(810) 750-1996 PH
Fenton Fitness (810) 750-0351 PH
Fenton Physical Therapy (810) 750-1996 PH
Linden Physical Therapy (810) 735-0010 PH
Milford Physical Therapy (248) 685-7272 PH

Learn more about Rehab, Sports Medicine & Performance

bone

Falling Facts

NY Times Article on Fall Prevention

When discussing fitness goals, most people never mention fall prevention, but I suggest that it is more important than fat loss or improving your cardiovascular capacity.  Please take the time to read Gretchen Reynolds excellent article; Falls Can Kill You. Here’s How to Minimize the Risk.  In the article, Ms. Reynolds presents several good lifestyle modifications and medication precautions that will help prevent a fall.  Try adding some of my long standing fall prevention training tips.

Exercise in a standing position. 

If your goal is to move better and remain free of injury, then 90% of your exercise activity should be performed in standing.  Developing better kinesthetic awareness, strength, and coordination in a standing posture is the crucial component of training that prevents a fall.  During my visits to commercial gyms, most of the exercise activity I witness is performed in a supine, seated, or supported position.

Practice moving in all directions.

Fall prevention training involves improving multi-directional movement skills.  Most falls happen from an unexpected disruption of your equilibrium.  You get pushed to one side, twisted off center, or a foot slides from under the body.  Most gym activities are predominantly sagittal plane- forward and backward.  We need to be able to move well in all directions.

Practice moving faster.

Fall reaction training should focus on exercise activities that make you quicker.  Research on falls has shown that a gait pattern (how you walk) that starts to slow down is the best predictor for a future fall.  Agility ladder footwork, medicine ball throws, and hurdle drills are examples of faster paced training activities.  Yoga, Pilates, recumbent bicycle riding, and muscle isolation exercises will not make you better at moving faster.

Stand on one leg.

A simple and proven fall prevention activity is single leg stance balance training.  Single leg balance is a skill that tends to deteriorate with age, injury, and a sedentary lifestyle.  Stand on one leg for twenty seconds.  Stand on one leg and turn your head side to side.  Stand on one leg and then close your eyes.

Practice getting up and down off the floor. 

One of the best anti fall training activities is consistent practice of getting up and down off the floor.  Moving gracefully from standing to the floor and back up again is a life skill that keeps you independent and safe.  As a Physical Therapist, I frequently find people who are very impaired in this basic task of mobility.  They crawl to a piece of furniture for an assist and transition from the floor in an unsteady and unsafe manner.  Most of these patients are not elderly, they are tight, weak, and deconditioned.

Perform single leg strength training. 

We are monopods.  We absorb and then create force one leg at a time.  During activities of daily living, one leg is loaded more than the other.  It only makes sense that we train our legs the same way we use them.  Work with a trainer and learn how to perform step ups, single leg squats, rear foot elevated split squats, single leg deadlifts…

Become a better shock absorber.

Fall events often occur because of an impact.  The force of the impact causes our body to give in to gravity and down we go.  Just like any other physical attribute, impact resilience can be trained.  Mat work, medicine ball throws, and rope drills are some of the activities that can be used to improve impact resilience.

Make balance practice a daily event.

Integrate anti-fall training into your lifestyle.  Stand on one leg while you brush your teeth–right leg thirty seconds then left leg thirty seconds.  Perform multi directional exercise as movement preparation before a bike ride or run.  Get some instruction on a program of exercise that improves agility, single leg strength, and power production.

Someday, somehow, and when you least expect it, you are going to have an unplanned interaction with gravity.  Your fitness program should make you more responsive to a fall event and less likely to be injured.

Link to article: here

Michael S. O’Hara, PT, OCS, CSCS

Push Ups and Longevity

Recent Study is a Biomarker Reminder

Take a moment and read the recent New York Times article, How Many Push-Ups Can You Do? It May Be a Good Predictor of Heart Health. It appears that being able to perform well on a push up test is a better predictor of heart health than the traditional treadmill test.  The article postulates several reasons for the research results.  We only need to read the book Biomarkers for a thorough explanation.

In the book Drs. Evans and Rosenburg looked at the measurable “biomarkers” that keep humans healthy, independent, and fit over an entire life span.  They have determined the top four biomarkers are:

  1. Muscle Mass.  What percentage of your body is made of muscle.
  2. Strength.  Can you use that muscle to push, pull, lift and carry.
  3. Basal Metabolic Rate.  The number of calories your body expends at rest.
  4. Bodyfat Percentage.  What percentage of your body is composed of fat.

The authors named these top four biomarkers, the decisive tetrad.  They are the prerequisites to maintaining healthy numbers in all of the other essential biomarkers.

  1. Aerobic Capacity
  2. Blood Sugar Tolerance
  3. Cholesterol / HDL ratio
  4. Blood Pressure
  5. Bone Density
  6. Internal Body Temperature Regulation

Push up proficiency requires muscle mass, strength, and a minimal amount of extra load to lift in the form of bodyfat.  Those three traits are all a part of the decisive tetrad. To age well, stay durable–no injuries, and maintain control of all health parameters–we need to maintain or improve muscle mass / strength and not avoid extra bodyfat.  An ongoing program of strength training and nutritional discipline are the foremost components of fitness and health.

Now get on the floor and give me twenty.

View the article here.

Michael O’Hara PT, OCS, CSCS

Bad Man Break

Men Need To Be More Aware Of Bone Density

Allen was getting out of his fishing boat when he twisted his left leg and fractured two bones in his ankle.  Six weeks after ankle surgery, he landed in our clinic with considerable pain and a very limited lifestyle.  Allen reported lower back pain that he attributed to his limping and use of the boot on his left leg.  On recommendation from his physical therapist, Allen had further medical assessment of his lower back pain.  An x- ray of his lumbar spine revealed two lumbar vertebrae fractures.

On a recent vacation, Mike went on a horseback ride with his grandchildren.  During the ride, he developed pain in his upper back that “took his breath away”.  A visit to the emergency room with what he thought was a cardiac issue revealed a three-level compression fracture in his thoracic spine.  Further assessment showed significant osteoporosis in his hips, pelvis, and lumbar regions.  Allen started on some bone rebuilding medications and physical therapy.  It took over four months to fully recover from this injury.

Randy was working on his garden and fell onto the lawn.  He had right hip pain and was unable to stand.  His wife called the ambulance and he was diagnosed with a hip fracture.  Four days after the surgery to repair his hip, he suffered an embolism and at the age of seventy-one, he passed away.

All three of these older guys had testing that revealed a significant loss of bone density.  Unfortunately, the tests occurred after and not before injury onset.  We are getting better at keeping men alive longer–less smoking and better medications.  As men get older, the need to monitor bone density becomes a crucial aspect of healthy aging.  Men need fewer commercials for the latest in testosterone replacement and ED medication and more awareness of how brittle their bones can become.

The general public views osteoporosis as a “women’s health issue”, but management of osteoporosis is just as important for men.  Although men are less likely than women to sustain an osteoporosis related fracture, they are much more likely to become permanently disabled or die from the fracture.  Since 2008, the rate of osteoporosis related hip fracture in the American male population is going up at an alarming rate.

Osteoporosis is a silent disease.  Most people do not realize they have a problem until something breaks and they are in the middle of a medical crisis.  Even after a fracture, many physical therapy patients are reluctant to follow up with a bone density screening.  Being proactive is the only method of managing osteoporosis.

We know that individuals that participate in consistent resistance training exercises are more likely to have better bone density.  Just like muscle, bone is a living thing that grows stronger in response to the force that is placed upon it.  The best bone building exercise activities produce a stimulus through your skeleton.  Bone building exercises are easy to understand, but they do require more effort than swallowing a pill or having an injection.  Everyone can perform some form of bone reinforcing exercise.  Proper exercise prescription and consistent progression can work wonders.  See the trainers and physical therapists at Fenton Fitness.

Jane Brody of the New York Times wrote a helpful *article on bone density testing. It covers the latest medical guidelines for testing and the when and why of testing for both men and women.

Michael S. O’Hara, P.T., OCS, CSCS

*New York Times, July 16, 2018, Jane Brody, When to Get Your Bone Density (View Article:here)

Biomarker Reminder

Drs. Evans and Rosenburg are Tufts University researchers interested in the measurable parameters that keep humans healthy and fit over an entire life span.  They have determined that the top four biomarkers are:

  1. Muscle Mass.  The percentage of your body that is made of muscle.
  2. Strength.  Can you use that muscle to push, pull, lift and carry.
  3. Basal Metabolic Rate.  The number of calories your body expends at rest.
  4. Body fat Percentage.  What percentage of your body is composed of fat.

The authors named these top four biomarkers, the decisive tetrad.  They are the prerequisites to maintaining healthy numbers in all of the other essential biomarkers.

  1. Aerobic Capacity
  2. Blood Sugar Tolerance
  3. Cholesterol / HDL ratio
  4. Blood Pressure
  5. Bone Density
  6. Internal Body Temperature Regulation

Drs. Evans and Rosenburg coined the term age related sarcopenia in their 1991 book Biomarkers.  It refers to the gradual loss of muscle mass that occurs as we age.  The keys to aging well, staying durable–no injuries, and maintaining control of all health parameters is maintaining or improving muscle mass / strength and eating properly.  An ongoing program of strength training and nutritional discipline are the foremost components of fitness and health.

Michael S. O’Hara, PT, OCS, CSCS

PDFStanding desks are great for posture and health, but many people have difficulty when they first start using them.  In this issue, Mike O’Hara, PT gives exercises that can help you stand for longer periods of time.  Watch the video for instruction on these exercises.  In his article, “The Biomechanics We All Need To Know, Mike agrees with the advice given by Stuart McGill.  Be sure to read about Fenton Fitness Member Jan Pilar and her success with her program.

Download Here

PDFIn this issue, Mike O’Hara, PT gives ten reasons to love lunges.  Video of lunge exercises/progressions are included.  In Going Grizzly, Mike presents the exercise combination of Crawls and Sandbag Carries; a combination that helps you train more efficiently and move better.  Watch the video for instruction on these exercises.

Download Here

Fracture Facts For Men

osteoporosisJane Brody of the New York Times wrote a great article on the risks men have for osteoporosis related fractures.  The general public views osteoporosis as a “women’s health issue,” but management of osteoporosis and prevention of falls is just as important for men.  Although men are less likely than women to sustain an osteoporosis related fracture, they are much more likely to become permanently disabled, or die, from the fracture.

In 2012, an international team of researchers and clinicians launched Too Fit to Fracture, an initiative aimed at developing optimal exercise recommendations for individuals with osteoporosis.  In October of 2014, they released a booklet that is available through osteoporosis.ca on managing osteoporosis through exercise.  Everyone should read this booklet and osteoporosis patients should follow their exercise prescription.  Their work brings clarity to an issue that is currently clouded with poor understanding and a lot of bad fitness advice.

The Too Fit to Fracture researchers recommend that individuals with osteoporosis (with or without vertebral fractures) should engage in a multi-component exercise program that includes resistance training in combination with balance training.  Balance train for ten to twenty minutes every day of the week and strength train for 30 to 45 minutes twice a week.  Make sure your strength training teaches you how to move correctly and improves the endurance in your back muscles.  If you have mild to moderate osteoporosis, balance train and strength train first and foremost, and use any extra time on some low impact cardio training.  If you have been told you are at high risk for fracture, keep your focus exclusively on balance and strength training and keep the cardio activities to a minimum.

We know that individuals who participate in consistent resistance training exercises are more likely to have better bone density.  Just like muscle, bone is a living thing that grows stronger in response to the force that is placed upon it.  The best bone building exercise activities produce a growth promoting stimulus through your skeleton.  Bone building exercises are easy to understand but they do require more effort than swallowing a pill or having an injection.  Everyone can perform some form of bone reinforcing exercise.  Proper exercise prescription and consistent progression can work wonders.  See the trainers and physical therapists at Fenton Fitness and Fenton Physical Therapy for guidance.

-Michael S. O’Hara, P.T., OCS, CSCS
View the NY Times article here: http://www.nytimes.com/2016/10/04/well/live/men-get-osteoporosis-too.html?_r=0

02misconception-bones-superJumboI recently received an email on an article in The New York Times.  The article stated that moderate exercise did not produce an improvement in bone density.  The article went on to state that only medications have been found to be effective at reversing bone loss.  The fitness client that sent me the email was understandably concerned because the article presented information that was dramatically different than what she had been told.  In her battle against osteoporosis, she had placed a lot of faith in exercise and dietary modification.  She had been given advice from her doctor, physical therapist, and trainer that she was on the proper path to better bone health.   I read The New York Times article, looked up the referenced research, and I have a reply.

The New York Times author is correct that moderate weight bearing activities do not produce a change in bone density.  Walking, running, yoga, and Zumba do not produce enough bone stress and muscle tension to improve Continue reading

Whether you are trying to maximize bone density at a young age or simply maintain it at an older age, your choice of exercises will be the key to your success. Select exercises that allow for large amounts of force and power to be displayed. Also, choose exercises that effectively stress multiple muscle groups as muscle preservation is highly associated with bone density.

The last two exercises in our series of six are listed below:

Power Clean

The power clean is a great exercise to stress the bones of the feet, lower/upper legs, hips, spine, clavicles, and even arms to a smaller degree. Power Cleans are a great movement for improving full body power, but they are a bit more advanced. You should probably refrain from this exercise if you have under one year of weight training experience. This exercise offers some of the highest power outputs of any exercise.

BetterBonesWk3

 

 

 

 

 

 

Split Squat

This is a good exercise for everyone, but especially for those who have low back issues (degenerative discs, bulging/herniated discs, etc.) and those at risk for osteoporosis often do. It places very little stress on the low back, incorporates a large amount of lower body muscles, works on balance and, most importantly, allows for very heavy loads to be used.

Click on the link below for step by step instructions and video demonstration on how to perform a power clean and split squat:

 

-Jeff Tirrell, B.S., CSCS, Pn1

Ten million people in the U.S. have osteoporosis. An additional 18 million are at risk to develop it. An additional 34 million are at risk to develop osteopenia, or low bone mass. These ailments lead to higher incidents of fractures which lead to lack of physical activity and a quick decline in the fitness and health of affected individuals.

Last week, we talked about the vital role our diet plays when it comes to preventing osteoporosis by providing the needed nutrients to build and maintain strong bones. It should be noted that over half of our bone mass is accumulated during adolescence (12.5 years for girls and 14 years for boys) with peak bone mass being achieved in our mid 20’s. It is, therefore, very important for people of all ages, especially younger individuals, to incorporate appropriate activities and nutrition and not wait until we are in our 50’s and beyond to start trying to modify diet and activity.

In addition to giving our bodies the needed nutrients of calcium, vitamin D, and protein, the most effective way to stimulate our bone density is through activity. Ultimately, putting our bones under large amounts of force gives them the stimulus they need to get dense and strong.como

There are two main ways we can put stress on our bones where the requisite force is being absorbed or transferred which in turn stimulates bone density. One such way is through weight bearing exercises which force your body to absorb impact. These include walking (on hard surfaces), running, sprinting, jumping, and various upper extremity plyometric exercises. The potential drawback to some of these exercises is that they can be hard on your joints (knees, hips, back, ankles), especially for those with preexisting conditions in these areas. This type of training should be used 2-3x/week for 15-30 minutes.

The second form is that of resistance training. This can be done with machines, bands, body weight, or free weights. It has been demonstrated that free weight activities using barbells, dumbbells, and kettlebells (especially at heavier weights/intensities) lead to greater force production. It would stand to reason, therefore, that utilizing primarily free weight exercises with moderate to heavy weights would be most effective at increasing/maintaining bone density. Resistance training should be performed 3-5 times per week for 30-60 minutes.

It should be noted that low/no impact activities such as swimming, water aerobics, yoga, elliptical trainers, and biking provide little stimulus for improving bone density. Also, even with the best training protocol, appropriate considerations must be made in regard to nutrition to be sure the needed nutrients are available to build up our bones.

Click on the link below to see video demonstration of one of our members in action:

-Jeff Tirrell, B.S., OCS, CSCS

Categories