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Fat Loss Nutrition 101

apple_w_tape_measureThe primary goal for most of my fitness clients is altering body composition.  They want to lose fat and gain muscle.  From these clients I often get the “What should I eat?” question and my reply is that they already know the answer.  We all know what and how much to eat.  The stream of weight loss nutrition has been endless.  Fitness magazines, newspapers, Dr. Oz, Oprah, and hundreds of websites have been serving us up weight loss nutritional advice for decades. I like to use my fat loss nutrition quiz to help prove my point.  If you can pass this quiz, you know all you need to know about nutrition in regards to weight loss.  The question most of my clients need to consider is, “What would motivate them to change their eating habits?”

Fat Loss Nutrition Quiz
1. Eating a fresh green salad every day.
Very Bad          Bad          Good          Very Good

2. Eating a fresh green salad with half a bottle of Ranch Dressing slathered on top.
Very Bad          Bad          Good          Very Good

3. Eating nothing but salad.
Very Bad          Bad          Good          Very Good

4. Eating a serving of fresh fruit every day.
Very Bad          Bad          Good          Very Good

5. Eating Fruit Loops every day.
Very Bad          Bad          Good          Very Good

6. Having a four ounce glass of wine with dinner.
Very Bad          Bad          Good          Very Good

7. Having a fourteen ounce tumbler of wine with dinner.
Very Bad          Bad          Good          Very Good

8. Eating breakfast every morning.
Very Bad          Bad          Good          Very Good

9. Waking up in the middle of the night and eating.
Very Bad          Bad          Good          Very Good

10. Consuming 80 grams of protein every day.
Very Bad          Bad          Good          Very Good

11. Consuming 18 grams of protein every day.
Very Bad          Bad          Good          Very Good

12. Having an apple as a snack.
Very Bad          Bad          Good          Very Good

13. Having an apple pie as a snack.  
Very Bad          Bad          Good          Very Good

14. Planning and preparing meals ahead of time.  
Very Bad          Bad          Good          Very Good

15. Dining at Taco Bell because you forgot to pack a lunch.
Very Bad          Bad          Good          Very Good

16. Keeping a daily food log.
Very Bad          Bad          Good          Very Good

17. Keeping Oreos in the house.
Very Bad          Bad          Good          Very Good

18. Consuming 1600 calories a day–women, and 2200 calories a day-men.
Very Bad          Bad          Good          Very Good

19. Having absolutely no idea of how many calories you consume in a day.  
Very Bad          Bad          Good          Very Good

20. Eating foods of as many different colors as possible.
Very Bad          Bad          Good          Very Good

21. Eating only brown, beige and black colored food.
Very Bad          Bad          Good          Very Good

22. Meals made exclusively from fresh produce.
Very Bad          Bad          Good          Very Good

23. Eating food that has been packed in a can.
Very Bad          Bad          Good          Very Good

24. Post training session rehydration with water.
Very Bad          Bad          Good          Very Good

25. Post training session rehydration with beer.
Very Bad          Bad          Good          Very Good

I have never had anyone fail this test.  It really is that simple.  Do not fret over dietary minutia–clean up your big nutritional mistakes.  Do some planning and preparing and exercise consistently.  The results will follow.    

Michael S. O’Hara, P.T., OCS, CSCS

The Lunge Matrix

Three Dimensional Leg Training

Twenty-five years ago, I participated in a three day “functional movement” seminar given by physical therapist, Gary Gray.  Gary got the entire class involved in a morning exercise class he called Pump and Praise.   One of the activities he taught was the lunge matrix.  I was 30 years old and had been exercising fairly regularly, yet I found the lunge matrix much more challenging than expected.  Since that time, I have used the lunge matrix with physical therapy patients, fitness clients, and in nearly every session of my own training.  Almost everyone can benefit from a little lunge matrix training.

The muscles in our trunk and hips are inter-twined, aligned in a spiral and diagonal fashion.  They are neurologically connected and work as a team to drive movement in three dimensional patterns.  The lunge matrix neurologically activates all of the muscles in all of the possible movement patterns.

The lunge matrix is ideal for anyone involved in a multi-directional sport.  Tennis, volleyball, basketball, soccer, and football require efficient transition in all directions. Injury prevention is the most important aspect of any athletic training program.  Your gym program should make you more bullet proof on the field of play.

The lunge matrix can be used as a movement preparation activity with just bodyweight (my favorite) or as a stand-alone strengthening exercise.  When performed as a strengthening exercise, use functional level loads, dumbbells, or medicine balls that equal the weight of the bag of groceries or the grandchild you are going to lift.  The loads should not alter the quality of movement or shorten the range of your lunges.  Choose shoes with flatter soles as some of the more cushioned running shoes can make lateral and rotational movement patterns difficult.

Lunge Matrix Series
1. Anterior lunge R / L
2. Lateral lunge R / L
3. Rotational lunge R / L
4. Posterior lunge R / L

Watch the attached video, and then give the lunge matrix a try.

Michael S. O’Hara, P.T. OCS, CSCS

The Best Training Partner For Endurance Athletes

A Stronger Immune System With Probiotics

A study published in the International Journal of Sport Nutrition and Exercise Metabolism* found that athletes who took a probiotic supplement during the winter had fewer colds and other upper respiratory tract infections.

LactobacillusThe study included 84 athletes that trained an average of ten hours per week in endurance sports such as running, cycling, or swimming.  They were divided into two groups: a probiotic group and a placebo group.  Over the course of sixteen weeks, the frequency of upper respiratory tract infection (URTI) was measured, as well as markers of immune function in the blood and saliva.

Research Findings
People in the probiotic group had far fewer cases of URTI (66%) than the placebo group (90%).

When they did get an URTI, the probiotic group reported fewer days with symptoms and spent less time on medications for the symptoms.

People taking probiotics who did get sick were less likely to have their training schedule interrupted by the URTI.

The probiotic group had higher levels of infection- fighting antibodies in their saliva.

The probiotic bacteria that was used in this study was lactobacillus casei Shirota.  There are 125 known lactobacilli species and many of them have been studied for their positive effects on health.  How can you get and keep more of these helpful training partners in your gut?

Eat foods that are cultured or fermented with lactobacilli.  These include yogurt, beer, wine (yeah!), cider, sourdough bread, and some sauerkraut (bleah!) and kimchi.  Eat foods that lactobacilli thrive on–the fibers in fruits and vegetables.  Lactobacilli are especially vulnerable to antibiotics, so take them only when necessary.  If you are going to supplement with probiotics, choose a quality product.  Keeping bacteria alive in a store and on its pathway to your gut involves some special handling.

*International Journal of Sport Nutrition and Exercise Metabolism 2011, 21:55-64

B. O’Hara RPh

Stripe Hype

The Good And Bad Of Kinesio Taping

In 2008, Kinesio tape (KT) was donated to 58 countries for use during the Olympic games.  Since that marketing effort, its presence in televised sports has exploded.  The athletic fashion statement found at many competitions is the brightly colored strips of tape across elbows, knees, shoulders, and hips.  At Wimbeldon, Novak Djokovic had green tape on his elbow.  Many of the soccer players at the last Euro competitions had tape on shoulders and hips.  Female beach volleyball players seem to be wearing more tape than clothes.

Kinesio tape was invented by chiropractor Dr. Kenzo Kase in the 1970s.  KT is made of cotton with an acrylic adhesive that permits it to stretch 40-50% of its resting length.  The website for Kinesio tape claims that it can alleviate pain, reduce inflammation, relax muscles, enhance performance, and help with rehabilitation.  Rock tape, a competing product, makes similar claims and uses the slogan Go Stronger, Longer.

Does Kinesio Taping work?
Serena Williams with Kinesio TapeA meta analysis performed by Wilson in 2011 looked at all of the studies performed with KT and found some evidence that it helped improve range of motion, but no evidence that it helped reduce inflammation, relax/activate muscles, or improve performance.  There is no evidence that it “off loads sensitive tissues” or improves “lymph drainage”.  The number of high quality studies was small.

How Might Kinesio Taping Work?
What we do know is that the elastic, compressive nature of any band, brace, or tape placed on the body stimulates receptors in the skin.  The receptors modulate the perception of pain and as a result, pain decreases.  An example is a research study in which the patients that wore a neoprene sleeve during a series of tests 12 months post anterior cruciate repair produced significantly more force and had better balance than without the neoprene sleeve.  The sleeve created a constant pressure on the skin surrounding the knee.

Should You Use Kinesio Tape?
If you have a minor ache or pain and no structural musculoskeletal damage, then go ahead.  The KT can make you feel better, and this will make exercise and activities of daily living easier.  The tape can provide some control over the symptoms, and it has no side effects other than occasional skin irritation.

Remember that your body sends pain signals for a reason.  Any type of musuloskeletal damage should be dealt with more comprehensively than just KT.  It is a bad idea to use KT to reduce pain and then participate in activities that create even greater tissue trauma.  A small and easy to rehab rotator cuff tear can become a big, full thickness, surgical repair tear if you tape it up and practice your tennis serves.

We do lots of things in medicine that have no solid, double blind research that proves efficacy.  The manufacturers of KT products need to spend more money on research and less on marketing.  I am hopeful that in time, more evidence will develop for the use of KT.  If some strips of KT make you feel better, go ahead and use it.  The best approach is to get to the cause of the problem and enact a treatment plan that resolves the pain or functional limitation.

Michael S. O’Hara, P.T., OCS, CSCS

Coke Is Giving Us Exercise Advice

The Real BearsNo other product makes it easier and more convenient to become obese and eventually ill than soda drinks.  Everybody knows this, even the “food companies”.  The Coca Cola company has recently launched a television fitness campaign for the good of all of its consumers.  The last thing Coke wants you to do is stop enjoying their product; instead they want you to get more active.  They are telling us that exercise is what we need to solve the obesity, diabetes, and heart disease problems in America.  While I am always in favor of greater exercise activity, some insight into the mathematics and physiology of exercise and soda drinks can help us all make better choices in our lives.

A 120 pound female at 22% bodyfat (common bodyfat percentage) has to walk at a 2.5 mile per hour pace for 50 minutes to burn the 140 calories found in a 12 ounce serving of coke.  That same woman could ramp it up and run at a 5 mile per hour pace and she would burn off her can of Coke in 18 minutes.  If she drank the one liter bottle of Coca Cola (400 calories), she would have to run 53 minutes.  If the weather was bad and she decided to stay inside and use the elliptical machine, she could work off her one liter serving of Coke in 53 to 80 minutes, depending on what machine she uses and how vigorously she worked during the elliptical session.  If our same 120 pound female decided she was really thirsty and stopped at the local 7-Eleven for a Double Gulp serving of Coca Cola -55 ounces totaling 744 calories, she would need to walk for 4 hours and 20 minutes or run for 82 minutes.
None of us can exercise our way around a bad diet.  You do not the have the time or physical endurance necessary to counteract the concentration of calories in soda drinks.  The caloric density of soda drinks is only part of the problem.  The cascade of hormonal events that occur when you ingest sugar saturated drinks is an even  stronger driver of health problems than the total number of calories.

Thank you Coca Cola for your endorsement of exercise, but I think we would see much better results if we drank water.

Michael S. O’Hara, P.T., OCS, CSCS

Getting Fat In The Gym

Training With Thick Grips

Strongmen have been using thick grip barbells and dumbbells for decades.  It makes their hands stronger and keeps their joints healthy.  The problem for the average gym member is that modified thick bars and dumbbells are expensive, and for many people, too heavy.  Over the last five years, several types of rubber thick grip handles have been developed for use on traditional 1.25 inch barbells and dumbbells.   Thick grip handle training is a beneficial addition for recreational lifters, fitness enthusiasts, and athletes.

Real World Grip Strength
Most of the objects you must push, pull, or carry during daily activities are not attached to a user-friendly handle—your opponent on the field of play,  that heavy bag of dog food, and the garden wheelbarrow all have large irregular areas you must grip.  Training with thick grip handles in the gym builds the strength that more readily carries over to real life.

Healthier and Happier Arms
Industrial ergonomic experts know that larger diameter handles on machinery and hand tools can reduce stress on the joints of the elbow, wrist, and fingers.  Big, strong athletes with larger hands and above average strength (more weight = more joint stress) can benefit from taking some time away from traditional diameter handles.  Many of the recreational lifters I have consulted with in physical therapy report decreased elbow pain, wrist pain, and median nerve (carpal tunnel) numbness / tingling with the inclusion of thick grip training in their exercise programs.

A Little Thick Grip At a Time
Introduce thick grip training slowly.  Reduce the weight you would normally use for a lift by 30% and evaluate how your body feels the next day.  Be careful with the volume of horizontal and vertical pulling exercises, as using a thick grip with these exercises can be problematic for some elbows and shoulders.

Don’t Be a Thickhead  
Do not perform ballistic lifts such as cleans and snatches with thick grips, as a failure in your grip could result in a barbell or dumbbell flying across the weight room.  Be careful on your first set of chin ups or pull ups with thick grips, as a grip failure can create a sudden unwanted interaction with gravity.  All of the thick grips on the market are designed to be used with barbells and dumbbells and not on a kettlebell or cable handle.

Makes and Models
Thick grips can be purchased online from Fat Gripz, Iron Bull, and Tyler Grips.  They are available in two, two and one-half, and three inch diameters.  They all attach fairly easily to most barbell or dumbbell handles.  The Tyler Grips are a cone shape, and I have found that they work well with physical therapy patients and industrial rehab clients who are retraining pulling strength.  At Fenton Fitness, we have been using the cylindrical shaped Fat Gripz and Iron Bull Grips for the last six months and the reviews have been good.

Michael S. O’Hara, P.T. OCS, CSCS

No, No Row Your Boat

Why I Don’t Row And Neither Should You

Equipment manufacturers have produced an endless selection of cardiovascular conditioning machines.  We have access to treadmills with shock absorbing decks, elliptical units with stationary and moving arms, escalator stairways, and every imaginable variety of bike.  The simple rowing machine has recently become more popular in fitness classes and training gyms.  I purchased a state of the art rowing ergometer in 1986.  While the training sessions always left me gasping for air, I developed several problems when my rowing sessions became more intense.  Four years later, I abandoned the rower as an exercise modality.  Over my thirty years as a physical therapist, I have treated numerous patients with rowing machine related injuries.  I have come to believe that some individuals can use a rowing machine and achieve excellent results, but the vast majority of us should stay away from a rower.

Lower Back Pain History
The rowing motion produces a compressive load on the lower lumbar joints and discs while subjecting the spine to many cycles of end range flexion.  This is the ideal formula for a posterior disc derangement.  If you have a history of debilitating lower back pain (80% of the American population) or a lumbar disc related problem, you should find another mode of exercise.

You Sit All Day
For many of us, work and daily commute time combine to account for six to ten hours of sitting a day.   In your fitness program, the last thing you want to do is chose an exercise activity performed in a seated position.  The deleterious effects of prolonged sitting must be trained away and not enhanced by your exercise activities.

A History of Anterior Hip Pain
With every repetition of a row, you fold the front of the hips into full end range flexion.  This can create all kinds of impingement/tissue distress problems on the front of the hip joint.  I have treated several patients with labral tears of the hip and “sports hernia” pain problems developed after a series of rowing sessions.

You Are a Postural Mess
If your mother always told you to “sit up straight” and you never managed to listen, the rower is probably a less than ideal training tool for you.  Age, wear and tear, and the passage of time tend to pull our skull, shoulders, and thoracic spine forward.  If you already have a head start on the slumped forward rounded over upper body, I would nix the rower.

Big Belly
If your abdomen protrudes to the point it inhibits the motion of your hips and the draw of the erg’s handle, you will not be able to row with a mechanically efficient stroke.  The knees out, 20 inch pull you so often see performed on the row ergometer is at best ineffective and often injurious.

Clueless on Technique
For many people, the rhythm of a proper rowing motion is difficult to learn and even more difficult to maintain in a fatigued state.  When your row technique falls apart, the stress on your peripheral joints and spine increases dramatically.

Cumulative Compressive Load
If your training week consists of deadlifts on Monday, box jumps on Tuesday, Olympic lifting on Wednesday, squats on Thursday, and then rowing ergometer on Friday, you will have performed five consecutive days of high spinal compression activities.  The older you are, the stronger you are, and the more intense you train, the more you need to be considerate of the cumulative compressive load placed on your spine over the course of a training week.  The rower is probably not the ideal training modality in this training scheme.

Michael S. O’Hara, P.T., OCS, CSCS

Texting And Driving=Drinking And Driving

A Video Everyone Needs To Watch

I get to meet people injured in car accidents nearly every day.  A car accident can change your life forever, so anything we can do to reduce the chance of a crash should be a top priority.  I suggest that anyone who uses a cell phone watch the video about texting and driving directed by Werner Herzog (available on Youtube).  Make your kids watch it with you.

The video, From One Second To The Next, was commissioned by cell phone carrier AT&T and released Aug. 7.  It has already amassed more than 3 million views. The makers are also planning to provide a twelve minute short version to government agencies, safety organizations, and schools.

In the video, you hear how an accident caused by a texting driver traumatizes four families from across the country.  The film was commissioned for an anti-texting and driving campaign also backed by Sprint, T-Mobile, and Verizon. (Learn more about the “It Can Wait’ campaign at www.itcanwait.com.)

University of Utah psychology professor David Strayer, who has conducted nationally recognized research on the effects of using cell phones while driving, said his studies show that texting while driving can result in an eight times greater chance of getting in an accident. In contrast, driving while legally under the influence of alcohol—a blood-alcohol level of .08 — results in a four-times greater chance of an accident.

38 states have outlawed texting while driving.  My question is why the other states have failed to outlaw this very dangerous activity.  Certainly the punishment for texting and driving should be equivalent to that of drunk driving.

Is there a technological solution to this dangerous telecommunication habit?  Automobiles are incredibly complex machines and it must be possible to design and install text blocking computers in a car.

Michael S. O’Hara, P.T., OCS, CSCS

It’s Rotator Cuff–Not Rotor Cup

Proper Strengthening Of The Rotator Cuff Muscles

In the gym, I see all kinds of shoulder exercises that I believe are meant to strengthen the external rotators of the shoulder.  Unfortunately, many of the moves are more harmful than helpful.  They are performed at fast speeds, in positions that foster shoulder impingement, and with no attention to spinal or shoulder posture.  A simple and highly effective exercise to strengthen the rotator cuff muscles is the band “no money” drill.   This exercise is time efficient–you train both shoulders at the same time.  Resistance is provided by tubing or a resistance band and is easily altered to suit all strength levels.  The best thing about this exercise is that it is hard to perform improperly.

Many of us are walking around with horrible upper thoracic, cervical, and shoulder girdle posture.  Poor posture makes using your external rotator muscles properly very difficult.  For the external rotators to work effectively they need to be on a solid, well anchored launch pad.  Elevated and rounded shoulder blades are poor platforms for your external rotator cuff muscles—supraspinatus, infraspinatus, and teres minor.  A forward head posture closes off the narrow neural openings between the cervical vertebrae.  Compression on the fifth cervical nerve root can unplug the neural drive to both the external rotators and the deltoid muscle.  Before you begin any rotator cuff strengthening exercise, always attempt to correct your posture before starting.  If you cannot correct your standing posture this exercise is made for you.

Band “No Money” Drill
You need some resistance tubing or a band for this exercise.  Stand up tall with the chest proud and the head pulled back.  Hold the tubing in each hand with the elbows at the side and bent to 90 degrees.  Keep the palms facing up and the thumbs pointed out.  Tighten the muscles in back of the shoulder blades and pull the tubing apart.  Hold at end range for three counts.  Return slowly to the starting position—this should take at least three counts.  Each repetition should take at least six seconds.  Repeat for five to ten repetitions.  This exercise should always be pain free.  Start with a resistance level that permits you to perform at least five repetitions and do not take this exercise to failure.

If you are unable to perform this movement with shoulder blades pulled down and in, head pulled back, and chest proud, you need to regress the exercise to a foam roll.  Position in supine and length-wise on a foam roll and perform the band “no money” just like you would in standing.  Positioning on the foam roll will allow gravity to pull you into a better posture and create the proper stimulus necessary to strengthen the external rotators of the shoulder.

Strengthening the external rotators is only a part of keeping your shoulders healthy and strong.  You must train the shoulder muscles as a team to produce more coordinate stabilization of the glenohumeral and scapulo thoracic joints.  The more athletic and active you are, the more important coordination and timing exercises become for comprehensive shoulder rehabilitation.

Michael S. O’Hara, P.T., OCS, CSCS


Front Squats

Stability, Mobility, And Better Posture

The squat has been described as the king of all exercises.  The large amount of muscle recruited during squatting makes it a very metabolically demanding exercise.  In athletics, the capacity to perform a full squat with proper torso, hip, and knee position has been correlated with greater durability–fewer injuries.  The overhead squat test is one of the patterns assessed in the Functional Movement Screen and is used in physical therapy and athletic training.  Squatting with the load placed on the front of the body is an excellent way to enhance mobility, stability, and strength.  Compared to leg presses, seated leg curls, and knee extension, front squatting creates much more carry over to activities of daily living and athletics.  The problem is most people do not know how to get started with front squats.

When you squat with the load across the front of the body instead of on the upper part of the back, the stress on the spine is reduced.  You can “cheat” a back loaded squat by leaning forward, but you cannot lean forward with a front squat.  Leaning forward on the front squat causes the load to fall from your shoulders or hands.  Front squatting creates a greater core stability demand and reduces shear force on the lower back.  Full depth front squatting will improve your posture and restore mobility in the hips, shoulders, and thoracic spine.

Front squatting is an exercise that is more equivalent to daily tasks and athletics.  Lifts in real life rarely place the load across your shoulders.  When you lift the grandchild, carry the groceries, or hoist the wheelbarrow, the load is in front of the body.  During athletics, the opponent is in front of you, and you must stay upright and tall to dominate the activity.

Front Squat 101
Before loading the squat, practice bodyweight squats to a depth target.  I like to use a 12 inch box or a Dynamax ball (12 inches in diameter).  You should be able to perform a body weight squat to a thigh below parallel position with a stable spine before attempting a loaded front squat.  When you perform a loaded front squat, initiate motion from the hips by sitting down and back.  Push the knees out and descend so the thighs travel to below a parallel to the floor position.  Keep the chest up and torso tall as you push back up.  Finish at the top by contracting the gluteal muscles and keeping the front of the rib cage down.

Choose A Proper Implement
While the barbell offers the greatest loading capacity, many individuals do not possess the shoulder mobility to hold the bar on the shoulders.  The Goblet Squat position with a kettlebell or dumbbell works just as well.  A sandbag hugged close to the body in the high Zercher position or bear hug hold has a high degree of athletic carry over.  Avoid the Smith machine variation.  You end up leaning on the machine and this eliminates much of the core stability demands and exposes the spine to greater shear force.

Michael S. O’Hara, P.T., OCS, CSCS