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Exercise Of The Week

Dynamic Bench Press

Training Objective: Increases upper body rate of force production. Improves ability to create and use elastic energy, with the result being a high increase in pressing power.

Setup: Loop two identical bands around each side of the bar and anchor the other ends of the bands near the floor, pulling down in a straight line from the bar.

Procedure: Lay supine on a bench with the heels comfortably on the ground. Squeeze your shoulder blades down and back and then un-rack the bar and position over the middle to lower part of the chest. Lower the bar with a higher than normal speed, then when the bar is about an inch from the chest, rapidly decelerate the bar and press back into the starting extended position. Immediately perform the next rep.

Recommended Sets/Reps: Perform 9 sets of 3 reps with 1 minute between sets. Use approximately 50-60% of 1 rep max.

bp1       bp2              bp3

Common Mistakes: Dropping the bar too fast and bouncing off the chest. Trying to do too much weight–speed must stay high. Lifting the legs off the ground.
Josh Kosier, MA, CSCS

Making Waves With Rope Training

ropeAt Fenton Fitness, heavy rope training is one of our favorite conditioning activities.   Conditioning is very different than long duration cardio training.  A conditioning session creates better neural response, denser fast twitch muscle fibers, and more active metabolic pathways.   Conditioning sessions are the missing elements in most gym goers’ training programs.  Conditioning with heavy ropes is about moving better and functioning at optimal levels.

Easy to Learn
The simplest training tools are always the most effective.  You do not need a weekend certification course or five sessions with a trainer to learn how to use a heavy rope.  In my experience, there is something intuitive and primal about rope conditioning drills that our nervous system seems to enjoy.

Less Injury Risk
The momentum created when a wave is generated down a rope does not travel back toward the user but is dissipated over the length of the rope.  Unlike kettlebells or free weights, you have no concerns about absorbing the impact of the returning implement.

Quick Recovery
When you condition with heavy ropes, the eccentric muscle activity (muscles lengthen against resistance) is minimal, so delayed onset muscle soreness (DOMS) is diminished.  You can perform a whole lot of metabolism boosting heavy rope training and still recover for your next gym session.

Metabolism Boosting
Rope training produces an intense training stimulus, similar to sprinting.  This creates and preserves more of the fast twitch muscle fibers that make us strong and lean.  Ramping up your metabolism with rope training is an excellent method of reaching body composition goals.

Better On the Field of Play and Game of Life
Rope training puts you in a standing position and reinforces the movement patterns that link the hips and shoulders through a stabilized torso.  The oscillating resistance from the rope teaches you how to create a strong isometric stabilization of the spine and transfer forces from the ground to the ropes.

Scalable To Any Fitness Level
The rope can be shortened to suit any fitness level.  A fifty foot 1½ inch rope weighs 26 pounds–you are moving 13 pounds on each side.  Shorten the rope by tying down ten feet at the attachment point on the floor, and you have reduced the load by 20%.   Take out twenty feet, and you reduce the load 40%.

Time Efficient
Anchor your rope and perform thirty seconds of rope waves followed by fifteen seconds of rest.  Repeat for ten intervals—I doubt you will need more cardio.  You are done with your conditioning in less than eight minutes.  Use the time saved to work on strength training.

At FFAC, we have several ropes of different diameters with dedicated attachment stations on the Move Strong unit.  Get with a trainer to learn how to make heavy rope training part of your fitness program.

Michael O’Hara, PT, OCS, CSCS

Semper Pullus

Strength Is A Skill–You Just Need To Practice

The Marine Corp just decided to delay implementation of the 3 pull up proficiency mandate for female recruits as only 45% of the female soldiers could achieve this level of proficiency.  They plan on revising their training protocol and assessing the results later in the year.

Bad news sells.  The stories that broke in the newspapers and on TV all mentioned that 55% of the female recruits could not achieve three pull ups, but what they did not tell you was that the duration of the training was only sixteen weeks and that the initial level of fitness for many of the female recruits was poor.  Ask any strength coach that has trained female clients and they will tell you that the Marine Corp pass rate of 45% on the 3 pull up test is above average.

The October 28, 2013 issue of the New York Times ran an article detailing all of the reasons women are unable to perform pull ups.  Research done at the University of Dayton on a pull up training program was the basis of the New York Times article.  The program consisted of only seventeen participants, so the training protocol was far from optimal.  The fact that they were able to progress four of the seventeen participants to one pull up with this flawed three month regimen shows that nearly every female can achieve pull up prowess.

For the military, the three pull up test demonstrates that the soldier can manipulate her body weight over an obstacle.  If you can perform three pull ups, you will be able to get out of a ditch, climb a fence, and haul your body out of the water and onto a raft.  For fitness clients, the ability to perform pull ups improves posture, bulletproofs the shoulders and makes you less likely to develop head, neck, and upper back pain problems.  Pull up proficiency makes you stronger at other skills, such as push-ups, sprinting, and throwing.  I have some suggestions on how female trainees can get better at pull ups.

Do Not Train With Other Machines
Strength is a skill and just like any other skill it is neurologically very specific.  You will not get better at hitting golf balls by hitting a tennis ball–it is too different.  Lat pull down machines, incline total gym trainers, and all other devices are too different from a fixed bar pull up.  If your goal is to get better at pull ups, you have to stay away from these devices.

Perform Inverted Rows
Watch the video and add this exercise to your training program.  Inverted rows require proper positioning of the spine and shoulders.  Inverted rows will make you better at initiating the movement with the back muscles and not the arms.  The horizontal pull strength you develop with an inverted row compliments the vertical pulling skill you need to perform a bar pull up.

Do Not Train To Failure
Pull up prowess requires you to make a connection between multiple muscles in a manner that will be very new to most fitness clients.  You need to keep the neural lines of communication fresh and free from fatigue.  You will start your training with one solid repetition followed by an extended recovery.

Do Not Train Your Biceps
You need to learn to pull with your back muscles and not your arms.  Stay away from any kind of direct biceps training while you are working on your pull up program.  Your biceps will get stronger from the pull up training.  Gymnasts are the “pull up kings” of the athletic world and they perform no direct biceps exercise activity.  This was a big mistake in the University of Dayton research program.

Do Not Do A Lot Of Cardio
The University of Dayton program had their female clients do cardio activity in an effort to lower their body fat levels so they would have less to lift during a pull up.   Lots of cardio blunts your acquisition of greater strength.  It is difficult to get stronger if you are sapping your recovery capacity with lots of miles on the treadmill or bike.  Use intervals of intense work with short rest periods as a substitute.  Increasing the strength and control of your muscles keeps you lean, pain free, and healthy for a lifetime.

Improve Your Thoracic Spine Mobility
Many fitness clients have a thoracic spine- mid and upper back- that is stuck in flexion.  Hours in the car, computer work, iphone, and some poor training practices have locked them in a bent over position.  You need to be able to extend the thoracic spine in order to set the pulling muscles of the back in a proper position for a successful pull up.  A simple foam roll can help improve extension in the thoracic spine.

Train With A Band Assist
The pull up novice needs to use the assist of an elastic band.  The band gives you assist at the bottom of the pull up, and then has you working harder as you get closer to the bar.  Make sure you keep your knee down so the band does not snap off the leg.

Do Not Kip a Pull Up
“Kipping” a pull up is when you use motion of the lower body and torso to help propel your body up toward the bar.  As a physical therapist who treats people with shoulder pain problems, I love the kipping pull—especially for high repetitions.  As a strength coach interested in improving function and not injuring clients, kipping a pull up places far too much stress on the shoulders of clients who are new to overhead training.  When you have trained on improving your pull up performance for six months and can execute six solid smooth pull ups, you may be ready for some kipping pull ups.

Train Pull Ups More Often
The beginner golfer who practices five days a week is going to have an advantage over the golfer who practices twice a week.  Pull ups are a skill and newbies need to practice more often.  Get a bar set up in a doorway at home–one you must walk under frequently.  Get your kids to practice pull ups and work on this skill as a team.

Improve Rib Cage Stability
The pulling muscles of the upper back attach to your rib cage.  You need to be able to hold the front of your rib cage down with your abdominal muscles to become proficient at pull ups.  Get better at planks, ball roll outs, and the power wheel, and you will get better at pull ups.

Be Patient And Stay Consistent
It is going to take longer than three or four months to become proficient at pull ups.  You need to give this training nine months.  If you have long arms it is going to take more time to get better at pull ups.  Female Olympic level gymnasts are four feet, nine inches tall, so they make it look easy.

The Formula
Three days a week in the gym you do this:  Set up a bar with a band if you need an assist.  Perform one smooth repetition and then stop.  Go do something else as long as it is not biceps exercises or long slow duration cardio, and then come back to the bar in seven to ten minutes and do another single repetition.  Repeat this process three or four times every time you go to the gym.  As you get stronger, use a lighter assist band or perform two repetitions as long as each repetition is smooth and struggle free.  On two of your off days, perform three or four single pull ups.  Space them out throughout the day.  One pull up in the morning, one in the afternoon, and one at night.  The emphasis should be on performing every repetition in a smooth and struggle free fashion and keeping your neural system free of fatigue.  Perform inverted rows for three sets at least twice a week.  Work on your thoracic spine mobility with a foam roll, and improve the strength of the rib cage stabilizers with some planks and roll outs.

Test Progress
Every six weeks, test your maximal pull up capacity.  How many pull ups can you perform in a row with no assist.  Do not get discouraged if after six weeks you cannot perform a single.  Only 20% of the female trainees will get a single with just six weeks of training, but after twelve weeks, 40% of them will get one pull up.  Most will require five months of training to get a single pull up.  The good news is that once you achieve a level of success with pull ups, your body holds on to the neural connections that make them easy to perform.  As your skill level increases, it takes less effort to get even better at pull ups.

Michael S. O’Hara, P.T., OCS, CSCS

Testing Fitness Readiness

Isometric Spinal Extension Strength Test

A big problem in the fitness industry is that there are no standardized performance evaluations that participants must achieve in order to begin or progress in an exercise activity.  Anyone, no matter how deconditioned, posturally flawed, and orthopedically challenged can walk into the gym and get a workout.  As a strength and conditioning coach, the present “free for all” system is a challenge that at times can be very frustrating.  As a physical therapist treating orthopedic injuries on a daily basis, the present system keeps me busy.  Performance tests and movement assessments identify asymmetries, strength deficits, and potential pain problems.  A good coach uses assessments to determine the appropriate exercise prescription for their client.  I will be posting some basic user-friendly performance assessment tests that should be a part of all fitness programs.  If you pass the tests, congratulations and keep up the good work.  If you did poorly on the tests, you need to get to work on improving your performance.

Isometric Spinal Extension Strength Test
The muscles around your spine and pelvic girdle are designed to reduce and not create motion.  They are isometric muscles that brace the torso and pelvis to create the pillar strength you need to carry in firewood, lift the wheelbarrow, or push the lawn mower.  The Isometric Spinal Extension Strength Test is an assessment of the component of core stability that isometrically resists spinal flexion.  This test is used in industrial medicine to assess a worker’s ability to return to material handling tasks.  In my evaluation of fitness clients, it is often the stability test with the most significant deficits.

You need a Roman Chair or Glute-Ham Developer Bench to perform this test.  The support pad of the bench should be on the front of the thigh just set below the pelvis.  Position your body so that the ankles, knee, hips, and lumbar spine are in one long line that is parallel to the floor.  Cross the arms across the chest and hold a solid, floor parallel position as long as you are able.  Pain with the test is a fail and you need to be evaluated to find out why the test is painful.  Less than thirty seconds is a poor grade.   You need to improve your performance, and in the meantime, avoid activities that require you to resist spinal flexion-resisted squats, deadlifts, kettlebell swings, and bent over rows.  Thirty to sixty seconds is a fair grade and clears you for most resistance training.  Athletes and those involved in occupations that require lifting and carrying need the isometric strength that permits a sixty-second hold.
Michael S. O’Hara, P.T., OCS, CSCS

30 Minutes Of Fitness

Remember, You Asked For It

“I don’t have enough time” is the big excuse people give for not exercising.  At FFAC, we can get you in and out of the gym in thirty minutes.  Our movement based training sessions produce excellent results with minimal time commitment.  We program in high value exercise activities that produce optimal gains.  This is the second of six, 30 Minutes of Fitness, sessions.  The best workouts are short, intense and frequent.  Intensity is usually the missing factor in most gym goer’s training.
Session Two
1.    Four point thoracic rotations x 10 each side.
2.    TRX “Stoney Stretches” x 10 each leg.
3.    A. Sled Push 3 x 50 yards.
B. Kettlebell Swings 3 x 12 repetitions.
4.    A. TRX Atomic Push-ups 3 x 6-10 repetitions
B. Dumbbell Row right / left 3 x 6-10 repetitions.
5.    Medicine Ball Rotation Throws 3 x 4 repetitions each side.

One and Two:  Start with the two mobility drills for ten repetitions on each side.  If you sit all day, these two drills should be part of your daily mobility routine.
Three:  Load up a sled with + /- 10% of your bodyweight and push it 50 yards.  Rest for no longer than thirty seconds and then perform twelve good kettlebell swings–lots of hip motion and minimal knee bend.  Remember a swing is a hip dominant explosive throw, not a slow squat pattern lift.  Repeat this circuit three times.  
Four:  Set up a TRX for Atomic Push-ups followed by a dumbbell row on each side.  Move back and forth between the two exercises for three sets.
Five:  Finish with some rotational medicine ball throws off the wall for three sets of four on each side.  You should be done in well under thirty minutes.

Session Two 30 Minute Synopsis
Effective mobility training.
Twelve sets of strength training exercises.
Explosive power production training.

Watch the attached video and if you are still unsure of how to perform any of the exercises get with one of our trainers for some instruction.

Michael S. O’Hara, P.T., OCS, CSCS

Skeletal Strengthening

Exercise Training That Prevents Osteoporosis

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

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

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

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

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

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

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

Moving Mortality

Just Slowing Down Will Slow You Down

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

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

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

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

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

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

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

Michael S. O’Hara, P.T., OCS, CSCS

Natural Testosterone Boosters

RaisinThe drug companies are spending millions of dollars in marketing to get us guys started on the latest lifestyle drug for men.  Testosterone replacement therapy is producing big gains for the pharma industry.  Unfortunately, the side effects with taking supplemental testosterone appear to be far greater than expected.  The latest studies have found substantial risks in prescribing testosterone to middle age and older men.  If you are over sixty five, the risk of heart attack doubles, and if you are middle age with a history of heart disease, the risk triples.  The best article I have read on the topic appeared in the New York Times Editorial section on 2/4/14—take some time and read it over.  The good news is that with a little effort you can change your testosterone levels with out resorting to medications.  These are the time tested and risk free methods.   (The NY Times article can be seen by clicking this link: http://www.nytimes.com/2014/02/05/opinion/overselling-testosterone-dangerously.html)

Lower Your Body Fat
This is the reason most guys say they “feel better” when they drop twenty pounds.  Higher levels of body fat are correlated with lower total and free testosterone levels.  Lowering your body fat levels down from 30% plus to less than 15% has been shown to produce a consistent jump in testosterone levels.  The biggest side effect to losing body fat is that you will be less likely to have a heart attack.

Get Adequate and Consistent Sleep
Human and animal studies have demonstrated drops in testosterone levels with short periods of sleep restriction.  Chronic sleep deprivation has a huge effect on your hormonal profile.  If you think you have sleep apnea–big time snoring and always sleepy– get a sleep study and take steps to remedy the problem.  Sleep apnea is implicated in the development of hypertension and heart disease.  A stroke or heart attack will produce a very negative effect on your testosterone levels.  Read the book Getting a Good Night’s Sleep by Nancy Foldvary-Schaefer and develop better sleep habits.

Change Your Training
Exercise duration and intensity have an effect on hormone levels.  Low intensity, long duration exercise (think distance running) has the effect of producing a catabolic hormonal response; while high intensity and short duration exercise (think sprinting) produces an anabolic response.  Testosterone levels rise with the anabolic response of short and intense workouts.

Optimize Vitamin D Levels
We know Vitamin D helps with immune system function, bone health, and appears to be protective for some types of cancers.  There is increasing evidence that vitamin D can increase testosterone levels.  You can have your vitamin D levels checked when you get your yearly physical exam.  During the winter months, when sun exposure is at a minimum, some vitamin D supplementation is even more important.

Less Alcohol
About four hours after your first drink, you get an increase in the stress hormone cortisol.  Cortisol inhibits the production of testosterone.  The hormonal impact of alcohol consumption lasts up to 48 hours.  The maximal drop in testosterone levels is produced twelve hours after you have stopped drinking.  If your goal is to increase your testosterone levels then abstaining from alcohol will help improve your numbers.

Eat Healthy Fats
Low fat diets inhibit sex hormone production.  Keep walnuts, salmon, avocado, and olive oil in your daily diet.  If you exercise on a regular basis, adding a quality fish oil supplement can help you recover between training sessions.
Michael S. O’Hara, P.T., OCS, CSCS

A $2500 Coat Rack

treadmillA past physical therapy patient of mine recently brought in a newspaper article that discussed the merits of different types exercise equipment you can purchase for your home.  She wanted my advice on the piece of machinery I would recommend for her and her husband to purchase for their home.  Should they get a $1600.00 elliptical machine, a $2500.00 treadmill, or $1100.00 recumbent bike?  My answer was that none of these machines are likely to be a good choice as most large cardio machines become an expensive coat rack in less than four months.  If you are starting out on a fitness program, my suggestion is to purchase the following:

Note Pad and Pen $10.00
In advance, you will write out your monthly “plan of exercise action”.  Set down in writing the date, time, place, and exercise activity.  The written plan is a commitment to keep on schedule.  Record your exercise sessions in a training log.  Write out the exercises you perform, the number of sets, repetitions, and loads.  Your initial successes with exercise will come in the form of better strength and work capacity—not pounds falling on the scale.  The training log will help you recognize your progress and this reinforces the exercise habit.

Tape Measure $1.00
A good exercise program is going to increase your muscle mass, hydrate your body, and add some bone to your skeleton.   In the beginning, the numbers on the scale may go up instead of down and this can frustrate many exercise newbies who are looking to “drop twenty pounds in four weeks”.  Put the bathroom scale away and record girth measurements.  Men measure around the belly button and women around the hips. These are the regions that are quickest to change with proper training.

Alarm Clock $25.00  
Research at the University of Michigan department of psychology demonstrated that individuals who are successful with long term exercise compliance get out of bed and do it in the mornings before other aspects of life have a chance to interfere with their plans.

Kitchen Scale $50.00
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 will educate you on portion size and total calorie consumption.

Home Exercise Equipment $200.00
One hundred dollars for a Lifeline suspension trainer.  Thirty-five dollars for a physioball.  Two sets of all-purpose resistance tubing at fifty dollars and two furniture sliders at five dollars.  You can get all of this from performbetter.com.  Shipping is about ten dollars.  My recommendation is that most people should not purchase any home fitness product that they cannot lift overhead with one hand.
Pedometer $55.00
A pedometer is a small device you wear to record the number of steps taken in a day.  Pedometers have become less expensive and more accurate.  Increasing daily step count is the easiest way to produce big changes with individuals returning to fitness activities.
Record your daily step count in your training log and work on increasing that number.  Ten thousand steps a day is a good goal for most people.

Professional Assistance $600.00
If you have been away from exercise for some time, hire an educated and qualified trainer to assist you in designing and implementing an appropriate program.  Numerous studies have shown that individuals who use trainers are more successful in reaching fitness goals.  The trainer will teach you how to properly use the home exercise equipment you have purchased.  No one performs exercises correctly after only one training session.  You need ongoing evaluation and progression on proper exercise performance.  Older and physically limited individuals need the assistance of a trainer more than any other group.

Total Cost $941.00
You will have more space in your house, more money in your pocket, and you will be much more likely to succeed in reaching your fitness goals.  Two years from now, you will sell that $2500.00 treadmill on ebay for $200.00.

Michal S. O’Hara, P.T., OCS, CSCS

Facing Facts

“Giving up smoking is the easiest thing in the world.  I know because I’ve done it thousands of times.”–Mark Twain

smoking_twin_photoIn 1964, we started adding warning labels to packs of cigarettes.  Over the last fifty years, the cigarette smoking habit in America has gone from 42% of the population to 23%-19%–figures vary as a degree of “shame” now factors into cigarette smoking survey responses.  If we extrapolate the present rate of change out another fifty years, we can expect that at least 11% of the American population will be smokers in 2064.  Based on our knowledge of the massive health care costs related to smoking and our desire to keep all American citizens healthy, this rate of progress is unacceptable.

The tobacco companies spend 8 billion dollars a year marketing (promoting addiction) cigarettes to Americans.  By contrast, anti-smoking efforts spend less than 250 million dollars a year.  Thirty-two dollars is spent encouraging and cajoling Americans to smoke for every dollar spent on prevention.  Anti-smoking groups have attempted to get more graphic warning labels on cigarette packages, but these efforts have been blocked by tobacco company lawyers and judges.  One judge ruled that the new labeling requirement violates the tobacco companies’ “free speech rights”.  Federal District Court Judge Richard Leon blocked more graphic labels.  He feels the labels are “calculated to provoke the viewer to quit”.  Out-spent and out-maneuvered in the court system, I believe the only path to reducing cigarette smoking addiction is the use of ongoing education on the horrors of smoking and higher taxes and fees on cigarettes.

Click here or on the photo above and see how easy it is to identify the “most smokin’ twin”.  Do this test with your kids and make sure they understand that the damage they see on these faces is also happening to the rest of the body.

One of my biggest concerns is that the tobacco companies are going to become involved in the new trend of legalized marijuana distribution.  They have demonstrated the marketing skills to turn us all into stoners in less than ten years.

Michael S. O’Hara, P.T., OCS, CSCS