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Learn more about Rehab, Sports Medicine & Performance


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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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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Halos And Around The Worlds Are The App For That

halosMuch like the collision avoidance computer systems built into automobiles, our brains run neural software that prevents us from overloading and damaging the spine.  If we are unable to adequately stabilize the spine, our neural injury avoidance system prevents us from loading the arms and legs in positions that will produce a spinal injury.  Developmentally, we master the capacity to control the muscles in the middle of the body first.  What this means for the average fitness participant is that hip/shoulder exercise activities have little value if we do not possess adequate spinal/pelvic girdle stability.  Training that enhances the coordinated control of the “muscles in the middle” enables our neural system to produce more efficient, graceful, and pain-free movement.

Halos and Around the World drills improve the coordinated control of the pelvic girdle and spinal stabilizers.  They act as a “neural reboot” of the software that controls stabilization of the spine and pelvic girdle.  These exercises are easy to learn and require minimal equipment.  An Airex pad under the knees makes the exercise more comfortable and you can use a kettlebell, sandbag, or an Iron Grip weight plate for resistance.

Kettlebell Halos in Tall Kneeling
Assume a tall kneeling position on the Airex pad.  The knees are under the hips and the toes should grip the floor.  Grip the kettlebell by the horns in an inverted position.  Make the shoulder girdle muscles active by pulling out against the horns of the ‘bell.’  Brace the gluteals and abdominal muscles and maintain a tall and stable posture during the exercise.  Start with the ‘bell’ in front of the chest and circle the kettlebell slowly around the head in the shape of an angel’s halo.  Perform three to five halos in clockwise and then three to five counter clockwise.

Sandbag Around the World
Assume a half-kneeling position on the Airex pad.  The left knee is under the hip and the toes of the left foot should grip the floor.  The right knee is in front of the hip and the foot is flat on the floor.  I like the unstable “shifting resistance” provided by a sandbag for this exercise but you can also use an Iron Grip weight plate.  Make the shoulder girdle muscles active by pulling out against the handles of the sandbag or Iron Grip plate.  Brace the gluteals and abdominal muscles and maintain a tall and stable posture during the exercise.  Start with the bag or plate in front of the body at belly button level.  Take the implement around the body in a very slow and steady fashion.  Each repetition should take at least six seconds to complete.  Do not permit the body to shift or shake.  Perform three to five cycles in clockwise and then three to five counter clockwise.  Switch the leg position and repeat with the right knee down and the left leg forward.

For the next six weeks, perform one of these exercises at every training session.  It is surprising how many people report improved capacity to squat, lunge, overhead press, and get off the floor with some dedicated neural retraining of the “muscles in the middle.”

Video demonstration of kettlebell halos and sandbag around the worlds can be seen here: https://youtu.be/LGodn9ImRqc

Michael S. O’Hara, P.T., 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