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Learn more about Rehab, Sports Medicine & Performance

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In the April 2018 issue, Mike O’Hara discusses the benefits of the farmer’s walk exercise. Jeff Tirrell tells you how to reduce injury to your ligaments and tendons, and tips are given for getting back out into the garden.

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Getting up and down off the ground is a movement skill we need to maintain.  It is the functional exercise activity that keeps us safe and independent for a lifetime. Developing proficiency in getting up and down off the ground has multiple benefits.  It takes away fear, builds confidence, and increases activity in other areas of life.  Your fitness training should involve activity that makes you better at moving gracefully in and out of the positions necessary to get up and down off the ground.  

Getting up and down off the ground is largely a neural activity.  Nearly everyone has enough strength, range of motion, and balance—you just need some practice.  Physiologically, we know that movement practice makes transmission of neural signals more efficient.  Research on motor learning has taught us that repetition, ascending challenge levels, and coaching produces the best results.  The reach and roll exercise is a good starting point for improving from the ground up movement skills.

Reach and Roll Performance

reach and rollYou need some open space.  Lay on your back.  Bend the right leg up and keep the left leg straight.  Reach the left arm out at 45 degrees in relationship to the body.  Brace the abdominal muscles.  Reach across the body with the right arm and then let the head follow as you rotate over to the left.  Roll the right leg across the body and turn over onto your left side.  Return back to the supine position and then repeat the exercise to the right.  Perform five times on each side.

One direction may be much easier than the other.  Try starting with that side and add in some extra repetitions to the weaker direction.  A common mistake is leading with the head instead of with the reaching arm.  Some coaching can make ground up movement skills much easier to master.  As you get better at the reach and roll, add in a lift up onto the elbow and then hand.

View video demonstration of reach and roll here: https://www.youtube.com/watch?v=n4B8A8rnzsQ

Michael S. O’Hara, PT, OCS, CSCS

core-deep-central-stability-systemHow To Make Stress Urinary Incontinence Go Away

Stress Urinary Incontinence (SUI) is a common problem in the female population.  SUI responds very well to a proper rehabilitation exercise program and modification of behavior.  Unfortunately, most women are either not directed or do not seek care for this problem.

SUI problems are happening to more women at younger ages.  The overall fitness level of younger women has dropped and problems with SUI are happening sooner.  Obesity, surgical interventions through the abdominal wall, and pelvic floor and systemic diseases such as diabetes all contribute to an earlier onset of SUI.

Women in the fitness population often suffer from what I call Permanently Contracted Abdominal Muscles (PCAM).  They hold their abdominal muscles in a perpetually pulled in position and their pelvis tilted backward.  They are unable to relax their abdominal muscles and properly inhale and exhale.  PCAM creates hypertonicity and weakness in the muscles of the pelvic floor.   It is also the reason many postpartum women develop a chronic diastasis recti hernia.

Modification of fitness activity is often necessary to resolve SUI in female fitness clients.  Many exercises overload the pelvic floor and impair the motor control necessary to prevent leakage.  You may have to temporarily give up the crunches, leave the yoga and lose the lifting belt in order to ditch the dribble.  Once SUI problems have resolved you will be able to go back to all activities.  My experience has been that most female fitness clients find they function so much better that they never return to those activities.

Physical therapy patients treated for SUI are often surprised by how simple changes in behavior and consistent training quickly resolves their leakage issues.  It is unfortunate that many of these women suffer with SUI for years before receiving some help.  I had a patient tell me that she thought SUI was just part of being a mom.  Her mother had SUI, and after delivering two children of her own, she developed symptoms.  All of her problems with SUI were eliminated with three months of simple exercise and some alteration of fitness activity.

Take a few minutes and read the article by physical therapist Ann Wendel on the Girls Gone Strong web site.  She does an excellent job of covering all areas of physical therapy for SUI.   You can view the articles here: https://www.girlsgonestrong.com/blog/injury-prevention/strong-pelvic-floor-isnt-enough/
-Michael O’Hara, P.T., OCS, CSCS

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