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extension

Anti Extension Progression

An interconnected team of muscles holds our spinal column stable.  If you wish to be strong in all endeavors, you need to develop isometric (no movement) torso strength that resists flexion, resists extension, and resists rotational forces.  Most people have poor anti extension torso strength, and many of them show up in the physical therapy clinic with lower back, hip, and neck pain.  Presented below is a time-tested progression of training activities that will improve anti extension torso strength.  Watch the video and make these exercises a part of your training program.

Anti Extension Torso Strength Program

  1. Wall Planks
  2. Bench Planks
  3. Push up Position Planks
  4. Push up Position Planks feet elevated
  5. Ball Roll Outs
  6. Ab Wheel Roll Outs

Initial anti extension exercises are all a version of planks that are scaled from easiest to hardest–wall, bench, push up position, and then push up position feet elevated.

Weaker people require more practice to develop the neural connections that improve strength.  They need two sessions a day to drive a reboot of their neural system.   Start with the wall planks for two holds of twenty seconds.  Gradually increase the time you hold the wall planks from twenty seconds to forty seconds.  When forty seconds gets easy, move to the next progression–bench planks.  Return to twenty second holds for two planks after each progression.

Once you can perform forty seconds of the push up position plank with feet elevated, move to the ball roll out exercise for five repetitions.  As your strength improves, gradually increase the repetitions until you can complete fifteen repetitions of the ball roll out.  The final progression is the ab wheel roll out–start with five and work up to fifteen repetitions.

View video of these exercises: here

Michael S. O’Hara, PT, OCS, CSCS

Sister Hermeta Saved My Soul and My Spine

Tall Kneeling Core Stabilization Training

During my parochial grade school education,  I was taught how to kneel in church.  Eyes forward, hands together, spine tall, and no leaning on the pew.  You maintained the kneeling posture for extended periods of Father Furlong’s mass.  I believe the good sisters were on to something.  Despite every one of them being well past 100 years of age, they all possessed excellent posture and remarkable mobility.  As a physical therapist, I am convinced that a daily dose of sustained kneeling helped keep the Felician Sisters in fighting form.  I have some tall kneeling training suggestions you can add your fitness routine.

Get to Know Kneeling

Many people will benefit from some sustained tall kneeling.  Protect your knees by placing an Airex pad under your knees.  In and ideal situation, you will have a mirror for feedback on posture and alignment.  Keep some space between your knees and line the feet up with the knees.  Pull the head back, lift the chest, and reach the top of the head to the sky.  Many people have difficulty getting into a fully upright position in kneeling.  The most common problem is a forward lean at the hips accompanied by complaints of tightness in the lower back and front of the thighs.  Holding a pvc pipe or dowel overhead while performing some deep breaths can help reduce muscle tone in the hips and torso.   Perform two or three, thirty second holds at every training session for the next six weeks

Tall Kneeling Pallof Press

The tall kneeling Pallof press is an anti rotation core stability exercise that helps recruit the postural muscles that keep us upright and tall.  Lack of isometric strength-endurance in the spinal muscles is a primary contributor to back injuries.  This exercise will improve that component of spinal function.

Place your knees on an Airex pad and set up in kneeling position.  Use either a cable unit or resistance tubing set at a level even with your sternum while you are in the kneeling position.  The tubing should be directly to your right and slightly behind the body.  Use a double overlap grip on the handle and hold at chest level.  Press the tubing out to arms length and then back to the chest.  Select a resistance level that permits execution of fifteen repetitions without losing the set up posture.  Rest and then repeat on the other side.

Tall Kneeling Anti Extension Holds

The pelvis is a bowl and the torso rests on the top of the bowl.  You need a pelvic position that makes stabilization of the torso over the pelvis effortless and automatic.  The tall kneeling isometric hold aligns your pelvis under the torso.

Kneel on an Airex pad.  Hold a kettlebell, dumbbell or Iron Grip Plate behind your back.  It is difficult to prescribe a load.  Twenty pounds may be too easy and five pounds may be too much.  My suggestion is that you err on the lighter side of the load equation.  Stay in the loaded kneeling position for at least thirty seconds.  Lower the weight, walk around, and take inventory of how you feel.  Repeat for another thirty seconds.

See video demonstration of these exercises: here

Michael S. O’Hara, PT, OCS, CSCS

Real Core Training Part Four

Anti-Rotation

Like everything in the fitness world, core training has evolved.  When I bought my first bodybuilding magazine in the late 90s, the word “core” wasn’t even used.  Instead, you would find ab workouts, oblique workouts, and sometime, low back workouts.  Like pretty much everything in the 90s, muscles were trained in isolation with little concern for how the musculoskeletal system was designed to function as a unit.  We have come a long way in our understanding of physiology, biomechanics, and injury prevention/reduction.

The core used to be trained and often still is through movement: flexion (anterior), lateral flexion, extension, and rotation.  Sit ups, crunches, side bends, and Russian twists aim to strengthen the muscles concentrically and eccentrically.  These build mass and thickness to the core musculature.  The second way we train the core is to recognize it as a stabilizer of the low back and hips.  This involves training this musculature to resist movement.  When it comes to increasing strength, power, speed, and reducing injury, this training is more important than dynamically training the core.  This style of training is referred to as “anti-core training” because we are resisting flexion, extension, lateral flexion, and rotation.  The other benefit of anti-core training is that it involves isometric contractions which are much less likely to create muscle hypertrophy, which individuals typically don’t want in their waist.  I typically recommend that 70-90% of your core training consist of anti-core work depending on your health/injury history and goals.

The key to good core training is understanding what you are trying to accomplish, as well as how to progress or regress the movement.  Here are the some of our favorites that we use at Fenton Fitness for each of the four anti-core categories.

Jeff Tirrell, CSCS, CSFC, Pn1

Anti-Rotation

Tall Kneeling Pallof Press: Grab some elastic tubing or a cable (anchored to something sturdy) and assume a tall kneeling position.  Hold with both hands and press outward away from body.  Do not allow your body to twist or rotate.  Increase load or stretch on tubing to increase difficulty.  Work up to 12 reps per side.

Half Kneeling Pallof Press: Set up in a half kneeling position.  Use the same execution as the tall kneeling version.  Make sure that you don’t allow your legs/hips to lean or twist.  Work up to 12 reps per side.

Standing Pallof Press: Assume an athletic stance with your feet just outside of shoulder width, slight bend in the knees, and slightly flexed at the hips.  Execute the same movement as you would for the tall or half kneeling Pallof press. Work up to 12 reps per side.

One Leg Pallof Press: Stand on one leg with the other leg flexed at 90 degrees at the foot, knee, and hip.  Execute the Pallof press the same way as the standing Pallof press. This is a much more a balance and overall body stability drill.  Tension/resistance will need to be reduced.  Be slow and gradual with your increases in load, volume, or frequency to allow your knee time to adapt.  Work up to 12 reps per side.

PUPP with alternating arm raise:  Assume a push up position with your feet slightly wider than shoulder width.  Raise one arm out in front of your body while maintaining spine and pelvic positions.  A wider feet position makes the movement more stable and easier, while a narrower foot position increases difficulty.  You can also slow the movement to increase difficulty.  Remember, top priority is no hip/spine movement before trying to increase difficulty.  Work up to 10 per side.

Landmine Anti-Rotations:  Place a barbell in a landmine and assume an athletic position.  Press the landmine away from your body and slowly make a rainbow arching pattern moving the barbell from one hip to the other.  Make sure that only your shoulder/elbow joints move, everything else stays stiff.  Work up to 10 reps per side.

Crawl: Get on your hands and knees with your toes dug into the ground.  Lift your knees slightly off the ground.  Keeping your back flat and stable, move your opposite hand and foot to crawl forward or backward.  Work up to 50 yards.

For video demonstration of these exercises, click here

Real Core Training Part Three

Anti-Extension

Like everything in the fitness world, core training has evolved.  When I bought my first bodybuilding magazine in the late 90s, the word “core” wasn’t even used.  Instead, you would find ab workouts, oblique workouts, and sometime, low back workouts.  Like pretty much everything in the 90s, muscles were trained in isolation with little concern for how the musculoskeletal system was designed to function as a unit.  We have come a long way in our understanding of physiology, biomechanics, and injury prevention/reduction.

The core used to be trained and often still is through movement: flexion (anterior), lateral flexion, extension, and rotation.  Sit ups, crunches, side bends, and Russian twists aim to strengthen the muscles concentrically and eccentrically.  These build mass and thickness to the core musculature.  The second way we train the core is to recognize it as a stabilizer of the low back and hips.  This involves training this musculature to resist movement.  When it comes to increasing strength, power, speed, and reducing injury, this training is more important than dynamically training the core.  This style of training is referred to as “anti-core training” because we are resisting flexion, extension, lateral flexion, and rotation.  The other benefit of anti-core training is that it involves isometric contractions which are much less likely to create muscle hypertrophy, which individuals typically don’t want in their waist.  I typically recommend that 70-90% of your core training consist of anti-core work depending on your health/injury history and goals.

The key to good core training is understanding what you are trying to accomplish, as well as how to progress or regress the movement.  Here are the some of our favorites that we use at Fenton Fitness for each of the four anti-core categories.

Jeff Tirrell, CSCS, CSFC, Pn1

Anti-Exension

Supine Bent Knee March

Lay on your back and lift your legs off the ground with your knees and hips at 90 degree angles.  Posteriorly tilt your hips so that your low back is pressed firmly into the ground.  Slowly lower one heel to the ground keeping your knee at 90 degrees and not allowing your low back to lift off the floor.  Bring this leg back up and repeat on the other side.  Work up to 10 reps per side.

Bent Leg Dead Bug

Assume the same position as the previous exercise.  Reach your arms straight up to the ceiling.  Keep your low back pressed into the floor and straighten one leg, getting the heel as close to the ground as possible without touching.  Simultaneously reach the opposite arm overhead without quite touching the ground.

Straight Leg Dead Bug

Lay on your back with your legs and arms all reaching up toward the ceiling.  Keep your leg straight. and slowly lower it toward the ground while simultaneously reaching overhead with the opposite arm.  Don’t allow your foot or arm to rest on the ground, and keep your low back pressed into the floor.

Hollow Body Hold

Lay on your back and press your low back into the floor.  Lift your feet, shoulders, and arms off the floor, keeping your low back pressed into the floor.  Keep your feet and arms as close to the ground as possible while also keeping your low back on the ground.  Hold for up to 60 seconds.

Plank

Lay on your stomach and place your elbows under your shoulders.  Put your feet together and lift your hips off the ground.  Maintain neutral lumbar, thoracic, and cervical spine positions. Contract your glutes, pull your ribs down with a forceful exhalation, and try to pull your elbows toward your toes (they won’t actually move) to engage your lats.  Try to create maximum full body tension.  Hold for up to 30 seconds.

Long Lever Plank

Use the same set up and execution as the plank, except that the elbows will be farther out in front of the shoulders.  The farther forward the elbows, the harder this will be.  Work up to 30 seconds.

Body Saw

Use the set up the same as the plank only with carpet sliders under your toes.  Use your shoulders to slide yourself into the long lever position and then slide back.  Make sure you maintain spinal and pelvis positioning during the whole movement.  Work up to 12 reps.

Physioball Rollouts

Start in a tall kneeling position with a Physioball at arm’s length in front of you.  Pull your ribs down and engage your glutes.  Allow your body to fall forward by letting your hands and forearms roll up onto the ball.  Once you feel you are going to break lumbopelvic positioning, reverse the movement to get you back to your starting position.  Work up to 10 reps.

TRX Fallouts

Use the same set up as with the physioball, but use a suspension trainer instead.  Set up with straps at mid-thigh height.  Execute in the same manner.  Lower the strap starting position to increase difficulty.  Work up to 10 reps.

Ab Wheel/Dolly Rollouts

Set up on your knees with your hands on an ab wheel or dolly and place your hands directly under your shoulders.  Begin to fall forward by flexing the shoulder (overhead) and extending the hips.  Go forward as far as possible without losing spinal positioning and then reverse movement back to the start.  Make sure shoulder and hip joints extend/flex at the same speed.

For video demonstration of these exercises, click here

Real Core Training Part Two

Anti-Lateral Flexion

Like everything in the fitness world, core training has evolved.  When I bought my first bodybuilding magazine in the late 90s, the word “core” wasn’t even used.  Instead, you would find ab workouts, oblique workouts, and sometime, low back workouts.  Like pretty much everything in the 90s, muscles were trained in isolation with little concern for how the musculoskeletal system was designed to function as a unit.  We have come a long way in our understanding of physiology, biomechanics, and injury prevention/reduction.

The core used to be trained and often still is through movement: flexion (anterior), lateral flexion, extension, and rotation.  Sit ups, crunches, side bends, and Russian twists aim to strengthen the muscles concentrically and eccentrically.  These build mass and thickness to the core musculature.  The second way we train the core is to recognize it as a stabilizer of the low back and hips.  This involves training this musculature to resist movement.  When it comes to increasing strength, power, speed, and reducing injury, this training is more important than dynamically training the core.  This style of training is referred to as “anti-core training” because we are resisting flexion, extension, lateral flexion, and rotation.  The other benefit of anti-core training is that it involves isometric contractions which are much less likely to create muscle hypertrophy, which individuals typically don’t want in their waist.  I typically recommend that 70-90% of your core training consist of anti-core work depending on your health/injury history and goals.

The key to good core training is understanding what you are trying to accomplish, as well as how to progress or regress the movement.  Here are the some of our favorites that we use at Fenton Fitness for each of the four anti-core categories.

Jeff Tirrell, CSCS, CSFC, Pn1

Anti-Lateral Flexion

Bent Knee Side Plank

Lay on your side and place your elbow under your shoulder and line your knees up below your hips.  Lift your hips off the ground and hold.  Work up to 45 seconds.

Side Plank

Lay on your side and place your elbow under your shoulder and straighten your legs out.  Stack your legs on top of each other and lift your hips off the ground.  Hold for up to 60 seconds.

Side Plank with Top Leg Elevated

Position yourself in the same set up as the side plank.  Once your hips are lifted off the ground, you will move your top leg away from the bottom leg.  Make sure that you don’t flex either hip when raising the top leg.  Work up to 30 seconds.

Side Plank with Top Leg on Bench

Lay on your side and place your elbow under your shoulder.  Place your top leg on top of a bench.  Lift your hips off the ground.  The bottom leg can squeeze the bottom of the bench or dangle in the air.

Suitcase Hold

Grab a KB/DB in one hand, stand tall, and maintain a neutral lumbar, thoracic, and cervical spine position. Make sure your shoulder blades stay down and back.  If possible, watch yourself in the mirror to ensure you aren’t leaning.  Hold for up to 60 seconds.

Suitcase Carry

Assume the same set up as the suitcase hold.  Start walking with a normal gait.  Make sure to not lean excessively.  Start with 20 yards per side and work up to 100 yards.

For video demonstration of these exercises, click here

Real Core Training Part One

Anti-Flexion

Like everything in the fitness world, core training has evolved.  When I bought my first bodybuilding magazine in the late 90s, the word “core” wasn’t even used.  Instead, you would find ab workouts, oblique workouts, and sometime, low back workouts.  Like pretty much everything in the 90s, muscles were trained in isolation with little concern for how the musculoskeletal system was designed to function as a unit.  We have come a long way in our understanding of physiology, biomechanics, and injury prevention/reduction.

The core used to be trained and often still is through movement: flexion (anterior), lateral flexion, extension, and rotation.  Sit ups, crunches, side bends, and Russian twists aim to strengthen the muscles concentrically and eccentrically.  These build mass and thickness to the core musculature.  The second way we train the core is to recognize it as a stabilizer of the low back and hips.  This involves training this musculature to resist movement.  When it comes to increasing strength, power, speed, and reducing injury, this training is more important than dynamically training the core.  This style of training is referred to as “anti-core training” because we are resisting flexion, extension, lateral flexion, and rotation.  The other benefit of anti-core training is that it involves isometric contractions which are much less likely to create muscle hypertrophy, which individuals typically don’t want in their waist.  I typically recommend that 70-90% of your core training consist of anti-core work depending on your health/injury history and goals.

The key to good core training is understanding what you are trying to accomplish, as well as how to progress or regress the movement.  Here are the some of our favorites that we use at Fenton Fitness for each of the four anti-core categories.

Jeff Tirrell, CSCS, CSFC, Pn1

Anti-Flexion

Kettlebell/Dumbbell (KB/DB) Throat Holds

Grab a KB/DB and hold it in the goblet position directly under your chin.  Stand tall and maintain a neutral lumbar, thoracic, and cervical spine position.  Don’t allow the weight to rest on your chest.  Hold this position for up to 60 seconds.

KB/DB Throat Carry

Once you’ve mastered Throat Holds, you are ready to walk.  Position yourself in the same set up, but now you are going to walk while maintaining the same upper body posture and a normal gait.  Start with 20 yards and work your way up to 100.

Hyperextension Bench ISO Lumbar Extensions

Set yourself up on the hyperextension bench with the thigh pad below your hips and above your knees.  Assume a neutral lumbar, thoracic, and cervical spine position. Hold this position for up to 45 seconds before adding weight.

Glute Ham Bench ISO Lumbar Extensions

Position yourself in the same setup as with the hyperextension bench but use the glute ham developer bench. Work up to 30 second holds before adding weight.

For video demonstration of these exercises, click here

Renegade Rows and SHELC

When designing programs for rehabilitation patients and fitness clients, I often pair up exercises.  This practice is commonly called super-setting and it has multiple benefits:
Train efficiently—You get much more work done during your training time.  
Abolish performance deficits—Most physical therapy and fitness clients need to work on glaring right vs. left movement asymmetries, postural restrictions, and stability limitations.  
Lose weight—Fat loss is a primary goal of most fitness clients.  Pairing exercises ramps up exercise intensity and creates the hormonal response that improves body composition.  
Move better—Training neurologically related movement patterns improves motor control.  

Renegade Row-SHELC Combo

Renegade Rows
The renegade row starts in the top position of a push up.  Rubber hex dumbbells work the best for this exercise since they do not move on the floor.  Place the dumbbells on the floor and position the hands on top of the dumbbells.  Try to align the dumbbells directly under the armpits.  Maintain a strong grip on the dumbbell handle during the exercise.  Spread the feet at least shoulder width.  Tighten the shoulder blades down the back and create total body tension.   Without allowing the torso to turn, row one dumbbell up so the thumb approaches the armpit.  Lower the dumbbell in a controlled manner and repeat with the other arm.  Perform five repetitions on each arm.

Supine Hip Extension Leg Curls
shelcSet the TRX straps so the bottom of the strap is at the mid-calf level of your leg.  Lay supine and place the heels in the foot straps of the TRX.  The feet should be directly under the overhead attachment point of the TRX.  Place the arms on the floor at a 45 degree angle.  Brace the abdominal muscles and keep the head down.  Push the arms against the floor for stability.  Lift the hips off the floor and keep them up for the duration of the set.  Bend the knees so that the feet travel toward the body.  Keep the hips up and extend the knees in a controlled manner.  Perform ten to fifteen repetitions.  Common mistakes are turning the feet outward and allowing the hips to fall toward the floor as the knees flex and extend.

The anti-flexion and anti-rotation core stabilization demand created by this pair of exercises produces some interesting next day abdominal muscle soreness.  The ability to link the hips to the shoulder and produce movement is what everyone tries to accomplish with functional training.  Move through three sets of the Renegade Row – SHELC combo and let me know how it goes.

View video of Mike performing these exercises here: https://youtu.be/2_fT0zShTSo

-Michael S. O’Hara, P.T., OCS, CSCS

Hip Lifts and Roll Outs

When designing programs for rehabilitation patients and fitness clients, I often pair up exercises.  This practice is commonly called super-setting and it has multiple benefits:
Train efficiently—You get much more work done during your training time.  
Abolish performance deficits—Most physical therapy and fitness clients need to work on glaring right vs. left movement asymmetries, postural restrictions, and stability limitations.  
Lose weight—Fat loss is a primary goal of most fitness clients.  Pairing exercises ramps up exercise intensity and creates the hormonal response that improves body composition.  
Move better—Training neurologically related movement patterns improves motor control.  

Hip Lifts and Roll Outs

An intricate system of muscles holds the spine upright over the top of the pelvis.  This pair of exercises coordinates and strengthens this support system.  If you sit all day long, have postural problems, or a history of lower back pain this pair of exercises is worthy of your training time.

Hip Lifts
hip_liftThis drill coordinates hip extension and lumbar spine stability.  It is very beneficial when progressed to the single leg version.  Lay with your shoulders across a bench with the head supported.  Place your arms out to the sides.  Plant the feet on the ground with the knees bent 90 degrees and the shins perpendicular to the floor.  Drop the hips to the floor and then push back up with the gluteals and hamstring muscles.  Hold at the top for two counts and repeat.

Roll Outs
The roll out can be scaled to serve any fitness level.  Beginners can start with a large 65 centimeter physioball, and as they become more proficient, progress to a smaller 55 centimeter ball.  The closer the hands get to the floor the more challenging the exercise becomes.  If you get strong enough, you can perform the forward roll out with a Power Wheel or Sorinex roller.

Kneel on a mat to keep the pressure off your knees.  Your femur (thigh bone) is positioned perpendicular to the floor and the hips are hinged at 45 degrees.  Place the hands on the front of the ball and the elbows directly under the chin.  Brace the abdominal muscles and roll out onto the ball until you feel a challenge through your midsection.  Hold in the challenging position for three counts and then return to the starting position.
Perform twelve repetitions of the hip lifts, rest 30 seconds, and then perform ten roll outs.  Rest and repeat the cycle.  Work up to three sets through this exercise combination.

View video of Mike performing these exercises here: https://youtu.be/Xf08rFU7A4w.

-Michael S. O’Hara, P.T., OCS, CSCS

PDFIn this month’s issue, Mike O’Hara, PT provides information on Achilles tendinopathy with exercises that will help prevent this painful condition. Watch the video for the exercises by following the link in the article “Achilles Recovery”. Mike also demonstrates and describes the combination of turkish get ups and waiters walks–paired exercises that can help you train efficiently. Video for this article can also be seen on our youtube channel; just follow the links in the article.

Download Here

 

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

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