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Learn how to keep your shoulders healthy in Mike’s article, “Graceful Shoulder Aging”. Jeff Tirrell gives some practical advice on how to train, and Mike explains the importance of changing your fitness routine.

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Standing Desk Exercise Rx

Work Station Transition Training

As a physical therapist making his living taking care of people with pain problems and physical limitations caused by prolonged sitting, I am an avid promoter of standing desks.  Over the last five years, the prices of standing desk products have come down and the variety has increased.  Manufacturers now permit a 30 day “no risk” trial.  Try a standing desk for thirty days and then ship it back if it does not meet your needs.  I encourage anyone who must sit for more than five hours a day to convert some of those sitting hours to a stand up desk.  Employers are now aware of the benefit of standing desks and actively encouraging their use.  It can take some time to become accustomed to working at a standing desk.  I have three training tools that can help make working at a standing desk easier.  Read this article and watch the video for a demonstration of how to use each product.

Foot Care With a Spiky Ball

The bottom of the foot is a busy intersection of muscles, tendons, ligaments, fascia, and nerves.  Heel and plantar pain are common reasons we see patients in the physical therapy clinic.  Foot pain problems can take months to fully recover.  A little proactive soft tissue treatment will bulletproof the feet from overuse injury and pain.   A spiky ball is a small sphere with fairly aggressive projections.  Take off your shoes and give your peds a little love by rolling the bottom of your foot over a spiky ball.  Spiky balls come in various sizes and resistances.  I have found the smaller (2 ½ – 3 inch) and firmer models work the best for my foot.  Most people report that it “hurts good” and often get one for work and one for the home office.  Most spiky balls cost around seven dollars.

Posture Correction With Resistance Bands

If you have been a long-term seated data input warrior, you have probably been infected with the i-hunch virus.  As we get older, the muscles that hold the thoracic region tall and pull the shoulder blades back tend to get weaker at a faster rate than other muscles.  Prolonged standing is going to be challenging without some remedial rebooting of the software that holds you tight and tall.  I keep a ¼ inch superband (nine dollars from performbetter.com) at my desk and perform two upper body postural strengthening exercises.  Posture restoration takes some time so work on these drills every day for at least three months.

Band Pull Aparts

Choose a resistance band that allows you to perform a complete set without reaching failure.  The force produced by the band becomes greater as you travel through the movement so avoid a band with a strong resistance.   The tempo of the movement should stay smooth and steady.

Stand tall with the chest proud and the head pulled back.  Do not arch the upper back.  Tighten the abdominal muscle and keep the front of the rib cage down.  Hold the elbows fully extended and the wrist in neutral.  You can use either a palms up or a palms down arm position.  Individuals with some shoulder wear and tear may feel better with a palms up position.  Hold the arms up to 85 degree shoulder flexion and start with a low level of tension on the band.  Concentrate your efforts on the muscles between your shoulder blades as you pull the band apart and bring the hands out to the side.  Let the band stretch across the chest and pull the hands behind the body.  Tempo: Two counts- pull the band apart. Two counts- hold at end range. Two counts- return to the starting position.   Repetitions:  10 – 20 repetitions.

Postural Band Aid

One of the most convenient and easy to perform postural correction activities is an exercise I call the postural band aid.  Take a short length of therapy resistance band and stand up.  Assume a tall posture with a proud chest and the head pulled back.  Hold one side of the band in each hand with the palms up.  Keep the elbows by the side and bent to 90 degrees.  Pull the band apart so that your arms form a letter W with your arms and body.  You should feel a tightening of the muscle between your shoulder blades.  Hold the band apart for three counts and then slowly release back to the starting position.  Perform ten repetitions.

Dynamic Core Stability With Dynamax Medicine Ball

Physical therapy patients and fitness clients often complain of lower back fatigue when using a standing desk.  Solve this problem with some dynamic stabilization training.  Place a Dynamax medicine ball or an under inflated basketball under the desk and take turns elevating one leg up onto the ball.  The round ball creates a degree of instability that kicks in the stabilizers of the pelvic girdle and lower back.  Changing position and relieving stress on the joints in the pelvic girdle and lumbar spine can help abolish symptoms of fatigue.  It is one of the reasons your local saloon has a place to rest your foot when you belly up to the bar.  The majority of standing desk users report an improvement in symptoms using this simple alteration in stance.

Watch the video here

Michael S. O’Hara, PT, OCS, CSCS

 

Learn how some simple exercises can reduce or prevent lower back pain in Mike O’Hara’s article “Daily Lower Back Pain Meditation”.  Jeff Tirrell explains the importance of working with a qualified trainer in a small group.   Do you know the five fitness numbers everyone should know?

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Five Fitness Numbers You Need to Know

Scale bodyweight, bench press maximum, some “girl name” and a time are all fitness numbers your hear in the gym.  If you are interested in optimal performance and health, I have the fitness numbers we all need to know.  Focusing on these numbers will keep you active and independent for a lifetime.

1) WAIST CIRCUMFERENCE

The location of bodyfat is far more important than the amount of bodyfat.  Visceral fat, the kind stored in and around the belly, is the hormonal driver of metabolic syndrome; the precursor to diabetes, elevated blood lipids, high blood pressure, and coronary artery disease.  To optimize health, you need to monitor the diameter of your waistline.  The number you want to know is your waist to height ratio.  You want your waist to be less than half your height.  If your waist size is greater than one half your height, then reducing your waist diameter should be the primary goal of your fitness program.

2) SLEEP TIME

Sleep is the ultimate exercise recovery activity.  One or two nights of sleep deprivation has been shown to reduce gym performance by 25% – 40%.  We need seven to eight hours of restful sleep, each and every night.  The most important benefits of exercise are neural and hormonal.  Sleep reboots our neural software and replenishes the hormonal system.  Medications, respiratory problems, sleep apnea, and obesity all can interfere with sleep patterns.  Fixing these health issues and developing better sleep habits produces magical progress in the gym.  Read the book, Sleep Smarter by Shawn Stevenson.

3) FUNCTIONAL MOVEMENT SCREEN SCORE

The Functional Movement Screen (FMS), developed by Physical Therapist Gray Cook and Athletic Trainer Lee Burton, is a seven-step dynamic movement based test that has become a standard of practice in physical therapy and sports performance centers.  The FMS helps prevent injuries before they occur by identifying risk factors.  Movement indicates how a body works and lets us know how the brain is controlling the body and how the joints and muscles communicate.  Just like a good medical work up, the FMS permits the trainer / therapist to make the proper decision about the clients’ most urgent needs and avoid gym activities that are detrimental.

4) GRIP STRENGTH

Recent research has demonstrated that knowing your grip strength is as important as knowing your blood pressure.  The PURE research of 140 thousand individuals revealed that a drop in grip strength is a strong predictor of mortality from all causes.  We will all face health battles and the stronger body wins while a weaker body loses.

5) NUMBER OF TRAINING SESSIONS PER YEAR

Exercise is ineffective absent consistency.  Even a haphazard program of exercise is beneficial if you perform it on a consistent basis.  The experts say a good goal is 150 training sessions per year.  That is three times a week for 50 of the 52 weeks in a year.  Link together several years of the consistency habit and amazing changes happen.  Most people overestimate the value of a month’s worth of exercise and greatly underestimate the value of a year’s worth of exercise.

Michael S. O’Hara, PT, OCS, CSCS

Hang Up and Drive

While on a recent trip out of town, I witnessed a young man plow his car into the back of a delivery truck.  The young man was gazing down at his mobile phone and failed to stop when the truck in front of him stopped for a school bus.  The airbag did its job and the driver appeared to be unscathed.  The passengers in the back seat of his car did not fair as well and both were taken away in an ambulance.

The technology exists to turn off a mobile phone if it is moving in a car.  The most dangerous thing the average American does in their day is travel in a car.  Mobile phone use makes car travel dramatically more dangerous.  Educational campaigns and fines have not reduced mobile phone use by drivers.  Many people will never be able to control their impulsive addiction to the mobile phone.  Locking out cell phones while the car is moving is the only answer.

Physical therapist clean up the physical damage created by drivers distracted by their cell phones.  Auto accidents often create pain and performance problems that never fully resolve.  Blocking the mobile phone while traveling in a car may have the unintended consequence of restoring the lost art of conversation–you remember talking, don’t you?  While cruising along on this brief bit of magic we call life, you do not want the final sound you hear to be the ring from your cell phone.

Michael S. O’Hara, PT, OCS, CSCS

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

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

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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