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Three Gifts I Would Give And Three I Would Take Away

Santa Gives You Gluteal Activation
You need a responsive and strong set of butt muscles to function at optimal levels. Many gym goers have gluteal muscles that are neurologically disconnected.  The term physical therapists and strength coaches use is “gluteal amnesia.”  Our sedentary lifestyle involves very little of the glute recruiting sprinting, deep squatting, and climbing that activates the butt muscles.  We mistreat our gluteal muscles with hours of compressive sitting and little in the way of full range hip movement.  Most fitness clients are in need of some intensive gluteal training.  The hip lift is a simple exercise activity that produces a superior response.  See the attached video for a demonstration.

Scrooge the Lumbar Spine Flexion
Drop the sit ups, stop doing crunches, ditch the glute ham developer sit ups, and forgo the toes to bar competitions.  Father time, gravity, and the stress of prolonged sitting are already bending our lumbar spines forward all day long.  The last thing you need to do is accelerate degenerative breakdown of the lumbar segments with more repetitions of spine flexion.  Please forget about isolating abdominal muscles.  Instead learn how to control the team of muscles that hold the lumbar spine stable.  It is a neural event that is worthy of all your efforts.

Santa Gives You Medicine Ball Throws
medballLife is an up tempo game.  What you do in the gym is reflected in how well you can move during activities of daily living.  If you continually exercise at slow tempos you will get better at moving slowly.  The capacity to decelerate a fall requires fast reactions.  Gracefully traveling up the stairs and getting out of the car are only improved with exercise that enhances power and speed of movement.  Medicine ball throws are the easiest way to improve power.  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 the block walls in the gym and are easy to catch.  Do not overload 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.

Scrooge Sitting Down in the Gym
Movement happens in an upright, standing position.  “Seated exercise” is an oxymoron.  If you want to improve how your body functions, you must stand up and defy gravity. Every athletic endeavor is performed in a standing position. Seated exercise reinforces poor postural habits and diminishes your capacity to move.  I call it the “illusion of exercise” and it will always be highly visible in commercial gyms because it is easy to sell.

Santa Gives You Four-Point Training
Crawling is the neurological training tool an infant uses to develop the capacity to stand and walk.  It is the pathway to better motor control and less pain.  Nearly every physical therapy patient and most fitness clients benefit from a healthy dose of four-point position exercise.  In your fitness program, reinforce the patterns of spinal stability and reboot the postural reflexes with some horse stance horizontal, crawling, and Jacobs Ladder training.   Four-point training can be scaled to any fitness level.  Watch the attached video for some examples.

Scrooge Elliptical Training
I know you love the elliptical.  It is the no impact, cardio darling of the gym but it should be used as a fitness dessert and not a main course.  Elliptical training has multiple drawbacks.  Ergonomically, it is a one size for everyone apparatus that does not work well for taller or shorter people.  When you walk or run, you improve the important skill of stabilizing your body over one leg.  An elliptical keeps both feet stapled to the machine and deadens any neural enhancement of balance or single leg stability.  Hip extension keeps our back healthy and our body athletic.  Maintaining or improving hip extension should be part of every training session.  There is no hip extension produced when you train on an elliptical.  Many people maintain a flexed spine when they use an elliptical.  Sitting produces the flexed forward spine we all need to work against in our fitness programs.  The repetitive use of the shoulder girdle is a frequent generator of referrals to physical therapy for head and neck pain.  Metabolic adaptation to elliptical training happens fairly quickly.  In January, a 30 minute session burns 330 calories, but by June, your body becomes more efficient and that same routine creates only a 240 calorie deficit.  The low impact, reduced weight bearing nature of an elliptical makes it a poor choice in your fight against osteoporosis.

I am happy when people are more active.  Patients and fitness clients love the elliptical and they believe it helps.  Use that belief to keep you motivated and training.  I just want everyone to manage the drawbacks of this type of training.  Injured people always say “Why didn’t someone tell me?”  Before you jump on the elliptical, take ten minutes and improve your core stability and hip function with some four-point exercises and hip lifts.  Learn how to throw a medicine ball and stay standing through the rest of your training program.  Next Christmas you will thank me.

Merry Christmas and a Humbug to you.

See video of Mike in the gym demonstrating these exercises here: https://youtu.be/H0my94BPHNQ

Michael S. O’Hara, PT, OCS, CSCS

shutterstock_223601353Over the last four years, John was a patient at our physical therapy clinic for three different problems.  He recovered from a shoulder surgery, left hip/lower back pain, and a fairly nasty case of Achilles tendonitis.  Newly retired at the tender age of sixty-four, he was disappointed that he had to deal with these pain problems.  John enjoyed athletic endeavors such as golf, tennis, and hiking, but like many people, he was not a fan of formal fitness training.  John wanted an active lifestyle but lacked the fitness regimen necessary to keep his body healthy and fit for those tasks.

What John needed was a training program that would make his body durable enough to tolerate his play activities but not so involved that, psychologically, he would become bored and abandon the training.  We set up a home fitness program that worked on correcting his three biggest deficiencies.  John had a limited squat pattern, poor posture, and weak shoulders.  This was John’s training program:
Three times a week, for a total of fifteen minutes, John performed this circuit-style routine.  His equipment included a Jungle Gym XT suspension trainer that he set up in his basement.
1.  Suspension Rows x 10
2.  Suspension Squats x 15
3.  Push Ups x 6
He rested for 60 – 90 seconds at the end of a circuit and then repeated.  During the rest time, he performed some hip and shoulder mobility drills.  John started with three circuits through this routine and has gradually ramped it up to five circuits.  As his shoulder strength improved, he increased the push ups to ten repetitions and the suspension rows to twelve repetitions.  That is a total of 60 rows, 75 squats, and 50 push ups in a training session.

The results have been excellent.  John went out west skiing last winter and has played tennis all summer.  He moves better during athletic activities and he has been pain-free.  His wife and children report his posture is better and he has been able to stop using a knee brace when he plays golf.  He has dropped two inches off his waist size.  More importantly, John is asking about exercise progressions he can add to his training program.

The reasons this worked:
1.  The training resolved John’s movement restrictions and strength deficits.  It was the proper medicine for the problems that were present.
2.  John was consistent in his training.  Consistency is king; everything else is details.
3.  It was simple and, psychologically, it fit John’s personality.
4.  It produced results and John has become addicted to the benefits of a proper training program.  He likes being pain-free and moving more efficiently.  I am certain he will continue with the habit of exercise.
-Michael S. O’Hara, P.T., OCS, CSCS

Fitness training for those of us past 40 years of age is more complicated. Physical performance and recovery capacity are dramatically different. If you need proof, look for the forty year olds in the NBA or NFL. The good news is that with proper planning, consistent performance, and the wisdom that comes with age, we can stay fit and active for a lifetime. I have compiled a collection of tips for the forty plus fitness client.

Recover Bettersleep
Many older fitness clients are able to train at intensity levels that are equal to their younger counterparts. What they are unable to do is fully recover between bouts of training. Insufficient recovery makes progress toward higher levels of fitness nearly impossible and creates an environment that invites injury. Activities that promote recovery between training sessions have great value for older training clients.
Quality sleep is essential for recovery. Unfortunately, many age-related changes can interfere with sleep. Menopause for women, prostate issues for men, arthritic joints, and acid reflux are just of few of the more common problems. If you have problems getting seven to eight hours of quality sleep, talk to your doctor about possible medical assistance to improve your sleep. Invest in better pillows and a quality mattress. If your schedule permits, take a nap during the day to boost your total sleep time.
Active Recovery is the term used by strength coaches and trainers for short and easy exercise sessions that speed up recovery. On your days out of the gym, take ten to fifteen minutes and work on these areas:

Resolve movement pattern restrictions
Develop a more efficient and pain-free squat, lunge, hip hinge, or toe touch pattern and it will reduce tissue overload during training sessions.

Eliminate postural flaws
Occupational responsibilities and daily activities place us in the positions that feed into poor postural habits. Nothing stalls progress more than posture restrictions. These deficits will only resolve with daily training.

Soft tissue work
Soft tissue work with a foam roller, massage stick, or any of the other myofacial tools can work wonders. Find a physical therapist or trainer who can teach you how to use these tools to assist in recovery.
Have a recovery day. Many older fitness clients are unaware of how much they are taxing their bodies until they end up with an overuse pain problem. If you are going to perform high level fitness activities such as distance running, resistance training, or an hour of yoga, you are going to need some days in between that involve solid sleep, minimal activity, and maybe an easy walk.

-Michael S. O’Hara, P.T., OCS, CSCS