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Learn more about Rehab, Sports Medicine & Performance

prevention

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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.

Download Here

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

 

Movement You Should Master

Weighted Carries

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 efficient and effective is a Weighted Carry.

Weighted Carries

Very few things are more functional than a carry.  You’d be hard pressed to get through daily life without having to carry something at least a few times per week.  While basic, a carry is an efficient and effective full body exercise.  Depending on the carry you choose, the load is virtually limitless.  Performed for time or distance, carries will always improve gait and core stability.  Depending on which version you use, they can also be an effective tool for improving shoulder mobility/stability, grip strength, balance, and overall awesomeness.  Watch the video and give it try: https://youtu.be/PaP4-IlVAOA

Coach Chad demonstrates my top four carry picks:

1) Farmers Walk (gait, core stability, grip strength, upper back, legs)

2) Suitcase Carry (gait, core anti-lateral flexion, grip, upper back, balance)

3) Waiters Carry (gait, core stability, shoulder stability, balance)

4) Double Waiters Carry (gait, core stability, shoulder mobility, shoulder stability, balance)

-Jeff Tirrell, CSCS, Pn1

 

Movement You Should Master

Pull 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 helps build upper body strength and maintain shoulder mobility is the Pull Up.

Pull Ups

If you are a superhero and find yourself hanging off the edge of a cliff or a building, you’ll need to pull yourself up.  All kidding aside, the pull up is a fantastic exercise to build strength in the lats, biceps, rhomboids, and rear delts, while helping to maintain shoulder mobility.  Pull ups can be done with a variety of grips.  The most important thing is to use a full range of motion and maintain control (avoiding excessive movement to reduce injury risk).  I utilize one of three pull up versions with most clients depending on their fitness level.  Watch the video and give it a try.

1) Eccentric Pull ups: Use a box to start in the top position, and slowly lower yourself with complete control down to the bottom position.  Once you can complete 10 of these with a good 4-6 second descent, then it’s time to move on to a standard pull up.

2) Standard Pull up:  Start hanging from a bar (or rings) with your arms completely straight.  Pull yourself up until your clavicle touches the bar.  Slowly lower yourself back down until your arms are completely straight and your body is motionless.

3) Xiphoid Pull ups: Start as you would for a standard pull up, but rather than pulling to your clavicle, you want to lean back and pull yourself up until your xiphoid process (bony part at the bottom of your sternum) touches the bar.  Then, lower yourself in a controlled manner back to the start.

See video of pull ups here: https://youtu.be/Cyvp4X2MRC0

-Jeff Tirrell, CSCS, Pn1

Think About This

The Latest Science on the Prevention of Alzheimer’s

Over the last 30 years, more than two hundred experimental drugs have failed to produce any success in the fight against Alzheimer’s.  It does not appear we are going to have a pharmaceutical for the treatment of Alzheimer’s any time in the near future.  A recent *article in the April issue of Scientific American discusses a treatment option that does appear to work.  This is currently our only hope in the fight against this terrible disease.  The good news is the treatment that prevents cognitive decline helps with so many other problems.

The study’s researchers demonstrated that an interventional program of exercise, proper nutrition, and cognitive training produced significant improvements in brain function.  The **Finnish Intervention Study to Prevent Cognitive Impairment and Disability (FINGER study) enrolled 1260 men and women between ages 60 and 77.  Over the course of two years, participants demonstrated improved cognitive test scores in processing speed (up 150%), executive function (up 83%), and complex memory (up 40%).

The exercise program in this study was not complex or time consuming.  The routines were developed by physical therapists and performed four or five days a week.  The exercise sessions involved strength training, balance skills, and aerobic activities.  As the participants became fitter, their training regimens were progressed–more challenging activities, more resistance, and/or more volume.  The time spent in training was four to five hours a week.

If your goal is to maintain or improve cognitive capacity and remain independent, then the prescription is a consistent routine of exercise.  Take the time to read the article, lace up your sneakers, and make a progressive program of fitness a lifelong habit.

* A Rare Success Against Alzheimer’s, Scientific American, April 2017

** The FINGER study, Alzheimer Prevention. Download the article here: http://r.search.yahoo.com/_ylt=A0LEViMTIfZYurkAQNsnnIlQ;_ylu=X3oDMTBybGY3bmpvBGNvbG8DYmYxBHBvcwMyBHZ0aWQDBHNlYwNzcg–/RV=2/RE=1492554131/RO=10/RU=http%3a%2f%2fwww.alzheimersprevention.org%2fdownloadables%2fFINGER-study-report-by-ARPF.pdf/RK=0/RS=fHWCrTAi9LEEDrH5jWfmRvAI7LU-

Michael S. O’Hara, PT, OCS, CSCS

Very Short Term Running Preparation

I was recently asked by a fitness client to post exercise recommendations that would prepare her for outdoor distance running.  This person was two weeks away from being out on the road, running two or three miles a day.  She is middle aged, has a prior history of lower back pain, and her goal was to lose fifteen pounds and “tone up”.   Given such short notice, these are my recommendations.

Perform soft tissue work on a daily basis.  Foam roll the legs and use a lacrosse ball on the plantar fascia.  The vast majority of overuse injuries in runners happen in the lower legs and feet.  Attempt to unwind the myofascial distress created by 600-700 foot impacts a mile.

Improve your reciprocal hip pattern–one hip goes back and the other goes forward.  Most general fitness clients have glaring deficits on one side.  Perform some split squats, posterior lunges, step ups, and or walking lunges.  If you struggle with these activities, I would reconsider running as a fitness activity.

Wake up your gluteals.  Every day, perform fifty or sixty bridges, hip lifts, or leg curls.  You need super gluteal strength / endurance to run distances and avoid lower extremity injury.  If your butt gets sore from fifty bridges, you need to do them more often.

Running is a skill and most recreational runners need some practice.  Running hills will improve gait mechanics, enhance hip extension, and decrease deceleration forces.  Find a fifty-yard hill.  Run up the hill and walk back down.  Perform five hill runs.

You are always better to run too little than to run too much.   Start with very short runs– no more than half a mile.  Increase your total weekly mileage by no more than five percent a week.

You can’t do this in two weeks, but this is my big recommendation to all future runners.  Lose the extra weight before running.  As a method of fat loss, distance running has a poor track record.  It tends to elevate the hormones that make you hungry, and physiological adaptation to distance running happens fairly quickly.  Extra adipose makes you far more likely to develop a running related injury.  I know the guys and gals you see running miles and miles every day are lean.  Please remember that lean runners are successful with running because they possess the optimal body mass to run long distances.  They did not start heavy and become lean.  Put a fifteen pound weight vest on that guy or gal and everything will change.  Their gait will lose efficiency and become less graceful.  The extra fifteen pounds of load creates the biomechanical overload that makes them much more likely to suffer an injury.

My final recommendation is that you not become disappointed if you develop pain.  A runnersworld.com poll conducted in 2009 revealed that 66% of respondents reported a running related injury that year.  The statistics indicate that one third of the participants at you local 10k fun run will require medical attention for a running related injury over the next year.  Have the good sense to stop when the pain begins.

Michael S. O’Hara, PT, OCS, CSCS

Aging Muscles and Exercise

Fast Reaction and Helpful Hormones

New technology has produced some surprising information on the cellular response of muscle to various types of exercise.  Super blood analyzers and computers have enabled scientists to monitor gene expression and hormonal release in muscle cells during and after sessions of exercise.  The information from this research is revolutionizing our understanding of optimal exercise prescription for health and longevity.  It appears that older individuals derive the most beneficial muscle cell response with fairly intense interval training sessions.  Please take the time to read Gretchen Reynolds article in the New York Times, The Best Exercise for Aging Muscles.

Dr. Martin Gibala, a professor at the kinesiology department at McMaster University in Hamilton, Ontario recently released an outstanding book, The One Minute Workout.  Dr. Gibala explains the science behind high intensity interval training (HIIT) and why it is safe and effective for older fitness participants.

Skeletal muscles produce beneficial biochemicals called myokines that stimulate a response in cells throughout the body.  Myokines are a fairly new scientific discovery and we have only recently begun to understand their remarkable effect on human physiology.  Myokines enhance blood vessel development, promote beneficial hormone levels, stimulate greater mitochondria production, and improve the metabolism of fat.  In the older individual, myokine levels are enhanced with strength training and high intensity interval training.

The best method of creating more of the beneficial myokine biochemistry is to consistently perform some progressive resistance training followed by a brief but intense interval training session.  This regimen of training is similar to that of track athletes involved in sprinting.  These athletes have high levels of muscle mass and very low body fat levels.

Michael S. O’Hara, PT, OCS, CSCS

Read the NY Times article here: https://www.nytimes.com/2017/03/23/well/move/the-best-exercise-for-aging-muscles.html

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