Archive for July, 2011

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!

 

 

 

 

 

 

 

 

 

 

 

Refined white sugar is particularly noxious, and by some perverse twist we have come to believe that sugar-sweetened desserts are essential to “having fun.” We feed our children this devitalized food because we are socialized to expect it, (amen!) and we to provide it (not me).”  As adults, most people like to end their meals with a sugar-sweetened dessert, anything from ice cream to cake or cookies. The absence of such a dessert at an elegant dinner party would almost be a social faux pas. What is so bad about this ubiquitous substance? According to nutritionist Robert Crayhon, author of Nutrition Made Simple, sugar can:

*raise insulin levels and contribute diabetes
*raise blood pressure, cholesterol, and triglycerides and so contribute to cardiovascular disease
*contribute to gallstones and obesity
*contribute to mood swings and depression
*increase stomach acidity
*cause migraines
*weaken the immune system
*deplete the B vitamins, calcium and copper
*interfere with the absorption of calcium and magnesium – and so contribute to osteoporosis

But despite what we know about the substance British physician John Yudkin calls “sweet and dangerous” and “pure, white and deadly,”many people still feel that they might be “deprived” when they consider quitting the consumption of sugar-sweetened foods. For our long term health, thats the kind of “deprivation” that would be a good thing, just like deprivation of tobacco would be good too.
Dont worry, a little treat here and there is not going to kill you, but consuming the amount of sugar that the average person does just might! What’s really sad is the kids that suffer from their parents choices. Just look around.

Get Strong! Stay Strong! (and sugar free!)
Chris


 

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

 

 

 

 

 

 

 

 

 

 

I often talk to people that ask about nutrition. One of the first things they ask me is what do I eat and how much do I eat? They are often surprised when I tell them I eat 5-6 times per day. Many people especially those trying to lose weight have a hard time with this concept.  It is still common for people to think they need to severely calories, which is true but they often go overboard with this concept.  I will often explain that our bodies are built for survival based on DNA that is millions of years old.  That is why it is hard to lose weight and also to gain (build muscle).  I further explain that the body is smart.  If it believes you are not going to give it adequate calories/nutrition it will store (hold onto) the fat for its energy.  By eating enough calories throughout the day your body will recognize this and “release” the fat.  One of the main reasons eating multiple meals is important is that it regulates the insulin response which influences fat and protein metabolism and helps maintain energy levels evenly throughout the day.  By skipping meals you tend to be hungrier when you do eat and over eat which leads to that food coma feeling and fat accumulation.  Another important factor in eating regularly throughout the day is that if you do not “feed” your body appropriately then the body will take the needed nutrients from your bones, lean muscle mass and other tissues possibly contributing to osteoporosis and loss of lean muscle mass.  It doesn’t have to be over-whelming.  Three nutritious meals and 2-3 healthy snacks is it!  Of course eating the right type of foods like lean proteins, low glycemic carbs and “good” fats need to be coupled with a good exercise program for optimal health.

Get Strong! Stay Strong!

Chris

 

 

 

 

 

 

 

If there’s one thing we guys like it is benching!  Unfortunately our shoulders suffer sometime or another.  Talk to any powerlifter or body builder and a majority will tell you of their shoulder problems.  Bench pressing is not kind to the shoulder.  In the lowered position, the shoulder joint capsule is stretched and the subacromial space is compromised setting us up for impingement, capsular instability, A/C joint and glenohumeral wear and tear and muscle and ligament strains.  One solution to protect the shoulder and resume benching after a shoulder injury, is to bench off the floor instead of the bench.  This prevents the elbows from dropping below the trunk saving the joint a whole lot of stress and strain.  And, you can actually bench more weight, which activates more fibers and ultimately leads to increased strength and size of the chest!  By benching from the floor you do not hit the “sticking point”, which is the weakest part of the chest press movement and the limiting factor to weight lifted.  Thereby protecting the shoulder and increasing your bench!  What guy is not going to be happy about that!  So, ladies please dont tell us guys we cant bench.  We have to! (it must be genetic), regardless of how skinny our legs are.  We love to bench!

Hopefully now you have a plan to protect the injured shoulder and begin the inured lifter back to benching and being happy.
Get Strong! Stay Strong!
Chris

Actually, it is the one you consume right after your workout. After your work out your muscles are most sensitive to insulin.  Insulin is what causes your muscle to take up glucose from the blood storing it as glycogen.  Glycogen is the fuel that your muscles use.  So, consuming adequate carbs and protein after your workout allows you to recover faster which means your body is better prepared for the next workout.  I often discuss this with patients due to the fact they are working their buts off in therapy (at least in my world of sports physical therapy they do) so recovery is important and their body is trying to heal itself therefore adequate nutrition enhances this process, not to mention proper hydration which most people lack.  Even if you are not an athlete, recovering appropriately can mean a better day at work or playing with the kids later or the next day.  By consuming protein after a workout you can enhance glycogen replenishment by 30% and if you consume carbs with that you can double the insulin response which means more nutrients are able to be delivered back to the musles.  Generally speaking, you should consume a carb to protein ratio of about 2-3:1.  If you are doing longer duration endurance type exercise then a higher dose of carbs (4:1 ratio) is more appropriate.  Optimally this should be consumed within about 20 minutes after exercise but technically there is a two hour window post exercise.  Whey protein is the best choice because it is absorbed faster and the carbs should be simple sugar.  A cheap and easy mix is to purchase whey protein and mix it with generic kool-aide.  Mix and match your flavors to your taste preference.  Again generally speaking, a ratio of about 40 g carbs (sugar) and 15g protein would work.  Dosage can vary based on training intensity and goals, but that at least gives a geral framework and rationale s to why it is critical to get you post work out supplementation in.  So dont forget this critical piece to your rehab or training process!

Get Strong! Stay Strong!

Chris

 

 

 

 

 

 

 

 

 

No, I dont advocate high heels for squatting (just for a night on the town). After an ankle injury or surgery many times the ankle is limited in dorsiflexion either due to joint restriction, tightness of the achilles/calf or both. This often occurs as a result of the foot/ankle being immobilized (casted or boot) or just not walking normally due to pain, swelling and/or apprehension to fully weight bear. This restricted ankle movement often limits the ability to squat. The ankle, knee and hip all have to flex (as well as rotate and ab or adduct) simultaneously during the descent. Obviously if the ankle joint motion is limited the the depth of the squat will be effected. This should’nt stop you from squatting, it just requires a little creativity. Simply put a 2×4 under the heels. This places the ankle in a plantarflexed position which allows the ankle (and lower extremity) to go through more motion thereby creating a more normalized squat. Now the legs can be strengthened while the ankle is protected and everyone is happy! Dont forget to gradually lower the heel lift as their mobility returns until they are able to performa proper squat with their feet flat on the floor.
The other benefit to the heels up squat is that it moves your center of mass forward and the body automatically will sit back into the squat creating a more “normal” pattern. Most of the people I see cant squat to save their lives and the sad thing is I deal mostly with athletes! As a whole our society has lost their ability to squat. Why? Good question, probably because we utilize toilets instead of a hole in the floor. Think about it, many other cultures dont utilize toilets which forces them to move through the full range of motion and thereby maintain a normal squatting pattern. Relative to the U.S. these other societies have fewer cases of low back pain and knee pathology. See, I wasn’t kidding! Other causes of poor squat mechanics are inactivity, injury, and overuse / repetitive movements.
As I always say, there is always a way. It just might take a little creativity and of course understanding your functional anatomy and biomechanics.

Get Strong! Stay Strong!
Chris

 

 

 

 

 

 

You have probably noticed that people with shoulder injuries have a diminished grip. (If you haven’t ,start checking) One of the things I like to regularly do in my therapy sessions (and my own training session) is to alter the grip of many exercises. When you have an upper extremity injury your brain will down regulate your grip because it wont let you grab something it doesn’t think the shoulder or elbow can handle. So by utilizing gripping (and focusing on contracting all the muscles of the arm during an exercise) you can improve the grip strength that is diminished and when you grip hard it actually enhances neural flow through the upper extremity via the irradiation effect. Also by gripping you stimulate activity in the rotator cuff. Therefore you can use gripping early on to enhance activation to this area. Grip strength is said to be an indicator of overall arm strength.
Some things I like to do is use a towel to vary the grip for cable pull (wrap towel around handle for thick grip. put towel through handle and roll ends 1-2 times for finger curl grip and put towel through handle and hold both ends for hand shake gip). Utilize a pre made gripper like the Grip Force (2 rubber pieces that fir on most bars that make the grip “fatter” and require you to grip to hold them on). I actually have the Grip Force and utilize these and a simple towel for most things. Also, just simply have the patient focus on squeezing harder while doing the exercise works great and costs you nothing! This can be applied to any exercise for any body part and can go a long way to enhancing overall strength and activation for rehab and strength training. The irradiation effect is a favorite of eastern block countries.

Get Strong! Stay Strong!

Chris

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