It's time for an update on how I am getting on with The Ultimate Rotator Cuff Training Guide. Their rehabilition exercise program is six weeks long split into three progressive two-week segments. I've chosen to repeat weeks 3/4 rather than move on to weeks 5/6. At my age you don't heal quite as fast as you used to.

I definitely feel that I am making progress. I can now do a kneeling press-up with only a slight twinge. Another stretch that I do based on internal rotation of the shoulder now has a greater degree of pain-free movement. I emailed Brian Schiff, the author, about the latter to try and understand more about what was happening anatomically and he was kind enough to reply. Finally I've been able to reintroduce a modified chest exercise into my weight training routine, although I'm using quite light weights for that at the moment.

So I think that's quite promising and hopefully in a few more weeks everything should be back to normal.

In my Cardio on Elliptical Trainers I mentioned that I had joined a gym to get more variety in my cardio workouts. The way that is has turned out I am now doing my cardio exclusively on the elliptical trainers in the gym. My waterrower is now only used for a quick warm-up before my weight training sessions in my home gym. This has come about for three reasons.

1. The motion of exercising on the ellipticals seems to be a lot more gentle on my knees than rowing.

2. On the elliptical you can control your work rate by setting the resistance or pedalling faster. On the rowing machine it's a case of pulling harder or pulling faster. Somehow on the elliptical it seems to be easier to get my heart rate up to the target zone and to keep it there.

3. Doing cardio for 30 minutes at a stretch is pretty boring. In the gym there is more going on to distract you, so the time seems to pass a bit more easily.

I've been on the Burn the Fat, Feed the Muscle programme now for nearly six months so it's now time to be brave and show the transformation that's been achieved over that time.

If you've seen a number of sites like this then you'll appreciate that there are certain conventions that should be observed for transformation pictures:

Complexion
Before: Dracula's younger brother
After: Baywatch extra

Hair
Before: Dragged through a hedge backwards
After: This cut cost me a fortune!

Facial expression
After: I've just won the lottery!
Before: My ex-wife/husband has just won the lottery!!

Posture
Before: Neanderthal
After: Atten...shun!

Stomach
Before: I've just had six pints of lager and a vindaloo.
After: If I hold this in any tighter I'm going to rupture myself.

In defiance of this I've tried to make the pictures like-for-like. Possibly I'm holding my stomach in a little on the after picure, but hopefully you can see that there's been some real progress.

According to The Sunday Times, the latest focus group driven nonsense idea, presented at a cabinet meeting last week, is that doctors and nurses should smile more "to give the impression of caring". Doesn't that just sum it up? Never mind whether they actually do care or not, let's just give the impression!

Now if you visit your GP I think there's every chance that you'll find him or her grinning ear-to-ear, as a result of the obscene amounts of your tax revenue that they are pocketing at the moment. Likewise should you happen to meet anyone who is raking it in from the Private Finance Initiatives then I think there's a fair chance that they will also be doing a good impression of the Cheshire Cat.

Meanwhile in your local NHS trust hospital things are probably a little different. I know because my wife works in one that is continually struggling to balance the books. Currently they are looking to cut beds despite the fact that these are permanently in short supply. Everyone is in 'headless chicken' mode as they continually battle over inadequate resources. The trust is in a seat which the Conservatives could comfortably hold if they selected a stuffed weasel as a candidate, so funds to ease their problems aren't likely to be forthcoming.

Meanwhile the BBC web site tells us "A report drawn up last year by the Department of Health's chief economist found the most crowded hospitals - with bed occupancy rates over 90% - had MRSA rates 42% higher than average." Pretty obvious really, but financial pressures on the trust are driving them to push bed occupancy rates higher and higher.

So if you see a hospital doctor or nurse smiling then it's highly likely to be a wry smile at the stupidity of it all. The best thing you can do is to clean up your lifestyle to maximise your chances of staying out of their domain.

Like everyone these days I get a ton of email spam and in amongst these quite a few for the weight loss product hoodia. Now, the first thing that I would want to know about such a product is whether it was safe. This article has something to say about that subject.

However, leaving aside the question of direct side effects, I would still caution against using this type of product. It acts as an appetite suppressant. In other words it is a drug which helps you starve yourself. Obviously if you do this then your calorie intake will be much lower than your calorie expenditure and you will lose weight.

One problem, though is that there is a lot more to food than calories. Your body continually rebuilds itself and it needs a constant supply of protein to do this. Furthermore there are a wide range of micronutrients, essential fatty acids, minerals and vitamins which are critical to the healthy function of your vital organs. When you restrict your food intake then you also restrict these. That can't be good for you.

There's worse. Our bodies are adapted to the ways of our ancient ancestors for whom food supplies were subject to periods of glut and famine. We have mechanisms to maximise our chances of surviving famine, one of which is that your body will hang on to its energy stores (i.e. your fat) as long as possible. When food is scarce your metabolic rate will drop. Furthermore your body will use catabolic processes to break down muscle tissue for energy. Your body literally eats itself. By starving yourself with these products you are triggering these exact same mechanisms. You will lose weight, but much of that weight loss will be muscle tissue, not fat.

So my advice would be to avoid these products. Find other programs that let you eat a normal, balanced diet whilst providing other ways of burning off the surplus fat.

I've now been on the programme for six months, so this is a good time to take a review.

As regards progress I'm now much more happy with my body shape than I was at the start and hopefully that is conveyed by my transformation pictures. I've lost a lot of fat. I haven't put on as much muscle as perhaps I expected, but that has been constrained for the last three months by my Rotator Cuff Injury. I'm pretty much through that now and I will be completely revamping my weight training regime starting from next week.

Do I feel better? It's really hard to say as the changes come in small increments and you continually adapt to your current state as being the norm. But I think the answer is probably that I do. I've got pretty good energy at the moment and I've made it through the winter without picking up a cold, despite my wife bringing home a couple of quite severe bouts.

So what of the programme? It certainly produces results. It isn't easy. Anyone who promises you a weight loss programme that is easy, sustainable and with no health risks is lying to you. On the other hand it isn't that hard. When first you look at the recommendations for nutrition and exercise your immediate thought is "I'm not sure I can do that". Tom has a simple and powerful answer to that, namely that hundreds of people manage to do it successfully, many of them overcoming much greater obstacles than those that you face. And sure enough after a month the changes have become habit and after six months you can't imagine living any other way.

In summary I would say that the ebook has been the second best purchase that I have ever made. The first? The dating agency subscription through which I met my wonderful wife.

My wife was looking at my transformation pictures the other day and commented that I had also lost most of my 'love handles' fat. To be honest I had been so focused on my stomach that I hadn't even noticed these, but looking at the pictures I can certainly see what she meant.

As I've mentioned before on this blog it isn't possible to do spot reduction of your fat deposits using exercise or nutrition. If your body burns fat then it will burn it from everywhere. Mostly, as in my case, that is good news. If you've got visible fat then you've probably also got a lot of invisible fat clustering around your internal organs and for the sake of your general health it would be good to shed some of this too.

However for the ladies there is one downside, in so far as your boobs are predominantly fat and you can expect to lose a bit from these. Never mind, you're still going to look great and the guys are going to love your new toned-up figure.

If you really are determined to spot reduce them I'm afraid the only option is surgery. I'm planning to do a post on the risks of liposuction sometime soon.

Our boiler has packed up and needs replacing, so we have been without central heating for the past week while we get quotes and weigh up the options. We've got an immersion heater in our tank for hot water and we've been able to light a coal fire in our lounge in the evenings, so it hasn't been too bad. I suppose all the shivering is good for burning a few extra calories.

Last Saturday evening we decided to go out, so first we grabbed a meal at one of the Gourmet Burger outlets. It was ok, but we probably wouldn't hurry back there. We much prefer Nandos for a meal in that price range.

We then caught the show at our local comedy club. The highlight was definitely the comedian Roger Monkhouse. His act is basically "middle-age grumpy" but his delivery and his use of language are really quite unique. His solution for the problem of childhood obesity had me in stitches, as did much of his other material. Definitely go and see him if you get the chance, if you are fond of good stand-up.

The other advantage was that I missed the purgatory that was the Israel -v- England match. I was home in time to see the lowlights on Match of the Day and goodness me that was bad enough.

Brrr, still no central heating! Still, today we treated ourselves to fish, chips and mushy peas, served with mugs of tea in front of a coal fire. Wonderful stuff.

Anyway, the good news is that after eight weeks of following The Ultimate Rotator Cuff Training Guide my shoulder is much better. There's still a little bit of stiffness in there, but it is 95% of the way to a full recovery. I've been able to resume full-on weight training, although I will continue to avoid certain exercises and now do modified versions of some others. I've started a new weight training regime based on alternating heavy weeks and light weeks. I'll cover that in more detail soon.

I suppose you could ask whether it would have improved to the same degree if I had just rested it for eight weeks, rather than following the programme. I don't know the answer to that, but I do feel certain that the exercises have strengthened the rotator cuff muscles such that the problem is less likely to recur. This should continue to improve as I do the maintenance exercises recommended by the programme. Furthermore, as noted above I now know what to avoid to reduce the risk of further problems.

In summary I think this was money well spent.