In the case of an acetaminophen overdose, damage to the liver occurs which sometimes means a liver transplant or death.

This happens when the body breaks down the acetaminophen. During this process, a part of this drug, which is toxic to the liver, is left behind. If too much is taken at one time or over a period of days, an accumulation of this toxic byproduct builds up. If it is more than the body can handle the results are an overdose.

The generally recommended maximum daily dose for an average healthy adult is no more than 4000 mg[1] including all other drugs that contain acetaminophen. In certain cases dosages of 4000 mg daily may still be toxic to the liver. To be on the safe side the recommendation is take only what you need and not exceed 3000 mg a day whenever possible.

Staying within these limits may mean a talk with your doctor or pharmacist to find out what your toleration (danger area) is, which is based on your age, body size, and your present health status.

Avoiding an accidental overdose

  • When purchasing cold and flu remedies look at the label and find out if it contains acetaminophen. If it does, be aware of how much and then stay within the guidelines listed earlier.
  • The over-the-counter acetaminophen products list the milligrams in each pill. Some contain 325, 500, or 650 mg in each pill, which means you have to be especially cautious when taking the 500 or 650 mg pills because you can easily exceed your daily limit by taking too many of these.
  • Follow the recommended dosages. Don’t be tempted to add just a little bit more; it could be hazardous to your health.
  • Drinking alcohol while using acetaminophen causes the liver to convert more of the acetaminophen into the toxic byproducts mentioned earlier. The suggested limit of alcohol consumption is no more than two standard drinks per day for male and one drink per day for a female.
  • Finally, ask your doctor or pharmacist if any of your prescription medications will adversely interact with your acetaminophen.

Acetaminophen: taking it safely[2]

  325 mg 500 mg 650 mg extended release
How many pills at a time? 1 or 2 1 or 2 1 or 2
How often? Take every 4 to 6 hours Take every 6 hours Take every 8 hours
The safest maximum dose per day for the majority of adults 8 pills 6 pills 4 pills
Do not exceed more than this within a 24-hour period. 12 pills (3900 mg) 8 pills (4000 mg) 6 pills (3900 mg)

[1] This is a maximum daily dose for a healthy adult weighing at least 150 pounds.

[2] January 2014, Harvard men’s health watch. “The maximum daily dose for a healthy adult who weighs at least 150 pounds is 4000 mg. However, in some people, taking the maximum daily dose for extended periods can seriously damage the liver. It’s best to take the lowest dose necessary and stay closer to 3000 mg per day as your maximum dose. If you need to take high doses of acetaminophen for chronic pain, check with your doctor first.”