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Lumbar Spine Fitness Guidelines

Janet injured her lower back while exercising in her local gym.  She was taking a trip through her favorite “ab ciruit” when she felt a snap in her lumbar spine.  The next day she was unable to stand up straight.  Two weeks later, we met her in physical therapy for her initial evaluation.  She was ready to return to her fitness program three weeks later.  Janet was very concerned she may suffer another exercise induced back injury and requested some advice.  These are the simple guidelines I give to physical therapy low back patients returning to exercise.

Mobilize the Thoracic Spine and Hips

Movement is supposed to happen at the thoracic spine and hips.  Unfortunately, prolonged sitting, deconditioning, and poor training choices tends to restrict mobility in these areas.  If you are unable to rotate and extend at the hips and thoracic spine, your brain will use other joints to make up for the deficit.  Pushing extra rotation and extension forces into your lumbar spine is never a good thing.  Dedicate some training time to improving thoracic spine rotation and hip extension / internal rotation range of motion.  If you sit for a living, work on your mobility everyday.

Make the Lumbar Spine Stable

Most fitness clients believe that more lumbar spine movement is a good thing.  They perform toe touches, back twists, and the many breeds of up and down dogs.  Unfortunately, greater lumbar spine range of motion is positively correlated with a higher incidence of lower back pain.  The incidence of low back pain escalates even further when we move those hypermobile lumbar spine segments against a resistance.  What does keep lumbar spines healthy is high level of lumbar spine strength endurance.  Can you hold the lumbar spine stable and prevent movement from occurring at the pelvis and five lumbar vertebrae.  Your lumbar spine stays happy and healthy when you focus training efforts on planks, roll outs, crawls, carries, and Pallof press exercises.  Avoid the sit ups, crunches, sidebends, toes to bar, and other assorted “ab” exercises that create lots lumbar spine motion.

Avoid Muscle Isolation Exercise Activities

The muscles that support the lumbar spine work together as part of a neurally connected team.  Training activities that support better communication between the team members will create optimal performance.  The neuroanatomy saying is “What fires together, wires together”.  Ditch the “upper abs”, “lower abs” baloney and sprint away from anyone who trys to strap you into a machine in an effort to “isolate your obliques”.

On her discharge from therapy, Janet was unable to perform a single roll out and fatigue fairly quickly with a twelve pound suitcase carry.  For the last three months, she has followed the guidelines and her progress has been excellent.   Janet is currently performing a suitcase carry with fifty pounds and has worked up to ten full reps on an ab wheel roll out.

Michael S. O’Hara, PT, OCS, CSCS

In our May issue, Mike O’Hara discusses the importance of walking.  If you have pain or difficulty with walking, there are things that help.  Mike demonstrates some exercises to get you ready.  Be sure to read Jeff Tirrell’s article on squatting, and read about Afterburn–a new class at Fenton Fitness that uses heart rate monitors while training.

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World’s Best Diet Part 9–Fasting

If you google the word diet, you will come up with over 200,000 results.  Every week, month, year, and decade a new study or article comes out claiming certain foods are killing us, or that some other food or nutritional approach will lead us to the promised land.  Unfortunately, articles are written to create traffic, so scientific research is often misreported or spun to sell magazines or generate website traffic.  The truth is, there are many ways to skin a cat.  All of the evidence on nutrition (in regards to weight loss) points to two undeniable truths.  First, that dietary adherence is king.  It doesn’t matter how perfect or evidence based a nutrition plan is, if you can’t follow it, it doesn’t matter.  Before starting any eating plan, you must ask yourself how easy it will be to maintain long term.  Second, you must achieve an energy deficit to lose weight (eat less energy than you expend each day).  Though “calories in, calories out” may be slightly over simplified, it is still the underlying rule to any weight loss success.   For any weight loss plan to work, you must consistently follow the pla, and you must be in a caloric deficit.  This series will highlight the nine most popular current nutrition approaches, and the pros and cons of each.

Fasting

Claims: There are a ton of different approaches to fasting.  The most common are ADF (alternate day fasting) and IF (intermittent fasting).  ADF simply means that one day you eat nothing, followed by a day of standard eating.  IF is a restricted eating format where you don’t eat for a given period of time (16 hours being the most popular) followed by a feeding window where you eat regularly (8 hours in the 16 hour example above).  Every person fasts when they sleep by default, the various fasting protocols simply extend this fast one way or the other.  Purported benefits include improved insulin sensitivity, improved heart health, weight loss, better brain function, and some eve claim better performance.

Reality:  There is nothing magical about fasting.  When calories are controlled for fasting protocols seem to offer many of the health benefits that other diets show (improved heart health, improved insulin sensitivity, weight loss, etc.).  One unique potential benefit is that of life extension.  Several animal studies have shown this to be the case, but more research is needed.

Pros:No off limit foods.  Even without tracking food directly many people will eat less food by reducing the window of time in which they eat food.  This is probably one of the simplest plans to follow in concept.  If you can tell the time you can follow this plan.

Cons: No emphasis on food quality, or protein intake.  May not get enough vitamins and minerals in if you aren’t sure to emphasize getting a large amount of whole and unprocessed foods since you aren’t eating on a daily basis.  May be harder to maintain muscle mass (though research hasn’t shown this yet).  Could lead to binge eating behaviors during the feeding window in some individuals.  If this is you, this plan is not right for you.

Jeff Tirrell, CSCS, CFSC, Pn1

World’s Best Diet Part 8–The Mediterranean Diet

If you google the word diet, you will come up with over 200,000 results.  Every week, month, year, and decade a new study or article comes out claiming certain foods are killing us, or that some other food or nutritional approach will lead us to the promised land.  Unfortunately, articles are written to create traffic, so scientific research is often misreported or spun to sell magazines or generate website traffic.  The truth is, there are many ways to skin a cat.  All of the evidence on nutrition (in regards to weight loss) points to two undeniable truths.  First, that dietary adherence is king.  It doesn’t matter how perfect or evidence based a nutrition plan is, if you can’t follow it, it doesn’t matter.  Before starting any eating plan, you must ask yourself how easy it will be to maintain long term.  Second, you must achieve an energy deficit to lose weight (eat less energy than you expend each day).  Though “calories in, calories out” may be slightly over simplified, it is still the underlying rule to any weight loss success.   For any weight loss plan to work, you must consistently follow the pla, and you must be in a caloric deficit.  This series will highlight the nine most popular current nutrition approaches, and the pros and cons of each.

Mediterranean

 

Claims: This diet emphasizes plant based foods such as fruits and vegetables, whole grains, legumes and nuts.  You are encouraged to use oils instead of butter, spices/herbs instead of salt, limiting red meat to 2x/month, and moderate to low red wine consumption.  The claims are that you will see reduced mortality rates, lower many cancer risks, and improved heart health.

Reality: This is another sensible eating plan that has been around for a long time.  Emphasizing whole foods such as fruits, veggies, whole grains, nuts,  and beans should be a no brainer.  There is a body of literature (albeit correlative in nature) that shows majority of health markers improve on this style of eating plan.

Pros: Fiber rich diet focusing on veggies, fruits, grains, olive oil, nuts/seeds, and legumes.  Encourages the social aspect of eating, and doesn’t directly forbid any food.

Cons: de-emphasizes lean protein consumption  by recommending fish/poultry only be eaten 2x/week, and read meat less than 2x/month.  Following this approach could lead to inadequate protein intakes.  No emphasis on food quantities, which may lead to some people over eating these “healthy” foods.

Jeff Tirrell, CSCS, CFSC, Pn1

World’s Best Diet Part 7–Paleo

If you google the word diet, you will come up with over 200,000 results.  Every week, month, year, and decade a new study or article comes out claiming certain foods are killing us, or that some other food or nutritional approach will lead us to the promised land.  Unfortunately, articles are written to create traffic, so scientific research is often misreported or spun to sell magazines or generate website traffic.  The truth is, there are many ways to skin a cat.  All of the evidence on nutrition (in regards to weight loss) points to two undeniable truths.  First, that dietary adherence is king.  It doesn’t matter how perfect or evidence based a nutrition plan is, if you can’t follow it, it doesn’t matter.  Before starting any eating plan, you must ask yourself how easy it will be to maintain long term.  Second, you must achieve an energy deficit to lose weight (eat less energy than you expend each day).  Though “calories in, calories out” may be slightly over simplified, it is still the underlying rule to any weight loss success.   For any weight loss plan to work, you must consistently follow the pla, and you must be in a caloric deficit.  This series will highlight the nine most popular current nutrition approaches, and the pros and cons of each.

Paleo

Claims: This approach purports to mimic the way of eating during the paleolithic era.  Also known as the caveman diet, the claim is that with the agricultural revolution over the last 2000 years, our diets have outpaced our evolution.  Proponents claim that that many of our health ills today are due to the fact that we have rapidly introduced too many new foods to the homosapien diet such as grains.  The benefits claimed range from reduced disease, weight loss, more/better muscle, improved performance, no need to track intake, and pretty much everything else under the sun.

Reality: Like everything else that over promises, this meal plan falls short.  Though there is nothing inherently bad or wrong with this diet plan, there is also nothing magical.  The whole premise of the meal plan according to Christina Warinner, who is an expert on ancient diets, is false as seen in this Ted Talk.

Pros: Increases protein intake in many individuals, encourages fruit and vegetable intake.  Often time leads to weight loss due to the fact that it eliminates many foods and thus calories from the diet.

 Cons: Needlessly eliminates grains, dairy, and many starches from one’s diet. This can lead to compliance issues long term and may lead to some nutrient deficiencies.

Jeff Tirrell, CSCS, CFSC, Pn1

World’s Best Diet Part 6–Vegetarian/Vegan

If you google the word diet, you will come up with over 200,000 results.  Every week, month, year, and decade a new study or article comes out claiming certain foods are killing us, or that some other food or nutritional approach will lead us to the promised land.  Unfortunately, articles are written to create traffic, so scientific research is often misreported or spun to sell magazines or generate website traffic.  The truth is, there are many ways to skin a cat.  All of the evidence on nutrition (in regards to weight loss) points to two undeniable truths.  First, that dietary adherence is king.  It doesn’t matter how perfect or evidence based a nutrition plan is, if you can’t follow it, it doesn’t matter.  Before starting any eating plan, you must ask yourself how easy it will be to maintain long term.  Second, you must achieve an energy deficit to lose weight (eat less energy than you expend each day).  Though “calories in, calories out” may be slightly over simplified, it is still the underlying rule to any weight loss success.   For any weight loss plan to work, you must consistently follow the pla, and you must be in a caloric deficit.  This series will highlight the nine most popular current nutrition approaches, and the pros and cons of each.

Vegetarian/Vegan

Claims: These diets claim to be healthier because they eliminate animal products as a food source.  Claims are vast and include: reducing cancer risk, improved bone health, lower mortality rates, protecting against chronic disease, etc.  Vegetarian diets are those which do not include flesh/meat of animals (though some do include fish) but will typically do include dairy and eggs.  Vegans on the other hand do not consume any products that come from animals (in some cases even excluding honey).

Reality: All of the claims from Vegans and Vegetarians on superiority for health come from correlative studies which do not control for confounding variables.  They simply take a survey and use correlations to draw conclusions.  Correlative research cannot draw conclusions, it can only direct us toward areas that need further study.  Of the 6 studies to ever look at health outcomes among vegetarians and vegans, 3 showed reduced mortality for meat eaters, while 3 showed reduced mortality for non-meat eaters.  The 3 studies that showed advantage to vegetarians all compared religiously motivated groups to general population (who tend not to be overly concerned about their health).

Pros: Tends to encourage the consumption of more whole grains, fruits, and vegetables.

Cons: Often leads to inadequate amounts of protein being consumed.  Anytime entire food groups are removed, there is an increased risk of deficiencies.  In this case, the following nutrients may be compromised: B12, Vitamin D, Calcium, Iron, Zinc, and Iodine.  Protein is the most satiating macronutrient, meaning it tends to fill you up more than fats or carbohydrates.  If protein levels drop, as is often the case in these diets, the chances of over consuming calories rises.  Low muscle mass levels are a risk due to inadequate protein intake.  In my experience, I have only met 2 (out of around 30) vegetarians over the last 20 years who were not either overweight and/or under muscled.

Jeff Tirrell, CSCS, CFSC, Pn1

World’s Best Diet Part 5–The South Beach Diet

If you google the word diet, you will come up with over 200,000 results.  Every week, month, year, and decade a new study or article comes out claiming certain foods are killing us, or that some other food or nutritional approach will lead us to the promised land.  Unfortunately, articles are written to create traffic, so scientific research is often misreported or spun to sell magazines or generate website traffic.  The truth is, there are many ways to skin a cat.  All of the evidence on nutrition (in regards to weight loss) points to two undeniable truths.  First, that dietary adherence is king.  It doesn’t matter how perfect or evidence based a nutrition plan is, if you can’t follow it, it doesn’t matter.  Before starting any eating plan, you must ask yourself how easy it will be to maintain long term.  Second, you must achieve an energy deficit to lose weight (eat less energy than you expend each day).  Though “calories in, calories out” may be slightly over simplified, it is still the underlying rule to any weight loss success.   For any weight loss plan to work, you must consistently follow the pla, and you must be in a caloric deficit.  This series will highlight the nine most popular current nutrition approaches, and the pros and cons of each.

The South Beach Diet

Claims: The South Beach Diet says that its balance of good carbs, lean protein, and healthy fats makes it a nutrient-dense, fiber-rich diet that you can follow for a lifetime of healthy eating.  It focuses on eliminating “bad” carbs that are high on the glycemic index scale (meaning these foods increase blood sugar quickly when eaten in isolation).  The diet also encourages the consumption of monounsaturated fats, limiting “unhealthy” fats, and consuming whole grains and other fiber rich foods.  The diet is set up in 3 phases.  Phase 1 eliminates virtually all carbohydrates and is claimed to help eliminate cravings. Phase 2 re-introduces “healthy” carbs and is the weight loss phase.  Phase 3 is the maintenance phase where you continue to use what you learned to do in the first two phases, but other foods can also be eaten in moderation.

Reality: This is another sensible meal plan which allows for eating a balance of lean protein, whole grains, and variety of fat sources.  The only fault with this program is the emphasis on low glycemic carbohydrates.  The Glycemic Index is based on what foods do in isolation.  If other foods are eaten in conjunction with these items, the blood sugar response can be greatly altered.  On top of that, even if a food does rapidly increase blood sugar, it doesn’t inherently make it a poor food choice, and weight loss can still be achieved with these foods assuming portions are monitored.

Pros: Encourages lean protein consumption, fiber rich foods, whole grains, and variety of fat sources.

Cons: Creates an undue fear of certain types of carbohydrates and doesn’t directly advise on portion sizes.

Jeff Tirrell, CSCS, CFSC, Pn1

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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World’s Best Diet Part 4–IIFYM

If you google the word diet, you will come up with over 200,000 results.  Every week, month, year, and decade a new study or article comes out claiming certain foods are killing us, or that some other food or nutritional approach will lead us to the promised land.  Unfortunately, articles are written to create traffic, so scientific research is often misreported or spun to sell magazines or generate website traffic.  The truth is, there are many ways to skin a cat.  All of the evidence on nutrition (in regards to weight loss) points to two undeniable truths.  First, that dietary adherence is king.  It doesn’t matter how perfect or evidence based a nutrition plan is, if you can’t follow it, it doesn’t matter.  Before starting any eating plan, you must ask yourself how easy it will be to maintain long term.  Second, you must achieve an energy deficit to lose weight (eat less energy than you expend each day).  Though “calories in, calories out” may be slightly over simplified, it is still the underlying rule to any weight loss success.   For any weight loss plan to work, you must consistently follow the pla, and you must be in a caloric deficit.  This series will highlight the nine most popular current nutrition approaches, and the pros and cons of each.

IIFYM (If It Fits Your Macros)

 

Claims: The IIFYM diet approach shares many characteristics with Zone and Weight Watchers.  It has its roots from the bodbuilding.com forums back in the 2004-2008 time.  At this time, many forum posters would routinely ask if it was ok to eat a given food while dieting and trying to decrease body fat.  There was a notion (and still is) that certain foods are totally off limits and ignorance of the role of energy balance and protein intake on success.  IIFYM can be different for everyone, but the basic premise is the same.  You have a certain target for total calories, protein, carbohydrates, and fat that you need to hit to be successful with your weight loss goals.  As long as those numbers are hit, then the food quality and micronutrients don’t matter.

Reality: If you hit a given caloric intake target below your maintenance intake needs for long enough, you will absolutely lose weight, regardless of food quality.  If you  hit a certain protein intake this will ensure that you are less likely to lose muscle mass in the process.  Carbohydrate and fat intakes will be dictated by food preference and performance goals.  There have been countless case studies proving that calorie intake is king ( Twinkie Diet , McDonald’s Diet , 100 Day Ice cream Diet ).

Pros: Allows lots of dietary flexibility.  Gives protein minimums.  Encourages accurate tracking of foods and quantity.

Cons: Potentially ignores food quality and micronutrient intake.  Many people have taken this approach as a pass to eat low nutrient foods as long as they are hitting their targets.  Can leave people feeling trapped if they can’t accurately measure or track a food at a social event or restaurant.

Jeff Tirrell, CSCS, CFSC, Pn1

World’s Best Diet Part 3–Weight Watchers

If you google the word diet, you will come up with over 200,000 results.  Every week, month, year, and decade a new study or article comes out claiming certain foods are killing us, or that some other food or nutritional approach will lead us to the promised land.  Unfortunately, articles are written to create traffic, so scientific research is often misreported or spun to sell magazines or generate website traffic.  The truth is, there are many ways to skin a cat.  All of the evidence on nutrition (in regards to weight loss) points to two undeniable truths.  First, that dietary adherence is king.  It doesn’t matter how perfect or evidence based a nutrition plan is, if you can’t follow it, it doesn’t matter.  Before starting any eating plan, you must ask yourself how easy it will be to maintain long term.  Second, you must achieve an energy deficit to lose weight (eat less energy than you expend each day).  Though “calories in, calories out” may be slightly over simplified, it is still the underlying rule to any weight loss success.   For any weight loss plan to work, you must consistently follow the pla, and you must be in a caloric deficit.  This series will highlight the nine most popular current nutrition approaches, and the pros and cons of each.

Weight Watchers

Claims: Weight Watchers markets itself as being flexible and livable.  They assign food points based on their “Smart Points System”.  They encourage the consumption of fruits, vegetables, and lean proteins, and discourage the consumption of sugar and unhealthy fats with this points system.  They even list 200 different foods as being “zero points foods”.  They encourage tracking of food and claim to be successful at helping people achieve long term sustainable weight loss.

Reality: Tracking your food intake in any way is usually helpful when it comes to weight loss–if done accurately.   The points system is really just a complicated marketing scheme similar to simply tracking calories, which anyone can do on their own for free.  There are no zero foods in existence that have no caloric impact, so the notion of “zero points” foods is ludicrous.  Any food eaten in excess can and will slow weight loss and/or lead to weight gain.  Every person I’ve ever met who was a lifelong Weight Watchers client had success with the program, but was 40+ pounds overweight..

Pros: Allows for dietary flexibility which should improve long term adherence.  Requires tracking of food and portion sizes.  If you opt into monthly meetings, there is an accountability factor built into it.

Cons: No minimum requirement given for protein intake.  Allows certain foods to be eaten with no limit.  Not a good long term success rate (think Oprah’s weight swings).

 

Jeff Tirrell, CSCS, CFSC, Pn1

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