Knee Pain?...No Problem!

Many suffer from knee pain.  It can range from intermittent aching to severe debilitating pain. The symptoms may include pain, stiffness, swelling, popping, difficulty climbing stairs, squatting and sitting for long periods. X-rays often reveal varying degrees of arthritis, but sometimes are normal.  Barring traumatic injury many of the symptoms of knee pain can be attributed to muscle imbalances and faulty biomechanics.  This leads to increased wear and tear and tendonitis from overuse.  Through advanced study and greater understanding of biomechanics and functional anatomy we realize that most knee pain has nothing to do with the knee.  The knee pain is a symptom, but the cause is usually elsewhere.  Many times we have found the foot and/or the hip to be the weak link. The foot and hip are  both very mobile joints, while the knee is primarily limited to flexing and extending.  The phrase “it’s all connected” is the central theme to human movement. For example, if the foot flattens out more than normal (overprontes) it will cause the knee to collapse more than normal towards the midline.  This will put stress on the medial knee joint, compress the lateral knee joint, cause the knee cap to track off center and subject the muscles to work harderto try to control and stabilize through a greater range of motion.  Another example would be tightness of the hip flexors and weakness of the gluteal muscles which are present in most people due to the fact that we sit a lot and sleep in the fetal position.  We refer to this as “dormant butt syndrome”. When the hip flexors are tight they cause weakness in the gluteus maximus (the butt, tooshee, cannon or powerhouse) through a phenomenon called reciprocal inhibition (when one muscle is tight it causes weakness in the opposite muscle).  The butt is a strong stabilizer/ motion controller of the lower extremity. When it is weak it also allows the knee to collapse into the midline placing more stress on the joint and soft tissues.  Over time the knee is subject to more wear and tear and many of the symptoms of knee pain begin to creep up. So if your knee pain persists it is a good idea to seek out a knowledgeable professional to help you. Knee pain doesn’t have to put an end to your fun, if the right approach is taken.

Get Strong! Stay Strong!

Chris

Kettlebells for Back Pain

Turning to Kettlebells to Ease Back Pain

By ANAHAD O'CONNOR - NY Times

Stephanie Diani for The New York TimesA kettlebell workout may be just the thing to ease back, neck or shoulder pain.

Kettlebells, cast-iron weights that have been used for centuries to train Russian soldiers and athletes, appear to be a promising therapy for back and neck pain, new research shows.

Although many people with backaches and other pains shy away from weight lifting for fear of hurting themselves, studies show that strength training can reduce pain and prevent reinjury. While most research has used traditional weight training exercises, researchers in Denmark set out to study whether a kettlebell workout offered therapeutic benefits to back pain sufferers.

The weights, named for their resemblance to a tea kettle with a looped handle, began showing up in American gyms about 15 years ago and have gained a popular following among exercise buffs looking for a quick full-body workout. Unlike traditional weight training, which typically focuses on lifting exercises, a kettlebell workout requires both swinging and lifting of the weights, which for beginners can be awkward and difficult to control.

In a study published last year, the Danish researchers recruited 40 pharmaceutical workers, mostly middle-aged women with back, shoulder and neck pain, who were randomly assigned to either a regular kettlebell workout or a control group that was simply encouraged to exercise. The first group trained with kettlebells in 20-minute sessions two to three times a week for eight weeks, according to the report, published in The Scandinavian Journal of Work, Environment & Health.

At the end of the study, the kettlebell exercisers reported less pain as well as improved strength in the trunk and core muscles, compared with the control group. Over all, working out with kettlebells reduced lower back pain by 57 percent and cut neck and shoulder pain by 46 percent.

The study’s senior author, Lars L. Andersen, a government researcher in Denmark, noted that workers who spend much of the day sitting are particularly vulnerable to back, shoulder and neck pain because they develop tightness and weak spots along the posterior muscle chain, which includes the muscles running from the lower back down to the glutes, hamstrings and calves. Kettlebell workouts strengthen the posterior muscle chain, and the increased blood flow to the back and leg muscles also may lessen pain by reducing the buildup of lactic acid, the authors wrote.

While isolation exercises like curls and presses have their benefits, kettlebell movements recruit multiple muscles and teach the body “to move as one unit,” said J.J. Blea, a certified kettlebell instructor and an owner of Firebellz in Albuquerque, one of the top kettlebell gyms in the country.

Because kettlebells can be difficult to control, it’s important to learn proper form from a certified instructor or a kettlebell class at a gym. The cornerstone of the kettlebell workout requires the exerciser to swing the kettlebell between the legs. In the Danish study, women started with a 17.5-pound kettlebell and men with a 26.5-pound kettlebell.

“When you’re doing a swing, you squeeze your quads, you squeeze your glutes, and you squeeze your abs,” said Mr. Blea. “By squeezing these muscles, you protect your back. It creates power, and it increases strength.”

Kettlebell training is also surprisingly aerobic. A study by the American Council on Exercise found that a 20-minute kettlebell workout burns about 21 calories a minute, the equivalent of running at a six-minute-mile pace.

Get Strong! Stay Strong!

Chris

Day 19 Purification, Workout and Food

WOW! only 2 more days and I'm done.  Its been a great experience and I feel great.  Ive only lost 2 lbs (wt loss was not a goal for me) so I have maintained weight and my energy throughout, despite no caffeine.
I am looking forward to pizza Sun. night and a cup of coffee Mon morning though.
Another great 6:30 am Fri workout.
We supersetted:        
1.)  Incline bench (4sec ecc/4 sec conc) x 10-12  w/ 1 arm cable low rows in staggered stance x 8-10 for 3
               sets.
2.)  25 yd walking explosive sled push/ return puling w/ lateral plank top leg lift and
              simultaneous shld abd x 10 each side for 2 sets.
3.)  Alt Post rot step /cable biceps pulls x 12 w/ TRX triceps for 3 sets.
4.)  Calf raises using leg pres x 10 w/ Ab wheel x10  for 3 sets.

All that in 45 mins and close to 400 cal burned.

My favorite meal today was a simple mix of brown rice, black beans red and yellow peppers, avocado and hot sauce.

If interested in the purification program let me know.  It is through Standard Process.  Its a whole foods based supplement co.  Awesome quality and products.

Get Strong! Stay Strong!
Chris

Back Pain? Then Read This Now

Millions of Americans suffer from low back pain each day. This can range from minor aches and stiffness to severe debilitating pain and spasm. There are many disorders such as degeneration, spurring, bulging and prolapsed discs, pinched nerves and fractures, which are the result of what we do (or don’t do) to our bodies day in and day out. So, the question you should ask is; what can I do to prevent back pain or at least reduce my risk? Simply stated, just get up off your butt. While simple, it is true. Too many people have become sedentary.  Many jobs require hours of sitting, driving or flying, Technology has created an environment in which you don’t even have to move to be part of it. Adults and children are lulled into inactivity with television and video games. Schools are also taking part by eliminating physical education from many curriculums.  Most people we see with back pain are deconditioned, have tight calves, hip flexors and chest muscles, weak hip and trunk muscles, rounded shoulders and poor abdominal integrity. And then, the ones who do exercise do exercises like sit ups which add to the spinal stress.  Inactivity (exercise), poor nutrition and aging are a potent recipe for many ailments.  Now, there are specific exercises for the core. I advise you to see a qualified physical therapist to evaluate and instruct you in the best exercises for you. In general, some useful tips for the “health” of your back include, but are not limited too: Drink plenty of water, many joint problems can be minimized with proper hydration (most Americans are chronically dehydrated).  Utilize a lumbar or towel roll in low back to maintain good sitting posture, don’t sit for prolong periods, get up and stretch frequently.  Get in shape with general exercise, lose those unwanted pounds. Avoid bending over for the first hour upon waking because your discs are more “swollen” due to reabsorbing water through the night.  As a result, you are more prone to a back injury in that first hour. When at the sink, open cupboard and place foot on ledge. Now when you bend over to brush teeth or wash face you will bend more at hip and less from the low back.

 

Get Strong! Stay Strong!

Chris

Plantar Fascia Anyone?

Plantar fasciitis is a painful condition effecting the heel and arch area of the foot.  Symptoms include pain in the heel and arch with walking and especially with the first steps  upon getting out of bed or after prolonged sitting.  The pain can range from mild to quite severe.  The pain results from an irritation to the thick fibrous tissue on the bottom of the foot known as the plantar fascia.  It attaches to the heel and runs along the bottom to the ball of the foot.  If the foot flattens out more than normal (overpronation) the fascia is excessively and repetitively stretched and can over time become inflammed at the heel where it inserts.  Microtearing occurs and the tissue can start to pull the bone away fron the heel resulting in a heel spur.  So, a bone spur is the result not necesarily the cause of the problem and the bone spur is horizontally oriented not vertically.  As you sleep at night or when you are off your feet the tissue begins to "scar down" as it attempts to heal itself and then when you take that first step in the morning it stretches or "tears" the fascia tissue.  Thats why those first steps are killers.  Symptoms can be set of by overpronation, changes in activity levels, improper shoe wear, climbing ladders or using your foot to dig with a shovel.  Most of the time plantar fasciitis responds to conservative therapy consisting of a good biomechanical evaluation, modalities for pain ( ice, iontophoresis, electrical stimulation), taping, proper stretching (hip flexors, calves), strengthening (hips, core) and temporary or custom foot orthotics.  So why would one have surgery but not correct what caused the problem in the first place?

Get Strong, Stay Strong!

Chris

Don't Give In To Aging, Fight It!

One thing is for sure, you will age, but that doesn’t mean you should go “quietly.” It is widely known that exercise and diet can significantly slow the effects of aging. The problem is that many don’t follow this. Over the years it slowly creeps up on you. The pounds start accumulating, the muscles get weaker, the joints get stiffer and before you know it you are out of shape! This is often the reason why injuries and pain arise. Years of neglecting your body, the aging effect and continuing to do the same things expecting different results. Many people take better care of their pets or cars than the most valuable thing you have—your body (and mind)! One of the best things you can do is resistance train and eat sensibly. Resistance training helps to offset the loss of lean body muscle that natural decreases with aging. Loss of strength is associated with decreased function, increased risk of falling and injury. Don’t be afraid to lift heavy weights either (obviously progress to heavier weights). That means you too ladies! Don’t worry you won’t get big! You can’t, you don’t have the hormones. Anyway, studies done by the University of Miami have shown that at about the age of 50 our muscles (especially the Type II strength and power fibers) significantly begin to atrophy and if not properly stimulated will eventually become innervated by the Type I, endurance fibers, so not only do you get weaker but also slower! This then is irreversible. Scary huh? Other studies have reported that men and women lose muscle and bone mass as they age beginning at age 30. This can be off set through resistance training. Keeping your muscles functionally strong helps to decrease the aging effect, improves our ability to absorb shock, control motion, stimulate bone growth, and ultimately lead a more productive, independent and injury free life. Research has shown that it is important to lift weights at the right intensity to stimulate the Type II fibers. Light weights at higher reps are not the answer. Developing functional strength is more important for health and fitness in older adults than developing isolated muscle groups. Train movement not muscles. Don’t wait, get out there and get “fighting”! After all, aren’t you worth it? Make sure you seek qualified assistance to get you started on the right track.

Good luck and don’t stop!

Get Strong! Stay Strong!

Chris

Do You Have Dormant Butt Syndrome??

Yes, I said dormant butt syndrome, DBS for short! I see it all the time in the clinic. In athletes and people of all ages. The cause of DBS is usually tight hip flexors, again, which most people have. This is due to repetitive hip flexion from walking, running, sitting, driving and sleeping in the fetal position. Other causes include injury and inactivity. If you remember back to previous posts the gluteus maximus generally attaches proximally to the sacruum, and illiac crest and wraps around the hip to distally attach to the greater trochanter (the big bony bump on side of hip). Although we think of the gluteus maximus as a powerful hip extender it is actually built for rotation. Just look at the fiber orientation (yes, you may have to crack open the old anatomy book). So, functionally its main function is to eccentrically control internal rotation of the femur in the transverse plane during the loading phase of gait or running, eccentrically control hip flexion in the sagittal plane and assist the gluteus medius in stabilizing hip adduction in the frontal plane. The ability to appropriately load enhances their ability to concentrically contract during the unloadong or propulsive phase. If the gluteus maximus is inhibited (which V. Yanda taught us) from a tight hip flexor, then the hamstrings and erector spinae group become overactive to compensate. This leads to the possibility of hamstring strains, low back pain, knee pain and possibly even plantar fascia. A simple way to check for DBS is to have patient lie prone and ask them to do a leg lift. Palpate the gluteus and the hamstring and see which contracts first. Many times I feel the hamstring contract then the gluteus. It should be gluteus then hamstring. Sometimes ive seen people have a 5/5 manual muscle test and not even fire the gluteus. They used all their hamstring and erectors to lift/hold the leg up. Some general strategies include a basic muscle re-education of laying prone over table or bed and actively squeezing butt then lifting leg. Sequence can also be done with bridge exercise. Stretching the tight hip flexor, of course, and functional hip dominant exercise like single leg balance w/ arm reaches, multi planar lunges, sled walks, various step up and downs. So now get moving and wake that sleepy butt up!

Get Strong! Stay Strong!

Chris

Weighted Sled For Core Training/rehab

Santa is not the only one to use a sled! The weighted sled can be used in rehab for lower extremity strength, endurance and makes a great core activator. Every patient suffering a significant injury to the lower extremity needs to restore integrated movement, strength, endurance and power. With the sled fastened around the waist and the sled towed behind leg drive and posterior chain strength can be developed for gait and transition into running. It simulates walking up hill without the hill. In addition it will get that heart rate jacked in a hurry! Walking backward will really fire up the quads. Now to use the sled for core strength and activation, I just put handles on the ends of the ropes where the waist band attaches. We can now repeat our walks holding the arms chest level or outstretched in front.

The resistance is now pulling back through the arms that have to be stabilized by the core as your legs are still driving forward, not to mention an even greater metabolic demand! Walking forward activates more of the abdominals and walking backwards (holding the handles) will activate more of the posterior core muscles. It also give you some additional bonus shoulder and arm work. A shoulder harness is a great alternative to the handles although not as demanding.

I am a big fan of asymmetrical loading due to the increased demand for stability and its relation to "real life" activity/movement. So, here are just a few of many tweaks to the sled I use.

1 arm push 1 arm pull over shld pull

So, as you can see (hopefully) these exercises can be used in rehab for the upper extremity, core or lower extremity.

Get Strong! Stay Strong!

Chris