Fill Your Pie Hole in the A.M.!

Everyone knows that breakfast is the most important meal of the day but how many of you 

actually eat it?  Breakfast literally means “break the fast”.   After going 6-8 hrs without food

the body is actually “starved” for nutrients. During sleep the body uses the available

nutrients for repair and recovery ( thats assuming it has quality nutrients in the first place).  So, when you wake up the tank is empty.  If you don’t refuel with a nutritious breakfast your body will rob your lean muscle stores to get what it needs to maintain itself.  Or has a poor supply of nutrients from eating crappy food.  This can lead to decreased strength and performance, in addition to mental and physical fatigue. It’s important that breakfast include protein, carbs, good fats and fiber.  Do your body good (it has to last a long time) and start the day off right!

Eat breakfast.  A good wholesome breakfast, not some processed garbage.

Get Strong! Stay Strong!

Chris

Tennis or Golfers Elbow Anyone?

Elbow pain can be a painful and debilitating problem. Pain located on the medial side is referred to as “golfers elbow” or  medial epicondylitis and pain that is on the lateral side is often referred to as “tennis elbow” or lateral epicondylitis. 

Now you don’t have to play golf or tennis to develop these problems. Pain in the elbow usually occurs as a result of repetitive use from typing, hammering, grip/ lifting or swinging a club or racquet. It can occur over time or with a sudden episode.

 Symptoms include pain with; grip, turning door handles or car ignition, fully extending or bending arm, typing, using the mouse.  Swelling and tenderness are also present. Pain can range fromminor irritation to significant limitations in use of hand/ arm.

Often times treatment includes limitation of exacerbating activity, stretches, use of a forearm strap and various pain modalities like ice, electrical stimulation and iontophoresis.  Iontophoresis is a treatment that utilizes an electrical current to drive a medication into the target tissue. We have found this to be quite effective in decreasing pain. This particular treatment requires a doctor’s prescription and is administered by the physical therapist. 

We have also found that stretching and strengthening the hip further enhances the recovery from elbow pain. The hip you ask? Yes, the hips (and trunk) are the power generators for the body. Think of hitting a baseball, swinging a golf club or tennis racquet. In order to swing, lift, push, or pull forcefully you must rotate the hips and trunk to increase force generation. If unable to load the hips/trunk due to weakness or limited motion (tightness) you will likely compensate by using the arm muscles more. Over time this can lead to tissue stress and “bam” the elbow starts to hurt. By improving hip mobility and the working relationship between the elbow, shoulder, trunk and hips we have seen marked improvement in our ability to address this painful condition. Due to the fact that we sit a lot and sleep in the fetal position our hips naturally get tight and develop muscle imbalances. Like we always say, “it’s all connected.”   

Seeking a rehab professional who understands function and the relationships of human movement can greatly improve your chances of overcoming your elbow pain.

Get Strong! Stay Strong!

Chris

Get Your Booty to "Bark"! Muscle Function

OK, since I enjoy talking about function and biomechanics lets talk about how to turn on your butt!  Thought that might get someones attention.  Any way, the Gluteal/hip/ butt muscles are the "powerhouse" muscles.  We call them the big house or the cannon.  The first thing to do before "shooting" the cannon is to "load" the cannon.  In function this simply means you need to efficiently load (eccentrically)the gluteus muscles in order to effectively unload or more forcefully create a concentric contraction.  During the loading or pronation phase ( front foot hits the ground in lunge or gait)

   the function of the gluteus muscles (max, min and med) is to eccentrically control hip flexion in the sagittal plane, hip adduction in the frontal plane and femoral/hip internal rotation.  If you look at an anatomy picture of the gluteus maximus you will notice that the fiber orientation is primarily in the transverse plane.  This baby was designed for femoral/hip rotation (a significant component of lower extremity pronation)

The gluteus attaches proximally to the saccrum and the illiac crest and distally to the greater trochanter and blends with the tensor fascia latae (TFL) to form the illiotibial band.  The ITB attaches distally to the anterior/lateral aspect of the tibia.

So, for example, when you are walking and your foot hits the ground and begins to pronate, the calcaneus everts causing the tibia to advance forward and internally rotate (see "When Foot Hits Ground" post).  This creates a quick "pull" on the ITB, which creates a quick stretch on the gluteus thereby stimulating the butt to contract.  This is further accentuated by the femoral internal rotation that also eccentrically lengthens the gluteus maximus.  Remember that neurologically a muscle responds to a quick stretch (eccentric load) by concentrically contracting. Therefore, if one has limited calcaneal eversion (after ankle injury or immobilization) they will not be able to effectively and efficiently turn on the butt which leads to compensation and further problems.  There in lies the beauty of function!

Get Strong! Stay Strong!

Chris

What Do the Adductor Muscles Really Do?

Despite their name, the adductor muscles work primarily as strong sagittal plane hip flexor or extensors. For example, if you are walking (or running) and the right leg is forward, the right adductor works as an extensor and the left as a flexor and then they switch as you alternate legs in the cycle. Have you ever went out and ran or sprinted for the first time? Where did you feel sore? Right, in the groin and inner thighs (as well as the rest of your body if was your first time).
The adductors (generally) attach proximally to the pubic bone and distally attach to the posterior medial aspect of the femur, giving them their mechanical advantage in the sagittal plane. In single leg stance or the single leg phase of gait running or kicking they work with the gluteus medius and the quadratus lumborum to stabilize the pelvis and limb in the frontal plane on the stance side. Now, in activities such as gymnastics, ballet, and karate where the leg is lifted or rapidly "thrown" out to the side the adductors will actually adduct the leg to bring it back into position to hit the ground.

Due to its atachment to the pubic bone, the adductors when activated, can stimulate (turn on) the pelvic floor muscles.  So, squeezing something between the legs while doing a bridge or squat for example can increase pelvic floor activity, which is important for women who have had multiple childbirths and people with core stabilization issues.

Some examples of functional exercises that activate the adductors include:  lunges - forward, lateral and posterior lateral w/ rotation, step up w/ opp. leg hip flexion (w or w/out resistance from cuff or cable), single leg balance w/ opp. leg reaches, and resisted walk, jog or running (cable, bungie, sled).

Once you understand what the bones are doing in all 3 planes (against gravity, ground reaction forces and momentum) and you know where the muscle attaches proximally and distally, you can begin to figure out its true function and design exercises to actually improve the bodies abilitiy to move.  Unfortunately, school doesnt usually teach us that.  Think back to anatomy.  We are taught that the adductors adduct the leg.  Well, now we know that in function they rarely ever do that!  Good luck and have fun!  There is always more to learn!

Get Strong! Stay Strong!

Chris

Secret Weapon to Burn Fat and Pump Your Muscless

If you want a piece of equipment that can provide, strength, power, fitness and fat loss all in one check out the video below and stay tuned for some cool PT/fitness applications!  My patients love it.  Our athletes, pro and amateur, love it!  Check this out!  And you guys thought I forgot about the PowerMax!  Still cranking on it daily.

Get Strong! Stay Strong!

Chris

Stop Making Excuses Not to Exercise!

I can't tell you how many times I've heard them; "I don't have enough time,"  "I don't have equipment" and "I get plenty of exercise during my busy day."  Whine, whine whine.  Well guess what, now there are no excuses because we have what you need, solutions!

As the strength and conditioning, fitness and rehabilitation worlds have evolved it has been realized that you dont have to spends hours on fancy equipment to be fit. There is a real crisis in our country and your starting to see it in other countries as well. People are getting bigger and bigger ( a nice way of saying fatter). Nutrition and decreased quality of food is a major contributor as is a lack of "adequate" exercise. Many who are "actively exercising" are still not geting the results they want because they don't have a well planned program, the intensity is inadequate and /or they don't support it with the proper diet. So lets conquer the excuses. The number one excuse I hear is "I don't have enough time" or "I'm too busy." I'm always suprised that people will spend more time and money on their pets or cars (don't get me wrong I like animals and cars) than they will on the most important commodity they have, their own bodies and minds. Take time out for yourself! It will do yourself, your friends and your family a world of good. Better yet make it a family affair. Think of the example you're setting for your kids. How much time you ask?  How about 4 minutes? Yes I said 4 minutes and I know you can spare 4 minutes if you really want to start getting fit. If not, just do it faster! Actually smaller bouts of exercise, at the right intensity, are more effective for fat loss and strength gains. The second excuse is an easy fix too. You don't need any fancy equipment. Grab some detergeant bottles with handles, a step stool, paint cans, even your infant (great mommy or daddy and me time) and your good old body weight and you've got yourself a home gym. The bottles can be used like dumbbells and if you put varying amounts of water in them they add a great stabilization componant as the water moves around during the movements. You can also make your own sandbags (pea gravel and duct tape) that are great for lifting exercises as well as squats, lunges and step ups with various holds. For a small investment (you're worth it!) you can purchase a medicine ball, chin up bar, resistance bands, a physioball and some dumbbells. Lastly, the "I get enough exercise during my busy day" excuse.  Well if that was true we would'nt be having this discussion nor would they be sitting in my clinic complaining of nagging aches and pains.  I'm sorry to say that just carying your body weight around all day is not enough.  Everyone is searching for the magic pill or diet and not many people realize it is as simple as portion control and some good old fashioned exercise.  It is the overload principle;  you must make a muscle work harder than it is used to in order to produce a change.  So just get over it, quit whining and get to work!  It will make a difference and it can be fun!  For your family, your kids and your self!  You are worth it and you can do it!  Believe in yourself and the power to change!

Heres a sample:  10 push ups, 10 squats, 10 dips (use chairs), 10 lunges.  D0 3-4 rounds.  Done!  Simple!

Get Strong! Stay Strong!

Chris

The Sports Medicine and Fitness Fanatic: Got Magnesium? I Hope So!

The Sports Medicine and Fitness Fanatic: Got Magnesium? I Hope So!: For the longest time people have focused on calcium and vitamin D for bone health. While important, without adequate magnesium (Mg) ...

Got Magnesium? I Hope So!

For the longest time people have focused on calcium and vitamin D for bone health. While important, without adequate magnesium (Mg) the absorption of calcium is hindered.  Magnesium is stored in our bones and is a buffering mineral when our blood becomes too acidic (from poor diet or high protein diet) or when needed in other areas of the body. Many people are Mg deficient and have used up the Mg in their bones and they begin to weaken    An Israeli study showed that 22(71%) of the 31 women who took 250 and 750 mg of magnesium daily for 2 years (without extra calcium or vit. D) increased their bone density by 1-8%.  The women who took placebos lost 1-3% of their bone density over the same 2 years.  Magnesium has also been called the anti-cramping mineral.  It is said to be good for migraine headaches, muscle and menstral cramps and other problems commonly associated w/ cramping/tension type symptoms.

 Great food sources of Mg include: broccoli, kale, collards, spinach, romaine lettuce, almonds, seafood and apples.  Of course you can also supplement w/ magnesium.  Since magnesium is needed for calcium absorption a supplement that contains a calcium: magnesium combo may be best.  Typically it is said that you need a 2:1 calcium to magnesium ratio so be sure to look for that.  Also, in terms of absorption, calcium citrate or malate are best.  For magnesium look for mag. citrate, malate or glycinate.

Get Strong! Stay Strong!

Chris

Shoulder Pain? Its Not Always the Shoulder!

Shoulder pain can range from nagging to debilitating depending on the problem and severity.  Generally, in the under 40 crowd shoulder problems usuually consist of impingement and instability.  Impingement occurs when the "ball" of the ball and socket joint "rides" up during shoulder movement and pinches the rotator cuff and bursae.  This can result from trauma or fatigue from repetitive movement.  Instability is from a laxity in the capsule (fibrous tissue.  Like the wrapper of a lollipop) that holds the ball and socket joint together.  This can occur from repetitive motion or trauma.  Some people are born with more laxity in their joints that predisposes them to these typess of problems.  These are the people that are "double jointed."  They don't actually have 2 joints they are just very flexible in their joint tissue.  This can range from mild to severe.  This creates "extra" movement in the joint that can irritate the tissue, rotator cuff and/or injure the cartilage of the socket (the labrum).  The over 40 crowd usually suffers from rotator cuff tears, although they can also have impingement and tendonitis.  Aging of tissue and the longevity of activity makes the older individual more prone to rotator cuff tears.  This can happen through gradual wear and tear leading to the cuff tear or from trauma such as a fall or heavy pulling movement.

Many factors can lead to shoulder problems and multiple steps can be taken to prevent or at least reduce your risk of shoulder injury.  Posture is a big problem for many people.  The rounded shoulders compromise the shoulder joint space and contribute to muscle imbalance and impingement.  Tight hip flexors can also contribute to shoulder pain.  The tightness in the hip flexor can "pull" the pelvis forward which can pull the shoulders forward leading to pec tightness which further pulls the shoulder forward.  Taken further this shortens the abdominal muscles (shutting them off) and contributes to an unstable back.  When looking at movement through a functional eye you would see that overhead activity requires extension and rotation through the spine and the same side hip.  So for example, if your hip flexor is tight and/or your shoulders or upper back was rounded and you were trying to change a light bulb, even if your shoulder motion was normal, your ability to work overhead would be limited and your chances of developing shoulder pain would be high.  The moral of the story is that it is all connected and that to successfully correct shoulder problems you must try to find and address the cause.  This requires understanding the functional relationships of the body.  Many times easier said than done.

In general, make sure your exercise programs are balanced and you are not just working the "mirror muscles," stretch your hip flexors, watch your posture especially when sitting, drink plenty of water (most of your tissue is water) and eat a balanced, nutritious diet (give your body the nutrients it needs to be healthy and support the growth and repair processes).

Get Strong! Stay Strong!

Chris

Are You Still Doing Sit Ups?...Really??

Many years ago the sit up was king of abdominal training.  Today in the world of rehab, function and performance training the tide has shifted away from the sit up.  Our study of the human body, how it works and how it responds to various training modalities has led to a shift in our training methods.  Also, Stuart McGill PhD has shown the shear and compressive forces on the lumbar discs while doing a sit up to be quite detrimental to the health of the spine.  Now, we don’t just train the “stomach,” we see the body as a link system and the trunk, front, side, back and hips collectively make up what is now referred to as the “core.” Most abdominal activity occurs while in the upright position working against gravity, ground reaction forces and momentum.   In fact clinicians and trainers, in the know, very rarely train muscles.  They train movement.  Activities like walking and swinging a golf club are engrained in our brain as patterns.

Think of this, people do thousands of sit ups to work their abdominals for the almighty six pack or what they consider “core” training.  If you think of this functionally, while standing, do you really need your abdominals to forcefully pull your shoulders down to the floor?   Of course not, gravity will do this for free!  So what is the “function” of the abdominals?  The rectus abdominus eccentrically controls back bending and the obliques eccentrically control rotation.  This all works together (with the back buscles) to control posture and produce rotational torque for efficient walking and more powerful activities like throwing a baseball or catching your child as they jump into your arms.  It is the rotational and side to side activity that drives us forward.  A bicycle moves forward only because the wheels are rotating.

Current abdominal exercises consist of arms overhead, reaching back, chops, diagonal chops and rotations using various modalities such as medicine balls and bands. We use kettlebell swings, waiter walks, snatches, cleans and windmills.   Also, variations of push ups, planks and bridges are utilized.  Assymetrically loaded squats, deadlifts and lunges are great core activators.  Many want the washboard ab "look", but the real question is are you training for show or go?  It is possible to have both!

Get Strong! Stay Strong!

 

Chris

Rise and Shine Workout: Time Under Tension

Despite being dog tired I dragged my a#% out of bed and got my workout in at 6:30am this morning.  A ritual I've been doing for the past 6 months.  Normally, I workout at lunch, but have found it nice to relax at lunch on Fridays and not have to rush to get the morning pts completed (and if needed take a nap!).
So today consisted of supersetting:  3 sets each
                 1.) Barbell Sumo Deadlift x 8 w/ DB Tempo Shld Press (3 sec up/3 sec down) x 10
                 2.) DB Flat Bench Tempo Press ( 3sec down/3sec up) x 10 w/ Alt Leg Press x 16
                 3.) Forearm Braced Chin Up x 8 w/ TRX Triceps press x 10
                 4.)  Calves on Leg Press x 8 w/ DB Tempo Lateral Raises (3sec up/ 3sec down) x 10
Total Time elapsed 50 min.

The benefit of the tempo is that you are using the time under tension principle.  The longer a muscle is under tension the more it is stimulated to grow!  Most people totally disregard this concept when lifting.  Just watch most guys at the gym do bicep curls.  They do 10 reps in about 10 sec!  Yes, they get pumped and they will build some strength and size, but they would probably gain more and faster if they slowed down a bit.  Im not suggesting the "super slow" method that was popular for a while.  You do have to put ego aside though b/c you will definitely have to lower the weight.  Try It!  Shoot for at least 40 sec of time under tension to begin and then progressively increase your time.  Its great for rehab when you want to build size and strength but don't want to or cant use a lot of weight.

Get Strong! Stay Strong!
Chris

Bone Health; More Than Just Calcium

Osteoporosis is a condition in which normally dense bone tissue has become less dense,

showing holes and spaces. This happens when the build up of bone is not keeping up

with the breakdown, and the bone’s protein structure and mineral content are lost.

Osteoporosis is estimated to affect more than 25 million people in the U.S. More than 1.3

million fractures annually are attributed to osteoporosis. Contrary to popular wisdom,

lack of calcium is not the only cause of osteoporosis. Additional factors contributing

to poor bone health include but are not limited to: low estrogen levels, poor

absorption of vitamins / minerals and lower secretion of calcitonin (the hormone that prevents calcium from leaving bone) related to aging, endocrine gland disorders involving

the thyroid, parathyroid and adrenal glands, lack of physical activity and bed rest,

malnutrition and high acidity from typical American diet, disease of the liver,

gastrointestinal tract and kidneys, smoking, alcohol, caffeine and lastly pharmacological

drugs. While calcium is important other vitamin and minerals are needed for proper

assimilation and absorption for optimal bone health. These include protein, vitamin C, D

and K, magnesium, boron, zinc, copper silicon, B6 and folic acid. 

Interestingly, bone does not fracture due to thinness alone; that is, osteoporosis by itself does

not cause bone fractures. We now know that diminished self repair abilities are also a significant

component. Dr. Melton of the Mayo clinic notes, “Osteoporosis alone may not be sufficient to

produce such (osteoporotic) fracture, since many individuals remain fracture free even

with in the subgroups of lowest bone density.” This is further substantiated by the fact that

older folks in many other cultures, ranging from France and Germany to China and Japan

have lower bone densities than we do yet suffer far fewer osteoporotic fractures. The

new osteoporosis fracture equation is as follows: Thin Osteoporotic Bone + Poor Bone

Self Repair = Osteoporotic Fracture.  Susan Brown PhD and Director of the Osteoporosis

Education Project identifies seven key intervention areas: maximize nutrients,

minimize antinutrients, build digestive strength, develop an Alkaline Diet, appropriate

bone building exercise, promote endocrine health and use alternatives to estrogen

therapy. Check out her book “Better Bones, Better Body; Beyond Estrogen and Calcium.”

Get Strong! Stay Strong!

Chris