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Learn more about Rehab, Sports Medicine & Performance


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In the February issue of our newsletter, Mike O’Hara discusses ways to improve hip mobility and strength.  Read Jeff Tirrell’s article on why dairy products may actually be good for you.  Having back pain doesn’t mean you can’t have a fitness program.

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In the January 2018 issue, Mike O’Hara focuses on strengthening your hamstrings.  Exercises to make your hamstrings stronger, not longer are given along with video demonstration.  Jeff Tirrell tells us how to make incremental changes in our diets to see positive changes, and the spotlight is on Fenton Fitness member, Robin Forstat–a nationally ranked power lifter.
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PDFRead about keeping your hip flexors healthy and working well in Mike’s article, Nobody Names Their Child Iliacus.  Video instruction of the exercises in the article is available.  Jeff Tirrell gives five nutrition rules than can be broke.  Find out the correct way to set up your dual action air assault bike.

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PDFFind out if you scalenes are causing problems in Mike’s article, Scalene Salvation.  Read the inspirational stories of some Fenton Fitness members who conquered osteoporosis.

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Remember What You Wrote

Things I’ll Do Differently When I’m Old

Steven Petrow of the New York Times wrote a great article, Things I’ll Do Differently When I’m Old.  As a physical therapist that has guided thousands of 60 year plus individuals through the rehabilitation process, I have some suggestions.

I will work with a professional on developing a sustainable fitness program.  The preventative against age related physical decline is a program of exercise.  Consistent exercise reduces fall risk and maintains independence.  No other modality has a greater impact on health.  Blood sugar levels, respiratory capacity, mental health, and cardiac fitness all respond favorably to exercise.  Do not be a fitness “do it yourselfer”.  Older, deconditioned, and previously injured individuals get much better results when under the direction of a qualified professional.   One way or the other, you are going to spend time and money on your health.  Spend it up front–you will be much happier.

I will not let pain linger. Pain is not a “normal part of aging”.  Chronic pain alters brain chemistry and destroys healthy movement patterns.  Left untreated, pain has the capacity to weaken and spread damage to joints not involved with the initial pain provocation. See a physical therapist and find out what you can do to resolve pain issues before they become chronic.

I will exercise caution with medications that have an effect on the central nervous system.  Many older people take multiple medications that impact brain neurochemistry.  More brain real estate is devoted to movement than reading, writing, and arithmetic.  A steady diet of pain medications, sleeping pills, and anti-depressants takes a toll on coordination, balance, and the ability to safely get around town.  Add in a cocktail or three and you have a dangerous combination.

I will make a sustained effort to recover from any and all physical challenges.   As we travel through our senior years, most of us will experience a health setback that requires rehabilitation.  Full recovery of strength, mobility, and function takes eight to twelve months.  Many physical therapy patients stop all rehab efforts way too soon.  More of the rehabilitation battle is being fought in isolation as reimbursement for physical therapy care is shrinking.  You may be done with formal physical therapy in four weeks, but you need to continue with a restorative exercise program for much longer.

I will not get fat.  Physical therapy patients that are overweight have much more difficulty recovering from an injury or a challenge to their health.  Sarcopenia is the medical name given to age related loss of muscle mass.  Adding extra fat onto a body that is losing muscle creates an environment that makes movement more difficult and pain more prevalent.

I will listen and answer all questions from my health care provider to the best of my ability.  The answers we get from the patient are the clues that lead us to the proper care.  We need to know how your pain / symptom behaves and the effect it has on your life.  Please do not omit any information that you feel is not important or unrelated to your condition.  Do not lie about any aspect of your functional status, medications, mental health, etc…  Your therapist, doctor, or physician assistant cannot help if we do not have all of the information.

I will plan ahead.  In my dealings with older physical therapy patients, these are the three things that make life easier for both the patient and their families.  Do what you can to manage these issues while you are healthy and clear headed.

  1. Have a Will with end of life directives.
  2. Insurance coverage that reduces the expense of long-term care.
  3. Pre-planned funeral services and insurance

Michael S. O’Hara, PT, OCS, CSCS

Read the NY Times article here: https://www.nytimes.com/2017/12/05/well/family/thing-ill-do-differently-when-im-old.html?_r=0


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

Wise Up Bone Head

Bicycle Helmets and Head Injuries

While on a much needed family vacation, Larry and his wife ventured off for a bicycle ride around the resort.  Larry is not sure what happened, but he woke up in the hospital with a severe wrist fracture and a concussion.  Larry was not wearing a helmet and his wife reported that he went over the handlebars during a low speed turn.  Surgical repair of the wrist and some therapy restored his ability to grip, lift, and carry, but his mental capacity has remained impaired since the fall.  He has been unable to return to work secondary to memory deficits and problems with planning.  Larry has difficulty remembering the names of his coworkers and neighbors.  His wife reports he is more emotional and that she cannot let him drive without a navigator to assist in the return home.  Every physical therapist has a number of these stories.

If you or your children ride a bike, take the time to read. Buckle Up a Helmet to Save a Life by Jane Brody in the October 23, 2017 issue of the New York Times.  Jane recounts her own helmet free tumble from a bicycle and the statistics on bicycle head injuries.

No helmet bike riders tell me they are “extra careful” and that they “stay off busy roads”.  They are assuming that people fall off bikes solely to due to pilot error.  Bike accidents happen because of bad roads, distracted car drivers, and more recently, other bike riders. People driving trucks, cars, and other bicycles are not looking for bicyclists.  They are on autopilot–listening to the radio, talking on the phone, and texting.  You need a helmet now more than ever.

As a physical therapist, I get to work with individuals who have suffered closed head injuries.  Nothing creates a more sudden and long lasting change in your world than an impact to your cranium.  It does not take that much in the way of force to permanently alter the way you move, think, react to stress, and function during the day.  If in the past you did not use a helmet because of the appearance, I urge you reconsider.  An eternity of cognitive impairment and an inability to find your way home should be more concerning than your bicycle style.

* New York Times, Buckle Up a Helmet to Save a Life, Jane Brody, October 23, 2017 issue.  Read the article here: https://www.nytimes.com/2017/10/23/well/buckle-up-a-helmet-to-save-a-life.html?_r=0

Michael S. O’Hara, PT, OCS, CSCS

Ladder Matters

Moving well is a combination of balance, coordination, strength, and power.  During everyday tasks, you must be able to plant, pivot, and shift your bodyweight over one leg to change directions or decelerate an impact.  Movement is a skill that we all take for granted until the day that it fails us.  “I can’t believe I can’t do that,” is commonly heard from people in physical therapy.  They are unaware of the level of motor control they have lost to age, injury, and a sedentary lifestyle.  The good news is that with some consistent training, most motor control skills can be restored.  For gym members, an excellent method of enhancing movement skills is the agility ladder.

Agility ladders help you move better.  How you move says more about your age than how you look.  Responsive legs that can react to a disruption in balance keep you durable and injury free.  Consistent agility ladder training develops the neural coordination that allows more graceful movement.

Rotation is the movement pattern that creates the distance in your golf drive, the pop in your punch, and the acceleration in your sprint.  Rotation is the missing movement pattern in most training programs.  Ladder drills improve cross body, shoulder, and hip rotation.

Ladders are the rehab bridge that allows the injured athlete to move from a controlled series of movement patterns to the chaos of competition.  Ladders are one of the best power production and injury prevention activities older clients can perform.

As a conditioning method, I call ladder drills “three-dimensional jump rope”.   Move through a few sixty second intervals of continuous ladder drills and your body heats up, respiration increases, and your metabolism is disrupted.  Ramp that up to 90 seconds and check your heart rate.  See video of agility ladder drills: https://youtu.be/CmLXGLeyGfE

Michael S. O’Hara, PT, OCS, CSCS

Discover the difference between muscle soreness following exercise activity and pain you should be concerned about in “Do I Have A Problem?”.  Jeff Tirrell gives advice for women on optimizing performance  and Mike O’Hara discusses training priorities for those over forty.

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Movement You Should Master

Step Ups

Modern medicine is keeping us alive longer, so now we need to put some effort into staying lively longer.  Mastering specific movements will improve our quality of life and help us stay independent and injury-free. I have come up with several exercises you can use to make yourself stronger, more durable, and develop a healthier, more functional body.  An exercise that I have found to be very helpful in restoring the capacity to get up and down off the floor is the Step Up.

Step Ups

The ability to go up and down steps will almost always be needed.  Losing this ability is a sure sign that one’s quality of life and independence are quickly fading.  Step Ups can be done in a variety of different directions and loaded a number of ways making them easily progressed or regressed based on goals and fitness level.  Step Ups improve balance and strength in the glutes, quads, and hamstrings.  Depending how you load, they can also challenge the core and shoulders.  The average step in the United States is 7 inches tall.  Strive to work up to a 14 inch box so that no flight of stairs will ever intimidate you.

Here Coach Katie demonstrates two different versions we like to use and the benefits of each along with some progressions.  Watch the video and give it a try: https://youtu.be/iGXtKyGlKMg.

1) Anterior Step up (Progression: Anterior Step Up with Racked Kettlebell hold)

2) Lateral Step Up (Progression: Lateral Step Up with one side loaded)

-Jeff Tirrell, CSCS, Pn1


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