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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

Mike O’Hara gives tips for aging gracefully and staying fit in his article, The Five Don’ts of Sustainable Fitness. Learn the importance of increasing mobility and stability in order to get stronger, and discover how a simple test that measures how well you get up from the floor can tell a lot about whether or not your fitness program is working.

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Will That Machine Help Me?

Home Gym Hints

Television ads, holiday gift giving, and the return of frigid temperatures brings out the “What cardio machine should I purchase for my home?” question.  Is it the bike with an internet trainer, the fat blasting high intensity elliptical trainer, or the Euro designed Nordic ski machine?  Many of these units sell for over $3000 and they wish to choose wisely.  Most of the questioners have no experience with any of these gizmos.  I have some pre-purchase questions they need to answer before buying that expensive cardio machine.

Can you currently walk for thirty minutes without stopping to rest?

If you answer no to that question, do not bother purchasing a treadmill, bike, or elliptical unit.  Focus all of your efforts on developing the strength and skill necessary to walk for thirty minutes without resting.  If pain is a limitation, get to the physical therapy clinic and resolve the problem.  Walking is the essential neuromuscular activity that keeps a body healthy and out of the assisted living center.  Leaning over on a treadmill, elliptical trainer, or recumbent bike is very likely to worsen those walking woes.

Do you have a prior history of consistent exercise?

Just owning a new high-tech training machine will not make you thinner or fitter.  You must use the machine three or four days a week for the next year.  Many people believe that locating the machine in the dwelling will jump-start the exercise habit.  If you answer no to this question, I have concerns that you will not develop a relationship with your internet connected mechanical friend.

Is fat loss the primary reason you are purchasing the home exercise machine?

The fat loss the exercise motto everyone needs to learn is; “familiarity breeds failure”.   The human body is a master at adapting to a physical stress and the forty-five minute spin class that burns 440 calories in February only consumes 180 calories in August.  The sad truth is that the same amount of exercise time and effort produces a weaker fat loss response.   The crucial components for fat loss are long duration meal preparation and high intensity portion awareness.  After you get those under control, progress to activities that you find challenging (difficult, not good at, loath, hate) and change the training modality on a frequent basis.  Using the same exercise device month after month will not produce optimal results.

Michael O’Hara, PT, OCS, CSCS

Save Your Back When Shoveling Snow

Improve Your Snow Shoveling Mechanics to Avoid Injury

‘Tis the season for hot cocoa, warm fires, and lots of snow. With snow comes shoveling, and unfortunately with shoveling comes injury. It is estimated that there are over 11,000 hospital visits each year due to injuries while shoveling snow. This number does not even include the thousands of people that see their primary care doctor with the onset of an injury. Many of these medical visits involve the low back including complaints of pain with movement, leg numbness, and the inability to maintain the proper posture. Lumbar injuries while shoveling are often due to the combination of repeated flexion and rotation of the spine. Adding the load of snow and having poor spine stabilization during the lift results in overload on the structures of the lumbar spine and resultant injury. Here are three exercises you can use to improve your shoveling mechanics in order to spend more time sipping cocoa by the fire, and less time in a physician’s waiting room.

  1. Hip Hinge – a proper movement pattern to bend forward and push snow involves flexion at the hips and knees, while maintaining a more neutral spine.
  • Stand with your feet shoulder width apart. Using a broom stick, golf club, or wooden dowel, place the stock along your lumbar spine.
  • The stick should come in contact with the back of your head, mid-thoracic spine (between your shoulder blades), and at the sacrum/mid-buttock.
  • With a slight bend in your knees, hinge your hips by driving your buttock backwards, while maintaining the three points of contact throughout the movement.
  • Perform ten repetitions

Common mistakes: squatting versus hinging – try and minimize knee bend. Your buttock should move backwards, not down.

Losing contact with the stick – if you notice the stick is leaving the sacrum the spine is flexing. Slow down the movement and move only as far as you can with contact.

  1. Isometric Hip Bridge – once you have properly bent forward to push and load the snow, using the buttock and hamstring muscles to lift the snow will decrease strain of muscles of the lower back.
  • Start lying on your back, knees bent, and hands raised straight in the air.
  • Push through your heels driving your hips upwards, hold for 5-10 seconds, and return. Repeat this movement 10 times.
  • If you find that you feel this more in the low back than the legs or buttocks, try squeezing a pillow at your knees during the lift.
  1. Rotational Step – now that you have properly bent to load the snow, and used the proper muscles to lift it, increasing rotation at the hips to move the snow versus rotating through the lumbar spine will reduce torsional strain on the vertebral discs and spinal stabilizers.
  • Begin by standing in an athletic stance with your feet shoulder width apart and slight bend in your knees.
  • Keeping one foot in place, open up through your hips by stepping to the side and backwards. Your weight should be evenly distributed between the feet.
  • Maintain a neutral spine throughout the movement, being mindful not to bend forward or rotate through the spine.
  • Perform 10 repetitions to each side.

See video demonstration of these exercises: here

Sean Duffey, DPT

Clinic Director, Ivy Rehab, Ortonville

To combat the effects of aging, consistent exercise is key.  Mike O’Hara discusses the benefits of fitness and gives tips on starting and continuing a program of exercise for life in his article, The Three Do’s of Sustainable Fitness.  Jeff Tirrell of Fenton Fitness gives nutrition tips for athletes and Mike’s exercise for better posture and more efficient movement is the bird dog.

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That pain in your arm or hand could be coming from somewhere else.  Read Mike O’Hara’s article, Changing Locations to find out more.  Jeff Tirrell gives nutrition tips and Mike discusses the benefits of using an agility ladder.

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Stay independent longer by increasing your stair climbing capacity.  Mike O’Hara shows you how in his article, “Keep Climbing”.  Mike also discusses standing desks and the many benefits of standing while working.  Jeff Tirrell explains the effect of exercise on appetite.

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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)

Play It All

How To Keep Your Child On The Field And Out Of The PT Clinic

Taylor was recently referred to physical therapy with a painful shoulder and a right hand that frequently went numb. For the last five years, she had been a year round participant in softball. At the age of fifteen, she was missing out on softball and a good night sleep secondary to the pain and limited function in her right arm.

Andy played soccer, and at the age of thirteen, he developed knee pain that prevented him from changing directions and sprinting. Andy practiced or played soccer four days a week for 50 of the 52 weeks in a year. It took four years of year round soccer to create the knee damage that required surgery and an twelve week rehab.

Many of the young athletes we treat in physical therapy are the victims of over exposure to the same training stimulus for far too long a period of time. Gymnastics, dancing, baseball, soccer, and softball are worthwhile endeavors, but a developing body needs a break in order to stay healthy. This becomes even more important as the athlete becomes stronger or more skilled.

Take a moment and read the *article by Jane Brody in the May 7th, 2018 edition of the New York Times. Jane interviews several Orthopedic Surgeons that are treating younger patients with injuries that usually occur ten or fifteen years later in an athlete’s career. The research they present is clear; year round single sports participation is not the best way to excel in athletics or remain healthy.

The recent popularity of the club system has children playing the same sport year round. In the clinic, we are treating more young athletes with old person overuse injuries. Participation in a variety of athletic activities is infinitely more beneficial and safer than single sports specialization. It is no coincidence that most successful collegiate and professional athletes are the product of multi-sport participation.

*New York Times, Jane Brody, May 7, 2018, How to Avoid Burnout in Youth Sports. View article: https://www.nytimes.com/2018/05/07/well/how-to-avoid-burnout-in-youth-sports.html

Michael S. O’Hara, PT, OCS, CSCS

 

 

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.

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