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Muscle Preservation and Fat Loss

NY Times on Fat Loss

One of the adverse effects of diets is the loss of muscle that accompanies a reduction of body fat.  Muscle is the metabolic engine, injury preventative armor, and longevity enhancing elixir of human biology.  Gretchen Reynolds of the New York Times has written an enlightening *article on the best method of losing body fat while holding onto valuable muscle.  The recent research reveals that a program of strength training produces optimal fat loss with significantly less muscle wasting.  Long slow distance exercise combined with caloric restriction accelerates muscle loss.  Your choice of exercise activity can have a profound impact on your physical performance and health.  Read the NY Times article here: https://www.nytimes.com/2017/11/15/well/move/to-maintain-muscle-and-lose-fat-as-you-age-add-weights.html?_r=0.

After the age of 25, the average American gains a pound of fat and loses a ½ pound of muscle every year.  If no action in taken to reverse this trend, the average American will have gained 25-30 pounds of fat and shed 12-15 pounds of muscle by the time they reach 55 years of age.  This 55 year old will stand on the scale 12 to 18 pounds heavier, but the true alteration in body composition is far more dramatic.

America does not have “an obesity epidemic”, it has a “muscle atrophy epidemic”.  We are not so much over fat as we are under muscled.  The simplistic notion of “losing weight” fails to improve health because it accelerates muscle loss.  Middle age muscle loss is the catalyst for many of the illnesses that plague us later in life.

Michael S. O’Hara, PT, OCS, CSCS

*To Maintain Muscle and Lose Fat as Your Age, Add Weights, Gretchen Reynolds, New York Times, November 15, 2017

Learn how to keep your spinal stabilizers strong by performing side planks.  Mike O’Hara explains this in his article, “Learning to Lean”, and includes video demonstration and explanation of the importance keeping your stabilizers strong to stand up to the demands of daily life. It’s time for another Fenton Fitness Love Your Jeans Challenge–see page 3 for more information. In his article, “The Periodization of Nutrition”, Jeff Tirrell gives tips on optimizing dietary intake.

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A Plea For Your Knee

In our physical therapy clinics, we treat patients with knee pain on a daily basis.  It has become more common to train younger clients with a history of knee injury and ongoing knee pain.  Jane Brody’s recent *article in the New York Times has some excellent advice on the care and management of knee pain problems.  I have some further suggestions and clarifications.

Less Mass

The mass portion of the Force = Mass x Acceleration formula needs to be at an appropriate level for your knees to stay healthy.  Carrying extra body fat creates an environment that invites knee wear and tear.  The common knee pulverizing mistake is to perform high impact exercise activities in an effort to lose fat.  If you are twenty pounds overweight, do not run, stadium step, soccer, tennis, or pickleball.  Start with strength training and low impact cardio.  Lose the fat first, and even then, the lower impact activity will be healthier for your knees.  From the overweight client limping into the clinic I get the “I need to move around to lose weight” protest.  I am sorry, but fat loss is primarily a function of dietary alteration.  Exercise has very little impact on body fat levels if you do not eat properly.

Train the Way You Wish to Play

A properly planned fitness program makes your knees more durable (fewer injuries) when you participate in your favorite recreational activity.  The training must be tailored to your activity goals.  If your goal is to play tennis, then you must perform three dimensional deceleration / acceleration activities as part of your training program.  Yoga will not prepare your knees for tennis.  If you want to water ski, then you must perform strength training for your back, hips, and knees.  Distance running will not prepare your knees for water skiing.  If hockey is your recreational past time, you need to be strong, well conditioned and competent in all planes of motion.  Long duration recliner intervals will not prepare your knees for hockey.

Look Above

If your hips do not move well, your knees will pay the price.  In this age of all day sitting and minimal physical activity, hip function is at an all time low.  Physical therapy patients with knee pain nearly always present with glaring restrictions in hip range of motion and strength.  If your knees hurt, dedicate some training time to restoring hip rotation and hip extension movement.  Learn how to perform some remedial gluteal activation drills.  Learn a proper hip hinge, squat and a pain free lunge pattern.

Think First

Participation in a single inappropriate activity can produce a lifetime of knee trouble.  That box jump workout of the day- maybe not.  The warrior, electric shock, mud hole, death run–bad idea.  Trampoline with the grandchildren–what were you thinking!

Be Proactive and Seek Treatment For Knee Pain

“Training through the pain” can take a graceful athlete and turn them into a lifelong speed limper.  The presence of pain changes the way your brain controls movement.  Left untreated, it can permanently alter neural signals and produce movement patterns that linger long after the pain has resolved.  Live with enough cycles of inefficient movement and you develop early breakdown in the knee.

Michael O’Hara, PT, OCS, CSCS

*What I Wished I’d Known About My Knees, Jane Brody, New York Times. July 3, 2017

Read the NY Times article here: https://www.nytimes.com/2017/07/03/well/live/what-i-wish-id-known-about-my-knees.html?_r=0

The Best Practices for Fat Loss

As the weather warms up, I get more questions from gym goers on the best way to lose body fat.  In the physical therapy clinic, we treat patients who have injured themselves with their exercise efforts to eradicate the extra pounds of adipose they gained over the winter.   For both populations, I direct them to an excellent article written by Alwyn Cosgrove, *The Hierarchy of Fat Loss.  View the article here: https://www.t-nation.com/training/hierarchy-of-fat-loss

Nearly all fitness clients say they have busy schedules and limited time available to spend in the gym.  At best, they can spare two or three hours a week.  In great detail, Alywn explains the optimal fat loss training schedule so that you make the best use of your training time.  For the deconditioned or orthopedically challenged individual, following a plan that focuses foremost on nutrition and strength training will decrease body fat levels and prevent injury.

Michael S. O’Hara, PT, OCS, CSCS

Very Short Term Running Preparation

I was recently asked by a fitness client to post exercise recommendations that would prepare her for outdoor distance running.  This person was two weeks away from being out on the road, running two or three miles a day.  She is middle aged, has a prior history of lower back pain, and her goal was to lose fifteen pounds and “tone up”.   Given such short notice, these are my recommendations.

Perform soft tissue work on a daily basis.  Foam roll the legs and use a lacrosse ball on the plantar fascia.  The vast majority of overuse injuries in runners happen in the lower legs and feet.  Attempt to unwind the myofascial distress created by 600-700 foot impacts a mile.

Improve your reciprocal hip pattern–one hip goes back and the other goes forward.  Most general fitness clients have glaring deficits on one side.  Perform some split squats, posterior lunges, step ups, and or walking lunges.  If you struggle with these activities, I would reconsider running as a fitness activity.

Wake up your gluteals.  Every day, perform fifty or sixty bridges, hip lifts, or leg curls.  You need super gluteal strength / endurance to run distances and avoid lower extremity injury.  If your butt gets sore from fifty bridges, you need to do them more often.

Running is a skill and most recreational runners need some practice.  Running hills will improve gait mechanics, enhance hip extension, and decrease deceleration forces.  Find a fifty-yard hill.  Run up the hill and walk back down.  Perform five hill runs.

You are always better to run too little than to run too much.   Start with very short runs– no more than half a mile.  Increase your total weekly mileage by no more than five percent a week.

You can’t do this in two weeks, but this is my big recommendation to all future runners.  Lose the extra weight before running.  As a method of fat loss, distance running has a poor track record.  It tends to elevate the hormones that make you hungry, and physiological adaptation to distance running happens fairly quickly.  Extra adipose makes you far more likely to develop a running related injury.  I know the guys and gals you see running miles and miles every day are lean.  Please remember that lean runners are successful with running because they possess the optimal body mass to run long distances.  They did not start heavy and become lean.  Put a fifteen pound weight vest on that guy or gal and everything will change.  Their gait will lose efficiency and become less graceful.  The extra fifteen pounds of load creates the biomechanical overload that makes them much more likely to suffer an injury.

My final recommendation is that you not become disappointed if you develop pain.  A runnersworld.com poll conducted in 2009 revealed that 66% of respondents reported a running related injury that year.  The statistics indicate that one third of the participants at you local 10k fun run will require medical attention for a running related injury over the next year.  Have the good sense to stop when the pain begins.

Michael S. O’Hara, PT, OCS, CSCS

PDFTreadmills are found in virtually every gym.  Read the six treadmill facts you need to know.  Meet a Fenton Fitness member who learned how to manage her back pain, and read about the seven best TRX exercises.  Do you have limited time to exercise?  Be more efficient with HIIT.

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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.

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Kettlebell Swings and Push Ups

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.   

Swings and Push Ups

Strength coach Dan John got me started on kettlebell swings/push up sessions.   This pairing challenges core stability as the swings create an anti-flexion core stabilization demand and the push ups an anti-extension demand.  If your goal is fat loss, this exercise pairing produces a total body metabolic boost.  A hidden benefit is getting up and down off the floor during the training session.  It is a basic mobility skill we need to practice in order to maintain our independence.

Kettlebell Swings
kb_swingA swing is not a squat and a squat is not a swing.  A kettlebell swing is a hip dominant motion; the hips move a lot and the knees just a little.  The handle of the kettlebell should stay above the knees.  At the bottom of the swing, the forearms should contact the upper thighs.  You swing the kettlebell forward with an explosive contraction of the gluteal and hamstring muscles.  Do not lift the kettlebell with the arms.  Project, or throw, the kettlebell to shoulder level and no higher.  The swing is an exercise that is worthy of some coaching.  Find an instructor that can help you with proper performance.

Push Ups
Keep the shoulder blades down the back and tight against the rib cage.  Hold the head in a retracted position and relax the neck.  The shoulders should not ride up into a shrugged position. Start at the bottom of the push up (flat on the floor).  Place the hands under the shoulders and keep the elbows tucked in to the side of the body.  Grip the floor with the hands and activate the muscles in the back of the shoulder blades.  Brace the abdominal muscles, tighten the glutes, and maintain tension between the legs by drawing them together.  Push up while maintaining spinal and shoulder position.   Hold at the top for two counts and repeat the push up.

Swing/Push Up Sessions
The great thing about these sessions is that you need minimal equipment—just a single kettlebell and a willingness to work hard.

This is a good place to start.  You will need a kettlebell and a stopwatch.
Swings x 20 seconds
Push ups x 6 repetitions
Rest 30 seconds
Repeat for fifteen minutes
As you get stronger, increase the push up repetitions.

This is one of my favorite swing/push up training sessions.
20 swings
20 push ups
20 swings
15 push ups
20 swings
10 push ups
20 swings
5 push ups
20 swings
You will finish with 100 swings and 50 push ups.

Try a push up “countdown” session.  Follow this pattern:
10 swings
10 push ups
10 swings
9 push ups
10 swings
8 push ups
Work your way down to 7-6-5-4-3-2-1 push up.  You will complete 100 swings and 55 push ups and transfer up and down off the floor 10 times.  If that is too much, modify the program and start at five push ups.  You will complete 50 swings and 15 push ups.

View video of Mike performing these exercises here: https://youtu.be/Vq3VYg847Xs

-Michael S. O’Hara, P.T., OCS, CSCS

Turkish Get Ups and Waiters Walks

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.   

Turkish Get Up and Waiter Walk Complex

How you move says more about your fitness than how you look.  The pairing of the Turkish Get Up (TGU) and Waiter Walk is an exercise complex that improves gait mechanics and the survival skill of getting up and down off the ground.  You will be performing a TGU and immediately move into a Waiter Walk so you need twenty yards of open space.  As you get stronger at this complex and use a heavier implement, some interesting things start to happen.  You get better at controlling respiration and have an intense focus on how your body moves during the TGU and Waiter Walk.  My yoga friends tell me this is the focus of their practice sessions: better respiration, improved motor control, and increased strength.

Turkish Get Up

t_get_upsThe Turkish Get Up (TGU) is generally performed with a kettlebell, but you can use a dumbbell.  A medicine ball can help teach body alignment to beginners.

Exercise activities that produce the greatest rewards are the ones that take the most time to master.  You can learn a barbell curl in five seconds but a TGU can take weeks to master.  Developing proficiency with the Turkish Get Up will require some patience and instruction, but for the time spent, the pay off is tremendous.  Complete instruction on the TGU is not possible in this short article.  Watch the accompanying video and work with a qualified trainer on this exercise.  Steve Cotter and Gray Cook both have excellent YouTube tutorials on the TGU.

Waiter Walk

You must have adequate shoulder range of motion and good balance to perform this exercise safely.  Hold the kettlebell overhead like a waiter carrying a tray.  Keep the chest proud and the neck relaxed.  The upper arm should be adjacent to the head and your walk should be smooth and free of any lean or limp.

Complex
I like to train TGU rookies with a soft Dynamax ball.  If they drop the ball it will not damage any aspect of their anatomy.  Balancing the ball on the hand tends to teach proper alignment.  Progress to a kettlebell as you become more proficient.  Start on the floor and perform the TGU ascent.  Once at the top of the TGU, perform a Waiter Walk for twenty yards and then lower back down to the floor with a TGU descent.  Switch the implement to the other side and repeat.  Perform two trips on each side.

When you perform this complex, strive to move more gracefully before adding more resistance.   Get up and down off the floor and walk in a coordinated and efficient manner.  Only then increase the load of the ‘bell.

View video of Mike performing these exercises herehttps://www.youtube.com/watch?v=s0U9GWMI4bU&t=8s

-Michael S. O’Hara, P.T., OCS, CSCS

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

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