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Body Parts

Skeletal Strengthening

Exercise Training That Prevents Osteoporosis

bending_the_age_curveI recently heard a talk by Dr. Joseph Signorile on the latest and greatest research in regards to exercise that prevents and reverses osteoporosis.  Dr. Signorile is a professor of kinesiology at the University of Miami.  He is an expert on fitness for older adults and conducts research in the field of geriatrics.  Based on what field proven research is telling us today, Dr. Signorile has these suggestions:

Bone reacts best to dynamic mechanical stimulation.  The best bone building exercises create a stress that changes as we move, rather than a static force.  Progressive resistance training involves moving your body against a resistance.

If a bone is to respond to training, the stimulus must be at a suprathreshold level.  The participants in the studies that got the best results carried, lifted, pulled, and pushed some serious loads.  “Suprathreshold level” means it has to be physically challenging.  Elliptical training and those five pound chrome dumbbells will not produce a bone building response.

Optimal bone building skeletal loading.  What the research studies have found is that the best gains occurred with forty repetitions of loading at each skeletal region per training session.  Less than forty is less than optimal.  More than forty repetitions have no further bone building benefit.  Two or three properly executed exercises can take care of loading the entire skeleton.  An appropriate skeletal training session can be made up of 80-120 repetitions.  You can get that done in fifteen minutes.

The response of bone to exercise is improved by brief but intermittent exercise.  Loading your skeleton more frequently creates a stronger mineralization response in the bone.  Five or six training sessions per week will produce more bone density than two or three sessions per week.

Bone responds best when you employ a loading pattern that differs from the usual loading pattern.    I have been ranting about this for years.  Bone only adapts–gets stronger–when the exercise stimulus is a challenge beyond what you have subjected the bone to in the past.  If you have been performing the same activity at the same load for months on end, the bone building stimulus is minimal.   To improve bone health, you should alter the exercises you perform every three to four weeks.

What the research recommends….
Based on what the research is telling us, Dr. Joe recommends you perform a program of dynamic weight training that delivers forty repetitions of loading at each section of your skeletal system.  You will see better results with more frequent training sessions and consistent alteration in exercise activities.  Pick two or three exercises and load them aggressively for forty repetitions each.  Perform your exercise three to five times a week and change your exercises every month.  To learn more, talk to our trainers for some bone building exercise suggestions.
Michael S. O’Hara, P.T., OCS, CSCS

Moving Mortality

Just Slowing Down Will Slow You Down

PedometerPhysical therapists and rehab professionals know that bed rest or immobilization of a limb in a cast creates muscle atrophy in a short period of time.  Two or three weeks of either can produce a 25% loss of muscle mass.  But what about just slowing down–deliberately restricting the number of steps taken in a day—what happens then?  A group of researchers in Canada wanted to find out*.

The researchers at McMaster University in Hamilton Ontario had ten healthy older adults restrict activity to less than 1500 steps a day for fourteen days.  All of the participants were active prior to the study.  The average daily step count for those two weeks came out to 1413.  The surprising test results are listed below.  Given the short duration of activity restriction, this study should make us all nervous about “slowing down” for any period of time.

•    Leg fat free mass reduced by 4 percent.
•    Insulin sensitivity was reduced by 43 percent.
•    Inflammation markers increased by 25 percent.
•    Muscle protein synthesis was reduced by 26 percent.
•    Total body fat increased 7 percent.

This study reinforces how essential consistent activity is to our health and independence.   As a society, our overall activity level has dropped.  I encourage my physical therapy patients and fitness clients to track their daily step count with a pedometer**.  Most of us over estimate our activity level and need to make a deliberate effort to move more during the day.

In another article, I will have more information on step studies and a reasonable step goal for optimal health.

*The study was published online April 15, 2013, in the Journal of Clinical Endocrine Metabolism.

**Yamax and Garmin make reliable pedometers and they cost around $45.00.

Michael S. O’Hara, P.T., OCS, CSCS

Super Recovery

Super Bowl Quarterback Peyton Manning

Peyton_ManningPeyton Manning, the Denver Broncos quarterback, will cap off a miraculous recovery from a serious neck injury with his appearance in the Super Bowl this weekend.   Mr. Manning has undergone numerous surgeries and procedures on his cervical spine.  The details of his medical treatment and rehabilitation are the topic of speculation on many sports talk shows.  We do know that he underwent an anterior fusion of his sixth and seventh cervical vertebrae.  An incision is made in the front of the neck and the two bones are fused together using screws and a titanium plate.  The fusion removes compressive forces off the nerve root that exits between the vertebrae and eliminates any movement between these two spinal segments.

Compression on the seventh cervical nerve root creates all kinds of problems for someone who throws a football for a living.  This nerve root carries the signals that fire the triceps muscle (back of the arm) and muscles that help grip the ball.  Trauma to the seventh cervical nerve root can cause loss of sensation in the fourth and fifth fingers of the hand.  Loss of neural control not only has an effect on muscle strength, but also on power production.  You need to be able to create muscle contractions quickly to throw a pass with any velocity.  If the signal that is sent down the seventh cervical nerve root is impeded by compression or inflammation, the pass will be slow.

There are risks associated with playing professional football with a fused cervical spine.  When you fuse the sixth and seventh vertebrae together, you lose about 10% of the range of motion in your neck and you also lose some of the shock absorption capacity in your spine.  The compressive forces and range of motion lost at the fused C6-7 segments are transferred to the vertebrae above and below the fusion.  In the general population, thirty percent of the patients who undergo a cervical fusion require a second fusion in 10 years.  I was unable to find a statistic on pro football players, but I am certain this percentage has to be much higher.

Cervical fusions are not uncommon in professional football, and 70% of the players who have a fusion are able to return to competition.  Mr. Manning plays at the high skill position of quarterback and his passing numbers this year have been amazing.  Win or lose this weekend, Peyton Manning, surgical medicine, and physical rehabilitation deserve applause.

Michael S. O’Hara, P.T., OCS, CSCS

How To Score Your First Push Up

Improving Performance Of A Fundamental Fitness Activity

Improving push up performance enhances spinal stability from the base of the skull to the pelvis, as well as strength in the shoulder girdle.  Push ups are a valuable exercise that improves multiple aspects of fitness in a short amount of time.  Various types of push ups can be used to achieve different goals such as better rotator cuff coordination, power production, or muscular endurance.  Many people have never been able to perform a single solid push up.  Getting better at performing push ups is easy.  The trick is breaking the push up into pieces.

Push Up Planks
The biggest limitation for beginners is limited core and shoulder girdle stability.  The torso and hips sag and the shoulder blades wing off the rib cage.  To remedy these problems, work on improving isometric stability with push up planks.  Set up in the top position of the push up and hold for thirty to sixty seconds.  Get a mirror or have a training partner check your position.  Keep the gluteal muscles tight and pull the shoulder blades down the back.  Elevate the feet on a bench or box to increase the challenge.

Eccentric Push Ups
The most difficult portion of a push up is the eccentric or the lowering phase.  You often see “half push ups” performed in the gym because the trainee is unable to maintain control if they drop any further.  Start from the top of the push up and lower in a controlled fashion all the way to the floor.  You will probably find that the bottom half is difficult to control–keep trying, it will get better.  Perform two or three sets of three eccentric push ups.

Dead Stop Push Ups  
The neural link up between varying muscle groups needs to be turned on to make a push up happen.  Starting your push up from a dead stop off the floor improves these connections.  Lay prone and place the hands on the floor directly adjacent to the armpits with the elbows back.  Your upper arm should be no higher than 60 degrees from your side.  Set your body by tightening up the shoulders, pulling in the chin, and bracing the abdominals and gluteal muscles.  Think about moving quickly off the floor.  Return to the floor, recharge your neural system with a ten second rest, reset, and perform another repetition.  Once you get up to five good dead stop push up repetitions, move on to a full push up from the top position.

BOSU Leverage Push Ups
If you are not able to perform a push up from your toes instead of dropping onto the knees, I recommend using a BOSU under the thighs.  It will produce a higher core stability demand, and I have found it has far more carry over to a true, full push up than the kneeling “girls push up’.

Avoid Training To Failure
Getting better at push ups is more neural than it is muscular.  You make better progress if performing fewer repetitions with good technique rather than dozens of bad push ups.  If you want to improve your push up performance, do not train your push ups to the point of failure.  Stop the set with one or two repetitions “still in the tank”.  If six repetitions is your maximum, stop at four, rest, and then repeat for another sub maximal set.  Try laddering your sets of push ups; perform a five repetition set, and then a four repetition set, and then a three until you reach one repetition.  You will increase the total work volume–more practice, without exhausting the nervous system.

Michael S. O’Hara, P.T., OCS, CSCS

30 Minutes Of Fitness

Remember, You Asked For It

“I don’t have enough time” is the big excuse people give for not exercising.  At Fenton Fitness,  we can get you in and out of the gym in thirty minutes.  Our movement based training sessions produce excellent results with minimal time commitment.  We program in high value exercise activities in a layout that produces optimal gains.  This is the first of six, 30 Minutes of Fitness, sessions.  The best workouts are short, intense, and frequent.  Intensity is usually the missing factor in most gym goers’ training sessions.

Session One
1.    Moving knee to chest mobility drill x 20 yards
2.    World’s Greatest Stretch x 20 yards
3.    Sled Push x 100 yards
4.    A. Push ups 3 x 8-12 repetitions
B. Inverted row or TRX row 3 x 6-10 repetitions.
C. Kettlebell Goblet Squat 3 x 6-10 repetitions.
5.    Medicine Ball Overhead Throws off wall 3 x 5 repetitions.

One and Two:  Perform the two basic movement preparation drills for twenty yards each.
Three:  Load your sled up with +/- 20% of your body weight and give it a push for 100 yards.  You can rest as needed, but try to get the entire 100 yards completed in less than five minutes.
Four:  You should be warmed up, breathing faster, and ready for some strength training.  Perform the next three exercises in a circuit fashion.  A set of push ups followed by a set of rows and then a set of goblet squats.  Between the different exercises, rest as little as possible, and then after you get through an entire circuit, you can take a longer 90 second break.  Repeat the circuit three times.
Five:  Work on power production with three sets of overhead medicine ball throws.  Use a weight that lets you throw a line drive and not a lob.
Choose the appropriate exercise variation and load for your strength exercises.

Session One Synopsis:
Effective mobility training.
Total body conditioning.
Twelve sets of strengthening exercises.
Explosive power training.

See the video for more information.

Michael S. O’Hara, P.T., OCS, CSCS

The Lazy Man’s VO2 Max

You’re In Pretty Good Shape For An Old Guy

VO 2 Max testing is a very useful assessment of fitness.  It is a measure of peak oxygen uptake and has been shown in large-scale studies to closely correlate with longer life spans.  Unfortunately VO 2 Max testing requires a physiology lab and a session on a treadmill that I can only describe as a nausea-inducing, up hill run while wearing a gas mask.  Recently a group of Norwegian researchers created a very accurate on-line calculator of VO 2 Max and fitness age.

The mathematical algorithms the calculator is based upon are from the physiology lab assessments of over 5000 Norwegians of every age from 20 to 90.  You simply plug in your age, sex, exercise frequency and intensity, resting heart rate and waist size in centimeters.  The computer will give you your VO 2 Max number (bigger is better) and fitness age (lower is better).

I have run the Norway VO 2 Max evaluation on several friends, fitness clients, and family members.  The results have been an education for everyone.  The need to exercise at higher intensity levels and reduce waist size was a surprise to many who took the test.  Take the time to plug in your data and get your score.

Evaluate your score here: http://www.ntnu.edu/cerg/vo2max

Michael S. O’Hara, P.T., OCS, CSCS

Huffin’ And Puffin’

Conditioning Sessions: Better Results, Less Time, And Fewer Injuries

sledFor most of the fitness clients I work with, long duration cardio training—thirty minutes on the treadmill, forty minutes on the elliptical, and any time on a recumbent bike is a waste of training time.  It does nothing to move them toward their fitness goals.  A far better choice is to perform strength training followed by a conditioning session.  Conditioning sessions are very different than long duration “cardio”.  Conditioning work is performed for short durations at high intensity.  You link different drills together in a series to produce a metabolism boosting session that lasts ten to twenty minutes.

Conditioning Benefits
Conditioning sessions speed up your metabolism–your body uses more calories just walking around, sitting, sleeping, etc.
It improves your capacity to perform functional tasks such as lifting, carrying, pushing, and pulling.
It is never boring–changing the stimulus changes your body.
Conditioning sessions maintain the physical properties we lose as we age–muscle mass, bone density, and power production.
Conditioning is time efficient–a properly designed session takes ten to twenty minutes and you are done.
You are far less likely to suffer an injury because you are not performing the same movement patterns for multiple hours every week.
Proper programming of a conditioning session will allow you train around an injury.
Conditioning can be scaled to any fitness level.
It is fun.

Conditioning Drawbacks
It will never–and should never–get easy.
You will need a new wardrobe because all of your pants will get looser.
You will not be able to watch TV while you exercise.
It will get you kicked out of Planet Fitness.

Since most gym goers are unfamiliar with conditioning training, we will be posting information on our favorite tools and a monthly conditioning session.  Give these a try and let us know how you do.

Michael S. O’Hara, P.T., OCS, CSCS

Everything Works–For Six Weeks

“The world hates change, but it is the only thing that has brought progress.”–Charles Keating

One of the most frequent complaints from gym members is that they exercise but see no results.  They ride the elliptical, lift weights, and Zumba three days a week, but they make no progress in how they look, move, or feel.  The common feature to almost all of these clients is that they have done the same activity at the same intensity for a prolonged period of time.  The human body is a master at adaptation, and the only way it will change is if you alter your exercise activity on a regular basis.

Novices can stay on the same exercise program for eight to twelve weeks and still see results.  More experienced trainees should alter their routine every three to four weeks.  Increase the weight you lift and lower the number of repetitions–four sets of five repetitions instead of three sets of eight.  Add in some balance challenging single leg training and discontinue the bilateral exercises you have used since high school.  Take a month and work diligently on improving a movement pattern that gives you difficulty.  If your conditioning is below average, program in a series of high intensity sled activities for four weeks.

Most programming changes make training more difficult and produce greater delayed onset muscle soreness.  This is all part of creating a new stimulus that the body finds challenging.  In a few sessions, the soreness will be gone.  In three or four weeks, the sessions will be less demanding and you will be ready for another alteration in the training cycle.

Many athletes and fitness enthusiasts would do well with taking two or three weeks away from training and focus on recovery and regeneration activity.  Elite athletes often schedule two or three periods of recovery into their yearly training plans.  Do not lift any weights, run, jump, or compete for a period of time.  Get plenty of sleep, and spend that time working on your soft tissue restrictions by using a foam roller or massage stick every day.  If you have tight hips, shoulders, or thoracic spine, dedicate this time to restoring motion at the restricted area.  A fourteen day rest period is often enough time to permit full physical recovery, but not so extended that you lose strength or endurance.  With full recovery, all systems will be able to respond much better once you return to training.

Change is good, but frequently neglected.  The best results will be produced with regular alterations of fitness programming.  See our trainers for information on a Functional Movement Screen Assessment and training program design.

Michael S. O’Hara, P.T., OCS, CSCS

Fitness Reinforcement

An Olympic Quest

As a society, we do not do enough to reward positive fitness habits.  I think the Russians are on to something with this novel method of earning a subway ticket.  As a country, we need to get into the fitness incentive technological race and expand on this advancement.  We aren’t going to let the Russians beat us.

I am sure Google has the software and hardware that would permit us to record our exercise activity and earn fitness credits.  Americans could use their earned credits to purchase health care, reduce income taxes, or bank them in their health care accounts.  This would be a non-mandatory incentive that would do more to lower health care costs than putting trans fats under FDA control or minimizing the size of our soft drinks.  It would reward good fitness behavior.  We could even link the program to the government Affordable Care web site…

Michael S. O’Hara, P.T., OCS, CSCS

What Women Need

Needs Are Different Than Wants

Rosei The RiveterI get to discuss fitness goals with women nearly every day.  They want to lose weight, get rid of musculoskeletal pain problems, have more energy, and “get arms like that girl”.  Many of them have been doing their favorite exercise activity for years and have been unsuccessful at achieving any of their stated fitness goals.  What they tell me they want to do is yoga, elliptical training, and Pilates.   What they need to do is start on a program of strength training.  

Ramping Up Your Metabolism
We all know that a body with more muscle burns more calories all day long.  You can get away with eating more food and not develop greater fat deposits.  Much more significantly, greater muscle mass positively influences fat metabolism, insulin levels, glucose processing, hormone profiles, and disease resilience.  These changes influence the “more energy” feeling you develop with strength training.  

Training To Abolish Pain
Nearly every patient that comes to physical therapy with a chronic pain problem has a glaring strength deficit that is perpetuating the pain.  They have gluteals, scapula retractors, or cervical stabilizers that are not functioning at a level that permit them to perform normal activities of daily living and remain free of pain.  What makes these patients better is a program of targeted strength training.  If you have chronic hip, knee, lower back, or neck pain, your best method of permanently resolving the problem is strength training.  

Bone Health
All of the current research says you need bone jarring, compressive, and aggressive loading of your skeleton to enhance or prevent further loss of bone density.  Over the last year, two government panels of experts have told us that taking more vitamin D and calcium does not appear to make any difference in bone density.  Better bone biology requires that the exercise stimulus be strong and consistent.  Low skeletal stress activities such as yoga, Pilates, and elliptical training do not create the forces needed to have a positive effect on bone density.  Read Bending the Aging Curve by Dr. Joseph Signorile.

Staying Independent
I am sorry Ladies, but muscle mass, strength, and power production all leave you at a far faster rate than your male counterparts.  It is not fair, but it is the truth.  As you age, training to restore these physical capacities becomes much more important if you wish to remain independent for a lifetime.  Ask any physical therapist who works with geriatric clients and they will tell you that weakness is the driver of debility.  The good news is that a properly designed program of strength training can work wonders.  

Motivational Goal Setting
Strength training provides motivation by having clear goals.  “I want to tone up” is not a clear goal.  Any psychology major will tell you that reaching defined goals reinforces positive behavior.  You improve from three to eight solid push ups, carry ten more pounds for fifty yards, press twenty pound dumbbells instead of tens, and it motivates you to stay with the program.  Numerous psychological studies have found that a lack of goal achievement is the number one reason people fail to succeed in staying consistent with an exercise program.  The girl with the arms you like has strength goals.  

Michael S. O’Hara, P.T., OCS, CSCS

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