Rethinking your rehab

As a personal trainer, I am constantly forced to adapt to different injuries and ailments which affect my clients. Recent examples have ranged from knee injuries to fractured wrists and even feet.

One similarity most cases share however is that one side of the body is impaired of completely immobile– throwing full body, two legged exercises such as squats, lunges and most weight bearing cardio completely out the window.

The other dilemma this creates is whether to apply more volume to the other side. Should we allow both sides of the body to decondition or risk looking like the a one armed version of Popeye?

According to research, the good news is training the uninjured side of the body has a tremendous carryover of strength to the impaired side. In fact studies show as much as a 77% strength retention in unilateral (one sided) training for both sides of the body.

With this in mind, heavy presses, pulls and one leged squats on the uninjured side are a great way to keep both sides strong for post rehab training. While this may lead to a slight imbalance in strength between each side, simply increase the volume for training for the weak side post rehab.

But even with this debate is settled, a more important question is what led to the injury in the first case?

Reading over the experiences of fellow strength coaches has reinforced my view that cumulative trauma (which accumulates over a lifetime of poor habits and posture) is often the cause of seemingly sudden breakdowns.

With this in mind, what you can do during an injury layoff is place a heavy emphasis on correcting the latent contributors to injury and daily pain. Most often, these are the stabilizer muscles of shoulders, spine, low back and hips which are often tight and weak.

Whether or not your training options are limited, included below are a few key exercises to include with your training (either as a warm up or training itself) to address flexibility and strength in these areas for injury free post rehab training.

Postural strength exercises:

1. Scap retract pushups (Middle back)

• Begin in a push up position on the floor or an elevated surface (bench, wall)
• Shrug the shoulders up and down while keeping the arms straight.
• Perform two sets of ten to fifteen reps. Increase this number to thirty continuous reps as endurance improves.

2. Pelvic tilts (abdominals)

• Begin lying your back with knees bent
• Push your lower back gently in to the floor. This will cause your abdominals to tighten and pelvic to tilt up slightly.
• Hold this tension for 3-5 seconds and release five to ten times. Try tensing your abs in a similar fashion while sitting and standing up as strength improves.

3. Internal/external rotation (rotator cuff)

• Begin by holding a stretch band and flexing both elbows 90 degrees, holding the upper arms next to the torso.
• Pull the stretch band apart by rotating your arms in opposite directions while keeping your elbows locked to the chest. through full range of motion. Pause, then slowly return to the starting position.
• Repeat this move 6-10 times.

4. One leg bridge (Glutes)

• Begin lying your back with knees bent
• Cross one leg over the other and raise the hips off the ground by pushing thru the heel of the with the foot which remains in contact with the ground.
• Hold in this raised position for 2-3 seconds and repeat five to ten times.

5. Side lying leg raises (Hips)

• Begin side lying with legs straight.
• Slowly lift one leg to side, 6 to 12 inches out to the side
• Keep your back and both legs straight. Keep the top leg in the air throughout the execution of the movement to maintain constant tension.
• Don’t point your toes downward; keep them facing forward during this exercise. Hold thi position

• Repeat six to ten times.

Postural mobility exercises:

1. Wall slides (Shoulder mobility)

• Stand against wall with feet shoulder width apart.
• Gently press low back against wall.
• Place back of elbows, forearms, and wrists against wall.
• Bring arms up and down slowly in a small arc of motion while keeping elbows in contact with wall.
• Do this 10 times.

2. One leg track swings (Hip mobility)

• Stand placing your arms on a wall or sturdy object with feet spread shoulder length apart.
• Bring one leg forward and swing it back and forth across the body. Use your upper body to lean against wall.
• Swing to the point of tension 10-15 times and switch sides.

3. Psoas stretch

• Begin in a lunge position as depicted
• Lean in while pushing the pelvis forward until a stretch is felt in the opposite hip.
• Hold for 20-30 seconds, repeat for 2-3 reps.

4. Piriformis stretch

• Begin lying on your back

• Cross your legs and the back leg toward you until you feel a stretch in the opposite hip.

• Hold this stretch for 30-60 seconds.

5. Straight leg stretch- The hamstrings are amoungst the most common areas of muscular tightness.

• Begin lying on your back with legs straight.
• Loop a rope or stretch band to the end of one foot
• Now, keeping the legs straight, pull the rope back until the leg is flexed to the point of tension above the floor.
• Hold this stretch for 1-3 second for a total of ten reps. Repeat twice for each leg

Food for thought: Exercises to expand your mind

At 5 am on a Monday morning, it can be difficult to remember your own name—let alone the agenda for a busy day. But before reaching for your cup of coffee (like you do every morning), building ( waking up) your brain may be as simple as a trip to the refrigerator.

Have you ever wondered what leads to addiction? Just as your muscles become accustomed to routine, the brain forms neural pathways around common behavior. As time goes by, these patterns become ingrained and expected.

By contrast, breaking from your daily routine—from rolling out of the other side of bed taking a new route to work—establishes new neural connections to accommodate new information. Because we never lose this ability, variety and learning are keys to staving off aging diseases such as senility, Alzheimer’s and dementia.

But what is the best way to train your brain?

As opposed to traditional learning, brain fitness programs focus on specific drills for cognitive abilities such as concentration, creativity, and memory. With this in mind, here are a few suggestions for training each quality:

Concentration is simply the ability to focus on one thing at a time. Meditation is one popular method of training this ability. While there are many popular forms of meditation, this can be done by simply closing your eyes and centering your thoughts in to a single ball of energy. Visualize this ball as a glowing ball whose size and shape can be manipulated with your mind. Focus on moving this ball in various directions, while altering it’s size and shape. Beginning with several 5-10 minute sessions, include several meditation breaks throughout your day to improve focus and quiet intrusive thinking.

There are numerous memory techniques available to strengthen your memory. Practice mentally placing a host of objects in fixed locations in your house and imagine them in strangest of al places. Or imagine the person you will visit next and call them by their name in your imagination. This could help you memorize names

Creativity enhancement needs you to be a little wild. Imagine something illogical like lights which fly. To make it more effective have the sense of the image in your mind. Imagine yourself being in a market where there are lights on helium balloons. Put in a little more thinking and imagination and you could be in the company of colorful flying lights.

It is undisputed that the more you exercise your brain the more it functions and in a better manner. The more the brain is exercised, the less then chances of you becoming a victim of age related mental disorders. Better to start as early as possible with simple exercises.

Source: http://www.wordofmouthexperiment.com/articles/iq-tests-brain-fitness/keep-your-brain-sharp

Could crunches be making you fat?

Rounded shoulders, flat feet and lower back pain. Throw in a protruding stomach and you have the typical symptoms of caveman posture. Common amongst those in desk bound occupations, caveman posture occurs when hours of leaning forward cause chronic tightness of the chest, neck and lower back muscles which pull the body forward.

So what does posture have to do with weightloss? One comment I often receive from my clients who have recently lost weight and inches is the continued present of a gut “despite substantial progress elsewhere.

An interesting (and annoying) side effect of caveman posture is a bulging stomach “which is pushed forward by a tight lower back. And chances are, if you own a computer and sit more than 2-3 hours a day, this means you.

For many, the solution to this problem is stretching tight areas (chest, low back) to improving posture and abdominal training for a washboard stomach. But if your workout involves hundreds of stomach crunches, exercise may well be part of the problem.

The abdominal region is made up of several muscles (obliques, rectus and transverse abdominus) which compose the upper, lower and sides of the stomach. Each muscle is responsible for a different movement of the trunk. By only training one movement (flexing the trunk forward), stomach crunches cause the upper abs (the part of the abs which tilt the stomach and pelvic forward) to become over active while the other areas (which tilt the pelvis and stomach backwards) become weak.

In addition to kissing crunches goodbye, the key to better posture and washboard abs is to stretch the upper area of the stomach and focus on a variety of abdominal movements “twisting and stabilizing the trunk.

Included below is a step by step approach to training these movements:

Exercise #1: Plank (Core Stability): This move directly opposes the movement of a stomach crunch by holding the torso in a stable position while tilting the pelvis back.

Directions:

* Begin in a prayer position with knees and elbows on the floor and hands clasp together
* Rise in to a pushup position by lifting the knees off the floor and bringing the hips to around 90 degrees.
* This movement is intended to establish stable pelvic position, so focus on keeping the hips in a stable position.
* Hold in this position for 20-60 seconds and repeat twice.
* Difficulty in the back can be increase by incorporating movements such as tucking the knees in, moving from a plank to push up hand position and even crawling in the plank stance.

Exercise #2 Russian twist (Trunk twisting): The Russian twist involves the legs and trunk in a twisting fashion to train the function of the side obliques.

Directions:

* Begin on your back holding a medball or weighted object above the stomach with your feet in the air
* Keeping the arms slightly bent, twist the ball to one side while moving the legs to the other side.
* Perform 15-20 reps and repeat twice.
* Beginners can keep legs on the floor while heavier objects can be utilized for increased difficulty.

Exercise #3 Deadbug (Posterior pelvic tilt): The deadbug trains the lower region of the abs which is responsible for tilting the pelvis backwards and flattening the stomach.

Directions:

* Begin lying on your back while hands and legs raised in the air.
* In slow-motion extend your left leg toward the floor, straightening it while at the same time bringing your left arm so that it follows the left leg.
* When both the left leg and left arm are extended fully, toes and fingers as close to the floor as possible (and your back still FLATTENED), just hold the position, breathing shallowly if necessary, for about 10 seconds. Then begin to exchange sides, bringing the left leg back into preparation position and the same with the left arm.
* Do the same thing on the right side with the right limbs.
* Perform 15-20 reps and repeat twice.
* Difficulty in this exercise can be increased by holding dumbbells or weighted objects in your hands.

Stretch #1: Rectus Abdominus stretch: Along with the above exercises, this stretch will help to alleviate your bulging stomach by stretching tight muscles.

Directions:

* Lay on a stability ball face up with the upper back and head in contact with the ball, knees bent and feet flat on the floor hip width apart.
* Extend the arms over the head and relax the hips onto the ball.
* Continue the flow of breath throughout the stretch and hold for 15-30 seconds.
* Repeat this stretch twice.

Questions to ask your personal trainer

In gyms across America, personal trainers commonly mix fitness training with nutrition and weightloss advice. But have you ever wondered how much your trainer really knows about weightloss (or fitness for that matter)?

In a recent survey of two “leading” personal training organizations (American College of Sports Medicine and The National Association of Personal Trainers, found that of the 43 trainers surveyed, 58% were able to list one currently or previously available weightloss medication, 42% were able to list two medications, and no certified personal trainer was able to provide names of more than two medications.

While this study demonstrates a clear bias against medication, more troubling is the sheer lack of information available to personal trainers. The fact is, working with clients with diabetes, high cholesterol and heart conditions requires a basic knowledge of the effects of medication on exercise.

For example, a client seeker on beta blockers (high blood pressure medication)—which depress heart rate—might well be unable to reach target heart rate with traditional aerobic or anaerobic training. Engaging in interval or intense aerobic training (common tools of the trade amongst personal trainers) with such clients presents tremendous a tremendous risk of injury and cardiac trauma.

Although certifications and health related degrees may seem impressive, the real proof of a trainer’s skill is in their approach. With this in mind, it is important to ask the following questions when

Do they present a detailed questionnaire?

A good trainer is intently aware of protecting both themselves and a client. In fact, I will not even trainer new exercise seekers before first reviewing their paperwork—which should include a detailed questionnaire about your goals, medication and health history as well as a release form.

While a knowledge of medication is not a pre-requisite, a good trainer will learn about your condition and take appropriate steps before training begins.

Do they conduct a thorough fitness evaluation?

After recieveing their paper work, I put all new clients through a required series of tests and movement screens to assess posture and fitness level. This gives me the basic knowledge to begin exercises at an intensity level that will not risk injury.

Do you use machines?

A good rule of thumb for effective training is at least a 5 to 1 ratio of standing versus sitting exercises. A good training sessions consists of a variety of core, strength, power and metabolic conditioning (weightloss) exercises.

When it comes to toning up, these movement will use as many muscles as possible (meaning they are performed in a standing position). If your trainer sticks you on a machine straight away, the red should begin to fly. straight away.

Do they find a better way?

While a knowledge of medication is not a pre-requisite, a good trainer will learn about your condition and take appropriate steps before training begins.

For those on medication or recovery from injury, this includes communicating with your therapist about rehab protocols and contradicted exercises. But whatever goal you are seeking, it is vitally important to communicate your wishes with your trainer—whether or not they ask.

If an exercise hurts or is uncomfortable, a good trainer finds a better way.

Food for thought: reasons for exercise

Perhaps the most common questions I receive from new clients is: when will I see results? While weightloss and toning are amongst the most visible outcomes, the benefits of exercise stretch beyond your muscles.

Exercise and depression:

Combining regular exercise with taking antidepressant medication may be more effective in treating major depression than medication alone, according to a Feb 2, 2004, news release from the University of Texas Southwestern Medical Center at Dallas. Researchers found that participants combining a moderate exercise program with with selective serotonin reuptake inhibitors (SSRIs) for eight to 12 weeks reported feelings of improved well being and productivity as compared those on medication alone.

Much like the medication, exercise encourages the production of pleasure producing hormone serotonin—which helps take the edge off depression.

But what type of exercise is best for depression? Researchers have linked intensity as the key variable in the release of endorphins—a chemical which helps to make serotonin. Participants reported the most dramatic improvements in mood after anaerobic exercises such as sprinting and strength training.

Exercise and cancer:

Several studies have examined the relationship between exercise, rehabilitation and quality of life in cancer patients and reported positive findings.

Studies have followed women undergoing breast cancer treatment who added moderate exercise to their treatment regimen. These studies have found that overall, exercise had a positive effect on physical and psychological functioning of cancer patients while in treatment. These benefits include the following objective and self-reported findings:

• decreased body fat
• increased lean muscle mass
• decreased nausea and fatigue
• improved natural defense mechanisms
• improved sense of control
• improved mood
• improved self-esteem
• self reported improved quality of life

While the effects of exercise as a cure for cancer remain tenuous, it is clear that a moderate exercise program aids in recovery from cancer while relieving symptoms of associated treatments such as chemotherapy.

Exercise and ADHD:

“Think of exercise as medication,” says John Ratey, M.D., an associate clinical professor of psychiatry at Harvard Medical School. “For a very small handful of people with attention deficit/hyperactivity disorder (ADHD ADD), it may actually be a replacement for stimulants, but, for most, it’s complementary — something they should absolutely do, along with taking meds, to help increase attention and improve mood.”

The latest news about exercise is that it helps kids push through past failures and attack things they didn’t succeed at before. “The refrain of many ADHD kids is, ‘No matter what I do, I’m going to fail,’” says Ratey. “Rat studies show that exercise reduces learned helplessness. In fact, if you’re aerobically fit, the less likely you are to learn helplessness.”

So how, exactly, does exercise deliver these benefits to the ADHD brain? When you walk, run, or do a set of jumping jacks or pushups, your brain releases several important chemicals.

“When you increase dopamine levels for example, you increase the attention system’s ability to be regular and consistent, which has many good effects,” explains Ratey, like reducing the craving for new stimuli and increasing alertness.

You don’t have to be a marathoner, or even a runner, to derive benefits from exercise. Walking for 30 minutes, four times a week, will do the trick. “Get your child involved in something that he finds fun, so he will stick with it,” suggests Ratey. Team activities or exercise with a social component are especially beneficial.

Core training for leaky bladders

Have you ever laughed (or jumped) so hard you peed your pants? If so, you are not the only one.

When it comes to quick weightloss, exercises such as hopping, skipping and jumping in place are a greater way to kick up the heart rate. Unfortunately for new moms and those who have experienced surgeries which cut the stomach (gastric bypass, tummy tucks, etc), they also come with an unintended side effect: urination.

Over my years as a personal trainer, I occasionally hear female clients comment that such exercises would cause them to “pee their pants” While I intially assumed this was something of an exaduration, I have learned the hard way this effect is very real.

So how does this occur? During pregnancy, the abdominals and core region stretches to accommodate the growing fetus. This causes the rectus abdominus–six pack abs– to literally split down the middle. This is good because it allows the baby to grow, but when the split is too wide (more than 2-3 centimeters) it creates instability in the trunk and pelvis.

Even after pregnancy, a weakness in the pelvic floor and deep abdominal “core” muscles– which regulate functions such as breathing and urination– may continue to have flabby, weak abs which literally “leak” urine. This reality makes proper core training particularly important for moms.

While situps and crunches are often employed to tighten the abs, these moes usually these moves often fail to address the problem at hand: core control. The first step retraining deep core muscles in learning to tense the abs on command. This can be learned by a simple exercise known as drawing in.

• Begin by lying on your back and imagining a line (or wire) connecting from the spine to the hip. Visualize pulling from deep inside and allow the hip to sink back in to the socket as the hip is brought in to flexion. Maintain this connection especially during ab exercises which involve loading (such as raising the legs)

• During this movement, a tensioning should be noted around the pelvis, abs and low back. Deep breathing through the mouth should be maintained effortlessly throughout this movement.

• Initiating this movement, before basic ab exercises– such as curling up, leg lifts and rotations– ensures the abdominals are integrated with the hip flexors.

After performing this basic move, the key is to incorporating various arm and leg raises while maintaining abdominal tension is the key to retraining endurance in core muscles.

The idea is to progress this ability to a standing condition so this contraction can be initiated during daily movements—walking, running, strenuous exercise—to tighten the core like a weightbelt. With this in mind, the curl up exercise accomplishes what a situp should (stressing the abdominals)

• In a lying position with arms to each side, begin by flattening your lower back in to the ground. This move will tense the core to ensure the abs are ideally stressed during this movement.
• Slowly and gently, roll your head and neck forwards, then your shoulders in to a half situp position.
• Hold in this position for 5-10 seconds and then return slowly to the starting position. Perform 6 to 10 reps and pay attention to keeping your back flat on the floor.

How your diet affects chronic pain

When was the last time you heard the saying “you are what you eat?” While this saying certainly rings true for dieters, your diet may also play a critical part in chronic hip and back.

Seemingly unrelated links between organs and pain elsewhere in the body can be observed in the gall bladder’s relationship with shoulder pain, the prostate affecting the low back and heart problems manifesting as left sided jaw, chest, and arm pain.

While little attention has been placed on the relationship between your stomach and pain by traditional medicine, eastern healers have long understood the importance of inflammatory reactions and disease in the body.

For most Americans, the average foods we consumed have been preserved and processed with any number of chemical additives. Processed foods, preservatives, carbonated beverages and any artificial colors, flavors or sweeteners irritate the lining of esophagus, stomach and large and small intestines. The body’s reaction to any toxic substance is to create an inflammatory reaction (swelling) to heal damaged cells. For those of you that regularly bloat after meals, this could well be an inflammatory reaction to the foods that you consume.

Inflammation also affects digestion by constricting the pathways which process food ia the stomach. In his book, How to Eat, Move and Be Healthy Paul Chek suggests that inflammation of the stomach causes a weakening of the muscles which stabilize the stomach. These smaller muscles (the transverse abdominus in particular) are particularly susceptible to weakening and inhibition.

Much like a weight belt, the transverse abdominus—along with other stabilizer muscles—tightens around the waist to protect against pain during tasks such as bending, prolonged sitting and standing. Without the ability to activate as effectively, weakness in these muscles is a prescription for pain (and bloating)

By contrast, drastic improvements (or even elimination) in both stomach definition and chronic pain can be achieved with a few changes to your diet.

Detoxing your diet:

More than 50 percent of our immune system is found in our digestive tract, which is why it is important to have a properly functioning digestive system.

A first step to calming inflammation is reducing intake of foods which produce allergic reactions. These foods often include dairy, wheat, corn, soy, peanuts, coffee, artificial sweeteners or MSG.

Including more un-canned natural fruits, vegetables and meats in your diet gives the digestive tract the chance to heal. Because over half the sodium (which causes the body to retain water) consumed in the American diet comes from canned foods, many individuals experience immediate water weight loss of several pounds.

Why go organic?

The biggest study ever of organic food was completed in the European Union in 2007 and found that organic fruit and vegetables contain up to 40% more antioxidants (anti-inflammatory chemicals) than conventional equivalents, and that the figure was 90% for organic milk.

As opposed to most fruits and veggies found in stores, organic foods are produced according to certain production standards, meaning they are grown without the use of conventional pesticides, artificial fertilizers, human waste, or sewage sludge, and that they were processed without ionizing radiation or food additives.

While organic foods are often more expensive in stores, farmers markets—where local growers come to sell their products—are an excellent source of more affordable fare. Check out this guide to find a farmers market in your area.

Smart supplementation:

One symptom of a poor diet is a poor ratio of good to bad bacteria in the liver and digestive tract.

Friendly bacteria are vital to proper development of the immune system, to protection against microorganisms that could cause disease, and to the digestion and absorption of food and nutrients.

Probiotics are microorganisms (in most cases, bacteria) that are similar to beneficial microorganisms found in the human gut. Available as a dietary supplement, probiotics have been shown to:

• Help reduce the risk of certain diarrheal illnesses
• Improve food absorption and reduce bloating
• Assist lactose intolerant people with lactose digestion
• Enhance immune system function

Choose your fruit carefully:

Whole fruits and vegetables are important to eat for their vitamins, minerals, and natural antioxidants, however some vegetables like potatoes, tomatoes, and eggplant may actually make pain from inflammation worse. These vegetables are part of the nightshade family of plants and contain a chemical alkaloid called solanine. Solanine can trigger pain in some people.

By contrast, anti-inflammatory foods counter this process by reducing inflammation. Check out this list of anti-inflammatory foods to learn more.

Do intervals really burn more fat?

Statistics show that over 80% of the personal training market is comprised of those seeking weightloss.
And when it comes to dropping weight, much has been made of the power of interval training– short and intense movements which cant be sustained for more than a minute.

Proponents of this style of training point to the fact that it raises resting metabolism slightly– burning more calories throughout the course of a day. The problem with this style of training is that because it cannot be sustained, It burns fewer calories during an exercise session than a bout of longer, lower intensity exercise (treadmill walking, jogging, Moderate elliptical work).

Both modes of exercise result in around the same caloric expenditure throughout the day, so what is the difference? Known as aneroebic exercise (or without oxygen), this form of training relies on energy sources that are stored in the muscles and, unlike aerobic exercise, is not dependent on oxygen from (breathing) the air.

By utilizing interval training, this form of exercise forces the lungs to expend more energy to recover when at rest. Because the body burns a higher percentage of fat when at rest, this means a more specific fat burning effect than traditional aerobic exercise.

But with “intervals” lasting anywhere from 10 seconds to three minutes, what is the ideal length for fatloss? Generally aneroebic exercise occurs anywhere from 80-95% of Max Heart rate (Max HR can be determined by subtracting age from 220). Through use of a HR monitor, this value can determine the length of both recovery and work intervals. For example, sprinting or running at maximum effort until your heart rate reaches between 90-95% capacity and then resting until HR returns to 60-65% of max HR.

With this in mind, I recommend this excellent article by Alwyn Cosgrove on different types of intervals and how they are administered. As a side note, interval training will be an intregal part of my cardio program come Monday (the first day of three week dieting period/AKA hell)

More to come later.

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