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Movement You Should Master

Segmental Rolling

Modern medicine is keeping us alive longer, so now we need to put some effort into staying lively longer.  Mastering specific movements will improve our quality of life and help us stay independent and injury-free. I have come up with several exercises you can use to make yourself stronger, more durable, and develop a healthier, more functional body.  An exercise that I have found to be very helpful in restoring the capacity to get up and down off the floor is Segmental Rolling.

Segmental Rolling

Rolling over seems simple, but many people over 60 struggle to roll from their back to their stomach and stomach to back. This doesn’t necessarily need to be an exercise within your training program but should be practiced at least 2-3x/week and is easily added to your warm up or cool down routine.

1) Segmental Roll led with arm

2) Segmental Roll led with leg

See video of rolling here: https://youtu.be/VttWNcN-g0o

-Jeff Tirrell, CSCS, Pn1

A Plea For Your Knee

In our physical therapy clinics, we treat patients with knee pain on a daily basis.  It has become more common to train younger clients with a history of knee injury and ongoing knee pain.  Jane Brody’s recent *article in the New York Times has some excellent advice on the care and management of knee pain problems.  I have some further suggestions and clarifications.

Less Mass

The mass portion of the Force = Mass x Acceleration formula needs to be at an appropriate level for your knees to stay healthy.  Carrying extra body fat creates an environment that invites knee wear and tear.  The common knee pulverizing mistake is to perform high impact exercise activities in an effort to lose fat.  If you are twenty pounds overweight, do not run, stadium step, soccer, tennis, or pickleball.  Start with strength training and low impact cardio.  Lose the fat first, and even then, the lower impact activity will be healthier for your knees.  From the overweight client limping into the clinic I get the “I need to move around to lose weight” protest.  I am sorry, but fat loss is primarily a function of dietary alteration.  Exercise has very little impact on body fat levels if you do not eat properly.

Train the Way You Wish to Play

A properly planned fitness program makes your knees more durable (fewer injuries) when you participate in your favorite recreational activity.  The training must be tailored to your activity goals.  If your goal is to play tennis, then you must perform three dimensional deceleration / acceleration activities as part of your training program.  Yoga will not prepare your knees for tennis.  If you want to water ski, then you must perform strength training for your back, hips, and knees.  Distance running will not prepare your knees for water skiing.  If hockey is your recreational past time, you need to be strong, well conditioned and competent in all planes of motion.  Long duration recliner intervals will not prepare your knees for hockey.

Look Above

If your hips do not move well, your knees will pay the price.  In this age of all day sitting and minimal physical activity, hip function is at an all time low.  Physical therapy patients with knee pain nearly always present with glaring restrictions in hip range of motion and strength.  If your knees hurt, dedicate some training time to restoring hip rotation and hip extension movement.  Learn how to perform some remedial gluteal activation drills.  Learn a proper hip hinge, squat and a pain free lunge pattern.

Think First

Participation in a single inappropriate activity can produce a lifetime of knee trouble.  That box jump workout of the day- maybe not.  The warrior, electric shock, mud hole, death run–bad idea.  Trampoline with the grandchildren–what were you thinking!

Be Proactive and Seek Treatment For Knee Pain

“Training through the pain” can take a graceful athlete and turn them into a lifelong speed limper.  The presence of pain changes the way your brain controls movement.  Left untreated, it can permanently alter neural signals and produce movement patterns that linger long after the pain has resolved.  Live with enough cycles of inefficient movement and you develop early breakdown in the knee.

Michael O’Hara, PT, OCS, CSCS

*What I Wished I’d Known About My Knees, Jane Brody, New York Times. July 3, 2017

Read the NY Times article here: https://www.nytimes.com/2017/07/03/well/live/what-i-wish-id-known-about-my-knees.html?_r=0

Movement You Should Master

Step Ups

Modern medicine is keeping us alive longer, so now we need to put some effort into staying lively longer.  Mastering specific movements will improve our quality of life and help us stay independent and injury-free. I have come up with several exercises you can use to make yourself stronger, more durable, and develop a healthier, more functional body.  An exercise that I have found to be very helpful in restoring the capacity to get up and down off the floor is the Step Up.

Step Ups

The ability to go up and down steps will almost always be needed.  Losing this ability is a sure sign that one’s quality of life and independence are quickly fading.  Step Ups can be done in a variety of different directions and loaded a number of ways making them easily progressed or regressed based on goals and fitness level.  Step Ups improve balance and strength in the glutes, quads, and hamstrings.  Depending how you load, they can also challenge the core and shoulders.  The average step in the United States is 7 inches tall.  Strive to work up to a 14 inch box so that no flight of stairs will ever intimidate you.

Here Coach Katie demonstrates two different versions we like to use and the benefits of each along with some progressions.  Watch the video and give it a try: https://youtu.be/iGXtKyGlKMg.

1) Anterior Step up (Progression: Anterior Step Up with Racked Kettlebell hold)

2) Lateral Step Up (Progression: Lateral Step Up with one side loaded)

-Jeff Tirrell, CSCS, Pn1

 

Movement You Should Master

Weighted Carries

Modern medicine is keeping us alive longer, so now we need to put some effort into staying lively longer.  Mastering specific movements will improve our quality of life and help us stay independent and injury-free. I have come up with several exercises you can use to make yourself stronger, more durable, and develop a healthier, more functional body.  An exercise that I have found to be efficient and effective is a Weighted Carry.

Weighted Carries

Very few things are more functional than a carry.  You’d be hard pressed to get through daily life without having to carry something at least a few times per week.  While basic, a carry is an efficient and effective full body exercise.  Depending on the carry you choose, the load is virtually limitless.  Performed for time or distance, carries will always improve gait and core stability.  Depending on which version you use, they can also be an effective tool for improving shoulder mobility/stability, grip strength, balance, and overall awesomeness.  Watch the video and give it try: https://youtu.be/PaP4-IlVAOA

Coach Chad demonstrates my top four carry picks:

1) Farmers Walk (gait, core stability, grip strength, upper back, legs)

2) Suitcase Carry (gait, core anti-lateral flexion, grip, upper back, balance)

3) Waiters Carry (gait, core stability, shoulder stability, balance)

4) Double Waiters Carry (gait, core stability, shoulder mobility, shoulder stability, balance)

-Jeff Tirrell, CSCS, Pn1

 

Movement You Should Master

Pull Ups

Modern medicine is keeping us alive longer, so now we need to put some effort into staying lively longer.  Mastering specific movements will improve our quality of life and help us stay independent and injury-free. I have come up with several exercises you can use to make yourself stronger, more durable, and develop a healthier, more functional body.  An exercise that helps build upper body strength and maintain shoulder mobility is the Pull Up.

Pull Ups

If you are a superhero and find yourself hanging off the edge of a cliff or a building, you’ll need to pull yourself up.  All kidding aside, the pull up is a fantastic exercise to build strength in the lats, biceps, rhomboids, and rear delts, while helping to maintain shoulder mobility.  Pull ups can be done with a variety of grips.  The most important thing is to use a full range of motion and maintain control (avoiding excessive movement to reduce injury risk).  I utilize one of three pull up versions with most clients depending on their fitness level.  Watch the video and give it a try.

1) Eccentric Pull ups: Use a box to start in the top position, and slowly lower yourself with complete control down to the bottom position.  Once you can complete 10 of these with a good 4-6 second descent, then it’s time to move on to a standard pull up.

2) Standard Pull up:  Start hanging from a bar (or rings) with your arms completely straight.  Pull yourself up until your clavicle touches the bar.  Slowly lower yourself back down until your arms are completely straight and your body is motionless.

3) Xiphoid Pull ups: Start as you would for a standard pull up, but rather than pulling to your clavicle, you want to lean back and pull yourself up until your xiphoid process (bony part at the bottom of your sternum) touches the bar.  Then, lower yourself in a controlled manner back to the start.

See video of pull ups here: https://youtu.be/Cyvp4X2MRC0

-Jeff Tirrell, CSCS, Pn1

Very Short Term Running Preparation

I was recently asked by a fitness client to post exercise recommendations that would prepare her for outdoor distance running.  This person was two weeks away from being out on the road, running two or three miles a day.  She is middle aged, has a prior history of lower back pain, and her goal was to lose fifteen pounds and “tone up”.   Given such short notice, these are my recommendations.

Perform soft tissue work on a daily basis.  Foam roll the legs and use a lacrosse ball on the plantar fascia.  The vast majority of overuse injuries in runners happen in the lower legs and feet.  Attempt to unwind the myofascial distress created by 600-700 foot impacts a mile.

Improve your reciprocal hip pattern–one hip goes back and the other goes forward.  Most general fitness clients have glaring deficits on one side.  Perform some split squats, posterior lunges, step ups, and or walking lunges.  If you struggle with these activities, I would reconsider running as a fitness activity.

Wake up your gluteals.  Every day, perform fifty or sixty bridges, hip lifts, or leg curls.  You need super gluteal strength / endurance to run distances and avoid lower extremity injury.  If your butt gets sore from fifty bridges, you need to do them more often.

Running is a skill and most recreational runners need some practice.  Running hills will improve gait mechanics, enhance hip extension, and decrease deceleration forces.  Find a fifty-yard hill.  Run up the hill and walk back down.  Perform five hill runs.

You are always better to run too little than to run too much.   Start with very short runs– no more than half a mile.  Increase your total weekly mileage by no more than five percent a week.

You can’t do this in two weeks, but this is my big recommendation to all future runners.  Lose the extra weight before running.  As a method of fat loss, distance running has a poor track record.  It tends to elevate the hormones that make you hungry, and physiological adaptation to distance running happens fairly quickly.  Extra adipose makes you far more likely to develop a running related injury.  I know the guys and gals you see running miles and miles every day are lean.  Please remember that lean runners are successful with running because they possess the optimal body mass to run long distances.  They did not start heavy and become lean.  Put a fifteen pound weight vest on that guy or gal and everything will change.  Their gait will lose efficiency and become less graceful.  The extra fifteen pounds of load creates the biomechanical overload that makes them much more likely to suffer an injury.

My final recommendation is that you not become disappointed if you develop pain.  A runnersworld.com poll conducted in 2009 revealed that 66% of respondents reported a running related injury that year.  The statistics indicate that one third of the participants at you local 10k fun run will require medical attention for a running related injury over the next year.  Have the good sense to stop when the pain begins.

Michael S. O’Hara, PT, OCS, CSCS

Are You Ready?

Spring At The Physical Therapy Clinic

The weather is warming up and soon we will leave the heated, insulated, safety of our home gyms and fitness centers.  The spring migration back to tennis, soccer, pickleball, golf, fitness running, ultimate Frisbee, and stadium steps will begin.  My physical therapy question is– Are you ready for these new challenges?  Has your fitness program prepared you to withstand the rigors of these spring endeavors?  This checklist should help you answer the question.

Have you been performing most of your fitness activities in standing?
Nearly every sport and most household chores are performed in a standing position.  During most of my visits to commercial gyms, the majority of the activity I witness is in the supine, seated, or heavily supported positions.  If your goal is to move better and remain free of injury, then 90% of your exercise should be performed in standing.

Do you practice moving in all directions?
Nearly every sport involves moving side to side, forward-backward, and in a rotational pattern.  Basketball, soccer, golf, and tennis all require you to accelerate and decelerate movement in all directions.  Most gym activities are predominantly sagittal plane– forward and backward.  You ride on the elliptical, spin the bike, and run on the treadmill for months, and your spring visit to the tennis court results in a twisted ankle because you are unfamiliar with side to side movement patterns.

Have you been working on better balance?
Balance is a skill that tends to deteriorate with age, injury, and a sedentary lifestyle.  Many commercial exercise machines take all balance demands away.  The elliptical, spin bike, recumbent bike, rower… all are heavily supported.  Proficiency with single leg stance balance prevents injuries and improves performance.  The older and more deconditioned you have become, the more your fitness program should include single leg stance balance training.

Do you perform any explosive exercises?
We get slower before we get weaker, and life is an up-tempo game.  We need to perform exercise that enhances quickness and improves control of deceleration forces.  What you do in the gym is reflected in how well you can move during activities of daily living.  If you continually exercise at slow tempos, you will get better at moving slowly.  If you train explosively, you get better at moving at faster speeds.  The capacity to decelerate a fall requires fast reactions.  Gracefully traveling up the stairs and getting out of the car are only improved with exercise that enhances power production and speed of movement.

Michael S. O’Hara, PT, OCS, CSCS

Advice From The Experts At Fenton Fitness

Tara Parker-Pope wrote a great article in the October 17, 2016 edition of The New York Times entitled “The 8 Health Habits Experts Say You Need in Your 20s.”  While I agree with some of these recommendations, we at Fenton Fitness and Fenton Physical Therapy have some suggestions of our own.

#10–Establish A Veggie And Protein Habit

One of the biggest deficits I see in many food logs is the lack of protein consumed.  We have been conditioned to snack on high carb/highly processed food, so eating more protein can be a difficult shift.  When I do see protein, it’s in the higher fat varieties of sausage, bacon, burgers, etc.  It would benefit younger individuals to start adding healthy doses of protein to their diets as soon as they are responsible for their own food preparation.  Shoot to have some form of lean protein as the base of your meal along with a couple of servings of vegetables. Once you have that base (taking up ½ to ⅔ of your plate), then you can add in whole grains, starchy carbs, fruits, dairy, healthy fats, etc.  Protein increases your metabolic rate more than any other nutrient, aids in recovery, helps build and maintain muscle mass, and much more.  We recommend 25-35% of total calories to come from protein, or 0.8-1gram/pound of body weight.  Most individuals should shoot for 4-8 servings of vegetables per day as well.

-Jeff Tirrell, CSCS, Pn1

To read the article, click on the link below:

http://www.nytimes.com/interactive/2016/10/16/well/live/health-tips-for-your-20s.html?_r=0

 

 

March is National Colorectal Cancer Awareness Month.  I can speak first-hand about the horror of this disease.  Colon cancer, slowly and painfully, killed my father at the age of forty-nine.  Everyone needs to learn the facts about colon cancer and get tested.

Colon cancer is the third leading cause of cancer deaths in the USA.  The good news is that colon cancer can be beaten if it is caught at an early stage.  The American Cancer Society recommends people over the age of fifty have a colonoscopy examination.  Unfortunately, only about 60 percent of the fifty years plus population are up-to-date on their colon cancer screening, and many have never been screened at all.  If you have a family history of colorectal cancer, you need to get tested at an earlier age.

A worrisome trend is a rise in colorectal cancers in young people.  Take the time to read the attached article by Roni Caryn Rabin in the February 28, 2017 edition of The New York Times.  Doctors are not certain why more 20 and 30 year olds are developing these cancers, but we need to be aware that this disease is no longer just an older adult issue.

Half of all colon cancer deaths could be prevented if people got tested regularly. That’s why the American Cancer Society, in partnership with several other organizations, has set a goal to increase colon cancer screening rates to 80 percent by 2018.  This could save more than 7,000 lives a year.

More than 50,000 deaths from colon cancer are expected this year.  That makes up 9 percent of all cancer deaths in the USA.  Proactive screening for colorectal cancer works.  We need to get more people involved.

Read the NY Times article here: https://www.nytimes.com/2017/02/28/well/live/colon-and-rectal-cancers-rising-in-young-people.html?_r=0

-Michael O’Hara, P.T., OCS, CSCS

Advice From The Experts At Fenton Fitness

Tara Parker-Pope wrote a great article in the October 17, 2016 edition of The New York Times entitled “The 8 Health Habits Experts Say You Need in Your 20s.”  While I agree with some of these recommendations, we at Fenton Fitness and Fenton Physical Therapy have some suggestions of our own.

#9–Build Muscle

Much like strength, muscle mass is often not prioritized until it is largely too late.  Though you can still build muscle at an older age, it is much more difficult.  Muscle mass is highly correlated with strength which is correlated with power.  All of these tend to decline substantially at around age 30.  If you take advantage of your hormonal environment and your recovery abilities in your 20’s, you can stockpile a good amount of muscle for the rest of your life so that you can keep doing everything you want as you age.  More muscle also means a better and healthier metabolism which means less accumulation of unwanted body fat and overall better health. The best way to build muscle mass is through resistance training with gradual increases to volume (weight x reps x sets) over time along with a moderate to high protein intake.

-Jeff Tirrell, CSCS, Pn1

To read the article, click on the link below:

http://www.nytimes.com/interactive/2016/10/16/well/live/health-tips-for-your-20s.html?_r=0

 

 

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