Our June issue brings information on preventing neck pain by strengthening your neck. Mike O’Hara describes and demonstrates in a video exercises that will help strengthen the muscles of your neck. In another article, Mike tells how grip strength can be a predictor of early death in some patients. Be sure to read Jeff Tirrell’s article on performance based training.
In our May issue, Mike O’Hara discusses the importance of walking. If you have pain or difficulty with walking, there are things that help. Mike demonstrates some exercises to get you ready. Be sure to read Jeff Tirrell’s article on squatting, and read about Afterburn–a new class at Fenton Fitness that uses heart rate monitors while training.
Triathlon Success: Hamstring And Glute Togetherness
To keep a triathlete healthy and resilient, the hamstrings and gluteal muscles must work together as a team. The athlete fires the gluteals and hamstrings simultaneously to stabilize the pelvis and produce force through the lower leg. When you run, bicycle, or swim, these muscles work at a team to produce efficient propulsion and reduce stress on the lumbar spine and knee. A triathalon is the ultimate long duration physical endeavor. Triathletes need hamstrings and gluteal muscles that can stay on and strong for a long time.
Most fitness programs do not properly train the muscle of the posterior chain. Fitness center exercise generally involves training the hamstrings as knee flexors on some type of “leg curl” machine. Gluteal training rarely occurs past neutral hip extension, with little effort on improving overall hip range of motion. Any type of seated gluteal training is inappropriate for an athlete.
The term physical therapists and strength coaches use for butt muscles that are non- responsive is “gluteal amnesia”. Our sedentary lifestyle involves very little of the glute recruiting sprinting, deep squatting, and climbing that activates the gluteal muscles. We mistreat our gluteal muscles with hours of compressive sitting and little in the way of full range hip movement. Many fitness clients and most physical therapy patients need some remedial gluteal training. Give these three drills a place in your triathalon training program.
Single Leg Bridges
Lay supine with the arms braced against the floor to stabilize the upper body. Bend the knees and place the feet flat on the ground. Lift the right leg up off the ground. Using the muscles in the back of the left leg, lift the hips up off the ground. Push up through the heel of the left foot and drive the left hip into full extension. Hold at the top for three seconds and then lower in a controlled manner. Perform ten repetitions on each leg. Common mistakes are allowing the pelvis to tilt and not fully extending the hip. Hamstring cramping is an indication that you are not using the glutes enough and need to focus on creating a better mind to butt connection.
The squat movement pattern is a skill that is easier to teach if you add some load. You can use either a dumbbell or a kettlebell for this exercise. It has been my experience that the exercise is easier to learn with a kettlebell. Hold a kettlebell by the horns, with the elbows down, and the kettlebell close to the chest. Keep the chest proud and pull the abdominal muscles tight. You may have to experiment with foot placement as everyone has different hips. The position you would place the feet if you were going to jump is a good starting point. Initiate the squat by pushing back the hips. Keep the torso tall and descend. Let your pelvis fall between the hips. The elbow should drop down between the knees. Nothing will inhibit your progress more than thinking about how you are moving during goblet squats. Keep your brain quiet and get in some repetitions. Effort has amazing capacity to improve motor control. Perform ten repetitions.
Mini Band Monster Walk
Your will need a mini resistance band–a nine inch loop of resistance band, (two dollars from performbetter.com). Most fitness clients will do well with a green or yellow mini band. Place the mini band loop around both legs just above the ankles. Assume an athletic stance with the feet straight ahead, knees bent, and hips flexed. The band should be held taught throughout the exercise. Imagine your feet are standing on railroad tracks. Walk forward for ten steps on each side, keeping the feet over the railroad tracks. Walk backward for five repetitions on each leg. Try to keep the hips and shoulders level throughout the exercise.
Once you have mastered all three exercises, build your gluteal and hamstring performance by traveling through the program for two or three trips.
- single leg bridges R and L x 10
- goblet squats x 10
- mini band monster walk x 10 each leg
View video of the exercises here: https://youtu.be/QeteeLPF4AU
Kat Wood, DPT, ATC
Triathlon Success: Core Connection
In the fitness world core stability training has gained a solid foothold and more people are getting away from spinal damaging resisted twisting machines and the ever present sit up gizmo. Most people know how to perform a “plank” exercise and have added this drill to their fitness routines. Learning how to properly brace the core stabilizers and perform a sustained plank type isometric exercise will resolve back pain, improve the hip to shoulder girdle connection, and make you a better movement machine. The problem is most people never advance beyond the basic plank exercise. Triathletes need significant anti-rotation and anti-extension core strength and endurance. I have three drills that will help keep you strong and resilient in your quest to complete you first tri. Read the directions and give these activities a place in your fitness program.
Alternate Single Arm Planks
Position the body in a toes and elbows plank, but separate the legs so the feet are wider than the shoulders. Lift one arm up at a 45 degree angle in relation to your body and hold for five seconds. Lower the arm back down and try the other arm.
If you are unable to perform the alternate arm plank on the floor, regress the exercise by placing the hands on a bench in a push ups position. Lift one arm up at a 45 degree angle in relation to your body and hold for five seconds. Lower the arm back down and try the other arm. How many and much? Perform three to five repetitions on each arm. Work up to longer hold times instead of more repetitions. Five repetitions on each arm with a ten second hold is a good goal.
You need a cable machine or resistance tubing set at mid torso level. Position your body at a 90 degree angle in relation to the pull of the cable. Assume an athletic posture with the feet at least shoulder width apart and the spine neutral. Push the hips back a little and keep a slight bend in the ankles and knees. You should look like a tennis player preparing to return an opponent’s serve. Use a strong overlap grip on the handle and set the hands in the middle of the chest. Brace the midsection and hips and move the handle out in front of the body and then back to the chest. Select a resistance level that permits execution of all repetitions without losing the set up posture. If one side is more difficult, start the exercise on that side. Perform fifteen repetitions on each side.
Many of us have terrible respiratory patterns. We are unable to fully inhale and exhale when under any physical stress. The Pallof Press can be used to improve respiratory control. Use the same set up and press the cable out. Hold the cable with the arm fully extended while inhaling for four seconds and exhaling for six seconds. Bring the arms back in and then repeat. Perform four of five inhale / exhale respiration repetitions on each side.
View the video here: View Video
Michael S. O’Hara, PT, OCS, CSCS
Triathlon Success: Hip Flexor Function
Two of the most important muscles for efficient running and a pain free set of knees are not visible in the mirror. Most people have never heard the names of these muscles. Located deep inside the body, covered by innards and all too often, layers of mesenteric fat, these muscles labor unloved and forgotten. Triathletes interested in optimal performance and a body that remains injury free should give some attention to the iliacus and psoas muscles.
Five muscles flex the hip–bring your femur forward. Three of the hip flexors attach to the front of your pelvis and run down the front and sides of your thigh. They are the sartorius, tensor fascia latae, and the rectus femoris. Two of the muscles attach to your spine and posterior pelvis and travel across all of the lumbar vertebrae, the sacroiliac joint, and the front of the hip joint. They are the iliacus and psoas muscles. The sartorius, tensor fascia latae, and the rectus femoris can lift your femur to parallel, 90 degrees hip flexion, and no further. The iliacus and psoas are responsible for lifting the hip above parallel. Many people have very weak iliacus and psoas muscles and are unable to flex the hip above 90 degrees.
Multi Joint Control
“Hip flexor” is a very simplistic description of the function of the iliacus and psoas muscles. The iliacus and psoas flex the hip, but they also rotate the hip, stabilize the pelvic girdle / lumbar spine, decelerate hip extension and co-contract with a team of muscles to hold us upright. Properly functioning iliacus and psoas muscles keep the pelvis stable when you walk or run and this mitigates stress on the knees and lower back. When the iliacus and psoas muscles are weak, the pelvis tilts forward and backward. This rotates the femur in and out and twists the knee. Your knee joint likes to bend back and forth and dislikes any extra rotation. Extra knee rotation wears out the back of the kneecap (patella) and places stress on the supportive cartilage (medial and lateral meniscus) of the knee. A triathlete with a wobbly pelvis places significantly more stress on their lumbar spine.
Riding a bike shortens and neurologically anesthetizes the iliacus and psoas muscles. A tight psoas muscle compresses the lumbar vertebrae together and increases pressure in the lumbar discs. Athletes with “quad strains” often have pain in the sartorius and rectus femoris muscles that has been brought on by overuse of these muscle as they compensate for a weak iliacus and psoas muscles. Tight and inhibited iliacus and psoas muscles are responsible for the wobbly gait pattern you frequently see as the triathlete transitions from the bike to the run. Two drills that will improve the function of the iliacus and psoas muscles are listed below. Read the directions and watch the video.
Standing Hip Flexor Isometric
The Standing Hip Flexor Isometric drill functions as both an evaluation and a method of restoring iliacus and psoas function. If you struggle with this exercise, you need to spend some time and effort on improving the performance of your iliacus and psoas. Listed below is a description of the exercise and several activity regressions and progressions.
You need a box or exercise bench. The taller you are, the higher the bench. Six feet tall, try a bench that is 24 inches high. Five foot, four inches, try a twelve inch box. A mirror for visual feedback is helpful. Stand with the right foot on the bench and the left foot on the floor. Hold a pvc pipe, broomstick, or golf club overhead. Brace the abdominal muscles to keep a tall spinal position and tight lordosis (inward curve) in your lower back. Lift the right foot off the bench by pulling the thigh up with the muscles in front of the hip. Hold the foot off the bench in a solid and stable position for five seconds and then lower. Do not let the position of the spine change. Do not bend the left knee or tilt the pelvis. The only joint that moves is the right hip. Athletes should be able to lift and hold the right knee 30 degrees above waist level. Start with sets of three repetitions and alternate sides. As you get stronger, increase the duration that you hold the foot up to ten seconds. If one side is weaker than the other, perform more repetitions or an extra set on that side.
Bench Assisted Hip Flexor Stretch
This drill will improve hip extension range of motion and enhance mobility in all of the hip flexor muscles. Bicyclists often have very flexed lumbar spines and limited lumbar and/or hip extension. This mobility exercise is the antidote for the physical restrictions created by too much time in the saddle.
You will need an exercise bench or a padded chair that is 12 to 16 inches tall. Place a cushion or Airex pad directly in front of the bench. Set up with the left foot on the floor in front of the Airex pad and aligned with the left hip. Place the right knee on the Airex pad and the front of the right foot up on the bench. Stay tall through the spine and hold the position for twenty to thirty seconds. For many people this will be enough stretch. If you are able take the arms overhead. Work further into the movement by bending the front knee and moving forward. Repeat on the other side.
Video of these exercises can be found here: View Video
Michael S. O’Hara, PT, OCS, CSCS
Triathlon Success: Foot Fitness
Foot and ankle injuries are the number one problem in the sport of triathalon. The thousands of spins on the bike, impacts on the run, and kicks with the swim can take a toll. Some preventative training can help speed tissue recovery in your feet and safeguard the ankles.
The foot and ankle are made up of twenty-six bones that are controlled by an elaborate combination of intrinsic and extrinsic foot muscles. A web of fascia interconnected to the muscles creates a dynamic sling that gives our foot form and acts as a spring to propel the body through space. Our feet evolved to guide us over an ever-changing environment of varying surface with minimal support from footwear. Modern footwear, deconditioning, and prior injuries can all take a toll on the functional mobility and strength of the foot and ankle. Preventative exercise activities can go a long way to prevent painful injuries in the lower leg and foot. Watch the video and give these activities a try.
You can perform this exercise throughout the day and it will help keep your feet healthy and strong. Point the foot (plantarflex the ankle) and flex all of the toes. Draw the foot up (dorsiflex the ankle) and keep the toes flexed. Extend the toes while keeping the foot pulled upward. Point the foot downward while keeping the toes extended. Keep the foot pointed and flex the toes. Move through this exercise in a steady and deliberate fashion. Take time to feel the muscles activate and stretch in the foot and lower leg. Repeat the “foot wave” for five to ten repetitions.
Short Foot Drill
The muscles on the bottom of the foot are called the foot intrinsics. The foot intrinsics function in a manner similar to the core muscles of the torso. Their job is to brace the foot so it can transfer forces through a stabilized series of boney arches. Weak or slow to respond foot intrinsic muscles impede the foot’s capacity to decelerate forces. The short foot drill will improve foot intrinsic muscle performance.
To perform the short foot drill on the right foot, place the right foot flat on the ground and place the left foot back. Bend the right knee about 20 degrees and lift the left heel off the ground so more weight is on your right foot. Lift and spread the toes of the right foot. Lower the toes back to the ground and grip the floor with the big toe. Contract the muscles on the bottom of the foot. You should feel a lifting of the foot arches. Tighten the muscles of the right leg from the calf to the hip and lift the pelvic floor. Hold this tension in the foot and leg for ten seconds and then release. Perform five repetitions.
Soft Tissue Mobilization
Treat the soft tissue structures of the ankle and foot with a consistent program of massage. Three or four times a week, take five minutes and perform some massage stick work to the muscles of the lower leg. Find a tennis ball and roll out the plantar aspect of the foot. Deep soft tissue work helps improve circulation, prevents aberrant scar tissue formation, and promotes tissue elasticity.
Age brings lower leg arthritic changes and circulatory deficiencies. These can create pooling of inflammatory byproducts in the feet and ankles created by a week of triathalon training activity. Cooling the feet and ankles in an ice bath can help break the chemical cycle of inflammation and enhance recovery. At the end of a training day, fill up a bucket with water and lots of ice. I like to get most of my lower leg under the water. Try fifteen to twenty minutes every other day.
Watch our Foot Fitness video for demonstration of these exercises: View Foot Fitness Video
Kat Wood, DPT, ATC
Find out if you scalenes are causing problems in Mike’s article, Scalene Salvation. Read the inspirational stories of some Fenton Fitness members who conquered osteoporosis.
The September 2016 newsletter contains information on preventing ankle sprains. Mike O’Hara, PT demonstrates exercises to prevent ankle inversion. Meet Fenton Fitness member Gay Adams and read her story on staying strong during a difficult time, and learn about the suitcase carry–a better alternative to weighted sidebends.
This summer, take time to remove your shoes and do your feet a favor. In his article Tenderfoot Training, Mike O’Hara, P.T. covers four simple steps to better foot and ankle function. Jeff’s story about women on weights explains why strength training leads to better body composition and Amy highlights a few members who have used weights to see big results. We round out our issue with fracture facts that everyone should know.
A recent article in the New York Times by Gretchen Reynolds* covers the latest research on lower extremity function and aging.
As any physical therapist can attest, the older you are, the more likely you are to suffer a tendon injury or an overuse pain problem in the foot or ankle. Movement analysis of older runners reveals that they use the lower aspect of the leg less than younger runners. Forward propulsion and deceleration become more hip dominated activities. Based on the movement analysis data, the researchers in the article suggest older runners preferentially strengthen the muscles that control the ankle and foot.
The research validates the need to train your legs with the foot in contact with the ground. In rehab and fitness, it is called closed chain training and it produces the carryover to real life performance and durability (no injuries) you need to age gracefully and stay independent. Many older gym goers have balance deficits and mobility restrictions that draw them to strength training in a non-weight-bearing seated position. They miss activating the muscles that are crucial for walking and moving well. Step ups, lunges, and squats all involve the muscles of the foot and ankle and should be a big part of every training program. Knee extension, leg curl, and that hip in and out machine –- not much help…
To read the article, click on the link below:
-Michael O’Hara, P.T., OCS, CSCS
*“Why Runners Get Slower With Age (and How Strength Training May Help)”, Gretchen Reynolds, September 9, 2015, New York Times.