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Throw Old Gracefully

Powering Up The Older Athlete

Exercise is like medicine—administer the correct prescription at the proper dose and the patient thrives.  Different patients require dramatically different medications.  The “exercise medicine” for older adults is a consistent dose of power training.

Fitness Age Changes
Between the ages of 65 and 89, explosive lower limb power production declines at a rate of 3.5% per year.  Strength, on the other hand, declines at a slower 1-2% per year rate in this same group.  Power is the ability to create force in a short period of time and is different than raw strength.  Power is the component of fitness that makes you able to react to a fall or sudden disturbance in balance.  As power recedes, falls and injuries increase.  As falls and injuries increase,  mobility and independent living decrease.

Speed Specific
The implication for older athletes that want to prevent falls and remain independent is that training is speed specific.  You must find exercise activities that make you move at faster tempos.  Seated or supine, slow-paced activities may be beneficial in other ways (strength, cardiac endurance), but they will not improve muscle contractile speeds.

Medicine Ball Wall Throws  
Adding a velocity component to your training is not complicated.  Nearly everyone can throw a medicine ball at a wall.  Throws will improve your balance, proprioception (positional awareness), core stability, power production, and overall coordination.  Watch the accompanying video of some of our favorite wall throws.  Choose a medicine ball of appropriate weight—most people go too heavy—and add three or four sets of throws to your gym program.

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

Heads Up

The Downside Of Upside Down Exercise

H_HoudiniExercise activities that place the head below the heart have become more popular in fitness programs.  In almost every gym you see decline bench pressing, incline sit ups, glute-hamstring developer exercises, and more recently, hand stand push ups as a regular part of many exercise programs.  While these activities may have some value, you might want to reconsider training in an inverted position for some other reasons.

Esophageal Reflux
When you invert your torso, the contents of your stomach can more readily travel back up into your esophagus.  Head below your belly with a hiatal hernia, a little extra mesenteric fat, and some strong contractions from the abdominal muscles, and you have the perfect environment for gastroesophageal reflux disease (GERD).  Millions of Americans (14%-20% depending on the study) take medications to manage the symptoms of GERD—heartburn, chest pain, persistent cough, difficulty swallowing, hoarseness.  Prilosec and Nexium are the biggest moneymakers the pharmaceutical industry ever created.  Many Americans (10%-15%) have GERD, but are unaware of the problem because the tissue damage has not reached symptomatic levels.  Erosive esophagitis or Barrett’s esophagus is a clinical finding of cellular change in the esophagus and a precursor for esophageal cancer.  Esophageal cancer is one of the more deadly types of cancer.

Glaucoma or Retinal Disease  
The head down position raises pressure inside the eyeball.  As little as 30 degrees of decline has been shown to increase intraocular pressures.  It is estimated that 2.2 million Americans have glaucoma, but only half of these know they have the problem.  Individuals with glaucoma already have elevated intraocular pressures and should avoid these positions.  The back of the eye (retina) is susceptible to changes in vascular pressures, so if you have any retina issues, avoid the head down position.

High Blood Pressure / Hypertension
Your heart, lungs, and arteries are conditioned to pump blood with your body in an upright position.  Many vascular alterations occur when we flip into a heads down position.  When you assume the head below your heart position, the arterial pressures inside the skull increase.  Elevated cranial blood pressures can lead to headache and much more severe problems such a stroke.  One in three Americans are walking around with high blood pressure.  Add in an exercise induced elevated heart rate and some less than pliable carotid arteries and you have the ideal environment for a big bad brain event.  If you have hypertension, I would not go about using any inverted positions in the gym.

Bottom Line
Apart from going blind, having a stroke, and developing an incurable cancer, you should be fine.

Michael S. O’Hara, P.T., OCS, CSCS

Robin Anthony McKenzie

1931-2013

“My patients taught me all I know.”

r_mcknzie_bookOn May 13, 2013, world renowned physical therapist, Robin McKenzie died.  Robin was an astute observer of his patients’ signs and symptoms.  Early in his career, he realized that many of his patients with back or neck pain would get better only to suffer the same problem months or years later.  To solve the problem of recurrence, he devised a very successful program of spinal therapy based on patient education and continued self-treatment with daily home exercise.  He developed a system of evaluation and treatment of mechanical spinal disorders that has gained a worldwide following.  His books, Treat Your Own Back and Treat Your Own Neck have sold over six million copies–more than any other medical self-help books.  In 1982, he founded the McKenzie Institute to educate fellow physical therapists on his evaluation and treatment methods.  I consider his most recent book, 7 Steps To a Pain-Free Life a must read for anyone who must lift, carry, or sit all day, or for patients with recurrent neck / lower back pain.

Thank You, Robin
Fresh out of college in 1984, I quickly realized that I had no idea how to help patients with lower back and neck pain.  Thirty years ago, I completed my first McKenzie course and became a much more effective and confident clinician.  Over the next two years, I completed three more of the McKenzie courses and went on to attend three of the McKenzie Institute’s International Symposiums.  The education from the McKenzie Institute has been priceless.  All of the physical therapists at our clinics have studied Mr. McKenzie’s teachings, and over the years, Fenton Physical Therapy has been fortunate to sponsor several of the McKenzie Institute educational courses.  Our entire professional staff is grateful for the insight and knowledge Mr. McKenzie has brought to our profession.

Michael S. O’Hara, P.T., OCS, CSCS

Get Bitten!

Rolling the Vipr Into Your Fitness Program

The latest addition to our training toolbox at Fenton Fitness is the Vipr.  Created by Kinesiologist Michol Dalcourt, the Vipr (vitality, performance and reconditioning) is a hollow rubber tube with strategically placed handles.  The Vipr is an elegantly simple device that allows us to train strength, balance, coordination, power production, and faster metabolism.

Movement Education
The Vipr has been designed to challenge compound, whole body movement patterns in standing positions.  Similar to a medicine ball, the Vipr can be reached and rotated through all planes of motion.  Unlike a medicine ball, you can move a Vipr in a larger arc of motion and still maintain a solid grip.  To improve balance and coordination, you must remain upright and stay stable despite the forces that are created when you move the Vipr.

Shape Matters
Grab a Vipr and move through some upper cut lunges, overhead matrix, and lateral hops.  The elongated shape of the Vipr puts more of the mass at a distance from the handles.  As you move the Vipr at faster speeds, greater inertia force is developed.  You feel this intertia pull on your shoulders, torso, and hips as you accelerate and decelerate the Vipr.  The nervous system and muscles must work against this force to maintain balance and stability.

Metabolic Demand and Fat Loss
Full body resistance training with a Vipr is the type of activity that produces significant elevated post exercise oxygen consumption (EPOC).  A faster metabolism burns up more calories all through the day.  Many fitness clients interested in changing their body composition have damaged their metabolism with repeated dietary restrictions and poor exercise choices.  Ramping up the metabolic response with resistance interval training is the key to restoring a sluggish metabolism and burning more calories.

Watch the video for some ideas on basic Vipr exercise that you can add to your training program.  Vipr training is part of our Met Con Team Training Class at Fenton Fitness.

Michael S. O’Hara, P.T., OCS, CSCS

Unlucky Me

In my sports and fitness life, I have some regrets.  I spent too much time in activities that turned out to be worthless or worse, unhealthy.  I missed some opportunities to learn new skills and have more fun.  Looking back, I would change several aspects of my fitness life.

Bad Coaches
Growing up, I had some great coaches—Dad, Coach Sharpe, Coach Boulus, Coach Ross–Thank you.   However, some of my coaches were horrible.  They had no idea what they were doing or how they should interact with young kids.  They usually had a child on the team and this was their true motivation for coaching.  They smoked, obviously did not practice what they preached in regards to exercise, and were poor role models.  I was taught not to quit on a team, but looking back, I should have opted out.  The drills we performed were often punitive.  They denied us water, gave us salt pills, and made us participate in ridiculous training exercises.  Unfortunately, many of my friends dropped completely out of organized sports at early ages because of these coaches.  I think this is still happening today.

Too Much Team and Not Enough Solo Sports
From grade school to high school, I played team sports–baseball, football, and basketball.  In retrospect, I should have tried more solo athletic activities.  I did not start playing golf until my mid forties and I really enjoy it.  I did not try snow skiing until I was in my twenties.  You can participate in these sports through an entire life span.  My big wish is to be able to play golf, tennis, or frisbee with my grandchildren.

Nautilus Stupidus
When Arthur Jones came out with the incredibly intricate “cam gear” driven Nautilus machines in 1977, I jumped in head first.  They were big, shiny, and complicated, so they had to be good for me.  The Nautilus sales pitch was that 30 minutes of intense training twice a week would turn you into a physical super hero.  I bought a membership at a Nautilus equipped gym, and spent two years wedging my body into all sixteen of these mammoth machines.  I got better at moving a lot more plates on each of the machines, but I saw no improvement in my vertical leap or performance on the basketball court.  During that two year period, I became more and more physically limited.  When my shoulders started to ache at night, I had to give up the pullover machine.  When I developed tendonitis in my knee, I had to give up the leg curl and “squat” machine.  I suffered an abdominal strain working on the “torso trainer”.  I ended my Nautilus Era limited to only six of the sixteen machines.  I learned the hard way that seated, strapped in, muscle isolation resistance training is a waste of time.

Synchronized Drowning
My body is not made to swim—I am too dense (no jokes please).  I don’t float–my body sinks like a stone.  In my early twenties, I spent six months trying to learn how to be a proficient swimmer.  I never became any better at moving horizontally through the water—just vertically.  I had great coaching, but the harder I tried, the more my shoulders hurt and my neck ached.  The sensory isolation of looking down at the line in the pool was more than I could psychologically bear.  In the future, I will spend less time on trying to master an activity that physically is inappropriate for my body type.

Road Running Era
I spent three years distance running.  My goal was to run a sub forty minute ten kilometer race time.  I liked being outside and enjoyed the camaraderie of my fellow runners.  In three years of running, my body composition changed from 195 pounds at 12% bodyfat to 175 pounds and 16% bodyfat—I got smaller and fatter.  I went from ten pull ups to three, sixty push ups to twenty two, and my strength in the weight room plummeted.  My vertical leap went down and I got pushed all over the basketball court.  I did get faster in the ten kilometer run, but the running left we weak, tight., and slow.  It took me two years to fully recover.

Michael S. O’Hara, P.T., OCS, CSCS

Lucky Me

Good or bad, you are the sum of the influences in your life.  When I read the latest and greatest research on motor control development in children and listen to the experts on sports performance and injury prevention, I realize I was very fortunate.  Some of my story may help you in fostering an optimal environment for your children.

My Father
My Dad was a high school teacher who also coached basketball and football.  We always had barbells, medicine balls, and jump ropes in the house.  We had a ladder nailed to the ceiling in the basement to climb on and a balance beam in the back yard that was three feet off the ground.  We had a swimming pool, swing sets, ropes to climb, and heavy bags to tackle and hit.  I was encouraged to play everything from football to badminton.  When I read the latest research on the development of motor control in children, I realize I was provided the ideal environment.

The Felician Sisters
In grade school, following recess, the sisters would line us up in the parking lot–no one was permitted to opt out.  They brought out a big box that Sister Ludmilla or Sister Euphrasia would stand on while using a bullhorn to lead us in calisthenics.  Six hundred kids did 20 minutes of jumping jacks, push ups, squat jumps, and lunges.  I always liked it because it was the one portion of the school day that you did not get into trouble for moving around.  As a third grader, I became pretty good at push ups and jump squats.  I do not know of a single guy or gal that grew up doing the Felician Sister Fitness program who tore an ACL or destroyed their shoulder playing sports in high school.  I have always wondered if that was coincidence, early training of neuromuscular control, or just divine intervention.

Minimal Equipment and Maximal Coaching
My high school weight room was small and poorly equipped.  In my basement were some dumbbells and a barbell.  My strength training options were limited.  As I look back, this was an enormous blessing in disguise.  It made me concentrate on the basics of strength training.  No wasted effort on decline bench press, lat pull downs, or preacher curls.  I did squats, lunges, overhead press (no bench for bench press), chin ups, push ups, and cleans.  What I did have was consistent coaching that kept me safe and motivated.  Despite all of the sports I played, I never had a major injury.  The last twenty years of sports performance research has reinforced the importance of basic movement patterns performed extremely well.  If an athlete is strong and moves efficiently, he or she is far less likely to be injured.

My Friend Frank
I met Frank when I was in pre physical therapy college classes.  Frank was an incredibly well read student of fitness and human performance.  He had been a physical education teacher, army fitness instructor, and former professional boxer.  He was nearly seventy years old when I met him and his advice was priceless.  He pulled me out of bodybuilding type training and taught me the essential components of being athletic and moving efficiently.  Now as a physical therapist listening to presentations on the latest research in strength and conditioning, I often laugh because Frank told me the same things more than thirty years ago.

Michael S. O’Hara, P.T., OCS, CSCS

Year 56 Fitness Goals

Reinforcing the mental motivation to stay consistent with exercise is important.  Keeping an exercise log and writing down achievable fitness goals helps to keep me motivated.  I focus primarily on process goals.  I want to remain injury free, metabolically healthy, fight off postural deterioration, and keep a consistent exercise habit.  I have found that if I reach all process goals, the performance goals–stronger, leaner, faster, all tend to follow.  Year to year, many of my goals are the same, but some years I emphasis one specific challenge.  These are my year 56 fitness goals.  I encourage you to write some of your own.

Stay Consistent
My goal is 200 training sessions a year.  That is about 17 sessions a month.  All the big benefits of exercise occur with long term, habitual performance of an exercise regimen.  Consistency is king, everything else is details.

No Dings, Dents, or Medications
I want to move well and remain pain free for a lifetime.  My fitness program will focus on injury prevention and a strong awareness of the risk to reward ratio involved in all exercise selection.  I plan on spending more time on movement preparation drills and soft tissue regeneration activities.  I want to be able to handle a fall and absorb impact without an injury.  I will keep my blood pressure readings normal, and my blood sugar and lipid numbers in a healthy range.  I do not take any medications and I want to keep it that way for another year.

Colonoscopy Number Three
My father was diagnosed with colon cancer at the age of 45 and died from the disease at the age of 49.  Because of my family history, I started early with this test.  This will be colonoscopy number three and all prior tests have gone well.  The preparation is no fun, but the test itself is an IV and a short nap.  There were about 143,000 new cases of colon cancer and 52,000 deaths in the United States last year.  Colon cancer is extremely treatable when caught early and most people are cured.  If you are over fifty you should get a colonoscopy.

Move More EfficientlyIMG_3853
I need to achieve a level of mastery in unilateral exercises.  In life and athletics, it is all about single leg or single arm.  I will work on more step ups, skater squats, Turkish get ups, slider push ups, and land mine presses.  I used to be able to do one arm push ups and I would like to reclaim that ability.  Strength is a skill that is more neurological than muscular, so practice is important.  See the video.

More Hikes
My favorite “cardio” is putting on my boots, throwing on the backpack, and hiking up and down some steep terrain.  I believe the best gym cardio is high (15%) incline walking.  It is low impact, and it improves your posture by training the muscles most likely to shrivel as we age—the gluteals and hamstrings.   My favorite vacations involve long mountain hikes.  After a hike, I feel mentally and physically recharged.  Last year, I got in twenty-five solid, long hikes.  This year I am aiming for forty.

Michael S. O’Hara, P.T., O.C.S., C.S.C.S.

Year 55 Scorecard

Fitness is a motivational mind game.  Setting achievable goals provides the ongoing positive reinforcement needed to keep at the fitness habit.  I no longer set as many performance goals.  As I get older (55), it is more difficult to get stronger, run faster, or jump higher.  I try to set attainable process goals.  I want to stay injury free, metabolically healthy, fight off postural deterioration, and train consistently throughout the year.  If I happen to lose some fat, get stronger or faster, it is a happy by product.  Every birthday, I do a fitness goal review and this is my year 55 fitness scorecard.

Two Hundred Training Sessions a Year
My goal is to get in 200 training sessions in a year.  I managed to fit in 212 sessions for the past year.  Setting specific attendance goals is critical.  In fitness, all of the significant long-term benefits happen when you show up on a consistent basis.

Maintain Proper Movement
This is how the downward spiral starts.  You lose some mobility in your lunge, squat, or overhead reach.  Limited mobility means you no longer can work the muscles through a full functional range of motion.  The muscles move less, atrophy takes hold, and the metabolism slows.  You gain fat more readily, and because you are weaker and heavier, you move less.  Less total movement activity leads to even less mobility.  Less muscle mass leads to far less stored glycogen and insulin sensitivity suffers.  Insulin sensitivity problems lead to diabetes, obesity, metabolic syndrome……. You get the idea.  Mobility is a key component to remaining injury free and staying metabolically healthy.  This past year finds me better in all lunge patterns, and my sprint strides no longer look like Barry Sanders on one side and Colonel Sanders on the other.

Better Single Leg Motor Control
This has been the biggest challenge and the biggest change.  My single leg balance is better and the strength in my hips and lower back has improved.  Single leg training becomes more important as you get older or have a history of injuries.  I enjoy the variety that single leg programming brings to my training.

Power Up
In 2012, I did much more power type training.  In athletics and daily survival, power is more important than strength.  As we get older, the ability to fire muscles rapidly recedes.  The last decade of research studies have shown that this trend is reversible.  My scores in the medicine ball throw and the standing long jump both improved.  I believe the drills that helped the most were the hurdle jumps and kettlebell swings.  I became more proficient in both of these exercises.  My vertical leap did not get any better, but it did not get any worse.

No Injuries
I started with a sore shoulder, but some dedicated mobility work and rehab training set that straight.  I made it through the rest of the year with no dings or dents.

No Medications
This is a goal of mine every year.  I consider it a fitness victory if I am able to go another year and not have to take a blood pressure pill, statin drug, or an anti-inflammatory. I can think of no better fitness goal than being able to eliminate medications because your health is better.

Michael S. O’Hara, P.T., O.C.S., C.S.C.S.

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