DEATH OF A GOOD GOVERNMENT IDEA
Tobacco and Our Judicial System
I am rarely enthusiastic about anything that happens with our Congress, but in 2009, they passed a law that would require the addition of large graphics and text warnings about the harms caused by smoking. Somewhat disturbing pictures and more direct verbiage was supposed to cover the top half of every package of cigarettes beginning in September 2012.
However, in an act of judicial activism, this rare good government idea has been stopped. Federal District Court Judge Richard Leon has recently blocked the implementation of the new labeling plan. He feels the labels are “calculated to provoke the view to quit”—ah duh! He feels that this crosses the line. He feels the new labeling requirement violates the tobacco companies’ free speech rights. The judge has no concern for consumer protection, the cost of health care, or the fact that this product continues to enslave millions of Americans every day.
Tobacco companies have a problem. Their product kills a significant number of their customers every year. They need new addicts to replace the dead ones, so cigarettes are pedaled to the most easily influenced and impressionable of our country’s citizens. Almost everyone gets hooked on cigarettes when they are young and naïve. I have never heard of anyone starting the smoking habit once they get past 25 years of age.
Gran for gram, nicotine is the most addictive chemical on the planet. It provides more withdrawal discomfort for your money than opiates and amphetamines. The severity of the withdrawal symptoms keep people hooked on this poisonous product through a lifetime.
“Giving up smoking is the easiest thing in the world. I know because I’ve done it thousands of times.”—Mark Twain
No other consumer product adds more to the cost of health care than tobacco. Cancer, emphysema, and heart disease are all extremely expensive health care problems in this country. I can think of no greater cost saving tactic than reducing the use of tobacco products. If stronger warnings can produce a once percent reduction in the number of American smokers, they are well worth the alleged infringement on the poor tobacco companies’ freedom of speech.
Our government needs to make tobacco products more expensive and the gruesome consequences of smoking more evident. The federal tax on a pack of cigarettes is only $1.01 and the State of Michigan excise tax is $2.00. Increase both of these taxes by 100% and use that money for smoking cessation programs and the enormous burden smoking places on the US healthcare system. The courts need to overturn this judicial silliness and get those pictures and warnings on every package of cigarettes.
Michael S. O’Hara, P.T., OCS, CSCS
YOU, A BOSU, and WHEW!
A New Twist On An Old and Much Hated Exercise
I had a basketball coach who was a Burpee fanatic. You lost–Burpees, turn the ball over—Burpees, late for practice—Burpee Eternity. I hated doing Burpees, but I was never, ever tired in a practice or a game. I believe Burpee conditioning drills gave me the physical stamina and mental toughness to stay strong an entire game.
Fitness engineering has developed a new training tool and now we have the Bosu Burpee. A Bosu is an inflated half dome with a hard, flat bottom. It has handles on either side that you use when performing the Bosu Burpee.
The Bosu Burpee gets you moving from the ground up, at a quick pace with a strong core stabilization demand. Too many gym activities are seated, slow, and neurologically numbing. Neurologically and metabolically, we need to practice moving the entire body at faster speeds to stay fit. The Bosu Burpee is a total body conditioner that brings us up to speed.
Start with your hands on an inverted Bosu—bottom side up, in a push up position. Perform a push up with your chest touching the Bosu. Jump both feet up under the hips. Try to get your feet planted flat on the floor. Rise up from the floor and lift the Bosu overhead. Return the Bosu to the floor and repeat the movement from push up to overhead lift. Learn to do this movement slowly, and then once you have the motion “neurologically grooved”, pick up the pace. Bosu Burpees are a conditioning drill that should be performed at a fast pace. They work best if performed for set periods of time. Try starting with twenty second intervals and build up to 60 seconds.
Bosu Burpee Modifications
If you cannot do a push up or your arms give out way before the rest of the body, try performing the push up from the knees or keep the elbows fully extended and eliminate the push up portion of the exercise. As you practice this exercise, your arm strength will improve. If your middle sags and/or the Bosu wobbles, you need to dedicate more time to core stability training. Add some physioball roll outs, TRX fall outs, and front hovers to your exercise program.
Scoring the Bosu Burpee
Set a timer for sixty seconds and count how many Bosu Burpees you can perform. Remember you must start from the bottom and only full repetitions are counted. The best I have ever done is 18 repetitions. My middle gives out before my arms or legs—I need more core training. I believe this scoring system is a fair representation of Bosu Burpee performance.
Levels Men Women
Beginner 10 4
Intermediate 16 9
Advanced 22 14
Michael O’Hara, P.T., OCS, CSCS
CORE-TEX TRAINING PLATFORM
The New Tool In Our Training And Rehabilitation Toolbox
The latest addition to our rehabilitation and training toolbox is the Core-Tex. This thirty inch round platform floats on three roller bearings that permit it to tilt, translate, and rotate. The tri planar motion of the Core-Tex creates an ideal environment for us to work on retraining our patients’ balance, coordination, and proprioception. It can also be used to create challenging core and shoulder girdle stability activities.
One Stop Shopping For Better Proprioception, Balance, and Coordination
You can improve all three of these critical components of function with one or two Core-Tex activities. Beginners can use the handrail to create a more supportive environment, and as they improve, progress to reducing the assist from the arms. Integrating head movement, arm reaches, and weight shifts into the drills enables the clinician to design activities specific to the patient’s needs.
Keeping The Loads Level
The Core-Tex reveals any deficits in weight distribution. If the patient is unconsciously avoiding loading one side the body, the movement of the Core-Tex platform quickly reveals the flaw. The therapist can then prescribe training to increase tolerance of loading on the affected side and return for re-evaluation on the Core-Tex.
Tuning Up Your Righting Reflexes
Many of the sensors that keep our body in an upright position are located above the neck. I don’t care how strong or flexible you are, if these neural feedback systems do not work properly, you will not move well. Evaluating and improving the function of righting reflexes centers in the inner ear and the neck is a frequently neglected area of rehabilitation and fitness. Incorporating activities that involve moving the head and neck while standing on the unstable Core-Tex platform has proven to be very beneficial in patients with slow reflex response times.
Rotation In The Right Places
Being able to rotate through the thoracic spine and hips is an important aspect of optimal function and pain free existence. Many physical therapy patients have neck and shoulder pain driven by a lack of thoracic spine range of motion in rotation. Deficits in hip rotation produce undue wear and tear and eventually pain in the knees and lower back. The Core-Tex turns 360 degrees and allows us to teach transverse plane motions at the hips and thoracic spine in a fully functional upright, weight bearing position.
Michael S. O’Hara, P.T., OCS, CSCS
BODY COMPOSITION 101
“I am just not seeing any results.” “I haven’t lost any weight.” I hear this from gym members nearly every day. They get frustrated at the lack of a change in their appearance despite dedicated attendance in the gym. After hearing this from so many members for so long, I have some suggestions to share that I hope will be of value.
Get your nutrition right.
Go to Dr. John Berardis’ web site and listen to his advice. Buy a Kitchen Scale and learn portion size. Positive body composition changes will only occur when sound nutrition is in place. Combine a solid program of diet along with consistent training and let the magic happen.
Change your routine.
Proper exercise prescription should create a stimulus that causes your body to change. Unfortunately, your body adapts to an exercise stimulus fairly quickly–four to six weeks. If you are taking the same step class from 1990, it is a good bet your body has adapted to that activity. Try different classes and new exercise activity. Our understanding of fitness has changed dramatically over the last fifteen years, and a fitness coach can help you implement the best practices.
Women must focus on lower extremity exercises.
More than two thirds of a women’s muscle mass is below the waist. To change body composition, you must put more effort into training the metabolically active (calorie burning) muscles in the legs. Arm curls and triceps pressdowns will never change your metabolism or your appearance. Most of your efforts should be spent on leg training.
It is called progressive resistance exercise for a reason. If you have been lifting the same size dumbbell for the last two years, you are not progressing. Lifting heavier loads creates greater muscle mass and therefore a faster metabolism. A faster metabolism burns more calories all day long and decreases body fat. Becoming stronger reduces your risk of injury. Ladies, unless you have a hormonal issue, you will not turn into the Hulk.
Keep a record of your training.
It is difficult to analyze where you are going if you do not know where you have been. Reviewing a training log is often very revealing in regards to the consistency, quality, and quantity of the work you are actually performing.
Bring on the intensity.
Training that changes your body composition is never going to be easy. You must “get comfortable with being uncomfortable” when you exercise. If it is easy to do—it will not work!
Throw out your scale.
Any well designed exercise program is going to create more muscle and diminish stored body fat. Muscle is denser than fat and takes up less space. It is not uncommon to get heavier as you get fitter. If you need indicators of body changes, try a digital camera and a tape measure. Pictures and girth measurements are easy to perform, and unlike fat calipers, they are repeatable and very consistent.
Michael S. O’Hara, P.T., OCS, CSCS
Simple training tools always produce the best results. Complicated Nautilus machines are gone, Universal circuits have disappeared and more “equipment extinctions” are soon to follow. You cannot get any simpler than a weighted ball. Since the ancient Greeks mankind has been using medicine balls to improve human performance. Medicine ball throws are one of the most beneficial and exercise activities you can perform.
Improve Your Power Supply
Power is strength expressed in a short period of time. Power production is the first component of fitness that is lost as we age or become physically deconditioned. It is the pop in a punch, the hop in your step, and more importantly, the ability to react quickly. Throwing a medicine ball off a wall or to a partner restores power production.
Develop True Core Stability
Throws performed in standing, kneeling, lunging, and squatting positions develop the primary function of your core stabilizers; transferring forces from the legs to the arms. It is what the “muscles in the middle” must be able to perform for you to move efficiently and maintain a healthy spine.
Intelligent Training of the Hips and Lumbar Spine
Throwing a ball teaches you how to rotate through your hips and not at the lumbar spine. Your lumbar spine is built to bend forward and backward and not rotate. If your hips do not rotate properly, you force damaging torsional forces into the lower back. Many gym machines reduce hip rotation (seated in and out / crunch-sit up machines) and a few actually force lumbar rotation (seated torso twist). Avoid these fitness gizmos and learn to throw a medicine ball. In general, stay clear of anyone who straps you into a “fitness machine”.
Q: What Part of Your Body Does Throwing That Ball Work?
A: The neural system. Medicine ball throws are the ultimate neurological wake up call. Neural signals must be sent from the bottom of your feet through to the tips of your fingers. Muscle must be fired in a coordinated manner to deliver a crisp pop of the ball off the wall. The development of efficient neural pathways (read The Talent Code) is what drives movement skill.
I rank exercises as very high, high, moderate, low, and no value activities. Squats and lunges: very high value, triceps kickbacks: no value. Medicine ball throws are a “very high value” activity. Three or four sets of throws enhances multiple components of human performance; balance, coordination, power production, proprioception, and core stability.
You Need To Know Throws
Medicine ball throws can be scaled to all fitness levels and are safe as long as you use a properly sized and weighted ball. The large, soft Dynamax balls are a good choice for beginners. They rebound well off of block walls and are easy to catch. Smaller rubber balls will return faster off the wall and are better suited for athletic training. Do not over load your medicine ball throws, a two to eight pound ball is best for most gym goers. Get with one of the trainers for instruction on adding medicine ball throws to your training program.
Michael S. O’Hara, P.T., OCS, CSCS
THE RIGHT THING TO WEIGH
Great Abs Are Made In The Kitchen
I have been advising people to throw away the bathroom scale for many years. Weighing yourself on a daily basis is a counter productive activity. It does nothing to encourage fitness success, and tracking the number on the scale tells you very little about your ability to move, state of health, or level of fitness. A far better investment in time and money is the daily use of a kitchen scale.
The bodyweight numbers from the bathroom scale are often misleading. A great program of exercise will add few pounds of muscle and subtract a few pounds of fat so the number on the scale will not move. The client will be stronger, fitter, have a faster metabolism but still becomes discouraged because the scale numbers have not gone down. A horrible program of exercise removes equal amounts of muscle and fat. It produces a weaker body with a suppressed metabolism but the client is pleased with lower scale numbers. In many ways, the perseveration on bodyweight numbers sets you up for failure.
The Number To Know
Ask any trainer or dietician who works with clients on body composition goals. The general public has no food portion awareness. Knowing the number of calories present in a portion of food is critical to reaching body composition goals. You will never be able to exercise enough to counterbalance the effects of a poor diet. Consistent use of a kitchen scale can quickly educate you on the number of calories in a specific portion size.
Modern kitchen scales are inexpensive, convenient, accurate, and easy to use. Use a kitchen scale every day, for every meal, for one month. Write down every bit of food you eat and track your total calories. Pick a daily calorie goal and stay at that level for the entire month. Do the tape measure test (see below) at the beginning and end of the month. The information you get from the kitchen scale will produce better results than the numbers from the bathroom scale.
The Tape Measure Tells All
If you want a more accurate and reliable measure of your fat composition, get a tape measure. Men measure around the bellybutton and women measure around the widest aspect of the hips. The tale of the tape will give you an accurate indicator of your progress, or lack of progress toward losing bodyfat. Make that tape measurement smaller and you can be assured that you are moving in the right direction.
Michael S. O’Hara, P.T., OCS, CSCS
YOUR WEEKLY FITNESS CHECKLIST
Push, Pull, Hip Hinge, Squat, Rotation, and Resisted Ambulation
These are the basic movement patterns you need to perform every week to keep your body performing at an optimal level. The push and pull can be vertical or horizontal. The hip hinge and squat can be both legs at the same time or single leg. Rotation movements are performed in both directions. If you possess enough strength, some sort of resisted ambulation in the form of a carry or sled work.
More than ever, we have become a nation of sedentary sitters. Prolonged sitting and the absence of normal movement activities causes much of the obesity, pain, and early degenerative changes we see every day in our physical therapy clinics. Fitness programming must include the movement patterns our bodies require to stimulate bone health, muscle strength, neurological function, and a fast metabolism. As we age, maintaining the capacity to move keeps us independent and safe.
You do not have to include all of these movement patterns in every training session but you should be training each of them at least once a week. Many training activities can cover more than one movement pattern. A TRX rotational row is a pull with rotation. Tubing squat, reach, and row covers two essentials in one exercise. Sled pushing is resisted ambulation with a push. A Turkish Get Up is nearly everything.
Prepare to be frustrated when training a movement pattern you have been neglecting. Training movement demands higher neurological control than muscle isolation type training. Anyone can quickly master the preacher bench curl or seated knee extension, but most trainees will have to work hard to regain a lost squat pattern or a limited hip hinge. Be diligent and focus your efforts on the most restricted movement patterns—you will be rewarded with better posture, fewer injuries, and a pain free life.
Even for the group that just wants to look better naked, moving well is critical. If your mobility is restricted, you will never be able to train for maximal metabolic response. The number of calories you burn during a training session is directly related to the percentage of muscle mass you place under a training stimulus. For the aesthetics only fitness enthusiasts, the missing link in their training is usually the squat and hip hinge patterns. They perform lots of upper body exercise and have no glutes or hamstrings. A full squat, kettlebell swings (hip hinge), or a sled push activate a greater percentage of muscle mass than any seated leg exercise.
Michael S. O’Hara, P.T., OCS, CSCS
“SO WHAT ABOUT CRUNCHES?”
Personal Training Question Number One
I get this question from many of my fitness clients at the end of their personal training or group coaching sessions. Somehow crunches are viewed as an essential part of fitness. Instructional DVDs are sold with an hour of abdominal exercises—I counted 12 different types of crunches and sit ups in one very popular infomercial product. In physical therapy, I get to treat the patients who in a valiant, but misguided effort to regain fitness launch into a series of crunch / sit up exercises only to wake the next day with searing lower back or neck pain. I was recently asked to e-mail my no crunches answer–so here we go.
Most fitness clients are already have earned a black belt in spinal flexion. Their thoracic and lumbar vertebrae are bent forward for many hours a day– sitting too much, driving too much, television too much. Most are proud at how easily they can fold the thoracic and lumbar spine over and “palm the floor”. The last thing they need is to pull the ligaments, discs, and joints of their spine into further flexion with crunches and sit ups.
Your Mother’s Eyes and Your Grandma’s Spine
As we age, our thoracic and lumbar spines tend to fall into a flexed over “crunched” position. Why would you want to accelerate the pace of this degeneration by performing activities that accentuate the slumped over forward flexed spinal posture of old age.
The Other Spot Reducing Exercise
Your abdominal muscles or “six pack” will not become more visible with lots of crunches, sit ups, rip twists, belly blasters, or any other targeted training. There is no such thing as spot reducing. The table push away is the best exercise to improve the visibility of any muscle. Unfortunately, it is the least utilized exercise in America.
A Little Kinesiology
The function of your abdominal muscles is not to create movement but rather prevent movement. They work with a team of other muscles to act as anti extensors, anti rotators, and anti flexor muscles. The six pack muscle or rectus abdominus makes up a portion of the cylinder of muscle that serves to support your spine in tall and stable position–not bend it forward. Think “movement preventers” and not “movement producers”. Crunches and sit ups train your abdominal muscles to do the wrong thing.
The Pros Don’t Use Them
I cannot think of any athletic activity that emulates the motion of a crunch or sit up. It will not improve your ability to run, jump, throw, or compete. The strength and conditioning coaches that get paid big money to make athletes more successful and keep them injury free do not use crunches or other repeated trunk flexion exercises in their programming.
Maybe Not Now, But Soon And For The Rest Of Your Life
Your lumbar spine hates combined flexion and rotation, and it really hates it if you throw in some compression from an exterior load like a medicine ball, weight plate, or kettlebell. Lumbar spine injuries are cumulative. The stresses build up until one day you bend over to pick up a pencil and your back “goes out”. Crunches and sit ups serve to accelerate the rate of accumulated spinal stress. I know you have a friend who does one hundred twisting, medicine ball crunches a day and has never had a problem. I have a friend who has smoked for twenty years and says he feels fine.
Michael S. O’Hara, P.T., OCS, CSCS