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Rehabilitation

Eight Habits for Long Term Fitness Success–#3 Work on Mobility/Stability

There are thousands of different workout programs and methods to use to become more fit.  These range from at home workout videos, to aerobic or yoga classes, to bootcamps and group functional training workouts.  Methods, benefits, and risks/drawbacks could be debated until our last breath and often are among fitness professionals.  One thing I’ve come to learn in my twenty years in this industry is that dogmatic approaches rarely pan out, and you are better off steering clear of anything or anyone who claims any one method of training is optimal and a cure all for everyone under every circumstance.  However, I do believe that there are some universal habits that will vastly improve someone’s fitness.  For the sake of this article, I will stick with habits which only involve movement, with an understanding that nutrition, rest, recovery, stress management, and body weight all impact fitness as well.

To know what habits will best improve long term fitness, we must first define the term.  There are three definitions of fitness. The first (and newest, brought on by the growth of the fitness industry) is “the condition of being physically fit and healthy.” This definition misses the mark as it uses the root of the word in it, and doesn’t really tell us anything.  The second definition is “the quality of being suitable to fulfill a particular role or task.”  This definition is a little bit better.  We can see here that the fitness required to be an NFL offensive lineman and the fitness required to run the Ironman in Hawaii is much different.  This still doesn’t get to what most of us think of when we describe someone as being fit.  The third definition, and the one I find to be most relevant to the general population, is “an organism’s ability to survive and reproduce in a particular environment.”  Put differently, your ability to reproduce and pass your genes onto the next generation.  At first glance, this may seem like a poor definition.  If we go back 100-500 years to a time where modern technology and medicine couldn’t “fix” everything, this definition is ideal.  If someone is over or underweight, they struggle with fertility.  If someone has major health complications, injuries, etc. they would have a hard time attracting a mate, defending themselves/home, or feeding themselves.  Certain lifestyle choices will absolutely reduce fertility rates (smoking, drinking, stress) therefore decreasing one’s fitness.  Operating with the biological definition of fitness, I find that the following eight habits will set you up for a lifetime of greatness.

Jeff Tirrell, CSCS, CSFC, Pn1

Work on Mobility/Stability

Make sure you can move each joint through its maximal pain free range of motion.  On top of being able to move through that range, we also want to be able to control or “own” that range of motion.  This can be done by using full range of motion in your strength exercises, as well as incorporating some full body warm ups that address each.  At Fenton Fitness, we try to hit 2-3 hip stretches, 1-2 thoracic spine/shoulder stretches, and 2-3 activation/stability drills at the beginning of each workout.  If an individual has no restrictions, a good bang for the buck warm up can be seen in this video. This type of work can be done daily, but I would suggest a minimum of 3 days per week to maintain your movement quality.

 View the video here

Eight Habits for Long Term Fitness Success–#2 Get Stronger

There are thousands of different workout programs and methods to use to become more fit.  These range from at home workout videos, to aerobic or yoga classes, to bootcamps and group functional training workouts.  Methods, benefits, and risks/drawbacks could be debated until our last breath and often are among fitness professionals.  One thing I’ve come to learn in my twenty years in this industry is that dogmatic approaches rarely pan out, and you are better off steering clear of anything or anyone who claims any one method of training is optimal and a cure all for everyone under every circumstance.  However, I do believe that there are some universal habits that will vastly improve someone’s fitness.  For the sake of this article, I will stick with habits which only involve movement, with an understanding that nutrition, rest, recovery, stress management, and body weight all impact fitness as well.

To know what habits will best improve long term fitness, we must first define the term.  There are three definitions of fitness. The first (and newest, brought on by the growth of the fitness industry) is “the condition of being physically fit and healthy.” This definition misses the mark as it uses the root of the word in it, and doesn’t really tell us anything.  The second definition is “the quality of being suitable to fulfill a particular role or task.”  This definition is a little bit better.  We can see here that the fitness required to be an NFL offensive lineman and the fitness required to run the Ironman in Hawaii is much different.  This still doesn’t get to what most of us think of when we describe someone as being fit.  The third definition, and the one I find to be most relevant to the general population, is “an organism’s ability to survive and reproduce in a particular environment.”  Put differently, your ability to reproduce and pass your genes onto the next generation.  At first glance, this may seem like a poor definition.  If we go back 100-500 years to a time where modern technology and medicine couldn’t “fix” everything, this definition is ideal.  If someone is over or underweight, they struggle with fertility.  If someone has major health complications, injuries, etc. they would have a hard time attracting a mate, defending themselves/home, or feeding themselves.  Certain lifestyle choices will absolutely reduce fertility rates (smoking, drinking, stress) therefore decreasing one’s fitness.  Operating with the biological definition of fitness, I find that the following eight habits will set you up for a lifetime of greatness.

Jeff Tirrell, CSCS, CSFC, Pn1

Get Strong(er)

Strength is probably one of the greatest indicators of longevity and quality of life that we have.  How strong is strong enough will get you different responses depending on what strength coach you talk to and what population we are talking about.  However, one thing is for certain.  You can almost always get stronger at something, and there is virtually no drawback to being stronger.  Most people will be best served by having 5-6 movements that they focus on getting really strong at, and keeping those in their training plan for 6-12 weeks at a time.  I typically recommend picking one movement from each movement category (Squat, Lunge, Hinge, Push, Pull, and Carry/Crawl) and getting as strong as possible on that given movement.  Pick movements that you feel comfortable with, are pain free, and of which you have maximal range of motion.  Stick with 2-6 repetitions, 3-5 sets, 2 times per week for best results.

Eight Habits for Long Term Fitness Success–#1 Move Daily

There are thousands of different workout programs and methods to use to become more fit.  These range from at home workout videos, to aerobic or yoga classes, to bootcamps and group functional training workouts.  Methods, benefits, and risks/drawbacks could be debated until our last breath and often are among fitness professionals.  One thing I’ve come to learn in my twenty years in this industry is that dogmatic approaches rarely pan out, and you are better off steering clear of anything or anyone who claims any one method of training is optimal and a cure all for everyone under every circumstance.  However, I do believe that there are some universal habits that will vastly improve someone’s fitness.  For the sake of this article, I will stick with habits which only involve movement, with an understanding that nutrition, rest, recovery, stress management, and body weight all impact fitness as well.

To know what habits will best improve long term fitness, we must first define the term.  There are three definitions of fitness. The first (and newest, brought on by the growth of the fitness industry) is “the condition of being physically fit and healthy.” This definition misses the mark as it uses the root of the word in it, and doesn’t really tell us anything.  The second definition is “the quality of being suitable to fulfill a particular role or task.”  This definition is a little bit better.  We can see here that the fitness required to be an NFL offensive lineman and the fitness required to run the Ironman in Hawaii is much different.  This still doesn’t get to what most of us think of when we describe someone as being fit.  The third definition, and the one I find to be most relevant to the general population, is “an organism’s ability to survive and reproduce in a particular environment.”  Put differently, your ability to reproduce and pass your genes onto the next generation.  At first glance, this may seem like a poor definition.  If we go back 100-500 years to a time where modern technology and medicine couldn’t “fix” everything, this definition is ideal.  If someone is over or underweight, they struggle with fertility.  If someone has major health complications, injuries, etc. they would have a hard time attracting a mate, defending themselves/home, or feeding themselves.  Certain lifestyle choices will absolutely reduce fertility rates (smoking, drinking, stress) therefore decreasing one’s fitness.  Operating with the biological definition of fitness, I find that the following eight habits will set you up for a lifetime of greatness.

Jeff Tirrell, CSCS, CSFC, Pn1

Move Daily

This is so simple, yet like many things in life, the simplicity of this basic habit causes it to get overlooked or ignored.  This is by far the most common habit among fit individuals.  Don’t over think it or complicate it–just move.  It doesn’t have to be strenuous or difficult.  When looking at the small number of individuals who are successful with long term weight loss, researchers have seen that doing 4-5+ hours/week of planned exercise/activity is a staple.  This comes out to 30-60 minutes per day.  Walk, ride a bike, kayak, paddle board, roll, carry, crawl, do a movement flow (as seen in the video) or whatever.  Just get off your butt and move around at least 30 minutes each day.  It doesn’t have to be all in one shot, but make it happen, and make it intentional.  Daily movement helps manage stress, regulate hunger, and has big cognitive benefits as well.  The only stipulation I would make is to avoid activities with high risk of injury.  After all, if you get substantially injured it makes daily movement a bit more difficult.

See video of some simple movement patterns: here

Five Fitness Numbers You Need to Know

Scale bodyweight, bench press maximum, some “girl name” and a time are all fitness numbers your hear in the gym.  If you are interested in optimal performance and health, I have the fitness numbers we all need to know.  Focusing on these numbers will keep you active and independent for a lifetime.

1) WAIST CIRCUMFERENCE

The location of bodyfat is far more important than the amount of bodyfat.  Visceral fat, the kind stored in and around the belly, is the hormonal driver of metabolic syndrome; the precursor to diabetes, elevated blood lipids, high blood pressure, and coronary artery disease.  To optimize health, you need to monitor the diameter of your waistline.  The number you want to know is your waist to height ratio.  You want your waist to be less than half your height.  If your waist size is greater than one half your height, then reducing your waist diameter should be the primary goal of your fitness program.

2) SLEEP TIME

Sleep is the ultimate exercise recovery activity.  One or two nights of sleep deprivation has been shown to reduce gym performance by 25% – 40%.  We need seven to eight hours of restful sleep, each and every night.  The most important benefits of exercise are neural and hormonal.  Sleep reboots our neural software and replenishes the hormonal system.  Medications, respiratory problems, sleep apnea, and obesity all can interfere with sleep patterns.  Fixing these health issues and developing better sleep habits produces magical progress in the gym.  Read the book, Sleep Smarter by Shawn Stevenson.

3) FUNCTIONAL MOVEMENT SCREEN SCORE

The Functional Movement Screen (FMS), developed by Physical Therapist Gray Cook and Athletic Trainer Lee Burton, is a seven-step dynamic movement based test that has become a standard of practice in physical therapy and sports performance centers.  The FMS helps prevent injuries before they occur by identifying risk factors.  Movement indicates how a body works and lets us know how the brain is controlling the body and how the joints and muscles communicate.  Just like a good medical work up, the FMS permits the trainer / therapist to make the proper decision about the clients’ most urgent needs and avoid gym activities that are detrimental.

4) GRIP STRENGTH

Recent research has demonstrated that knowing your grip strength is as important as knowing your blood pressure.  The PURE research of 140 thousand individuals revealed that a drop in grip strength is a strong predictor of mortality from all causes.  We will all face health battles and the stronger body wins while a weaker body loses.

5) NUMBER OF TRAINING SESSIONS PER YEAR

Exercise is ineffective absent consistency.  Even a haphazard program of exercise is beneficial if you perform it on a consistent basis.  The experts say a good goal is 150 training sessions per year.  That is three times a week for 50 of the 52 weeks in a year.  Link together several years of the consistency habit and amazing changes happen.  Most people overestimate the value of a month’s worth of exercise and greatly underestimate the value of a year’s worth of exercise.

Michael S. O’Hara, PT, OCS, CSCS

Hang Up and Drive

While on a recent trip out of town, I witnessed a young man plow his car into the back of a delivery truck.  The young man was gazing down at his mobile phone and failed to stop when the truck in front of him stopped for a school bus.  The airbag did its job and the driver appeared to be unscathed.  The passengers in the back seat of his car did not fair as well and both were taken away in an ambulance.

The technology exists to turn off a mobile phone if it is moving in a car.  The most dangerous thing the average American does in their day is travel in a car.  Mobile phone use makes car travel dramatically more dangerous.  Educational campaigns and fines have not reduced mobile phone use by drivers.  Many people will never be able to control their impulsive addiction to the mobile phone.  Locking out cell phones while the car is moving is the only answer.

Physical therapist clean up the physical damage created by drivers distracted by their cell phones.  Auto accidents often create pain and performance problems that never fully resolve.  Blocking the mobile phone while traveling in a car may have the unintended consequence of restoring the lost art of conversation–you remember talking, don’t you?  While cruising along on this brief bit of magic we call life, you do not want the final sound you hear to be the ring from your cell phone.

Michael S. O’Hara, PT, OCS, CSCS

Anti Extension Progression

An interconnected team of muscles holds our spinal column stable.  If you wish to be strong in all endeavors, you need to develop isometric (no movement) torso strength that resists flexion, resists extension, and resists rotational forces.  Most people have poor anti extension torso strength, and many of them show up in the physical therapy clinic with lower back, hip, and neck pain.  Presented below is a time-tested progression of training activities that will improve anti extension torso strength.  Watch the video and make these exercises a part of your training program.

Anti Extension Torso Strength Program

  1. Wall Planks
  2. Bench Planks
  3. Push up Position Planks
  4. Push up Position Planks feet elevated
  5. Ball Roll Outs
  6. Ab Wheel Roll Outs

Initial anti extension exercises are all a version of planks that are scaled from easiest to hardest–wall, bench, push up position, and then push up position feet elevated.

Weaker people require more practice to develop the neural connections that improve strength.  They need two sessions a day to drive a reboot of their neural system.   Start with the wall planks for two holds of twenty seconds.  Gradually increase the time you hold the wall planks from twenty seconds to forty seconds.  When forty seconds gets easy, move to the next progression–bench planks.  Return to twenty second holds for two planks after each progression.

Once you can perform forty seconds of the push up position plank with feet elevated, move to the ball roll out exercise for five repetitions.  As your strength improves, gradually increase the repetitions until you can complete fifteen repetitions of the ball roll out.  The final progression is the ab wheel roll out–start with five and work up to fifteen repetitions.

View video of these exercises: here

Michael S. O’Hara, PT, OCS, CSCS

Sister Hermeta Saved My Soul and My Spine

Tall Kneeling Core Stabilization Training

During my parochial grade school education,  I was taught how to kneel in church.  Eyes forward, hands together, spine tall, and no leaning on the pew.  You maintained the kneeling posture for extended periods of Father Furlong’s mass.  I believe the good sisters were on to something.  Despite every one of them being well past 100 years of age, they all possessed excellent posture and remarkable mobility.  As a physical therapist, I am convinced that a daily dose of sustained kneeling helped keep the Felician Sisters in fighting form.  I have some tall kneeling training suggestions you can add your fitness routine.

Get to Know Kneeling

Many people will benefit from some sustained tall kneeling.  Protect your knees by placing an Airex pad under your knees.  In and ideal situation, you will have a mirror for feedback on posture and alignment.  Keep some space between your knees and line the feet up with the knees.  Pull the head back, lift the chest, and reach the top of the head to the sky.  Many people have difficulty getting into a fully upright position in kneeling.  The most common problem is a forward lean at the hips accompanied by complaints of tightness in the lower back and front of the thighs.  Holding a pvc pipe or dowel overhead while performing some deep breaths can help reduce muscle tone in the hips and torso.   Perform two or three, thirty second holds at every training session for the next six weeks

Tall Kneeling Pallof Press

The tall kneeling Pallof press is an anti rotation core stability exercise that helps recruit the postural muscles that keep us upright and tall.  Lack of isometric strength-endurance in the spinal muscles is a primary contributor to back injuries.  This exercise will improve that component of spinal function.

Place your knees on an Airex pad and set up in kneeling position.  Use either a cable unit or resistance tubing set at a level even with your sternum while you are in the kneeling position.  The tubing should be directly to your right and slightly behind the body.  Use a double overlap grip on the handle and hold at chest level.  Press the tubing out to arms length and then back to the chest.  Select a resistance level that permits execution of fifteen repetitions without losing the set up posture.  Rest and then repeat on the other side.

Tall Kneeling Anti Extension Holds

The pelvis is a bowl and the torso rests on the top of the bowl.  You need a pelvic position that makes stabilization of the torso over the pelvis effortless and automatic.  The tall kneeling isometric hold aligns your pelvis under the torso.

Kneel on an Airex pad.  Hold a kettlebell, dumbbell or Iron Grip Plate behind your back.  It is difficult to prescribe a load.  Twenty pounds may be too easy and five pounds may be too much.  My suggestion is that you err on the lighter side of the load equation.  Stay in the loaded kneeling position for at least thirty seconds.  Lower the weight, walk around, and take inventory of how you feel.  Repeat for another thirty seconds.

See video demonstration of these exercises: here

Michael S. O’Hara, PT, OCS, CSCS

Will That Machine Help Me?

Home Gym Hints

Television ads, holiday gift giving, and the return of frigid temperatures brings out the “What cardio machine should I purchase for my home?” question.  Is it the bike with an internet trainer, the fat blasting high intensity elliptical trainer, or the Euro designed Nordic ski machine?  Many of these units sell for over $3000 and they wish to choose wisely.  Most of the questioners have no experience with any of these gizmos.  I have some pre-purchase questions they need to answer before buying that expensive cardio machine.

Can you currently walk for thirty minutes without stopping to rest?

If you answer no to that question, do not bother purchasing a treadmill, bike, or elliptical unit.  Focus all of your efforts on developing the strength and skill necessary to walk for thirty minutes without resting.  If pain is a limitation, get to the physical therapy clinic and resolve the problem.  Walking is the essential neuromuscular activity that keeps a body healthy and out of the assisted living center.  Leaning over on a treadmill, elliptical trainer, or recumbent bike is very likely to worsen those walking woes.

Do you have a prior history of consistent exercise?

Just owning a new high-tech training machine will not make you thinner or fitter.  You must use the machine three or four days a week for the next year.  Many people believe that locating the machine in the dwelling will jump-start the exercise habit.  If you answer no to this question, I have concerns that you will not develop a relationship with your internet connected mechanical friend.

Is fat loss the primary reason you are purchasing the home exercise machine?

The fat loss the exercise motto everyone needs to learn is; “familiarity breeds failure”.   The human body is a master at adapting to a physical stress and the forty-five minute spin class that burns 440 calories in February only consumes 180 calories in August.  The sad truth is that the same amount of exercise time and effort produces a weaker fat loss response.   The crucial components for fat loss are long duration meal preparation and high intensity portion awareness.  After you get those under control, progress to activities that you find challenging (difficult, not good at, loath, hate) and change the training modality on a frequent basis.  Using the same exercise device month after month will not produce optimal results.

Michael O’Hara, PT, OCS, CSCS

Save Your Back When Shoveling Snow

Improve Your Snow Shoveling Mechanics to Avoid Injury

‘Tis the season for hot cocoa, warm fires, and lots of snow. With snow comes shoveling, and unfortunately with shoveling comes injury. It is estimated that there are over 11,000 hospital visits each year due to injuries while shoveling snow. This number does not even include the thousands of people that see their primary care doctor with the onset of an injury. Many of these medical visits involve the low back including complaints of pain with movement, leg numbness, and the inability to maintain the proper posture. Lumbar injuries while shoveling are often due to the combination of repeated flexion and rotation of the spine. Adding the load of snow and having poor spine stabilization during the lift results in overload on the structures of the lumbar spine and resultant injury. Here are three exercises you can use to improve your shoveling mechanics in order to spend more time sipping cocoa by the fire, and less time in a physician’s waiting room.

  1. Hip Hinge – a proper movement pattern to bend forward and push snow involves flexion at the hips and knees, while maintaining a more neutral spine.
  • Stand with your feet shoulder width apart. Using a broom stick, golf club, or wooden dowel, place the stock along your lumbar spine.
  • The stick should come in contact with the back of your head, mid-thoracic spine (between your shoulder blades), and at the sacrum/mid-buttock.
  • With a slight bend in your knees, hinge your hips by driving your buttock backwards, while maintaining the three points of contact throughout the movement.
  • Perform ten repetitions

Common mistakes: squatting versus hinging – try and minimize knee bend. Your buttock should move backwards, not down.

Losing contact with the stick – if you notice the stick is leaving the sacrum the spine is flexing. Slow down the movement and move only as far as you can with contact.

  1. Isometric Hip Bridge – once you have properly bent forward to push and load the snow, using the buttock and hamstring muscles to lift the snow will decrease strain of muscles of the lower back.
  • Start lying on your back, knees bent, and hands raised straight in the air.
  • Push through your heels driving your hips upwards, hold for 5-10 seconds, and return. Repeat this movement 10 times.
  • If you find that you feel this more in the low back than the legs or buttocks, try squeezing a pillow at your knees during the lift.
  1. Rotational Step – now that you have properly bent to load the snow, and used the proper muscles to lift it, increasing rotation at the hips to move the snow versus rotating through the lumbar spine will reduce torsional strain on the vertebral discs and spinal stabilizers.
  • Begin by standing in an athletic stance with your feet shoulder width apart and slight bend in your knees.
  • Keeping one foot in place, open up through your hips by stepping to the side and backwards. Your weight should be evenly distributed between the feet.
  • Maintain a neutral spine throughout the movement, being mindful not to bend forward or rotate through the spine.
  • Perform 10 repetitions to each side.

See video demonstration of these exercises: here

Sean Duffey, DPT

Clinic Director, Ivy Rehab, Ortonville

Central Park Fitness Test

This is a picture of my 85 year old Mother and I on a recent family vacation to New York City.

My Mom has kept herself fit and active.  She has traveled with us on many vacations.  I have taken her to the top of mountains in Banf and across rock formations in Moab.  She is an elderly person who is enjoying a long and big life.  On this New York City vacation, we walked from the south end of Central Park, up into Harlem for a well-deserved lunch of beer and Italian cuisine.  She traversed six floors in the Empire State Building stairwell.  Every day required multiple trips up and down subway stairs.

I hope and pray I have inherited every single amino acid of the genes that code for this vitality.

Michael S. O’Hara, PT, OCS, CSCS

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