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Intensity Know How

Exercise Intensity Is a Mystery For Most Fitness Clients

Cheryl trained in the gym three days a week and went to yoga class twice a week.  At the gym she used the elliptical machine for thirty minutes and did the “ab circuit”.  The yoga classes lasted an hour and she was always very tired after a session.  Despite six months of this program, she had not lost any fat and her blood pressure remained elevated.  After recovering from a heel pain problem, Cheryl began training at Fenton Fitness.  After her first session, it was evident what was stopping Cheryl from reaching her goals.  She had no idea what constitutes effective exercise intensity.

Cheryl’s problem is not an uncommon one.  Many fitness participants overestimate how hard they are exercising.  What they perceive as a moderate or intense work level is actually a low exertion level.  As the body accommodates to the same exercise stress repeated day after day, the intensity level falls even further.  A recent article by Gretchen Reynolds in the June 12, 2014 issue of the New York Times discusses a recent study on the overestimation of exercise intensity.

Many fitness clients and rehab patients are not comfortable with being uncomfortable.  They stop an exercise activity well before they reach a level that will produce a training effect.  They require guidance and reassurance that the feelings they get when heart rate and body heat elevate are normal and necessary.  Heart rate monitors are often the solution for these clients.  Gradually introducing ten second intervals of exercise at 70% of age adjusted maximums on a bike or treadmill followed by a fifty second recovery will get the client accustomed to the feeling of more intense exercise.  Having the client wear a heart rate monitor while walking and monitoring sensation while making an effort to push up the rate with faster paces and uphill walks is effective.

Cheryl felt lightheaded and short of breath during her first five exercise sessions but, after using a heart rate monitor and becoming accustomed to the intensity of each session, she started feeling better.  Four months later, she was able to stop taking one of her blood pressure medications, and she had lost eight pounds.  Cheryl now knows what mild, moderate, and intense exercise sessions feel like and no longer uses her heart rate monitor.

To view the New York Times article, click the link: http://well.blogs.nytimes.com/2014/06/11/judging-badly-how-hard-we-exercise/

Michael O’Hara, P.T., OCS, CSCS

Falling In Love With Fitness

Fall Prevention And Intervention

fallMrs. J. had pain in her lower back and left hip.  The problem had been present for over a year, and she sought treatment in physical therapy because the pain was making it difficult to get in and out of her car and work in the garden.  At 73 years of age, Mrs. J. lived in Michigan during the summers and traveled south for the winters.  She enjoyed working in her garden, visiting with friends, and walking on the beach in Florida.  On further discussion, Mrs. J. reported that she had fallen three times over the previous year.  Two falls occurred while getting out of bed and once while working in her yard.  She did not bother to tell her doctors about these falls because she had not been injured.

Mrs. J. had all of the factors that placed her at high risk for falling in the future.  She was over 65 years of age.  She took four medications, two of which had psychoactive effects.  She had a prior history of falls in the past and she was weak.

Falls are the leading cause of accidental death for those 65 years and older.  Just over a third of the population over 65 falls every year.  One half of those falls happen to individuals who have fallen before.  It is the most common injury related hospital admission.  In 2012, we had over 340 thousand hip fractures from falls in this country.

Risk Factors For Falls
A prior history of falls.  If you have fallen in the past you are more likely to fall again.

Balance impairment.  If you are unable to balance on one leg or you lose your balance easily when you close your eyes, then you are at greater risk.

Strength deficits.  The weaker you are, the more likely you are to fall.

Postural hypotension.  A twenty point fall in systolic and/or a ten point drop in diastolic blood pressure on changing position from supine to standing places you at a greater risk of falling.

Visual impairment.  If you are unable to see the dog, curb, or chair, you are more likely to have a collision and subsequent fall.

Multiple medications.  Taking more than four medications is related to more frequent falls. The risk is amplified if the medications have a psychoactive component.   Several studies have identified antiepileptic medications as more problematic.

Dementia.  Cognitive impairment doubles the risk of falling.

Post hospital stay.  For the two weeks after a hospital stay, you are four times more likely to fall.

What Definitely Helps
Home assessment and modification.  In my experience, peace in the Middle East may be more readily attained than getting grandma to move her rug and install a grab bar in the bathroom, but it is what has been shown to reduce falls in higher risk individuals.

Exercise programs.  Strength, balance, mobility, and power production activities.  The activities should take place in a standing position and should be tailored to the specific needs of those at risk.  These programs work–you just need to do them.

What is Likely to Be Beneficial
Vitamin D supplementation.  Several studies have documented fewer falls in individuals that supplement with Vitamin D.  The mechanism for the decrease in falls is not known, but it seems to work.

Medication review.  If possible, minimize psychoactive medications and reduce the total number of medications.  Discuss this with your physician before making any changes in your medications.

Assessment and awareness of postural hypotension.  If blood pressure drops with transfer from supine to sit to stand, you are at higher risk for falls.  A simple blood pressure test performed in the doctor’s office can determine if you have this problem and enable management of this risk factor.

Vision assessment and management program.  Get your eyes checked and consult with your doctor on a treatment plan to keep your vision as healthy as possible.

Better footwear.  This is the most common sense advice, but it gets the lowest level of compliance.  Ladies those shoes look nice, but that pin in your wrist looks a lot worse.

Mrs. J. had a blood pressure assessment that showed her systolic pressure dropped twenty-two points with transfer from supine to standing.  We contacted Mrs. Js’ family physician to alert her of her patient’s recent fall episodes and blood pressure findings.  Mrs. J. was taken off one of her medications and her blood pressure improved.  The pain in her hip and lower back resolved, and she was able to perform a program of exercise to improve balance, strength, and mobility.  Mrs. J. completed five weeks of therapy and then continued with her exercise program at our fitness center.  She has been exercising three times a week for the last two years and has not had another fall episode during that time.

Michael S. O’Hara, P.T., OCS, CSCS

How Less Is More

Get Bored And Get Better At A Few Basic Exercises

The weight room at my high school was small and had only basic equipment.  It consisted of two Olympic weight set, some mismatched dumbbells, a squat rack, and a chin up bar.  In the gym, we had a pegboard and a rope for climbing.  No bench press, curl bar or pulldown machine.  It was the ultimate blessing in disguise.  We did not have the temptation of exercise variety for varieties sake.  What we did have was solid instruction on basic lifts.  We performed the same exercises repeatedly and became more proficient at squats, hang cleans, overhead presses, and pull ups.  Four simple activities performed consistently with an effort to add weight to the bar on a regular basis.  The results were magic.

The television fitness gurus have brought forth the latest craze of “muscle confusion”.  You change your exercise activity often in an attempt to stimulate a greater adaptation response.  The problem is that you never get the chance to practice the exercise long enough or with enough resistance to get stronger.  Getting stronger is the performance parameter that preserves muscle mass, speeds up your metabolism, and makes you more durable–less likely to get hurt.
I never want any of my muscles, nerves, joints, or any other part of my body to be “confused” when training.  I want the bodies of the athletes I train to perform better at every session.  My suggestion is that you pick five or six exercises and set a goal of getting better at each of them over the next six months.  The exercises you chose do not have to be a barbell or dumbbell exercise.  Bodyweight exercises will work just as well and are a better choice for most fitness clients.  Keep a record of your performance and work on improving the number of inverted rows, pull ups, or push ups you can perform.  Single leg strength training is a good choice for nearly everyone and works wonders for athletes. Athletes should choose exercises that not only improve strength but also mobility—front squats.  Long term dedication to the mastery of an exercise will reward you with better body composition, enhanced mobility, less pain, and the strength you need to perform in athletics and daily activities.

This training approach requires mental toughness and a willingness to at times be bored.  Toughen up and get after the challenge.  Read this recent article in the New York Times.   Better yet go out and buy the book Starting Strength.

Read the NY TIme’s article here: http://www.nytimes.com/2014/05/25/opinion/sunday/fitness-crazed.html?_r=0

Michael S. O’Hara, P.T., OCS, CSCS

Spine Unwind

An Exercise That Prevents Lumbar Rotation

Your brain is a master of physical manipulation.  It has the capacity to move your body by any means necessary.  If your hips and thoracic spine are stiff, weak, and unable to rotate, it will demand rotation from your lumbar spine.  Frequent and excessive rotation at the lumbar spine is never good.  The five lumbar vertebrae are only able to handle 10-13 degrees of total rotation before bad things start happening.  In our treatment of patients with chronic lower back pain, our physical therapists work to restore thoracic spine / hip mobility and reduce rotational movement in the lumbar spine.  Lower back pain can be trained away with better control of excessive lumbar rotation.  One of our favorite anti-rotation core stability exercises is the Pallof Press.  This exercise deserves a greater presence in the programs of the general fitness population.

Why You Should Do It
Nearly everyone can perform a Pallof Press.  If you can stand up without assist, you can perform the Pallof Press.  Physical therapy patients start with light loads and usually progress quickly.
It is one of the few exercises that will strengthen the abdominal / back muscles that resist rotation of the lumbar spine and improve hip stability at the same time.
The Pallof Press develops the proprioceptive awareness you need for better posture.  It is a great exercise for those suffering from the epidemic of SNSS -soggy noodle spine syndrome.
It can also be used to teach better breathing patterns.

You need a cable machine or resistance tubing set at mid torso level.   Position your body at a 90 degree angle in relation to the pull of the cable.  Assume an athletic posture with the feet at least shoulder width apart and the spine neutral.  Push the hips back a little and keep a slight bend in the ankles and knees.  You should look like a tennis player preparing to return an opponent’s serve.  Use a strong overlap grip on the handle and set the hands in the middle of the chest.  Brace the midsection and hips and move the handle out in front of the body and then back to the chest.  Select a resistance level that permits execution of all repetitions without losing the set up posture.  If one side is more difficult, start the exercise on that side.  Perform fifteen repetitions on each side.

Many of us have terrible respiratory patterns.  We are unable to fully inhale and exhale when under any physical stress.  The Pallof Press can be used to improve respiratory control.  Use the same set up and press the cable out.  Hold the cable with the arm fully extended while inhaling for four seconds and exhaling for six seconds.  Bring the arms back in and then repeat.  Perform four of five inhale / exhale respiration repetitions on each side.
You can make the exercise more difficult by adding more resistance, but I like to use a change in the base of support as the initial progression.   Assume a split stance and perform the Pallof Press with one leg forward and one leg back.  The half kneeling Pallof Press is an excellent injury prevention exercise.  During this exercise you want a firm anchor to the ground so avoid the Bosu, Physioball, and other circus versions of this exercise.

Michael S. O’Hara, P.T., OCS, CSCS

Rolling Over

Creating Strength With The Lifeline Power Wheel

True core stability involves holding your pelvis, spine, and rib cage in a solid, stationary position while you move the arms and the legs.  When you run, jump, lift, or carry, the muscles in the middle must efficiently transfer force from the lower extremities through your pelvis and spine to the arms.  Any weakness in the “core stabilizers” creates a power leak that reduces performance and makes you more susceptible to injury.  The Lifeline PowerWheel is one of my favorite core stability training tools for plugging those leaks.

Your core stabilizer muscles act to prevent or limit joint movement.  They function as anti-extensors, anti-flexors, and anti-rotator muscles.  Exercising with the Lifeline Power Wheel trains all aspects of core stability.

PowerWheel Roll Outs
Kneel on a mat to keep the pressure off your knees.  Your femur (thigh bone) is positioned straight up and down from the floor and the hips are hinged at 45 degrees.  Place the hands on the padded handles of the Power Wheel and the elbows directly under the chin.  Brace the abdominal muscles and roll out until you feel a challenge through your midsection.  Hold the challenging position for three counts and then return to the starting position.  Perform five to ten repetitions.

PowerWheel Resisted Roll Outs
Progress the roll out by adding a sandbag across your back or wearing a weight vest.  Challenge yourself even more by attaching resistance tubing to the PowerWheel.  The forward pull of the tubing will make it more difficult to pull back up to the starting position.

Wheelbarrow Walking
Velcro strap the Power Wheel onto your feet and assume the push up plank position.   Tighten up the gluteals and shoulder girdle muscles and walk down the turf.  Do not let your middle sag and try to keep a steady pace.  Twenty yards is a good goal for a beginner.

Alligator Push Ups
Set up just like the wheelbarrow walk, but instead of just traveling down the turf, perform a push up with every step you take with the arms.  Alligator Push Ups are tough–if you can travel twenty yards you have my compliments.

PowerWheel Jackknifes
Assume push up plank position with the wheel on your feet.  Draw the knees up toward your elbows and try to keep the hips from rising more than six inches.  Hold for one count and then return to the starting position.  Try to work up to ten solid repetitions.

Power Wheel Leg Curls
Lay on your back with the Power Wheel Velcro strapped to your feet.  Place the arms to the side and use the gluteals and hamstrings to bend the knees and extend the hips as you curl the wheel up toward your butt.  Return to the start position and repeat for five to ten repetitions.
Michael S. O’Hara, P.T., OCS, CSCS

Slam Ball Conditioning

Slam balls are compact, non-bounce,  medicine balls that weigh between 10 and 25 pounds.  They enable performance of high velocity throws into the ground without the worry of the ball bouncing back up into your face.  Slam ball training reinforces the triple flexion/triple extension movement patterns necessary for success on the playing field and daily activities.  The faster speeds created with slam ball drills makes them an excellent tool for training power production.  Conditioning drills with a slam ball will ramp up your metabolism and improve how you move.

Power Production
Most of the exercise activity you see in commercial gyms is of the slow and controlled variety.  It is deemed a safer and non-intimidating method of training.  Unfortunately, it is ineffective.  Most deconditioned individuals are already masters of slow and controlled movement.   What they need to learn is how to move at faster speeds if they wish to function better and remain injury free.   No one ever slowly twisted an ankle or slowly fell and fractured a hip.

Metabolism Boosting
Slam ball training produces a training stimulus similar to sprinting.  This creates and preserves more of the fast twitch muscle fibers that make us strong and lean.  Unlike traditional cardio, you never accommodate to slam ball training–a heavier ball or harder drill is always waiting for you.  Ramping up your metabolism with slam ball training is an excellent method of reaching body composition goals.

Triple Extension to Triple Flexion Transfer
The smooth and efficient transfer from a multi-joints flexed position to a multi-joints extended position is the essence of athletic training.  You need to be good at these patterns to jump, hop, skip, or get out of a chair.  The weight of the slam ball acts on your neural pathways and reinforces the link between the hips and shoulders as you deliver the ball to the ground.

Slams Are Scalable To Any Fitness Level
Pick the weight and slam ball drill that is appropriate for your level of fitness.  In the video link below, you can start with a basic overhead slam and work up to more aggressive jumps and sprawls.  Start out with performing three or four sets of five repetitions and, as you get better at the drills, progress to timed intervals.

At FFAC, we integrate slam ball throws in our conditioning training sessions.   In our team training classes, we perform a steady pattern of slams for thirty seconds followed by a short rest and then move to a rope drill or a suspension trainer activity for another thirty seconds.
Michael S. O’Hara, P.T., OCS, CSCS

We Are Climbing…

Jacob’s Ladder Takes You Up The Fitness Mountain

A pair of Jacob’s Ladder climbing machines have recently arrived at Fenton Fitness.  The Jacob’s Ladder is a 40 degree inclined total body conditioning activity.  The ladder is self-propelled and your position on the ladder sets the pace of the climb.   Training on the Jacob’s Ladder unloads the spine, challenges your core, improves coordination, and activates the beneficial crawling pattern.

All Crawl
At one time, we could all crawl, and we did it very well.  The crawling performed by an infant develops the strength and coordination necessary to stand upright and walk.  Many people are unable to even get into the crawl position.  Crawl activities help restore joint stability, coordination, and balance.  All of us have established neural pathways for crawling.  They are just cluttered up and inhibited by prior injuries, poor posture, bad training habits, and a sedentary lifestyle.  Performing some Jacob’s Ladder climbs will help bring those pathways back to life.

Shoulder-Spine-Pelvis Connection
The core consists of everything that links the shoulder, spine, and pelvis together.  The muscles are arranged in an interconnected, spiral, and diagonal fashion.  They are wired to connect your left hip with the right shoulder and the right hip with the left shoulder.
The Jacob’s Ladder creates the anti-rotation and anti-extension forces that these muscles are expected to control.

Unloading the Spine
Sitting increases the load on your lumbar disc by 80-120%.  Running creates an impact of 2 to 4 times your body weight with every stride.  Rowing loads the lower lumbar segments, and as your legs get stronger, the compressive loads on the spine increase.  Lower back pain is one of the biggest reasons patients visit the ER, attend physical therapy, and see the chiropractor.  The statistics tell us that lower back pain is the number one injury for the average gym member.  If you have reason to be concerned about your lower back, try using the Jacob’s Ladder as your primary conditioning tool.  The forward lean and all-fours position unloads the spine and improves strength in the lumbar stabilization muscles.

How To Use the Jacob’s Ladder
Wrap the belt around your waist with the emblem set over the side of your right hip.  Adjust the white section of the strap so that it matches your height.  Step onto the ladder and start climbing.  Initially, place the hands on the side rails and get use to climbing with just the legs.  Once you get comfortable with the stride pattern, progress to using the hands on the rails.  When you are ready to stop, simply ride the ladder to the bottom and the ladder will stop.

Proper Form
Work on improving your coordination and form during the initial Jacob’s Ladder sessions.  Keep your back flat, hips low, and the shoulder blades down your back.  Maintain a neutral neck position–do not look up.  Contact the rung with the front of your foot and not the mid arch region.  Reach up so that you grip the ladder rung while it is slightly above your head.  Next week, I will have some training suggestions for the Jacob’s Ladder.

Michael S. O’Hara, P.T., OCS, CSCS


Snapshot 1 (4-30-2014 10-51 AM)Choose A Climbing Challenge

Jacob’s Ladder Routines

The Jacob’s Ladder is the latest addition to the training toolbox at Fenton Fitness.  Last week, we went over the why and how of the Jacobs Ladder.  Today, I have some suggestions on training routines you can implement with the Ladder.  Give these a try and let me know how you do.

Just Getting Acquainted Intervals
Most of us will need to work on the coordination component of the Jacob’s Ladder.  It is a bit like learning how to ride a bike—once you master the movement it becomes easy.  Start with three intervals of 200 feet.  Jump on and when you reach 200 feet step off.  Rest, and when you feel ready, go another 200 feet.  Rest again, and repeat one more interval.  The rest between intervals will make it easier to develop the coordination skills needed to use the Jacob’s Ladder.

1000 Feet Challenge
After you are comfortable with using the Jacob’s Ladder, try this test.  I think it is an excellent measure of athletic strength/endurance.  This test is simple–see how long it takes you to climb 1000 feet.  Start the stopwatch and climb.  You can rest as needed.  Record the total time it took to climb 1000 feet, and every two or three weeks, check your fitness level with another 1000 feet challenge.

Ladder and Swings
The Jacob’s Ladder is a great device for cardio-strength training.  Pairing up a resistance exercise with the Ladder produces an intense metabolic jolt.  This is my favorite pairing to date.  Strap into the Jacob’s Ladder and start your stopwatch.  Climb 200 feet on the Ladder and then perform 20 kettlebell swings.  Repeat this pairing three times and record how long it takes you to get done.  On your first attempt at this routine, use a lighter kettlebell as it is a demanding session.

Ladder Ladders  
This routine will help you develop better endurance.  Climb 100 feet and rest 60 seconds.  Climb 200 feet and rest 60 seconds.  Climb 300 feet and rest 60 seconds.  Climb 400 feet and rest 60 seconds.  Climb 500 feet and rest 60 seconds.  If you feel strong enough, climb back down 400-300-200-100 feet.

Save My Baby Sprints
You are the fireman.  The building is on fire and the lady with the baby is at the window.  Hold onto the side rails and sprint up to that baby located 200 feet up.  Rest 30 seconds and then go get another baby.  Try saving four babies.

Tenzing Says Its Easy
Bring out your inner Sherpa with the Mount Everest Challenge.  See how long it takes you to climb 29,035 feet.  On the Jacob’s Ladder web site someone did it in six days!  That divides out to 4,839 feet a day.

Michael S. O’Hara, P.T., OCS, CSCS

Exercise Of The Week–Sled Sprints

Improve anaerobic conditioning. Improve speed and power of the legs.

Strengthen and increase power in the hipflexors, glutes, hamstrings, and calves. Improve efficiency of the glycolytic energy system. Increase fast twitch muscle fibers with less impact or stress than sprints or jumps.

Load a sled with 25-50% of your bodyweight. Extend arms and grab handles toward the top. Brace your core and keep a straight spine from the back of your head to your hips leaning slightly into the sled.

Once into position, initiate sprint by leaning slightly more into the sled. Quickly and forcefully flex the hip joint of one leg while simultaneously extending the other leg. Repeat this action as quickly as possible until you reach the desired distance.

Not keeping arms extended. Using too much weight so that speed can’t be maintained. Not leading into the sled. Failing to move as fast as possible.

Jeff Tirrell, BS, CSCS

the_outskirts_of_a_family_of_three_highdefinition_picturePhysical Literacy Part 2

The Expert’s Advice On Improving Physical Literacy In Children

the_outskirts_of_a_family_of_three_highdefinition_pictureThese are the most frequently voiced suggestions I have taken from the Canadian Physical Literacy program and from many of the physical therapists, coaches, and physical education experts who work with youth programs.  Most of the advice is simple and straight forward.  I did not say it would be easy.  

Family Affair
Make family decisions that improve and develop physical literacy.  Children learn from the examples set by their parents.  Families that make physical activity part of their life develop children with greater physical literacy.  

Start Slow
When a child learns to read, he does not start with a novel.  Physical activity is no different.  Start slow and work at your child’s speed and not yours.  You will build more confidence and positive feelings with frequent successful activity sessions.  

Start Early
The research shows that as children develop, they have windows of neurodevelopmental capacity that open and then close.  Similar to how it is easier to learn a second language at an early age, learning how to move is easier during these formative phases.  The neural connectivity that is necessary for balance, coordination, and power is more plastic and amenable to training at early ages.  

Learn a New Skill Together
Find a golf instructor who will teach you and your child together.  Take tennis lessons together as a family.  Buy some skis and learn how to downhill ski as a family project.  Get involved in archery, mountain bike riding, hiking, paddle boarding, kayaking.  Find an activity that you enjoy and learn a new skill together.    

Play All Sports
The tendency today is to have children specialize in one sport from an early age.  Coaches sell training programs to parents that promise a college scholarship with 10,000 hours of proper practice.  You develop a more competent and injury free athlete with the time tested system of multiple sport participation.  Ask Wayne Gretzky, Michael Jordan, Russel Wilson, Tony Gonzalez, Tom Glavine, John Elway, Bob Hayes…

Praise Participation More Than Performance
Children need to hear positive and consistent praise when they participate in physical activity.  Give them a pat on the back for having the discipline to get up early for a cold day of soccer practice, a “high five” for going to karate class on a night they would rather stay home.  Reinforce the positive behaviors that lead to a lifetime of physical activity.  

Get Some Help  
Enroll your children in martial arts training, dance classes, gymnastics sessions, or sports performance programs.  If they express an interest in volleyball, basketball, or tennis, there are programs for every skill level. You just need to look.  Find something they like and get them to a trainer or coach who will instill in them a love for that particular physical activity.   

Michael S. O’Hara, P.T., OCS, CSCS