Archive for the ‘Blog’ Category

Why Some of your exercise is probably wrong– Part 1

Tuesday, February 28th, 2012

I see people exercising every day- a lot of them in gyms.  And every day I see people making some fundamental mistakes in their exercising.  These mistakes lead to underperformance and decreased results, but also to muscular and postural imbalance and ultimately injury and joint damage.  Today let’s talk about one type of super-common mistake made by exercisers in our society– the use of “non-functional” resistance and cardio machines.  This includes machines like the leg press, the ab machine and the elliptical.

 

I’m using the word ‘non-functional’ in quotes because functional is an overused word and a vaguely understood concept nowadays. It’s a little tough to define.  So, let’s just cut to some examples.

Let’s take a real-life movement like standing up from a chair.  When a movement like this is done as an exercise (repeatedly, maybe done with added resistance like weights, done as repeated jumps from a squat position…) , it’s a squat.  In this everyday movement, a number of muscles work in conjunction: certain muscles are primary movers propelling the body while other muscles assist those main movers and still others stabilize numerous aspects of your body’s position throughout the movement.  This complex and delicate balance of muscle work makes this more than a movement, but really a movement pattern. A partial list of muscles at work during a squatting and standing movement includes: the quadriceps, the gluteals, the hamstrings, the deep and superficial spinal muscles, the deep abdominal muscles, the hip adductors and abductors, the ankle dorsi- and plantar flexors…. and more. Functioning properly in this movement means they are finely tuned in terms of order and speed of firing and varying amount of force produced.  This happens partly through development of the muscles and other soft tissues.  But neural control of those muscles is what determines how a movement pattern is executed.

This exercise is functional for everyone who wants to be able to stand up and sit down from a chair, car or toilet.  And it’s functional for people who want to be able to pick things up off the ground, push things, walk or run up hill and jump. It’s also a fundamental exercise for building strength for athletes, bodybuilders and recreational exercisers.

In real life, whether in sport or in activities of daily living, you move in patterns. Your brain learns certain patterns of firing muscles and those muscles, and their related connective tissues, become stronger and better at performing those patterns.  Every pattern of movement or position (like sitting) that you repeat or maintain for periods of time, trains your brain and body to function just that way.  The important take-away from this is that repeating particular movements trains you to move that way preferentially.

So, now let’s look at the common gym mistakes I mentioned.  To pick a specific example, let’s look at a leg press machine in a gym, as that is vaguely related to a squat. There are different versions but they all (that I’ve seen) have some things in common.  Using a leg press uses similar muscles to the squat as primary movers (mostly quadriceps and gluteals.) But in the leg press you are sitting (or lying) and leaning  back.  Muscularly, this means that core stabilizers that need to work in a squat, don’t need to fire as much and so don’t get stronger doing this movement.  Neurologically, your brain learns patterns of muscle firing specific to this movement.  In this case, it learns to fire major leg muscles independently of many core and other stabilizers.  This is different from any pattern you are likely to use in life.

So, whereas a squat is functional to sitting and standing, jumping and landing and even picking things up off the floor, the leg press is functional to what? Lying on the floor and lifting your kids on your feet?

(This sounds slightly harsh.  I’m not saying no one should ever use a leg press…  Just not everyone and not too much.)

The bottom line is this–weight and strength machines that isolate movements are ok sometimes for rehab or what’s called pre-hab (working with specific muscular imbalances, sometimes by isolating particular weak muscles in order to create better muscular balance, biomechanical alignment, neuromuscular function and reduce injury.) But the lion’s share of your exercises should be movements that use multiple muscle groups together, possibly move through different planes of motion and that in some clear way (muscularly and neurologically) support some real-life movement patterns.

 

This does mean fewer machines (weight and unnaturally patterned cardio machines like ellipticals) and more exercises on your feet, with free, weighted items for resistance (weights, medicine balls, sandbags etc.) and/or with your own body weight.

And yes, you probably need some qualified instruction to learn appropriate exercise selection for you and proper form and programming for these exercises.  But in my view, it’s well worth it.  You’ll have your body for the rest of your life.  It seems a worthwhile investment of time and probably some money to learn ways to use it that will help you become fitter, more vital, more functional and less injured.

And on top of that– appointments with a qualified trainer or conditioning specialist are motivating!

What do you think?

You like food sweet? Maybe you’re addicted. Sugar part 1.

Friday, February 3rd, 2012

Though I have no formal training in addiction counseling, I have for years freely used the word “addiction” when talking to clients and others about the pervasiveness of sugar in the American diet.  To be fair to myself, I will say that in graduate school and since, I have read studies indicating this is true: sugar is addictive to humans.

(By the way, white table sugar is really just one chemical- sucrose.  So, by many, it is not technically considered a food, but rather a food extract or chemical isolate.)

The former head of the FDA, Dr. David Kessler, in his book, The End of Overeating ,describes a bit of the mechanism by which sugar triggers the reward section and actions of your brain and makes you want more and more of it. And, like other addictions, as your addiction progresses, it takes more and more sugar for you to get the same pleasure feelings (read: “high.”)

Rats that are addicted to cocaine will give it up when forced to choose between that and sugar.

Rats genetically prone to become obese will drink so much sugar syrup, when it is provided ad libidum, that they become so obese their feet no longer touch the floor.

The immense amount of sugar we consume (131.9 lbs per capita in the US in 2010) has massive health implications. Many have pointed out the connection between sugar consumption and overweight and obesity.  It also leads to more inflammation in the body and is thus linked to all the major killer diseases in the US, including heart disease and cancer.  And of course, it’s linked to the continuously increasing rate of diabetes. Even a NY Times article covered the powerful lecture by Dr. Robert Lustig in which the UCSF MD overtly describes sugar as a toxin and describes how, essentially, it is killing many people every year.

Though our astronomical sugar consumption is down from a high of 151.3 lbs per capita in 1999 (kudos!) it still amounts to more than 650 calories per American per day. In a typical 2,000 calorie/day diet (though many people eat fewer calories than this) that amounts to approximately a third of calories.  What?? (To be fair, the amount of sugar per year is really a statistic of sugar delivered for food availability, and therefore must be higher than what is actually consumed because there is certainly some waste.) Nevertheless, that’s a lot!

Even in other parts of the world, that figure is much lower.  In China, the average annual per capita sugar consumption is only about 12 lbs.

Keeping in mind that human history is thousands of years long, we can understand that for the lion’s share of our existence, the vast majority of human beings consumed no refined or condensed sweetener like sugar.  Even as the middle ages brought better refining technologies to Europe, “sugar”- as a refined product of either sugar cane or sugar beet (and nowadays as a refined product of corn)– was still a highly valued, expensive commodity with limited availability and most humans had little or no exposure to it.

All of this means one thing– we are not wired (created, evolved- take your pick) to have this much sugar in our lives.  This affects us in 2 major ways.  The first is that, since we have a natural taste for sweets (largely believed by evolutionary biologists to be be based on the healthfulness and calorie density of fruit) we simply become addicted to refined sweetener. (Remember David Kessler.)  The second main way this unprecedented availability of sugar affects us is that, since our metabolisms are not suited to handle it, we get fat and we get sick. (See above.)

Just one of the reasons I think this has persisted is because we have not, as a culture, acknowledged that sugar is such a great contributor to disease and such an addictive substance.  In fact, it generally has happy psychological associations– birthdays, holidays, grandmothers… everyday life. It’s place in our society as something “normal” has made it more difficult for people to curb their consumption.  It’s everywhere and it’s accepted. And most of us are very accustomed to it.

So, we’ll save the discussion of how to make lasting dietary changes, particularly changes in sugar consumption, for next time.

But for now, try and remember these 3 main points:

1. We consume more sugar than any group of humans in history.  A lot more.

2. Sugar is addictive– eating more makes you want to eat even more.

3. Our level of sugar consumption (including high fructose corn syrup) is closely linked with serious negative health consequences, including connection to all the major diseases in the US.

Athletic conditioning tips

Thursday, January 19th, 2012

And here’s the first in a series on how to train properly for specific sports and other athletic endeavors. This also applies to physical rehab and increasing function in activities of daily living. In this first post, we’ll start with general tips…

First, the term “specificity” is one everyone training for a particular task should know. It basically means that the way you work towards certain physical goals should have much in common with the physical goals themselves.

If you are a tennis player, for example, you make many short burst movements, a lot of lateral movements, and do a lot of torso rotation and quick repositioning of feet. You want your conditioning to prepare you specifically for these. So, for example, jogging is not very specific to your sport. Both for the type of movement, the direction of movement, the speed of movement and the body fuel systems used.

Court drills like crossovers, shuffles, line hops and side hops are examples of conditioning exercises with specific application to tennis. These are the types of movements and training drills to focus on as a tennis athlete.

A second broad tip for athletic conditioning is to have some understanding of seasonal periodization. I have worked with many high schoolers who are multi-season athletes. This means they don’t have a traditional pre-season, season, post-season, off-season configuration to their year. But to the greatest extent possibile understand the following:

In the off-season is when an athlete focuses more on building up the aspects of fitness that he or she most needs (eg strength, power, speed…) and as the season approaches the athlete shifts more and more towards sport-specific movements and drills and more away from general conditioning (such as the weight room.)
In season, the athlete is mainly focused on playing the sport and performing very sport specific movements. This is not the time to spend energy in trying, for example, to pack on muscle.

In choosing exercises and drills to prepare you for your sport, consider the following:
What are the typical directions of movement in your sport?
What are the typical speeds of movement in your sport?
What movements are normally combined in your sport?
What is the typical time element of movements in your sport? (eg work:rest ratio, as well as balance between various intensities of movements.)

Based on this, or on getting some qualified guidance, design a training program that will maximize your ability at your sport.
Do your best!

Omega 3s- #1

Wednesday, December 28th, 2011

Most readers have probably heard a lot about Omega-3 fatty acids in our diets. You may have heard that we not only get much less of this stuff than our ancestors did, and also that these are “essential” fatty acids (meaning that we have to consume them in our diet- our bodies cannot produce them {basically]), but also that the proportion of these fats in our diets compared to others has dramatically shifted in the modern era mostly because of the availability and usage of relatively cheap vegetable oils (corn, soy, cottonseed, rapeseed) which are primarily composed of other fatty acid types (mostly Omega-6.)

There is a lot to say on this topic so we’ll do a short series on it, but a recent article in The Economist (http://www.economist.com/science-technology/displaystory.cfm?story_id=16214142&source=features_box_main)
makes some important points.

Let’s bullet them:

  • In 1909 the percentage of linoleic acid (an Omega-6) in the American diet was 1%. By early 21st century it was 8%.
  • In rats fed diets composed of either 1% linoleic acid or 8% linoleic acid, the rate of obesity doubles with the higher percentage.
  • Linoleic acid, when consumed by humans, is converted into molecules called cannabinoids, which increase appetite.
  • Some estimates of the historic human consumption of fatty acids say that the average human used to consume Omega-3 fats in a 1:1 ratio ratio with others. In the modern US, the ratio is 20:1, Omega-6:Omega-3.

So, while there are many reasons to be aware of and to try to improve the type (and proportion) of fatty acids present in your diet, let’s just sum up one important point covered here:
As you eat more Omega-6 fatty acid, your appetite increases, you probably eat more, then you weigh more.
One simple tip for now is to start looking out for prepared/packaged foods and their fat content and type. (Especially think chips and fries!)
The general recommendation for so many health reasons, is to start to lean more and more towards eating foods that you (or your family etc.) make, and eating less out of packages if possible. And if you prepare a food, learn which fat sources are the highest in Omega-3 fatty acids and which in Omega-6s and Omega-9s.
Eat well! It makes a difference.

Making Dietary Changes– the 5% Method

Sunday, December 11th, 2011

One of our main wellness categories is food and nutrition. While there is a lot of “information” out there about what is the best way to eat (and we talk about that on this site as well) there is one aspect of dietary change not discussed nearly as much.

Almost everything you read or hear about diet is about what to do, not about how to do it.
Behavior change is its own science, with its own methods and research. So, in this thread of posts we will discuss how to make changes that you may even already know you’d be better off making.

We’ll start in this intro post with Behavior Change Tip 1:
Don’t be afraid to be gradual.
Remember, it’s better to be a little slower and make changes you won’t constantly “rebound” from but rather will happily keep for the long term.

True story: I was discussing nutrition with a woman who, at the time, had a husband and 2 kids at home for whom she cooked every day. They were big pasta eaters and, in her quest to help them all lose a little weight, she said maybe they shouldn’t eat so much pasta.
Among other things, I suggested switching to whole wheat pasta. (It’s much healthier.)
She came back the next week to say she tried it, and none of her family members wanted to eat it.
So, I gave her the gradual method. I said, the next time you make pasta, use your regular pasta, and put in just 5% whole wheat. Do that several times (or as many as needed!)
Then, add another 5% whole wheat for a period of time. Continue this way, in whatever time frame works.

Bottom line: 3 months later the family was eating all their pasta whole wheat and no one minded any more.
In the course of a lifetime, if a change doesn’t have to be immediate, 3 months is not too long to make a healthy, lasting change– that you end up liking.

FitTip 1– no spot reduction!

Monday, November 28th, 2011

One of the most common questions I have gotten for years from fitness clients is, “What exercise can I do to get rid of ‘this?’” People usually ask this as they hold onto some flabby or fatty part of themselves– the belly, the butt, the back of the arm etc.

Though most exercisers at some point ask a version of this question, let me reiterate the scientific conclusion that this (spot reduction) does not work.

Muscle and fat are 2 separate biological entities and, while working muscles certainly use fat as a fuel, the distribution of fat on your body is not (at least according to western physiology) primarily determined by the amount of work done specifically by the muscles that lie just beneath the targetted fat layer.
Rather, burning fat is based on a general balance between the amount of energy (calories) you take in compared with the amount of energy your body uses and also on the nature of your metabolism. (For example, a 16 year old boy is more likely to turn calories into muscle than a 70 year old woman. Largely because of hormones…)
Bottom line: if you’re holding a roll of fat on your belly and wondering how to get rid of it, as opposed to dropping to the floor immediately to do crunches, you might instead think of how to cut some of those extra, especially junky, calories from your diet and maybe how to increase your overall metabolic fuel usage– like by moving. We don’t like crunches anyway. But that’s for another post…

FitTips Introduction

Monday, November 28th, 2011

While some of our posts will be more in depth and more article-like, we’ll also keep some down to very manageable size and content. One of these categories will be FitTips, a series of short posts giving specific and concise tips on fitness, movement and your health. Enjoy them!

Posture, movement and Biomechanics 2– Example: Carpal Tunnel Syndrome

Monday, November 21st, 2011

So, you work a lot of hours at a desk, or you travel a lot by car, plane or other vehicle. You sit. You’ve had some occasional pain in your back or neck and, well, maybe you’re not a kid anymore. Or maybe you’re a carpenter, an assembly line worker or a roofer. And now, you’re getting this numbness and tingling in your hand and fingers. You go to the doctor and she tells you it’s Carpal Tunnel Syndrome (CTS). And you need surgery.

Well, maybe.

(First of all, for you to be properly diagnosed you pretty much need either some imaging or to perform two small physical tests, called Tinel’s test and Phalen’s test. Ask the doc.)

To be concise, CTS results from irritation or inflammation of the median nerve as it passes through the tunnel in the wrist partially formed by the carpal bone. It’s a relatively small space, so if the nerve becomes inflamed and swollen, it is subject to pressure and the resulting neorogenic pain, possibly accompanied by numbness and tingling in the hand.

The surgical option enlarges the tunnel (relieving pressure on the median nerve) by cutting the ligament that forms the top of the tunnel and possibly removing other “excess” tissue such as scar tissue or a tumor.

Now, I am not going to tell you that no one ever needs this surgery or that no one ever needs surgery for anything. OK?
But, the fact is that the causes of CTS are usually preventable and the syndrome often curable without surgery. (I can’t tell you when it is or isn’t, but you usually have little to lose by trying the non-surgical methods first.)

The median nerve, of course emanates from your spinal cord. It comes out in your cervical spine with roots coming through several cervical vertebrae. It runs down your arm to a few of your fingers.

The hook is that the inflammation that is associated with CTS can result from numerous factors including compression of that nerve anywhere along its course, from your neck to your finger tips.
In fact, statistically, incidence of CTS is also associated with the incidence of Thoracic Outlet Syndrome (TOS—variable nerve compression or pain in the shoulder girdle)(Kisner), inflammation of the pronator teres muscle in the forearm (Kendall), and “excessive activity” of the neck muscles like sternocleidomastoid (SCM) and paraspinals (Chaitow.)

These all can happen from simple poor posture and or faulty movement patterns.
Now, if you swing a hammer for a living you may not have too much choice in trying to avoid a repetitive movement that may inflame your median nerve.
But pretty much everyone can do the following—

Correct your posture—sitting up straight, keeping your shoulders neutral (not rounded forward), keeping your chin in and head straight and, as much as possible, keeping your wrists in neutral position (which means not bent back.) This can prevent much of the muscle shortening and tightening as well as positions that can compress the median (or numerous other) nerve(s.)

Stretch— (If you have no medical limitations preventing you.)
To offset time spent with the typical poor posture connected to CTS, you should probably stretch your upper shoulders and neck (upper trapezius, levators, SCM, scalenes), your upper chest/shoulders (pectoralis major and minor, serratus anterior) and forearm (numerous muscles, including pronator teres.)
How—Reaching your right hand down at your side towards the floor, let your head tip to the left. Slightly vary the angle of your head to feel different versions of the stretch. Hold this to each side for 15-30 seconds and repeat 2 or three times per side.
–Standing up straight, tightening your belly, reach your straight arms to your sides at shoulder height and then move them straight back as far as they’ll go without arching your back. You can do this with an assist from a doorway or similar structure too to help your hands move back. Hold 10-30 seconds, without pain. Repeat 2-3 times.
–With your right arm held out in front of you, use your left hand to stretch the wrist down (flexion) and hold. Then do the same but stretching the hand up (extension.). Hold each for 15-30 seconds, 2-3 times. Repeat on other side.

Massage—while better if done by a trained professional, you may also be able to do this safely yourself focusing on the areas mentioned above. The idea is to find and relax contracted muscles in the abovementioned areas. As we will discuss more on this blog, simple muscle contraction can cause all kinds of pain and damage, including carpal tunnel syndrome. And it is usually at least partially correctable with massage and stretching.

In sum, we talked about carpal tunnel syndrome here, but the real message is that poor posture and incorrect biomechanical function can cause real medical problems. Further, most of your doctors are just not going to help you correct these problems at their root causes, for example, short, tight muscles. But we will.
Again, I’m not telling you not to go to you doctor. Or even not to have surgery. I’m trying to help you see the big picture and figure out how it applies to you.

Keep reading for more tips!
Be well.

Works Cited: Kisner and Colby, Therapeutic Exercise, 5th Edition, 2007;
Kendall et. al, Muscles Testing and Function 5th Edition, 2005;
Chaitow, Muscle Energy Techniques, 2007;
Mayo Clinic Website: http://www.mayoclinic.com/health/carpal-tunnel-syndrome/DS00326/DSECTION=prevention;
WebMD website: http://www.webmd.com/pain-management/carpal-tunnel/carpal-tunnel-syndrome-surgery

Posture, Movement and Biomechanics—An introduction

Thursday, November 10th, 2011

We plan to do a number of posts on this general topic.

So let me first tell you what it’s about.

In short, anything you do repetitively as a movement or any position you hold for significant amounts of time, trains your body and brain.

For example, when you sit a lot at a desk and let your shoulders slump forward, you are shortening muscles in your chest and shoulders. When you keep two ends of a muscle closer together, the muscle actually remodels (Davis’ Law) and becomes shorter. Opposing muscles (antagonists) that perform the opposite action (in this case the retraction of your shoulders) become elongated and weak. Your body and brain are literally memorizing this faulty posture.
In addition, this posture is usually combined with a forward head position which additionally causes muscles in your neck and upper shoulders to become tight as well.

Similarly, if you do a specific motion repetitively (e.g. hammering nails) you repeatedly use the same muscles in the same way—similar force, movement pattern, range of motion etc. These muscles too can become “over”-developed and tight. If this is a one-sided movement, you’ll also have a discrepancy between the side you use and the one you don’t.

So, what’s the big deal?

Well, there may be a bunch of big deals. Here are a couple.

First, there are usually direct results of these short muscles and compacted joints. For example, when your shoulders slump forward and those related muscles become tight, you are shrinking passageways in your front shoulders through which pass nerves, tendons, blood vessels, lymph vessels etc. Possible long term results include pain, nerve damage, joint degeneration, arthritis and muscle damage.
Similarly, the muscles that contract from the faulty posture, themselves compress structures in the body. For example, tight neck and shoulder muscles can compress nerves and cause headaches, nausea, arm pain, carpal tunnel syndrome (see next blog post) and more.

Next, remember the kids’ song about the thigh bone being connected to the hip bone and so on? Well, the message there is that our body parts are all connected and related and you can infer from that that change in one place can have effects somewhere else.

A hypothetical example. Think of that same slumping seated posture, with forward head tilt. The slumping forward of the head and upper torso has a tendency over time to cause an overall rounding of the spine so that the tailbone gets tucked under and the lower back curve is reduced or disappears. One result of this is that when standing the ankle joints go into partial plantar flexion (like you’re pointing your toes a little.) That tightens and shortens the calf muscles. You go on walking around with this multi-joint dysfunction. Maybe, over time this causes Achilles tendonitis or plantar fascitis. If that were to happen, it’s unlikely that your doctor would talk to you about sitting up straighter at your desk, even though that may well be the root cause.

This is just one example, but the simple lesson here is to try and maintain good posture.
The slightly deeper lesson is that your posture is important in ways you probably haven’t imagined. And that correcting it may eliminate things you had no idea were connected.

Do what you can to keep correct posture and movement patterns and learn what needs to be stretched and what needs to be strengthened in order to do that. Most important is to start being aware of your posture and doing what you can to feel long, poised and relaxed whenever possible.
And keep checking with us to learn more.

We look forward to helping you towards greater and greater wellness.

Be well.