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

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

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