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Archive for the ‘Injury Rehab/ Prevention’ Category

Avoid the Pain-Injury-Surgery Cycle!

November 24th, 2009

When working with people at my facility I always need to help them get over the “no pain, no gain” myth. Actually, I guess I should say that I need to help them understand it better. You see, muscular “pain” and discomfort are alright and needed – if you are not uncomfortable you are not pushing hard enough to elicit a change in the body.

 However, joint pain is a totally different thing. Joint pain is a sign that your body is not moving correctly and is much like the “check engine soon” light has gone on in your car. You can ignore it for a while but a break down is going to eventually occur.

 So, gutting through an exercise when your knee, low back or shoulder are talking to you is not the type of “no pain, no gain” you want. The vast majority of surgeries and rehabbing going on in the sports arena are not acute, traumatic injuries like those that occur when you crash on a bike. Most of them followed a pattern similar to this:

 Step 1: You notice a little pain in an area while you are participating in a sport or working out but it goes away after you get into your workout a bit.

 Step 2: The pain doesn’t go away as fast and now it tends to linger for a while after training, sometimes for a day or two afterwards. You can still work through it; it is just a bit more annoying now.

 Step 3: You have to pop a few Advil before training in order to keep the pain under control. Without some sort of pain reliever you just couldn’t train as hard. You are also much more likely to need a day or two off after a hard workout to let the painful area recover.

 Step 4: You are forced to go see your doctor after the pain relievers stop working as well and you can not get through a workout without some serious consequences. Your doctor says that you have some sort of tendonitis or bursitis or some other “fill in the blank-itus”. You get some physical therapy prescribed and you do the work but it doesn’t seem to get a whole lot better.

 Step 5: You are now scheduled for surgery. Maybe the pain just got so bad you couldn’t take it any more or a minor impact injury caused something to “break” but you now have some serious damage to a key joint that is going to impact you for the rest of your life.

 This process may take years to get through but the sad part is that a lot of active people tend to go through this cycle a couple of times in their lifetime. Think about how many people you know that have had a knee “cleaned up” or a shoulder “tightened”. This speaks volumes about the poor level of understanding about preventing these injuries in the first place.

 With rare exception, bad movement causes pain. In addition, where the pain shows up is usually not where the real problem is. Look at the joint above or below the area that is painful for dysfunction and you will find the real culprit. The low back is a great example of this – low back pain is not caused by a “weak” low back but instead from poor hip function and mobility. Ignoring the hips role in low back pain will never take care of the problem and will result in a lot of pain relieving drugs or, God forbid, surgery.

 Don’t spend the next few months ignoring the pain and simply popping some pain relievers or just sitting on the couch to “let it rest”. Work on your mobility and core strength. Clean up your movement and get strong on that movement.

 The secret to progressing each year is to address things when they are still in the Step 1 or Step 2 phase of the pain-injury-surgery cycle. You’re stuck with your body for a long time so take good care of it – you’ll be stoked when you’re 70 and can still be active and have fun!

Categories: Injury Rehab/ Prevention Tags:

21st Century Core Training

October 16th, 2009

Certain subjects just never seem to get old. Nutrition, supplements, cardio and core training are things that I could probably write about every day and people would still be interested in them. The other night James gave another talk on core training to a group at our chiropractor’s office and, as usual, had a great turn out and got to share some great info.

The first thing James covered was what exactly the core is. Core training is a huge buzz word that has been used to sell magazines, books, videos and late night television products. It is also one of the most important areas to understand and train. While most people think of the midsection (basically the abs, low back and obliques), we also include the hips and upper back. In essence, if you cut off your head, arms and legs you would be left with your core. 

The core is important because it is the center of your body and if it is weak it will affect everything else. For example, if you do an exercise like a lateral raise (where you raise a dumbbell out to your side) it is traditionally looked at as a shoulder exercise. However, if you had an injured rib you would not be able to lift nearly as much weight. Same shoulder but a “weaker” core which resulted in the arm not being able to lift as much weight.

 

The next thing covered was the difference in how we trained the core back in the 80’s and 90’s vs. our current understanding of how the human body works. It used to be that if you wanted to get a muscle stronger you picked exercises that allowed you to move that muscle and then you used sets, reps and load with those movements. Crunches, side bends and back extensions are prime examples of this “old school” methodology.

 

However, we now understand that some areas want to be mobile and some want to be stable. Training all joints in the body the same way is a recipe for pain and decreased performance. For our purposes here, the hips want to be mobile, the lumbar spine (low back) wants to be stable and the thoracic spine (upper back) wants to be mobile. So, based on this understanding of functional anatomy we can see that we want to train the midsection to resist movement, not create it.

 Since this is the case we want avoid exercises that encourage movement and instead emphasize exercises that resist movement. A great place to start is with some simple exercises like planks, side planks and bird dogs. If you have not done so already, start incorporating those exercises into your routine. Doing them on a daily basis will really help jump start your core strength.

core holds -Note: doing crunches on a stability ball is not more functional and still falls under the “creating movement” category.-

 However, there is more to “core strength” than simply doing exercises for the core. The next thing I covered in my talk was how movement ultimately defines your core strength. You can have the strongest core in the world but if it is surrounded by dysfunctional joints then it will have to compensate for that dysfunction no matter how many planks and side planks you do.

 Most people have a lower back that moves too much to compensate for tight hips. If your hips are tight, which describes 90% of everyone I have seen, then you will not be able to shift them back far enough to get the range of motion you need when picking stuff up off the ground. Your body will figure out a way do what you are asking it to do and so it will then get the extra range of motion it needs from your low back.

 This is why you have to look at how your body moves and train it how to move better. For most, this means getting aggressive with your mobility tactics. Stretching, foam rolling and dynamic mobility exercises for the hips and upper back are a must if you really want to break the cycle of bad movement most of us are caught up in. If those areas can not move freely then you are doomed to a lifetime of compensation and, eventually, pain.

 The next step is to utilize exercises that teach your body how to integrate your increased core strength and hip mobility in order to create cleaner, more efficient movement. For most people nothing beats the deadlift for this purpose. It is literally learning how to lift with your hips and legs and not your lower back. This is another reason that machines are sub-par. They do nothing to help you learn how to move better and allow you to take the core out of the equation. Since the core is always part of the equation outside of the gym then you better train it that way in the gym.

 So there you have it – a 21st century blueprint for creating a strong, high performance, injury resistant core. As you can see there is far more to it than simply doing exercises that target the core. Building core stability, hip mobility and then systematically integrating them together into more complex movements is the only way to truly build a functional, pain free core.

Releasing the Brakes

October 7th, 2009

There is always a lot of talk about how to get more out of your workout, but recently a new concept has been introduced to us by Alwyn and Rachel Cosgrove of Results Fitness Gym in California.

That concept is releasing the perverbial brakes that are holding you back from outstanding results when it comes to working out.

Think of it like this. When you’re driving your car with the Emergency brake on, you can floor the gas and you won’t get going too quickly.

The same goes for your body when working out. Here are a few brakes you can release to fast-forward your success.

-Working out on an empty stomach. You can do more reps or add in another round of intervals, but if you’re famished and your energy reserves are on empty, you’re only making a bad situation worse.

Making sure that you have a good source of protein and simple carbs pre and post workout will make you ready to work out and push yourself to levels needed to see results.

- Warming up properly. So many people dismiss the importance of warming up. You think “I can just skim over this” and get to the workout. Well, if you’re tight from a long day, or night (whatever the case may be), skimming over your warm up will again make a bad situation worse when you go to workout. You’re piling weight and reps on top of bad movement, which will only lead to injuries.

- Getting enough sleep. I can’t stress the importance of getting enough sleep. I have difficulty with this one. By the time I get Shilo in bed and watch a little TV, it’s way past my bed time! I’ve been making an effort to get in bed and read for 10-15 minutes instead of watching an hour long show on tv. When well rested, your body functions much better, allowing you to get more out of your workout.

Not to mention you will fight off colds and disease better when you allow your body the necessary time to rest at night. Times differ from person to person, but a good standard is 8 hours of sleep!

Let’s re-cap. Fuel your body for your workout, get your body ready for the workout, and make sure you’re allowing your body the rest it needs to recover from and energize for your workouts!

BrakeLightsAfter.jpg image by txblu

Releasing these Three “brakes” will allow you to work harder, feel better, and look better as well!

A Joint by Joint Approach

August 28th, 2009

As the world of fitness is ever changing as far as studies, new techniques and methods are concerned, we do our best to continually educate ourselves. One part of our continuing education at Elite Fitness Solutions is to have an article of the week that our staff reads.

 These articles can range from nutrition to exercise methods to physical therapy to anatomy and physiology.

One article we recently read and discussed was by a great strength coach named Mike Boyle. It’s called a “Joint by Joint approach to training”.

 If you’re interested in reading the article in its entirety, you can find it here.

This article addresses the basic movement principles of our body. It’s a unique approach to how the body functions and I feel can really help people to get to the root of the problem where pain and discomfort are concerned.

As an excerpt from the article states: “The inability of joints to function normally places stress on the joints above or below. In the book Ultra Prevention (actually a great nutrition book, too), the authors describe our current method of reaction to injury perfectly. Their analogy is simple; our response to injury is like hearing the smoke detector go off and running to pull out the battery.”

For example, let’s look at lower back issues. How often have you experienced pain in your lower back and went to a professional for that pain and they’ve addressed only the lower back? Rarely will you have someone also address your hip immobility, or thoracic immobility, or lack of core stability.

When there’s a preverbal fire raging due to immobility in other areas of the body, your body is sounding the “smoke alarm” in your lower back, because it is doing the moving when it should be stabilizing.

As stated in the article, “Those with a bad back generally have stronger back extensors than those with a weak back.”

I found that interesting. Most of the time, those with a bad back generally have stronger backs. So, it’s not that the back is weak and needs fixing, it’s that the surrounding areas need the fixing so that the back can relax and get back to doing what it’s supposed to do, which is stabilizing.

Now, let’s look at the body as a whole, as they do in the beginning of the article.

How does each joint operate and in turn affect the surrounding areas due to stability and/or mobility dysfunction?

Joint-Primary Training Needs

Ankle- mobility (particularly sagittal)
Knee- stability
Hip- mobility (multi-planar)
Lumbar Spine- stability
T-Spine- mobility
Gleno-humeral- stability

Now, think about the aforementioned relationships for a minute. If you experience knee pain, can you also think about your hips…or ankles? Do you think that possibly you are doing more work with your knees, essentially causing a joint that requires stability to become mobile in order to compensate for its surrounding joints?

I know this is a different way to look at knee pain, but again, we need to address the fire, and not the smoke alarm.

Or shoulder pain and problems. Do you find that your posture is forward (as is a majority of the population)? Causing your thoracic spine to become immobile and your shoulders to operate in unnatural positions?

Recognize the “smoke alarm” and address it, but don’t stop there and let the “fire” keep going. Find the source and hopefully your symptoms will be a thing of the past!

I hope this has opened your eyes to new possibilities when it comes to addressing recurring aches and pains.

Categories: Injury Rehab/ Prevention Tags:

Trigger Point

December 10th, 2008

About eight years ago, I was a licensed massage therapist in California. I have always been facinated with how the body works. One of the many reasons that I love what I do today. To this day, I continue to buy books regarding massage.trigger

One of the books I use on a regular basis is “The Trigger Point Therapy Workbook” (http://www.triggerpointbook.com). Until recently however, I have been all about doing this as treatment for my husband and others. I have just recently began to experiment on getting myself “straightened out”. These little knots are facinating things, painful as anything when they’ve gone too far, and the relief once they’ve been remedied is astounding.

What are Trigger Points? Travell and Simons define them as “a highly irritable localized spot of exquisite tenderness in a nodule in a palpable taut band of muscle tissue.” In other words, these little knots are crazy painful, and are found as knots in tight bands of muscle tissue.trigger-points1

Without going into way too much detail, trigger points literally can cause your body to stop using a muscle. When you stop using a muscle, it will shorten and tighten up, making the situation worse, not to mention the stress caused on surrounding muscles due to the fact that they are trying to overcompensate for movement within that area.

Many times, pain and discomfort in an area have nothing to do with that area at all. For instance, you may feel pain in your glutes (butt) for a period of time, well, after ignoring that pain long enough, it seems to have gone away, or is less intense. Then one day, you find that your lower back is killing you doing every day activities. Well, remember that pain in your glutes? It could be directly causing your back pain and discomfort due to your body overcompensating for trigger points in your glutes.

massageRemember that song you’d sing as a kid…your ankle bone connected to your leg bone, or something like that? Well, the same goes for our muscles. Along with learning to create movement properly, I’d highly suggest either learning about trigger points and addressing them yourself, or consulting a local professional that knows about trigger points and can help you sort yours out.

A little side note…having trigger point therapy work done is not pleasant at the time. You may feel like the person doing it (even if it’s yourself) means you harm. Just remember the relief in the long run is well worth it!

Are you “false fit”?

November 26th, 2008

Most exercise professionals would agree that there are many components to fitness. A well rounded approach to fitness that addresses all of them is usually the best way to achieve lasting gains and continual progress from a program. Being deficient in even one of these components leads to slow progress and results in a condition I call “false fit”.

“False fit” is when someone perceives themselves to be fit when there are glaring holes in one of the 5 Fitness Components. While each area can cover other, more specific concepts here is a list and brief description of 5 Fitness Components you need to work on:

1. Mobility – Your ability to move freely while maintaining good posture. Also includes elements of body control and body awareness.

2. Core Strength – Your ability to properly use your core to create a strong platform around which movement is created. Emphasis is on stabilizing the lower back and mobilizing the hips and shoulder blades.

3. Power – Your ability to coordinate your muscles in order to create quick, dynamic movements. Life is dynamic and so everyone should have some sort of power training in their program, even if it is something as simple as slamming a medicine ball into the ground.

4. Strength – I define this a little differently than most. I define strength as your ability to create proper movement and maintain that proper movement under load. Creating a movement through compensation, such as using your lower back during leg exercises, is not true strength no matter how much weight you move.

5. Conditioning/ Endurance – Your ability to engage in your chosen activities without excessive fatigue. A good conditioning program will also act as a catalyst for fat loss. For most people proper conditioning should focus more on intervals than on traditional steady state aerobics.

Do you do yoga and/ or Pilates but do not work on power and conditioning?yoga

Do you run or bike but don’t work on mobility and strength?

Marathon

Do you “body build” but don’t work on mobility and conditioning?

bodybuilding_1

If you answered yes to any of those questions, or if you see something on the list above that you are not addressing, then you have developed the “false fit” condition. You are fit as it pertains to the particular activities and exercises you engage in but the truth is your fitness is limited. Get you outside of your comfort zone and your true fitness levels will get quickly exposed.

Our body wants to maintain a balance between the 5 Fitness Components. When we lose that balance we slow down our progress and set ourselves up for pain and injuries. Sometimes the answer to achieving the fitness levels that you want is not in looking for different twists on what you are already doing but in looking outside your box for new elements.

I tell people all the time that if you do not want to look and/ or perform like everyone else don’t train like everyone else. Most people are dissatisfied with their current fitness condition so don’t take the same approach they do. Make sure that you work on developing true, well rounded fitness and avoid the pain and frustration that goes with being “false fit”.

-James Wilson-

Low back hurts after exercise…

November 21st, 2008

low-back-pic

A friend of mine recently e-mailed me about his lower back hurting him after mountain bike rides. He is an avid mountain biker and was particularly trying to figure out why the right side of his low back hurt him after longer (2 hour) rides. Here was my advice to him…

Here is the first thing I always think when someone tells me that something hurts as a result of exercise – bad movement causes pain. Bad movement also robs you of performance so the trick is to hunt down the bad movement and fix it.

Typically, if someone is getting pain in the erector muscles as a result of riding they will have a mobility deficit in the hips and/ or upper back and the body is coaxing excessive movement out of the lumbar spine. It sounds to me that you have upper back mobility issues as a result of your shoulder traumas.

You should be able to hold your arms straight over your head (elbows locked out and in line with your ears when viewed from the side) while keeping your head and lower back in a neutral position. If you can’t then you need to work on increasing your upper back, and specifically scapular, mobility.

Our body is designed to be a series of mobile and stable joints. In this case we want mobile hips, a stable lumbar spine and a mobile thoracic spine (upper back). You have to restore balance to the system first before you can really hope to address the real causes of the back pain.

As far as it hurting more on the right side, there are few things that could cause that. My guess would be that it is extra movement on that side. Since our left side lower body works with the right side upper body that would make sense if you are weaker with the left leg and you are compensating with the right lower back.

Here is my advice – don’t do any two legged strength training exercises for the time being. Do everything one leg at a time and get your left leg’s movement patterns cleaned up. Cue in on the lumbar movement and stop it by squeezing the glute even harder when it happens.

Also, get super aggressive with your body work. Get a tennis ball and put it between your back and the wall and dig in. The main areas to concentrate on are the right trap and lat but you should dig in all over the place and get the tension levels back there under control. It will hurt like hell but it has to be done.

Long, repetitive efforts like cycling and running will expose small “chinks” in your movement patterns and cause pain. That is why strength training and mobility work is so important – they are the only chance you get to fix those “chinks”.

Bad movement causes pain – find the bad movement and fix the pain. Pretty simple theory but one I have found to work pretty well.

Hope this helps, let me know if I can answer any more questions for you…

-James Wilson-

Choose your own path…

November 18th, 2008

path1Here is a fact of life – most people want to look and feel better. If you did a poll I would guess that 80-90% of Americans would agree with that statement. However, 2/3 of all Americans are overweight. Why is this? What is stopping people that want to look and feel better from accomplishing that goal?

I know from experience that “lack of time” is by far and away the number one reason given to this question. Whenever I hear this though I am reminded of this fact of life – time is just like money.

Simply put, we “spend” our time on certain things and not on others. Be it work, watching television, eating, exercising, taking a vacation, riding a bike, skydiving or one of a million other things you can spend your time on, we make a decision on what our time gets invested in.

What we choose to spend our time on impacts our life in significant ways. The focus of your time and effort will ultimately decide your fate. However, not getting sidetracked by life is easier said than done.

That leads me to something that I have been thinking about in my own life – we either choose our own path or it will be chosen for us. We don’t have to be victims of our circumstances. Letting circumstances cloud our vision that we have for our future is the wrong way to try and choose a path for ourselves.

Getting some clarity on where we want to go is needed to help us clear our vision and stay above the fog of circumstances. Pretty much every successful person I have ever come across recommend having defined goals written down for this exact reason. They recommend looking at those goals daily to help you stay focused on them as you make decisions on what you spend your time on.

Of course, you know where this is going – investing some time in your health and fitness can make a huge impact on your life. Always saying that “I don’t have time for it” or “I’ll start tomorrow” when you look in the mirror is a horrible rut to put yourself in. But where do you start when you want to take back control of the path you are on?

I suggest starting at the beginning – write down what your goals are and review them daily. Even better, write down your goals and then write down some things you need to do in order to accomplish them. Then post that goal sheet somewhere that you can review it often – the refrigerator door is my suggestion ;) .

Once you have your goals written down and you are looking at them daily I guarantee it won’t be long before you take action on it. This initial action is the catalyst for change and the first step down a path towards the body, and ultimately the life, that you want.

We only get one shot at life and no one knows how much time we have been given to spend. Get some clarity and choose wisely where you spend it.

-James Wilson-

A punch is not just a punch…Wisdom from Bruce Lee

November 17th, 2008

Bruce Lee was a brilliant coach and his wisdom transcends martial arts and has a lot of relevance for fitness training. Here is my take on one of his most famous quotes…

[youtube=http://www.youtube.com/my_videos_annotate?v=gRBIcTZWUwk]

-James Wilson-

Are you twisted?

November 11th, 2008

Most of us are twisted in one way or another…and I’m not talking about anything that you might be involved in (that’s your business). What I am talking about is how your body holds itself. Whether you realize it or not your body is probably contorting itself in order to give you the illusion of being “straight”.

Here is what I want you to do. Go into a quite, darkened room and close your eyes. Keeping your eyes closed, start to march in place. Make sure that you are bringing your knees up to that the top of your thighs are parallel to the ground. Set a timer for 60 seconds and march until the timer goes off.

When you open your eyes see where you are in relation to where you started. Odds are pretty high that you will have turned significantly to one side. If this is the case, it indicates that your body is twisted.

When we take away the auditory and visual stimulus (which is achieved by the quite, darkened room) your body will start to show you how it really holds itself. We don’t even realize it but our body will contort itself in order to keep you moving straight ahead. The underlying causes of this contorting are imbalances in the body that must be address in order to avoid injuries.

When you take your eyes and ears out of the equation your body will simply “untwist” itself and as a result you will start to turn as you march. The side you twisted towards is usually tight in the hip flexors and quads and weak in the glutes. This imbalance means that you are overcompensating for this bad movement with the other leg.

All of this adds up to one thing – you are going to break down and get hurt at some point if you do not restore balance to your body. Odds are you are already dealing with some sort of chronic pain as a result of this imbalance and the bad movement it causes. Your exercise program needs to play a major role in this correcting this.

I highly suggest that if you found yourself facing a different direction when you stopped marching that you avoid much in the way of two legged exercises. Every time you use both of your legs at once your dominant leg is making up for the bad movement on the other leg which just reinforces the imbalance.

Instead, concentrate on single leg exercises, particularly the Cook Hip Lift and the Split squat. You can find video demos of both of these exercises on this blog. just type their name into the Search field and hit enter.

Both of these exercises will help to retrain the bad movement on the weaker side which will save wear and tear on the other side. Restoring balance between your limbs is essential. Some studies have shown that imbalances between limbs are one of the biggest indicators of injury potential. You ignore these imbalances at your own peril.

This twisting is also one of the biggest reasons that people seek chiropractic, massage, yoga, Pilates and a whole variety of other means of lengthening, loosening and restoring balance to the body. All of these methods can be helpful, if they are being applied in a way specific to your condition. Taking responsibility to know what you need and how to best address it is the best way for ensure the results you are looking for.

So try the march in a dark and quite room…you may be surprised by what you find out. If you are twisting take some time to build your single leg strength and quality of movement. Using your training program to help restore balance is the best way to make sure that it is helping you do more than just burn some calories and not setting you up for a future injury.

-James Wilson-