We are proud to be a part of GRU, the Boulder county community and support its players in their health and wellness. GRU hosts ultimate frisbee leagues year-around in Boulder, Longmont, and Broomfield.
We are proud to be a part of GRU, the Boulder county community and support its players in their health and wellness. GRU hosts ultimate frisbee leagues year-around in Boulder, Longmont, and Broomfield.
What's the difference? What does it matter? Why should I care? For some of you out there looking to lose a few pounds or training lingo is a foreign language, this is an important concept to understand. The two ideas were introduced many many years ago to help differentiate workouts. The Fat burning zone was meant to be for those looking to lose weight. The Carb burning zone was meant for those looking to maintain a healthy weight.
What's the difference?
First, the Fat burning zone is a work rate that requires a lower heart rate, 60-70% of heart rate max, slow and steady. Where fat stores in the body are broken down into glucose in order to fuel the activity. The slower pace of the work allows the body to breakdown energy stores outside the muscle in order to maintain the work rate. When possible the body prefers to maintain glycogen stores in the muscle. When its a slower intensity workout the body will call on fat stores from other parts of the body, adipose tissue mostly found in the abdominal area, instead of using up the local energy stores in the muscles themselves. This is the main reason its considered the "fat burning zone".
The Carb burning zone requires a higher level of intensity, +70% of heart rate max, where the energy is taken from glycogen muscle stores. All muscles maintain energy stores called glycogen, long chains of glucose molecules strung together for storage purposes. When these local stores are full the remaining glucose in the blood will be stashed away into adipose tissue. When the intensity of the work exceeds the speed at which the body can breakdown, glycolysis, the fat reserves it is forced to use the local supply until it is exhausted. The local supply includes the local muscle glycogen reserves as well as glucose already present in the blood. This threshold is around 70-80% of heart rate max or higher.
On a side note, yet very important, if you're curious about heart rate max....... take 220 and subtract your age. For me, my max heart rate would be 220-39= 181 beats per minute. This means, for me I'd need to get my heart rate up above (181 x .7=127) 127 beats per minute to maintain a good cardio/carb burning workout.
The important concept to understand is that your burning calories REGARDLESS. The biggest difference is how much time do you want to spend, or even better, how much time do you have!? Not many people these days have 4 hours to spend on the treadmill to burn the calories they need, NOT THIS GUY!!
Why should it matter? It matters because you should be aware of what your goals are and how you can be both effective and efficient in your workouts. For those folks that are high risk of a cardiac event (older, more obese, previous history, etc.) the high intensity workouts should be done for less time and be closely monitored. No point in hitting the gym hard just to keel over with a heart attack a couple weeks into the new workout regimen. Checking with your primary physician and using a heart rate monitor are both good starts. Consulting with a dietician or nutrition expert are also good choices.
You should care because if all you ever do is the slow and steady burn, you're missing out on much needed cardio. The Carb burning zone (higher intensity) gets 2 birds with one stone in that it burns calories faster and it also pushes the heart to work hard! Making the heart push to its upper limits, based on age and ability, are what keeps it healthy. Keeping active (fit bit, pedometers etc.) is good but it doesn't ever really push the system to get stronger. High intensity workouts, which varies from person to person, is where you get stronger in the heart and cardiovascular system. So don't be satisfied with walking 10,000 steps each day where your heart rate never gets above 50% max, push for more! Push your body and you'll be pleasantly surprised with how it reacts!
Agility ladders are a good example of Blocked training, which can be beneficial for introducing and refining basic movements that are the basis for developing more complex movements.
...is worth MORE than a pound of cure or all the Chemo in the world! Please, PLEASE adopt a preventative strategy as you get older. Even after you've had the prostate removed, as a male, it doesn't mean you are immune from cancer in the future! If you were ever diagnosed with cancer, regardless of the stage, there is a very distinct chance they didn't get it all. One cancer cell is all that's necessary for it to come back and if you go more than a couple years between checkups it will most likely be too late. It is no different for you ladies out there that have been through and defeated breast cancer. Anyone out there that has been diagnosed with cancer it is never over!
For example, a 74-year old patient 10+ years after he's had his prostate removed, only one follow-up after the surgery, goes in for a hip pain in September. Tests come back with a PSA level above 7. Nothing else is done, that he shares with me. Come December hip pain is even worse, he is sleeping much more than usual and has experienced unanticipated weight loss. He is urged to go back to the doctor for more testing; PSA is now 11+....... Following a prostectomy the PSA levels should remain less than 1 for the remainder of that patient's life, presuming all the cancerous tissue was removed in the initial surgery. With a prostate intact the allowable levels for PSA shouldn't exceed 4. In order for the PSA levels to be that high means that either during the biopsy or the removal some tissue escaped the prostate itself and was left behind. Had he been diligent following the surgery with his follow-ups every 6-12 months this would have been discovered much sooner and appropriate steps could have been taken (Chemo, diet changes, radiation etc.) to prevent it from getting out of control!
I IMPLORE you to be proactive in your later years. If you wait till it hurts, it's too late! Don't rob your loved ones of your company for your pride. No one is invincible, even Superman met his match! Don't presume you have nothing to live for and just let it go. If not for your children, do it for their children! Don't be in any rush to leave this world any sooner than you absolutely must. Make sure to get every ounce out of this life before you go to the next!
A healthy baby at the 3 month phase of postural progression; upright head with independent rotation, weight bearing in the arms and pelvis, legs free to move and ribs elevated from the floor.
Are you thinking about getting into heavy lifting? Already doing a good bit of heavy lifting? Maybe you are a competitive weight-lifter and you can't quite get over a hump? Well then, this article may be of interest to you.
Many of us that played sports in middle school or high school were introduced to squats, deadlift, snatch and/or clean and jerk. For those of you just starting to learn what these movements are all about, the last 2 being the fundamental movements of Olympic lifting. For most of us, regardless of when we were first introduced, we were just thrown to the wolves with a bit of coaching on form and plenty of peer pressure to "go big or go home"! There were a few that got sufficient coaching, but that may not even have been as good as we thought. Yes, some are better than none and they had good intentions but these old/current coaches may not fully understand the most efficient stabilization techniques.
Think back to when you first stepped into the squat rack, what were your cues? Shoulders back? Head back? Arch your back? Stay on your heels? Squeeze the shoulder blades together? Keep your knees behind your toes? I'm sure there are more, but these are the most popular. Unfortunately, all are INCORRECT. These are all extension patterns that take you out of neutral. A neutral spine position is the most efficient means of weight bearing. All of these are also requiring the posterior fascial chain to crank into overdrive, which results in compression of the posterior elements of the spine. Long term this stabilization pattern can cause ruptured disks in the lumbar spine.
If you look at the worlds best weight-lifters you may see these men and women in extension during competitive settings. Considering the weights that these folks are moving there will be a little loss in form. When pushed to extremes there will be some loss in form. I challenge you to find videos of these folks during practice, they will have perfect form. But what does that mean? That's easy: a neutral spine, the foot is equally loaded in the 3 arches, maximal abdominal stabilization, knees in good position (varies based on athlete and type of lift), head in neutral (not extended or flexed). Not very descriptive, I know but I'm trying to keep it simple!
The Idea of maintaining a "Neutral spine" is fundamental when pushing the body to the limits. For those of you not looking to become an olympic level athlete that;s ok, the concept applies to you as well. When you train a movement long enough it becomes habit. Which means it becomes subconscious. When an activity becomes subconscious you do it without having to think about it. Like walking, talking, chewing gum; when was the last time you thought about how to walk? We've been doing it for so long we don't think about contractions necessary to stabilize the body to create the movement. Ideally when you begin your weight training you start with proper form and maintain said form throughout and if you do it long and enough times it translates into your daily life, helping you maintain good posture in all movements.
Neutral spine and abdominal pressure allow for optimal "Joint Centration" which is the key to optimal muscle activity. Joint centration is the process of aligning the articulating surface of the body in a position allowing for maximal surface area in contact. Without joint centration the pressure of the weights is increased on the joints causing premature degradation of the joint surface resulting joint replacement surgery at a much younger age.
Maximal abdominal pressure is achieved through diaphragmatic and abdominal co-contraction. This means your breathing into the belly and contracting ALL your abdominal muscles (Rectus, obliques and transverse) equally. This only occurs when you can maintain a neutral spine. An extended spine puts the abs on stretch and stretch reduces the maximal contractility of a muscle. The diaphragm is fundamental to lumbar spine stability. Sucking the abdomen to the spine doesn't increase stability. Contracting the diaphragm, pushing down into the abdomen, with the abdominals engaged drastically increases intra-abdominal pressure resulting in lumbar stability.
The point of all this is to help you stay healthy and active. Improper stabilization patterns can and do lead to dysfunction and pain. When in pain we move differently, causing further dysfunctional movement and substitution patterns. If you'll take the time to commit good movement patterns to your subconscious you'll be able to stay active longer today and 30-40 years down the road. So if you have any questions about any of the above material please feel free to schedule a free 15 consultation and I'll be happy to clarify.
Effective vs. Efficient:
Although they can be synonymous they are not always the same. When using the two terms while describing human movement they are rarely the same. Many times we get things done without thinking about how efficient we are in the process. Efficiency can also be somewhat subjective. for example when on a road trip is it can be more efficient to be faster by using more gas to go faster or more gas efficient to go slower requiring less gas. With human movement its pretty straight-forward, effort! Not every movement is the same therefore you can train everyone to be efficient for everything. A shorter person, regardless of training, will never be quite as fast as a taller person in the pool, all else being equal, its just physics. We can, however, train efficiency on a person to person basis to more efficient in general. The side effect of this efficiency is improved function and health. Whether you're an athlete or a "weekend warrior" efficient movement patterns allow you to enjoy your chosen activities more. Less time catching your breath and more time enjoying the scenery.
Like any other system, efficiency starts with a good foundation. A good foundation for quality, efficient human movement is a stable trunk or core. Although this may seem cliche, in this case its a new take on an old concept. This is because of the starting point. Most people think core stability starts with sit-ups or planking. These are nice but they aren't the foundation. The foundation is in the breath or the diaphragm to be exact! Without proper breathing patterns, by that I mean expansion of the diaphragm into the abdomen, you cannot properly stabilize the lumbar spine or the trunk. Second to that is a loss of stability in the extremities. When you lose stability you become inefficient in your movement. Peripheral stabilization is then required, recruitment of other muscles. In other words, when unstable you use 2x the energy to accomplish the same action as someone with proper stabilization. Do you think these world champion weight lifters squat 1200 pounds without stability and efficiency? HECK NO!!
So if you are one of the thousands of folks out there that can't seem to get rid of that nagging low back, upper back, neck pain, etc.; perhaps its time to stop the insanity (def. insane: repeating the same action and expecting different results) and get properly assessed and learn how to be more efficient. Pain shouldn't be a part of your every day routine. If it feels like you aren't as energetic as you used to be, maybe its not "low T" or old age, maybe its inefficiency? You're wasting half your mental and physical resources just trying to stabilize!? I'm here to help, make an appointment and lets talk about what you want to improve!
New Years resolutions are coming soon and after the gluttony of Thanksgiving and Christmas, they are well overdue! So I thought I might throw a little info out there for you to help succeed in the diet changes you are looking to make.
1. Plan ahead: Going "cold turkey" on anything is setting yourself up for failure. Take the next couple weeks to clear the pantry. If you want the new diet to take you have to get rid of all the temptations in the house. You also should start tapering the "bad" out of your diet the month leading up to the new diet.
2. Eliminate Bags, Boxes or Bottles from your diet. Anything coming in the above packaging contains preservatives and aren't quality food. Everything in a container must be pasteurized for health purposes. this involves heating to kill bacteria, this also kills the nutrients found in raw foods. Processed foods also have loads of salt and/or sugars.
3. Choose nutrient-dense foods. Calories and nutrient levels are inversely proportional. As the nutrient level increases the calories decrease and vice versa. Raw vegetables have trace amounts of calories, the brighter (green, yellow, red, orange etc.) the color the better.
4. Up the cardio. Muscles are nice but cardio is where the calories are burned! You want to lose weight, get on the cardio! If you insist on hitting the weights, thats fine. Implement a circuit workout where you are hitting all your lifts in succession with minimal rest in between sets. You'll want to drop the weight but this will keep your heart rate up, burning more calories. Optimal calorie burn is around 60% of your max heart rate.
5. Cook less. Too often the vegetables we eat are overcooked, heat kills the good stuff in food. Vegetables are most nutritious when eaten raw. If you need to cook them, brussel sprouts, do so minimally. We have a hard enough time getting proper nutrition these days, let's not cook out the small amount of nutrients left in the foods.
6. Cut out the dairy and wheat. Yes, they can be good for you, but they are calorie dense and not necessary. Everything you get from dairy you can get from meats and veggies with a fraction of the calories. For you fitness athletes, you don't need as many carbs as you think!
7. Eliminate the sugars. We eat too much sugar as it is! Diabetes (symptom) is the biggest issue with kids these days.... SUGAR is the root problem! Regardless of the source (honey, granular, fruit, etc...) we eat too much sugar. I know I eat far too much, we all need to decrease our sugar consumption!!
8. reduce the alcohol. Yeah, I said it... booze has a TON of empty calories! I'd challenge you to eliminate alcohol for 60 days and see how much extra weight you lose. I lost 15 pounds last year when i did it. It wasn't fun but I felt 10 years younger in the morning!!
9. Hydration! Drink water, not tea, diet soda, coffee, Red Bull or GATORADE etc.. Water is what keeps your muscles, skin, and heart healthy. It's not sexy but it works! It's what is needed. All the others have sugars and toxins. None of it helps at game-time like you would be lead to believe. Do you want to prevent cramping? Drink water. Do you want to feel energized regularly? Drink water. Do you want to perform at your best? Drink water!! Water! Water!! Water!!! #rantoverlol
If you liked what you read, have questions, please feel free to make an appointment to discuss more. Have a safe and very merry Christmas!
People are regularly asking me what to use, heat or ice? So I thought I'd take this time to give a little feedback, for the record. Before I do, I need to explain a thing or two. First, There is no research that has definitively linked heat or ice to any significant change in recovery. Considering that most research design has an inherent flaw, some more flawed than others, there is just as much research supporting hot/cold therapy as there is refuting it. Most research suggest neither manage to effect tissue more than 1/8-1/2" deep, the skin is normally about 1 sheet of paper thick. There will be body parts it can be more effective than others, ankle v. gluteals, but overall the research is inconclusive. Secondly, considering that half the game is in the athletes head, if you think it helps..... IT HELPS!! haha! Seriously though, this isn't the only treatment out there that science has failed to confirm or deny that is still widely used. So with that said if you like to take contrast baths after a big game to prep for the next game, be my guest. One thing science hasn't done is prove it hurts to ice or contrast! So if it provides you a mental edge, then don't hesitate! I know I used to do it all the time when playing, I'll be the last person to tell you "stop". So with that said, on to the point of this article.
Heat should only be used on a subacute injury (old or chronic injuries) before activity. Heat is something you would use to start the day or before your workout. The body responds to heat by sending more blood to the area, through vascular dilation, increasing blood flow to the area. The additional blood to the area helps increase the core temperature of the muscles of the area of application. The increased muscle temperature helps to prevent muscle damage like strains and/or tears. Its the same principle behind dynamic stretching. They both are used to increase blood flow to the area. With increased blood flow comes increased temperature and increased elasticity. To get a nice visual, try taking 2 rubber bands, freeze one and put the other in a warm water bath then try stretching them and see which one snaps first. Although a little exaggerated, this is very similar to how your muscles work. cold muscles are fragile and warm ones are responsive and adaptive, which is key in injury prevention.
Ice should be applied at the end of the day when all activity is completed. Ice will aid in lower the core temperature of the muscles/joint over the area applied. Cold causes vascular constriction in the area of application, this reduces the amount of blood that makes it to the area. This is the bodies response to cold in an effort to maintain core body temperature, much like when you are outside in the winter and you feel fine but your fingers and toes go numb. Its the bodies natural response for staying alive. The use of ice helps decrease inflammation in the area. Its especially helpful in the event of an acute injury (new), like an ankle sprain, to prevent/limit secondary injury due to excessive swelling. With a new injury tissues are torn, including capillaries, causing blood to flood into the muscle compartments. If the swelling is left unchecked it can overfill these compartments resulting in rupture of the fascial dividers and further injury. It can also cause compression of other structure restricting blood flow and sensation, which can lead to necrosis (death) of compressed tissue (muscle and nerves alike) if left long enough. It's imperative to make sure the PRICE (Protect, Rest, Ice, Compress, Elevate) guidelines are implemented immediately following injury. Here's a general rule of thumb for ice usage is 20/40 (20-minutes on followed by 40-minutes off) with compression till bedtime. Some people like to use contrast baths for recovery. As mentioned above, the research is inconclusive but if that's part of your routine and you feel it helps, by all means, keep it up!
I hope this was useful. Please don't hesitate to reach out with any questions or concerns. Hope to see you soon on the field or in the office. Until then take care and best of luck! Cheers!
First, Observation! It's important to understand movement is a big key to your function or dysfunction. When in pain movement is altered to reduce the pain. These altered movement patterns can contribute to further dysfunction. I want to see how you walk, stand, sit, lay down and breath. Ever think about breathing? I find dysfunctional breathing in most patients with pain. proper breathing is key to trunk and core stability, so if your breathing pattern is off, makes sense you'd be in pain!
Secondly, we'll have a lovely little chat. This is where we get to know each other while I get a little history. I want to know what you do every day, what you used to do and what you want to do going forward. Are you an accountant trying to make it through tax season, are you a high-level athlete trying to recover from a nagging hamstring that won't stay healthy or are you somewhere in between. I'm happy to help wherever I can but I'm not trying to make you something you aren't. I am not for everyone and I cannot fix everything. There is a limit to what I can do. One of the best indicators for care is your patient history. While we talk we will get to know one another and whether or not you are in the right office. This is important so we can be as efficient as possible while in the office. We all got things to get to so I'm not interested in keeping you here any more than necessary. Let's get you patched up and on your way again!
Third, I'll conduct a thorough physical exam that will include vitals, neurological exam, orthopedic exam, muscle testing, a movement screen, and reflexes. Before treatment is rendered it is imperative to make sure you are physically fit enough to do so. These exams are designed to ensure there isn't something more sinister going on that would necessitate a referral to your PCP. Without a physical exam, I could miss something that could cause me to hurt you even more. At the same time, they provide clarity to a foggy picture of dysfunction. Every step of the process provides more insight to the root of your problem. Although we do not perform imaging here (X-ray or MRI) we do have referral privileges at Health Images, located just south of town, and can have you seen, imaged and results in our office in the same day.
Fourth, appropriate treatment will be rendered. Depending on the primary complaint it may include some or all of the following: Chiropractic adjustment, palliative care (e-stim, heat, ice etc.), Soft tissue work, taping (k-tape or the like) and home exercises. I am a chiropractor and will always adjust when indicated and safe but its not adjusting for the sake of adjusting. I try to adjust with specificity, to make a change in the nervous system. Hearing a "pop" is good but if it doesn't improve function then what was really done? The first visit won't involve much adjusting of the spine. The focus will be making sure a few key areas are aligned. When addressing a problem you start with a narrow focus and get broader as you eliminate variables. Treatment on the first visit will be more soft tissue, extremities, breathing and exercises than adjusting.
Lastly, care plan. I like to see my new patients 2x/week for 2 weeks to make sure you're responding appropriately to care followed by 1x/week for 1 month to reinforce care and modify home exercises as needed. Home exercises are imperative to improvement. Dysfunction involves faulty motor patterns. In order to change them the patient MUST do the work, this is called active rehab. The treatment I perform (adjustments, e-stim etc.) are all passive. Passive therapies are helpful in reducing inflammation and correcting misalignments but they do not create new motor stabilization patterns for the joint. Therefore, if you want a change, you'll have to make it! Nothing new there, just thought I'd remind you.
At the end of the day, we were designed to move, pain-free. If pain causes you pain something is wrong and the sooner you have it looked at, the easier it is to fix. Pain shouldn't be a part of your day and I look forward to making sure it isn't but I can't do it by myself. So call for your appointment and let's see what we can do together to get you moving pain-free.
Do you know what your Diaphragm muscle is, or where and what it does? So that we are all on the same page, its the muscle separating the intestines from the lungs. a thin sheet of muscle attached at the bottom of the ribs that's designed to be the primary muscle for respiration. On inhale it pushes down into the belly and on exhalation is pulls back up into the chest forcing the air from the lungs. You know what else it does...... CORE STABILITY!! If you are not a belly breather, most of us are not, One of the biggest and best core muscles isn't being utilized which will eventually lead to core instability and low back or pelvic dysfunction. So how do you work that particular muscle, I know I've never seen a "diaphragm" station in the gym!! Breath, yes, just breath! Lay flat on the floor with your legs elevated and just breath in and out of the stomach. On a side note, if you have a problem with acid reflux, this may help with that as well. The cardiac sphincter, meant to prevent acid backflowing into the esophagus is connected to the diaphragm. If the diaphragm is weak would it not make sense the cardiac sphincter could be weak as well? So if you get the diaphragm working right you could in-turn, stifle your acid reflux.
Ever hear of Regional Interdependence? Its a newly emerging concept in the health field. Its the idea that the regions of the body (upper and lower extremities) should be able to move and function independent of other extremities. Example: Hip extension should only require stabilization of the core and activation of the lower extremity. When I have a patient perform prone extension while palpating the cervical spine and can feel the neck muscles contracting it tells me there's a lack of regional interdependence. To be more specific, it tells me the core isn't stabile, not to be confused with weak, theres a big difference between the two. So how is it achieved, regional interdependence, that is? The first step is a proper exam and movement assessment, second is to identify the causes, third is intervention (adjustments, soft tissue work etc.) and finally exercises to reinforce the work done by the healthcare professional. All of these things we specialize at Power Chiropractic. So if you're interested in fixing any long standing aches and pains feel free to make an appointment today @ athletepowers.com
After this last weekend, covering for the Shoes and Brews 4th annual Soul Mates 5k, something occurred to me: running isn't for the faint of heart. This may cause a few of you to chuckle to yourself but perhaps you should try it sometime, for longer than a couple weeks or miles!
My above statement is designed to help you understand its not about intensity, necessarily. More so, its about the amount of force that can go into the body, which can be substantially increased if done without proper preparation! Preparation? Yes, Preparation! If you're the type that thinks you can just throw on a pair of runners from the value store and hit the pavement for a couple miles and be just fine, you are poorly mistaken! If done without proper preparation, running can be very taxing on the lower extremity and back! So how does one prepare? I thought you'd never ask!
Here's a quick list of things to consider:
1. Make sure your physically fit for running. A quick adjustment from your trusty chiro can ensure the lower extremity is functioning properly to prevent injury. Coupled with a quick physical wouldn't hurt, making sure there's nothing internal that may result in a coronary attck in the middle of your run
2. Equipment check. Not all shoes are created equal! If you're gonna take this thing seriously you should know there are good shoes and bad shoes to be running in. The bargain bin runners are not for running! Shoes breakdown. If you're running distance you should be changing out you runners every 3-5 months, 6 years is WAY too long! Get fitted by people who know their stuff, Shoes and Brews is a good locally owned and operated shop near main street.
3. Start small. Don't go out trying to run 10 miles your first day. Its unrealistic and you'll most likely be so sore it may take a few weeks before you're able to run again. Depending on your ability, start with 1-2 miles and as you get your lungs and legs back start bumping the mileage up after a few weeks.
4. Hydration. At altitude hydration is HUGE. Most people don't understand what hydration is! The guys you see walking around with gallon jugs of water may be cliche but I'm pretty sure they don't get cramps or heat stroke very often! Coffee, soda and alcohol all cause dehydration, more so than you think, so if you have any of that stuff you need to offset it with extra water that day.
5. Set goals and keep track. Depending on why you are running (weight loss, increase activity, cross training, etc) you should have goals to keep you on track. Using a heart rate monitor isn't a bad idea either. The Polar models are great at tracking you calories, heart rate, time etc..
6. Get a workout buddy. It's amazing how effective having a workout buddy can be! Someone to hold you accountable for your workouts. Someone with similar goals that you can, essentially, race towards against. I know I love a good competition!
7. Break up the monotony with a little cross training. If all you do is run the same distance at the same intensity every day your body will plateau and your progress will cease. Change it up weekly. Run a couple days and hit the bike, the pool, the rower the basketball court for a pickup game once or twice a week. The change will keep you mentally engaged making it more enjoyable and in turn more long term! Nobody likes doing the same darn thing everyday for 30+ years, or do you!? haha
8. Listen to your body. If at any time you start feeling light headed, dizzy, nauseous or pain that ordinarily isn't there don't be scared to stop. Better safe than sorry. You're not an international athlete so theres no reason to push too hard. Be smart and be safe
I hope all this has been helpful. If you feel I've left anything off feel free to let me know and I'd be happy to add it. Best of luck with your running and feel free to stop in for an adjustment anytime.
Just wanted to share a thought from a conversation I had with a colleague yesterday. We were discussing patient care and progression through pain and we started talking about home care instructions.
Its important to realize that when you, as a patient, experience pain, its more than likely that your lifestyle is the biggest variable in the equation! To put it another way, the things you do on a daily basis are the reason you are in pain/dysfunction. All the negatives and the positives combined are resulting in pain. Which, in a way, is saying you are living an unbalanced life.
You might ask "what do you mean unbalanced?" Thats easy! It could be a number of things leading to the imbalance. It could be your work, diet, family, stress, workouts, hobbies, relationship, etc.. Ever hear the saying "all things in moderation" or any number of variations? It couldn't be more true when looking at life. Most anything can be a positive in life as long as you don't overdo it.
So with that in mind when a patient comes in with back pain its not only my job to treat the specific pain at the moment, its also my job to identify the imbalances in their life that may be contributing to their current dysfunction. I can add positives, treatment and exercises, but if I don't identify and eliminate negatives, bad posture or bad diet, the cycle of dysfunction continues.
So the key to balance is eliminating negatives. Adding positives, home exercises etc., won't do it alone. Without identifying negatives and removing them your routine is just muddying the waters of progress. It kind of reminds me of the definition of insanity: repeating the same action expecting different results. If you want change you have to make change! I can acquire all the licenses and certifications in the world and they can only do so much for you. The real improvement comes when you make the decision to put in the work!
For all of you out there that don't feel great on a daily basis and don't know why, kids aside! For you that don't feel as young and spry as you did 10 year ago or even a few years ago. For those of you who have noticed a spare tire shaping up around your hips. This is for you!
Movement is as close to a fountain of youth as any of us will find! There is no miracle pill, no treatment, no diet that will lose the weight or get you out of pain faster than just getting out and moving! Our bodies are designed to be constantly moving. Think back 500 or 1,000 years ago and imagine how unsuccessful the human race would be if we lived as we do now, sitting most of the day. You don't have to be a brain surgeon to recognize the obvious answer here. You might suggest we live longer now than back then and you'd be correct. The average life span, depending of the time your referencing, has nearly doubled in most societies. Unfortunately what that number fails to consider is quality of life. First world amenities aside, we are living longer but breaking down faster. Whats the point of living 150 years if you're confined to a bed for 80 of those years!? No thanks!
So, what to do? Simple, ANYTHING!! Now depending on your current level of physical fitness there are many different entry level activities that you can enjoy both physically, psychologically and socially. These days the new fad to introduce many people is the Fit Bit, counting steps in a day. I'll take it if it gets you started if gets you on the road to movement and its something you can do pain free. However, for many people this is both the start and finish lines. They never progress past walking. My problem lies in the fact that walking isn't good enough, its entry level and never REALLY challenges the cardiovascular and musculoskeletal systems like other exercises/activities can and do.
Now, I am speaking to those of you that are able bodied and quite capable of progressing but choose not to. Why?? Why do you stop here? Is it a lack of understanding, are you lazy, not enough time, are you uninspired? If you don't understand what you need to do, thats cool, ask someone! There are too many gyms and trainers around to use this excuse. They make their living to inform you on how to exercise properly. Lazy?? Heck, we're all lazy from time to time! I'll challenge you to make excuses TO workout instead of making excuses to stay on the couch or in bed! If time is your limiting factor, easy! Work smarter and harder! Be efficient with your workout by ramping the intensity. In the gym setting, instead of doing 30 minutes of cardio then 6-10 exercises spending 10 minutes at each station do them at the same time! Make a circuit of your workout where you go from one exercise to the next with little to no rest in between each set. You can easily condense a 90 minute workout into 30 minutes and still get all the work in! If you're the one that starts running to get in shape and can't make it more than 2 weeks before you fall out of the habit. Sounds like you need to find something that you enjoy more. A field sport perhaps: soccer, rugby, ultimate frisbee are all great workouts. For the colder months there are just many options: martial arts, Cross fit, racquetball, basketball etc.. If you don't enjoy what you're doing for fitness it'll never last! You gotta find things you enjoy, that challenge you both physically and mentally! For those who are less mobile or just not at the level of running or weight training, cool, we all have a different starting point. AS long as you're willing thats all that matters. For you, theres plenty to do as well: Yoga, swimming, the stationary bike, elliptical machine are a few examples.
Now, a very important part many people overlook is health measures. Yeah, you might have been a phenomenal high school athlete but if that was 20 years ago, you aren't him/her anymore! Things change and they don't change for the better. If you haven't even thought of hitting the gym in 20 years its not like riding a bike, you could hurt yourself and then your movement plan just got shelved for 4-6 weeks if not longer. Be smart and get checked out by your Primary care physician to make sure you're not gonna have a coronary in the first 10 minutes. Get a functional movement screen so you know where you are physically and can be made aware of any biomechanical restrictions that could lead to injury and if you're already in pain (shoulder, low back, knee, ankle etc.) you need a Selective Functional Movement assessment to correct existing biomechanical deficits, both of which are done in the office.
At the end of the day you need to be moving to keep living and it needs to be more than a few weeks at a time. It should be a part of life, not just something you do when you have time. I understand we all have things going, other priorities but when it comes to your health, your life, many of those "things" can and should wait. If your efficient and can plan properly there is always 30-45 minutes to spare for a little time to get the heart rate up! Just make sure you do it safely and smart!
Now when I ask the WHY, I don't expect to hear answers like "arthritis, bad ankles or old injury". These are not the "WHY", they are simply contributing factors. I'm looking for "whys"! You USED to be active. You USED to be pain free. You USED to be able to touch your toes. You USED to be able to roll over with minimal effort. Now? Not so much, yeah? I know what I'm capable of doing and have a good understanding why, but then again thats my job. Do you know why you can't touch your toes? I'll be willing to bet it can be isolated to 3 possibilities: Tissue, Joint or Motor control!
In the Selective Functional Movement assessment there are 3 possible explanations (aside from anatomical variations, congenital or acquired) and they are as follows: 1. Stability Motor Control Dysfunction (SMCD). 2. Joint Mobility Dysfunction (JMD). 3. Tissue Extensibility Dysfunction (TED). With any dysfunction, usually indicated by the presence of pain, there will be either a stability or mobility dysfunction and in some cases both can be present. So what are these 3 categories, allow me to explain.
The Stability motor control is the neurological side of things where the brain has forgotten how stabilize a joint during active motion while in a weight bearing position. In the scenario where a patient can't touch the toes while standing but can do it while sitting on the ground, it tells me there is something wrong the brains understanding of stability somewhere in the posterior chain. At which point we would issue motor control exercises to rewire the connection (so to speak) for the brain and retest for improved stability.
The Joint mobility Dysfunction (JMD) is much simpler in nature. It is very simply what it sounds like. It's what we use to label a joint that cannot physically move, active or passsively, with in the normal anatomically accepted ranges of motion. At this point the joint is "stuck" or "subluxated" and is in need of mobilization or chiropractic adjustment to reintroduce the proper motion in the joint. A good example would be when a patient is unable to touch their chin to their chest in either a vertical or horizontal position, actively or passively.
The Tissue Extensibility Dysfunction (TED) is similar to the JMD in that they are both mobility issues. Obviously they differ in the nature of the mobility restriction, but they can be equally troublesome. In this case the active/passive ranges of motion in weight bearing and non weight bearing are are restricted. The difference is noted in the passive range of motion when the end point of the joint is a soft "bouncy" feel to it, while theJMD has a "hard" stop to the motion that is finite in nature. For the patient, the TED illicits a "stretch" in the hamstrings (back of the leg) when touching the toes and the JMD would be pain in a joint when being pushed to end range.
If you are in pain, annoying or debilitating, you have dysfunction and all the aspirin, advil, TENS units, copper wraps, kiniesiotape, pain pills etc. are gonna fix it! The only way to fix it is proper assessment, diagnosis and treatment will get you started in the right direction. after that its up top you to put in the work. Improving dysfunction is not a passive activity. You can't just sit there while the doctor or physio does they're magic to make you whole again, we all saw how well that worked for Humpty Dumpty!! As a responsible physician I can only tell you what is wrong and provide a little guidance, but you have to put in the effort to make it work!! So let's get you feeling better together and see where it takes us!! look forward to seeing you in the office!
Known as the SFMA, you may be more familiar with its predecessor the Functional Movement Screen (FMS). If not familiar and you're an aspiring athlete then you should! The SFMA is a series of movement used to evaluate an individuals basic functional movements providing a road map to their pain or eventual dysfunction.
One of the biggest problems with todays healthcare, as a whole, is the tendency of physicians to "chase the symptoms" or treat pain. For many people this is great! They go to the doctor in pain and get pain pills, massage, adjustments or any other number of palliative treatments. They essentially are getting pampered and lets be honest, who does like getting pampered!? The problem is that none of this provides long term relief. When you chase the symptoms/pain you are ignoring the problem! Don't get me wrong, on occasion the pain and dysfunction are one in the same, especially in a scenario where there is a direct trauma to the area. However, when dealing with chronic pain, like like back pain, to isolate treatment to just the low back you are ignoring the problem.
First the FMS. The FMS is a series of 7 functional movements designed to screen athletes for movement deficiencies. The idea is use this tool to predict the likelihood of injury with activity. These movements are not complicated yet most people are unable to perform these basic motions adequately. The FMS is usually implemented with pre-participatory screenings for personal trainers, gyms and team sports. The screen is not designed to be diagnostic in nature. It is simply a pass or fail test that tells the coach, trainer or instructor whether or not the athlete should be attempting the activities upcoming.
Now the SFMA is a much more diagnostic set of movements. There are a couple movements that they share but where the FMS stops at pass or fail the SFMA takes the fail and asks "why". Once movement limitation or dysfunction is identified further tests are implemented to differentiate between mobility or stability problems. In the SFMA there are 3 different types of dyfunction: Joint Mobility dysfunction (JMD), Tissue Extensibility Dysfunction (TED) or Stability Motor Control Dysfunction (SMCD). Once these are identified in either the joint or the spine rehab protocols are in place to correct said dysfunction. Exercises are designed to either create stability or mobility in the appropriate joints where the SFMA indicates. The best part...... Pain is not a requisite for these tests to elicit positive indicators. The SFMA can indicate dysfunction both before and after pain is present! As a matter of fact, for those of you who feel as though are in tip top shape I'd challenge you to make it through the SFMA without any dysfunctional movement indicators.
So, In the event you're in the market to prevent/remedy dysfunction, pain and/or injury the SFMA is something that would be useful to you. Regardless of your level of competition (Olympics, high school, college or recreational) or sport (baseball, rugby, ultimate, swimming etc.) the SFMA is an invaluable tool for preventing injury by identifying faulty movement patterns before they cause pain.
A quick thought about what most people know as "core stability". How many of you out there are familiar with the constant battle between form and function? To put it another, simpler way: Looks versus functionality! AHHHHH, yes!! Pretty sure EVERYBODY is familiar with this one! Girls, those high heels you LOVE to wear out on a hot date but almost invariably end the night carrying them instead of wearing them...... Yes they LOOK amazing, but it doesn't take long to find out they aren't very functional! Guys, Those big trucks we like to drive sure look nice until you do the math on the petrol bill! So heres another one I think is very commonly overlooked when it comes to exercising and core training.
So according to all the magazines a strong core would look something like a six pack with that nice little "V" starting at the waist line going down into the groin area. Yes, it is very appealing to the eye and considered a good look by most. The reality: it's just "window dressing" and from the functional rehab standpoint indicates core INSTABILITY! This look indicates that you do a great job working your rectus abdominus muscles (the 6-pack muscles) and an even better job ignoring the rest of your abdominals! If your wondering what this actually means; you're only working 2 of the 8 abdominal muscles (4 on each side). It doesn't take an engineer to recognize the eventual problems when only 25% of the stabilizers are used to support a structure! Now don't take that to mean that everybody that has a six pack is gonna get hurt, rather when you DO experience some sort of pain/dysfunction a possible explanation is that due to core instability everything else (arms and legs) are unstable as well. After all, all movement starts must start with a solid anchor and for the human body the core is the anchor for our extremities.
If there are any questions I encourage you to make an appointment (multiple options) so we can discuss any concerns you may have.
Most everybody at some point will experience low back pain. If you're lucky its short term and very mild! Unfortunately, this is not the case for most of us and for a small percentage of us we will experience life long, debilitating low back pain! In almost every case it could have been prevented with a little foresight and hard work. For those with low back pain caused by a major trauma (car crash etc.) this article may not provide much insight but it may help you understand a little more about your pain and suffering.
What is the psoas!? The psoas muscle's primary job is to perform hip flexion. Its attachments are as follows: the proximal attachment is at the anterior aspect of the lumbar spine, it then runs down through the pelvis and attaches to the lesser trochanter of the femur (inner thigh). So what is hip flexion? To put it simply, anytime your knee gets closer to you chest or head, hip flexion is occuring. Examples include: sitting, running, walking, sit ups (not crunches) and leg raises.
Ok, so what does this have to do with back pain? Possibly nothing but theres just as much chance that its a direct contributor to your daily discomfort. When you consider our lifestyles include a lot of sitting (daily commute and desk jobs) and bad posture it makes sense that the psoas can become shortened and when it becomes shortened it pulls at its attachments on either end. How does it become shortened? Muscle memory or habit! I'm sure most everybody is familiar with muscle memory, but in case not: Muscle memory: the ability to reproduce a particular movement without conscious thought, acquired as a result of frequent repetition of that movement. So to equate that definition to our current topic, When you sit around (at your desk or in traffic) for 8-12 hours/day (30-50% of your day) the psoas becomes conditioned to remain in a contracted state. So know when you go to lengthen it by standing, it resists and does what it can to remain in that shortened position. When it does that the majority of the pulls goes into the lumbar spine resulting in constant lumbar spine extension. So what does this mean? Well for one, when you're in constant lumbar extension the posterior elements of the vertebra are compressed and two your spine is in a less than optimal weight bearing position when in extension. The spine is designed to be its strongest in neutral, allowing for short term stability when in flexion or extension. Prolonged hyper lordosis (exaggeration of the natural lordotic curve of the lumbar spine) can lead to permanent changes in the structure of the vertebral bodies as well as ruptured intervertebral discs (think spinal sciatica) at which point your intermittent low back pain is now chronic if not permanent.
So how do I prevent this? Easy, a little hard work never hurt anybody, right!? It starts with being conscious of your posture and making sure to stay balanced. Don't sit too long at your desk, get up and move around. Our bodies aren't designed to sit all day, so keep moving. Stretch the psoas. The hurdler stretch many of us know from youth soccer is a good one. Make sure to push through the hips and not through the chest. If you're extending your back to get a stretch you'll feel it in the quads and miss the boat. When done properly you should feel the stretch in the groin. Massage can be helpful with right LMT. Chiropractic care is a big part of it. In most cases the psoas is just a small part of a bigger picture and proper diagnosis is necessary to formulate an effective care plan, which should include adjustments, soft tissue work and exercises designed to correct any muscle imbalances.
At the end of the day its up to you to do something if you're in pain. Pushing the pain out of your pain will only result in 2 things: 1. more pain and 2. Longer recovery period. So I highly recommend anybody with anybody with back pain or any pain for that matter, take the initiative and let a professional get them on the right track to wellness. We aren't getting any younger people! As always, If you have any questions feel free to schedule a free 15 minute consult or a new patient visit form the website and I'll be happy to see what we can do together.
In the previous article I talked about the dynamic joint stabilizers. Part 2 is focusing on the static stabilizers or ligaments and joint capsules. The static stabilizers are designed form a hard barrier limiting joint range of motion, much like a rope tethering a ship to the dock. There is play in these ligaments but once the tensile threshold is exceeded they will fail and allow the joint to exceed normal anatomical limits. Once this occurs the joint is no longer stable and more times than not surgery is required to reestablish a base of stability. The Anterior Cruciate Ligament is a good example that happens quite often. Once ruptured most athlete's season is over for surgery and subsequent rehab for 9-12 months depending on the nature of their competition or extent of injury. The important part of surgery that many people overlook is the need for proper rehab both before and after surgery. As discussed in part 1, the dynamic stabilizers are the real safeguards to joint control and in order to make a full recovery and prevent repeat injury the dynamic stabilizers are the ones to focus on. In the case of a non-contact ACL injury there is an imbalance in the hamstrings and quadriceps that causes the ACL rupture. So once the rupture occurs, surgery is performed and rehab begins if careful attention is not paid to correcting previous aberrant muscle activation, balancing the quadriceps and hamstrings properly, the same injury will occur later on.