Post pregnancy FYI

Post pregnancy FYI

    For all you mothers out there, The post-pregnancy period is hard, right?  Not that I would know, but I've been told...... by all of you!! haha, #funnynotfunny.  On a serious note though, I was working with a patient, just the other day, on her breathing when she made an interesting comment about her pregnancy.  As I was describing the importance of utilizing the diaphragm to drive inspiration she noted how impossible it was the last couple months of her pregnancy.  She then described her mindset was that of "whatever it takes to get this kid out of me".  I understand not all women share the same sentiment but everybody has their breaking point and not all of us are strong like an Oak.  

benefits-to-doing-kegel-exe-600x600.jpg

    The more I thought about this interaction I realized postpartum stabilization is generally overlooked.  Post-pregnancy can wreck the female body; abdominals, pelvic floor, hormones, breast tissue, back, feet, hips..... I'm sure there are many more I'm forgetting, but for now, we get the point, right?  For most mothers, the most common "recovery" tools utilized are Kegel exercises, spa days, massage etc..  Unfortunately not all mothers have the opportunity or funds to splurge on the later of those options.  Luckily, of the options mention above the one that is free and can be done anywhere is Kegel exercises.  If you are among the minority of females that haven't heard of Kegel exercises, they are exercises designed to target the pelvic floor muscles.  Considering the amount of trauma the pelvic floor goes through during labor, not to mention that it controls bowel and bladder function, it's probably the most important to pre-hab and rehab before, during and after pregnancy.  

download.jpg

    For you overachievers out there; if you want to retake your pre-pregnancy glory (assuming you aren't that unicorn that does it naturally) then I would urge you to spend some time working on Transverse abdominus and diaphragm function.  Uhhhh, yeah! Good point! How do I do that?  Easy, just breath!  Ok, it's not that easy, but it's not hard!!   

 Many people with acid reflux (heart burn) find relief with rehabbing their breathing pattern.

Many people with acid reflux (heart burn) find relief with rehabbing their breathing pattern.

    So to rehab your breathing pattern from dysfunctional (chest breathing) to more functional (diaphragm) you start on your back with your legs elevated (hips and knees at 90 degrees).  You then place one hand on your chest and the other over the belly button.  This is the setup position that allows you to offload the lumbar spine from any weight-bearing and the hand position allows you to monitor the areas of movement while breathing.  Once you've gotten into the proper position you know just breathe.  Now the key to this is breathing into the lower hand keeping the upper hand (on the chest) still.  Many of you will find this difficult at first.  The idea is to, during inhale, you push your lower hand (belly button) to the ceiling as best you can.  You will want to relax everything in the abdomen to do so.  Once you can do this with ease and good expansion in the belly you are on the right track.  At this point, you are able to contract the diaphragm functionally and that is the start of re-establishing transverse abdominal activity by resisting expansion at the belly button and redirect that expansion into the love handle area (area between the ribs and hip on your side) and lower abdominals (below the belt line, in the groin area).  If you can do this you are on your way back to a stable core and lumbar spine.

   If any of the above instructions are unclear feel free to call the office for a free 15-minute consultation with Dr. Aylor.  If you have mastered the above skills and are keen to progress from there to more functional movements to further stabilize the trunk, pelvis, hips or shoulders schedule an appointment from the website or call the office for your first appointment with Dr. Aylor.  I hope this helps, take care and hope to see you in the office soon.  Cheers

Functional Stability

     What is functional Stability?  I'd define it as the ability to perform work while maintaining a neutral joint position.  Ok, sounds great but what the heck does that mean?  Well, let's see.....  Let's try a little self-check: Do you have unexplained low back, neck, shoulder, knee or hip pain?  If you answered yes, then you are not functionally stable!  If you can't remember an event that caused your pain then there is something about your movement pattern, stabilization, that is flawed.  You have dysfunctional movement stemming from improper stabilization patterns that have culminated in pain!

   So how can you tell?  It starts with breathing patterns, then we go to the abdominals and no I'm not looking at your six-pack or lack thereof.  Matter of fact I'd say those of you that have a six or 8-pack of abdominals are just as dysfunctional as those without!  Why is that, you may ask!  That's because they aren't the abs that stabilize the spine.  The Transverse Abdominals are the ones that I'm concerned with.  Their ability to resist expansion in all directions while inhaling and maintain tension during the exhale is what provides core stability more than any other abdominals muscle.  The Diaphram is #1 followed closely by transverse abdominals.  The deeper the muscle is the more stability it's designed for and the more superficial muscle the more its meant to perform gross movement or locomotion.

   So what does this have to do with my shoulders, hips, or knees?  When the shoulder, knee or hip move they require a stable foundation to move properly, maintaining optimal joint centration during movement.  When the abdominal area of the body is properly stabilized (appropriate activation of the diaphragm and Transverse abdominals) the muscles designed to move the extremities are now required to work overtime to both move the joint AAAND stabilize it on the torso, which is inherently unstable at this point.  These muscles are terrible at stability, which results in faulty movement and eventual pain due to premature joint deterioration.   

     For those of you not in pain at the moment and curious about your stabilization mechanisms please take advantage of our free Functional Movement Screen, offered for a limited time.  There is no obligation for care with this screen.  Its simply offered as an education tool so you can be aware of where you are and what you may need to change going forward.  IT only takes 15 minutes and is a brilliant tool for establishing your movement I.Q..

 

Functional Movement Screen

Functional Movement Screen

   For those of you out there constantly on the move, I would like to introduce you to the Functional Movement Screen (FMS).  If you haven't already heard of the FMS its something with which you should be familiar.  Whether you're an aspiring athlete or well established one, the FMS is the gold standard for assessing quality movement.  Since being introduced back in 1997 by Gray Cook, a well-known name in the physical therapy world, it has become the one tool used to screen for potential injury in active people.   

   So what is the FMS then?  Simple, the FMS is a series of 7 movements that combine strength, stability, and flexibility.  With movements like the overhead squat and inline squat patients are required to stabilize numerous joints and segments in order to achieve whole body movements.  The inability to achieve these movements, some or all, allows the physician to predict the likeliness of injury in the athlete going forward.  The test is scored on a 0-4 scale for every movement: 3 points for full movement as described. 2 points for limited, mild difficulty,  achievement of the motion described.  1 point for inability or moderate to severe difficulty achieving the movement.  0 points are awarded if pain is experienced at any point during the movement.  It's important to understand that the FMS is not designed to elicit painful movement

FMS.jpg

     It's important to understand that the FMS is not designed to elicit painful movement.  If at any point during the FMS you experience pain the FMS should be stopped and done at a later date when the painful movement has been remedied.  When painful movement is present it is important you find a healthcare professional for a Selective functional movement assessment (SFMA).  The SFMA is better designed for painful movements.  It's structured so that the pain can be isolated and identified.  But the SFMA is another topic for another day.

   So if your concerned about yourself or even your children experiencing injury due to your activities the first step is to get your movement screened for dysfunctional movement.  After we know how well or poorly you move we can provide exercises that will help to prehab your movement that will help to prevent those silly, inconvenient injuries that never seem to go away.  

Copy of C-Posture

Copy of C-Posture

 This is C-Posture at its finest!  All angles are bad here but the most obvious is the big hump in the middle of this gentleman's back.

This is C-Posture at its finest!  All angles are bad here but the most obvious is the big hump in the middle of this gentleman's back.

In the Golf world, there are 3 setup postures: C-Posture, S-Posture and neutral posture.  I'm sure somebody somewhere is the exception to that rule but we're not talking about them today! Today we are talking about the C-posture.  So what is the C-posture?

    The C-posture presents with overly rounded upper shoulders over the ball.  When setting up to hit the ball this player rounds his chest over the ball instead of bending at the waist.  The same player usually walks around with a similar posture.  His/her head is forward of the shoulders and the shoulders are pulled forward from the spine.  These folks have an abnormal posture in general and it carries over into their golf game.

 This is a nice neutral swing.  See how there is no obvious curve in the spine?  This is the start of a good swing!

This is a nice neutral swing.  See how there is no obvious curve in the spine?  This is the start of a good swing!

   So what the problem with C-posture?  Is it bad for me and my game?  Why do I care?  You should!  if not for your golf game then for your everyday activities!  This bad posture can cause a number of problems in life and golf!  Another name for C-posture, in general, is upper crossed syndrome and it can contribute to breathing complications.  With C-posture a player will most likely have problems achieving a full backswing in a good position.  The lack of motion in the thoracic cage will limit thoracic rotation and extension meaning the player will recruit from other joints for the motion.  This recruitment causes instability and results in excessive wear and tear in the joint which will manifest as pain and injury at some point.

 This is a side to side comparison of all 3 variations when setting up on the ball.

This is a side to side comparison of all 3 variations when setting up on the ball.

   So how do we fix this "C Posture" then?  That's easy!  Find your nearest TPI golf or Medical Pro and have them put you through the TPI 16 part golf specific movement screen.  From there we can isolate each player's physical limitations and treat specific dysfunction.  Without a proper diagnosis, the physician is just guessing.  If you're going to spend the money and the time on getting better you desrve specificity!

Golfer's elbow v. Tennis elbow

Golfer's elbow v. Tennis elbow

 The inflammation is in the periosteum of the bone due to constant pull from the muscles/tendons from wrist extension.

The inflammation is in the periosteum of the bone due to constant pull from the muscles/tendons from wrist extension.

If you're scratching your head as to why these two are being compared, keep reading!  It'll be very clear in a few short paragraphs.  And just to make sure you are on the right page; Yes, these 2 problems both apply to the average golfer.  I'm pretty sure if you're experiencing elbow pain you're nodding your head in agreement.  So let's get to it, shall we! 

   I'll first explain the difference between the two problems.  Tennis Elbow, or lateral epicondylitis, is inflammation of the extensor muscles of the forearm.  There can be a number of explanations but when treating a golfer or tennis player its usually due to excessive forces created when the wrist is held in extension too often under load.  Over time these excessive forces irritate the bone on the lateral side, outside, of the elbow.  What does this mean?  It means your extending the wrist during your swing when you shouldn't be.  Most times its occurring in the lead hand, it can happen on the trail hand as well but is much more frequent in the lead hand.

 Chicken-winging can be the result of improper shoulder mobility and/or an Over the top swing.

Chicken-winging can be the result of improper shoulder mobility and/or an Over the top swing.

  Golfer's elbow is caused the exact same way but with excessive flexion of the wrist during load.  Meaning, for a golfer, during the swing your wrist is cocked far too much, resulting in excessive load into the medial epicondylitis or inside of the elbow.  

  Both of these scenarios can be very painful, even debilitating, if not given the proper medical attention and rest.  If by chance you find yourself struggling with this frequently, you may need to seek out professional swing help.  The most common symptom for Tennis elbow in golfer's is "chicken winging".  If not familiar with this term you DEFINITELY need to seek help with your swing.  The reason being is that in the scenario in which you are suffering from Tennis elbow, seek proper medical treatment and don't identify the faulty swing mechanics causing the problem you will be back to the medical physician regularly for the same thing over and over again!

 Scooping is another flawed swing pattern resulting in Tennis elbow.  

Scooping is another flawed swing pattern resulting in Tennis elbow.  

    So now the good stuff!  So how do I keep this from happening?  Easy...... Kinda!!  It's easy if you go to the right folks but it's gonna be hard work fixing it once you have a proper diagnosis.  With a proper diagnosis of physical limitations, both painful and nonpainful, the medical physician can identify areas for improvement in the physical screen as well as areas that may be constants (things like anatomical anomalies that can't be changed no matter the amount of treatment, scoliosis is a good example) that have to be worked around.  Once these variables and constants have been identified communication occurs with the fellow golf pro that now takes this information and uses it to find the most efficient swing for you, as a golfer.  This is important because it's important you understand its not about turning you into Tiger Woods or Dustin Johnson but rather finding the swing that is most efficient for your body and body movement. 

Titleist Professional Institute

Titleist Professional Institute

 A couple of the TPI stalwarts Greg Rose and Jason Glass rehabbing a golfers biomechanics

A couple of the TPI stalwarts Greg Rose and Jason Glass rehabbing a golfers biomechanics

   For the Golfers out there I would just like to announce I am officially a certified Medical professional registered with the Titleist Professional Institute (TPI), Level 1.  So what does this mean?  For you, as a golfer, it means a number of good things like golf specific care and understanding of the biomechanics of what may be affecting your performance or causing injuries.  It also means I have a access to a network of golf professionals that are able to take care of any and all of your golf related needs: fitness, medical and swing coaches.

 Chicken winging can results in excessive tension on the lead elbow resulting in lateral epicondolitis or "Tennis elbow".  This may be a result of decreased lead shoulder strength or shoulder stability or an "Over-the-top" path to the ball.

Chicken winging can results in excessive tension on the lead elbow resulting in lateral epicondolitis or "Tennis elbow".  This may be a result of decreased lead shoulder strength or shoulder stability or an "Over-the-top" path to the ball.

   In the event you've never heard of this so-called TPI, I've already met a few golfers unaware of its existence, you're missing out!  The TPI takes pride in assembling great teams of like-minded professionals to help all golfers return to healthy play, stay healthy and get the best from their clubs and body.  Whether you're a junior or seasoned veteran that's played every course in the western US, the TPI pro can help.

   So what do we do?  Although many of us come from a spectrum of different disciplines we are all trained to identify swing characteristics, movement screen and golf specific terminology.  This is the meat of the level 1 certification.  After level 1 we are allowed to go into discipline-specific further education as it applies to our profession.  The golf pro would delve into more swing mechanic specific material, the fitness professional would go further into golf-specific fitness material and the medical professional dives into golf specific injuries and how to rehab for return to play. 

 Reverse spine angle Is a big contributor to low back pain due to increased lumbar extension that be caused by a number issues in the lower or upper extremity.

Reverse spine angle Is a big contributor to low back pain due to increased lumbar extension that be caused by a number issues in the lower or upper extremity.

    What does this mean for the average player?  Simple, it means that when you seek out assistance from a TPI pro you are privy to a team of professionals to get you back on the course faster, stronger than before, fitter than before and with a more efficient game which should result in lower scores in no time!

   "So what is the medical side of things", you might ask?  Simple, with the experience of the TPI's staff, led by the infamous Greg Rose who helped to create the functional movement screen and selective functional movement assessment, they have constructed a 16 part movement screen that identifies limitations in any golfer that can help to identify possible swing deficiencies.  Why is this important?  Even easier, when movement deficiencies are identified we are able to recognize compensations and predict injuries.  When movement deficiencies are identified they can then be eliminated with appropriate interventions including chiropractic adjustments and rehabilitative exercises to stabilize or mobilize areas in need.  

 Early extension is another Low back killer due due reduced mobility in the spine that can easily by fixed with a course of care with a certified TPI medical physician.

Early extension is another Low back killer due due reduced mobility in the spine that can easily by fixed with a course of care with a certified TPI medical physician.

    The TPI also goes the extra mile to ensure every TPI pro is familiar with the game of golf.  Not necessarily that we all play, which I do, but more by way of requiring us to understand the terminology of the game.  This may not seem important but when my golf pro sends me a player that has a problem with early releasing, chicken winging and elbow pain I need to know what that means straight away.  Without that understanding of those terms, I would be wasting both our time screening something that I've already been given the keys to the castle to jump straight into treatment.  Oh, by the way, I do play!  I even have my own clubs, that may or may not fit my taller frame.  Haha, make sure to ask me when you see me, I may be getting some new ones in the near future. 

 Your approach stance can tell us a lot about whether you already have back pain or will develop it in time.

Your approach stance can tell us a lot about whether you already have back pain or will develop it in time.

    So if you're serious about your golf; getting out of pain, dropping your score, being able to play more than just 9 holes before you fatigue or fix that "Charles Barkley-esque" hitch in your swing got to MYTPI.com today, click the link "find an expert", enter your postal code and find the fitness, medical or golf pro for your needs.  And if they are doing their job they will have a network of pros to refer you to for the areas they don't work in.  

 

    

Intra Abdominal Pressure

Intra Abdominal Pressure

Notice the core and its shape, perfectly rounded to stabilize the enormous weight being lifted.

Child developmemt

DNS BASIC B class day one and good stuff already being shared!  Although some of us may already know this I’ll share anyway: when it comes to child development, mentally and physically, for sport it’s best to expose your kids to as many different activities as possible. This exposure increases their physical and mental development by challenging the body in many different ways. These challenges are most effective before the age of 10 when they are the most impressionable. Soccer, basketball, baseball, ultimate, etc. AMYTHING and everything you can make time for, whether they are good or not makes no difference.  These early challenges make for a more well rounded child and adult later in both physical awareness and cognition. 

Joint Mobility and Golf

Joint Mobility and Golf

download.jpg

    Nearly all of us out there are active folks. Ever notice excessive soreness or tightness in the low back, hips or neck after a regular day of golf, Ultimate or soccer? Have you ever noticed PAIN during or after activity? I know most of us have and yes, we aren't as young as we used to be but that's just an excuse and doesn't need to be the case on a daily basis.

    The folks over at the TPI (Titleist Pro Institute) recently brought to my attention something I  already knew but had slipped my mind. They were so kind to point out mobility of a player's joints can play a big part in their swing, effecting ball-striking efficiency. The golf swing, for example, requires movement of the hip, low back and thoracic spine (to name a few) in numerous directions, simultaneously, and when mobility is lost in one, it is pulled from another.  

 Back pain is very typical for golfers without proper mobility due to the high amounts of force generated from the hips.

Back pain is very typical for golfers without proper mobility due to the high amounts of force generated from the hips.

   The body is designed to alternate mobile joints with stable joint.  Whats this supposed to mean? Well as you look at the body in terms of "joints" you will see a pattern of alternating types of mobility.  A mobile joint would be one that can and does move in multiple planes/directions freely.  A stable joint would be one that moves in one plane primarily, they all move in multiple planes but in a stable joint the motion is disproportionately in one direction.  Mobile joint examples would be the shoulder and the hip.  They are easily moved in all three anatomical planes with little effort, when healthy.  Stable joints would be best described by the elbow and knee.  These joints primarily flex and extend in the sagittal plane (front to back) with little rotation or side to side movement.

    Ok, so why the anatomy lesson?  That's easy!! Based on the above model, the golf swing involves everything from the arch of the foot all the way to the wrist.  With a loss of joint motion in one area, specifically a mobile joint, the mobility requirements are transferred to the joint above and below.  A good example is mobility restriction in the hip that requires an increased mobility requirement from the lumbar spine and knee.  Although this may not cause immediate pain or discomfort, if done long enough the system will fail and at this point, pain is introduced.

  Why is this important?  A couple reasons: 1. Painful activities aren't very fun.  2. You don't play as good when you're in pain.  3. Pain causes altered stabilization patterns that can affect the stability of the system long term.   I could go on.....  The point is that proper flexibility and mobility of your joints is imperative for long-term enjoyment of ANY activity.  

    How do I get fixed?  The "old-school" approach to back pain was simply strengthening the abs or "core" muscles.  That's good and all but if your problem is mobility (lack of) what good does it do to strengthen?  If there's a lack of mobility in a joint it needs mobilization.  Strengthening only applies to joint instability, which may apply to the low back that's compensating for an immobile pelvis or thoracic spine.  Mobilization (chiropractic care) is what is needed for an immobile joint.  But before that, proper screening and assessment are required to isolate the primary causes of your pain and dysfunction.  Without a proper diagnosis, we are just shooting from the hip hoping what we are doing fixes the problem.  

New Parents

     Those of you out there with newborns be sure to get them screened regularly for neurological developmental stages. It's important to monitor their progress physically to confirm the proper neurological progress. It's important you stay on top of this aspect of development so you can catch flaws early and correct them. No one wants to think their child is anything but perfect but the truth is that you have to acknowledge when something isn't right and the sooner you do so the better off the child is. If caught early you can find the proper care and help to decrease the deficit while the child is still moldable, if you wait too long their ability to rehab the deficit is substantially hindered. They are absolute sponges and much like Play Dough in the first 5 years of life, after that they have a foundation of mental and physical competence that is significantly harder to un-train. At the end of the day a birth defect isn't a reflection of your parenting it's just a fact and the sooner you acknowledge its presence the sooner you can seek treatment and provide the child with the life tools needed to be successful in life. We can't be there to take care of them forever so do them a favor and give them the skills they'll need when you're not around to do it for them anymore.

Heres a few things to look for an approximate time you should notice it:

- at 4-6 weeks: optical fixation, primitive reflexes diminish, Co-activation of muscles, Postural activation of phasic muscles, the fencer's stance.

-3 months: when face down they are head up with weight on the elbows and pelvis, Galant reflex and grasp reflex diminish, lateral grasp, foot to foot touching when on their back.

-4.5 months: tripod support (elbow, hip and opposite knee) in prone and grasping object, asymmetrical trunk lengthening.

-5-6 months: rolling (back to front only), grasping across the midline, they push up onto their hands and thighs, hand to foot coordination, most primitive reflexes should be gone at the end of 6 months.

7-9 months: rolling (front to back), quadruped position (hands and knees, 7 months), grasping a toy in quadruped in month 8, crawling by month 9, pincer grip (thumb and forefinger opposition) 9 months.

Hope this helps. For any clarification please don't hesitate to make an appointment and clarify. --Cheers

See the Forest for the trees........

See the Forest for the trees........

   When rehabbing an injury it's important not to lose sight of your goals.  Many time in traditional, old-school thought of rehab, the clinician and patient get so focused on individual muscles to be activated they fail to recognize the dysfunctional system, hence the "forest for the trees" comment.

   Rehabbing individual muscles does not make a dysfunctional system functional.  that sort of thinking would be no different than thinking a replacing the engine of a rundown old junker suddenly makes it a hot rod! There can be some muscular rehab for some injuries but to apply that to all scenarios and limit rehab to isolated muscle activation would be ineffective.

    The emerging trend in rehab is to train the system.  The muscles you would normally rehab have to function appropriately within the system they are a part of in order for the system to be efficient.  Therefore it only makes sense to train the system as a whole.  

   In order to do so, you have to remove the stress of being upright, weight bearing.  If/when the system fails in weight bearing you take it down to non-weight bearing, like kneeling or sitting.  If that is still too much for the system take it down further to a suspended spine (hands and knees).  And if this is still unstable then you take it back to the most basic of positions, on you your back.  From here you are in the simplest of position and have removed all postural stability requirements.  In this position you can perform any exercise without a need for postural stabilization, allowing the brain to focus on the unimpeded motion in the joint.  Once you can perform proper ranges of motion without pain with stability, you start climbing the ladder back to standing.

   For some people even laying on their back is unstable.  For those folks, we focus on breathing, because when the diaphragm isn't being utilized as designed, nothing can be stabilized.  It may not seem like much but relearning to breathe with the right muscles is the foundation of spinal stability which is necessary to achieve extremity stability.

   Anybody can get by without stability for a period of time but eventually, the compensations will fail and the system fails.  This is where you start noticing pain, some worse than others.  At the point of pain you know has dysfunction, to postpone rehabbing said dysfunction means you move in pain regularly which also means you move differently in an attempt to reduce painful movements.  These compensation further destabilize the system and only prolong the road to recovery.

 

Carb or Fat Burning..... which to train in


     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!

Block vs. Random Training

Block vs. Random Training

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.

An Ounce of Prevention...

   ...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!

Child Development

Child Development

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.

Efficiency in Heavy Lifting: Squats, Deadlift, and Others

Efficiency in Heavy Lifting: Squats, Deadlift, and Others

 So as you can see we learn proper form innately but somewhere along the line theres a disconnect.  

So as you can see we learn proper form innately but somewhere along the line theres a disconnect.  

     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.

 I'm sure plenty of you have been told to practice this.  Stop!! This only encourages posterior chain overactivity putting you in a position of weakness.

I'm sure plenty of you have been told to practice this.  Stop!! This only encourages posterior chain overactivity putting you in a position of weakness.

    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!

 Keeping the diaphragm parallel with the pelvic floor is key! This requires the obliques to keep the ribs from flaring upwards.

Keeping the diaphragm parallel with the pelvic floor is key! This requires the obliques to keep the ribs from flaring upwards.

    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.  

 Notice the attachment to the ribs for the oblique abs, this allows for that pulling down to keep the torso in neutral.

Notice the attachment to the ribs for the oblique abs, this allows for that pulling down to keep the torso in neutral.

   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.

  

     

Dynamic Neuro Stabilization

Dynamic Neuro Stabilization

 Postioning of the diaphragm relative to the pelvic floor are key to trunk stabilization, resulting in more efficient movement. 

Postioning of the diaphragm relative to the pelvic floor are key to trunk stabilization, resulting in more efficient movement. 

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.  

 The Prague School's approach to Trunk stability is based on 60+ years of clinical application.  They have worked with numerous international weightlifting programs producing dozens of medalists in that time.

The Prague School's approach to Trunk stability is based on 60+ years of clinical application.  They have worked with numerous international weightlifting programs producing dozens of medalists in that time.

    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!! 

 movement rehabilitation is based on human developmental stages.  

movement rehabilitation is based on human developmental stages.  

    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 year, New you! Planning for the New Years resolution.

New year, New you! Planning for the New Years resolution.

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.

images.jpg

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.

download.jpg

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!

Hot vs. Cold

Hot vs. Cold

download.jpg

   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.

 There are numerous forms of heat that can be useful.  Just make sure to be aware of too much heat.  Too much can cause burns that can complicate your achy muscles.

There are numerous forms of heat that can be useful.  Just make sure to be aware of too much heat.  Too much can cause burns that can complicate your achy muscles.

     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.

 Old school bags of ice cubes or frozen veggies are out of style these days with all the different colds packs made these days but they can be expensive and don't work any better than your "old reliable"!

Old school bags of ice cubes or frozen veggies are out of style these days with all the different colds packs made these days but they can be expensive and don't work any better than your "old reliable"!

     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!