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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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Many of life’s activities involve using our legs in a reciprocal pattern.  Find out why training in half kneeling position can help.  Exercise instruction and demonstration included in a video link. Learn the four steps to a successful fitness program and how to correctly use the Concept 2 rowing ergometer.

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Are You Ready?

Spring At The Physical Therapy Clinic

The weather is warming up and soon we will leave the heated, insulated, safety of our home gyms and fitness centers.  The spring migration back to tennis, soccer, pickleball, golf, fitness running, ultimate Frisbee, and stadium steps will begin.  My physical therapy question is– Are you ready for these new challenges?  Has your fitness program prepared you to withstand the rigors of these spring endeavors?  This checklist should help you answer the question.

Have you been performing most of your fitness activities in standing?
Nearly every sport and most household chores are performed in a standing position.  During most of my visits to commercial gyms, the majority of the activity I witness is in the supine, seated, or heavily supported positions.  If your goal is to move better and remain free of injury, then 90% of your exercise should be performed in standing.

Do you practice moving in all directions?
Nearly every sport involves moving side to side, forward-backward, and in a rotational pattern.  Basketball, soccer, golf, and tennis all require you to accelerate and decelerate movement in all directions.  Most gym activities are predominantly sagittal plane– forward and backward.  You ride on the elliptical, spin the bike, and run on the treadmill for months, and your spring visit to the tennis court results in a twisted ankle because you are unfamiliar with side to side movement patterns.

Have you been working on better balance?
Balance is a skill that tends to deteriorate with age, injury, and a sedentary lifestyle.  Many commercial exercise machines take all balance demands away.  The elliptical, spin bike, recumbent bike, rower… all are heavily supported.  Proficiency with single leg stance balance prevents injuries and improves performance.  The older and more deconditioned you have become, the more your fitness program should include single leg stance balance training.

Do you perform any explosive exercises?
We get slower before we get weaker, and life is an up-tempo game.  We need to perform exercise that enhances quickness and improves control of deceleration forces.  What you do in the gym is reflected in how well you can move during activities of daily living.  If you continually exercise at slow tempos, you will get better at moving slowly.  If you train explosively, you get better at moving at faster speeds.  The capacity to decelerate a fall requires fast reactions.  Gracefully traveling up the stairs and getting out of the car are only improved with exercise that enhances power production and speed of movement.

Michael S. O’Hara, PT, OCS, CSCS

Fitness training for those of us past 40 years of age is more complicated. Physical performance and recovery capacity are dramatically different. If you need proof, look for the forty year olds in the NBA or NFL. The good news is that with proper planning, consistent performance, and the wisdom that comes with age, we can stay fit and active for a lifetime. I have compiled a collection of tips for the forty plus fitness client.

Ease Into Training
LiftingStart slowly and gradually increase the duration and intensity of your training sessions. Do not start with an hour long yoga class, 30 minutes of a P90x training DVD, or the Crossfit workout of the day. Beginners’ training enthusiasm very often leads to injury, surgery, and further debility.

One of the best reasons to hire a fitness coach is to reign in your impulse to do more. “That’s it?” Is the complaint I hear from the older, deconditioned, overweight, and previously injured fitness client after his or her first training session. For some reason, the guys are much more prone to want more. What I hear from the patient lying on the treatment table:

“I thought if two sets of an exercise are good then four sets must be better.”

“I felt good that day and decided to try the 16 kilo kettlebell.”

“My back had been feeling stiff but it usually loosens up with the rowing machine.”

If you have just completed physical therapy treatment for an injury or surgery, you need to be more cautious. Statistically, the biggest predictor for a future injury is a prior injury. A suggestion I have for patients finishing rehab and asking about starting a fitness program is to continue with their daily home exercise program and add in some walking. Increase the repetitions and sets of the home exercises, and when they can exercise for twenty minutes and then walk for ten minutes, they should be ready to start training in the gym. Some patients reach this level of activity tolerance in two weeks and some take months.

If you wish to navigate your own way through the beginning stages of a fitness program, start with some education. Get a copy of New Rules of Lifting by Lou Schuler and Alwyn Cosgrove or Core Performance by Mark Verstegen. Begin the basic programs and ever so slowly increase your training activities. Buy and learn how to use a foam roller and a stretch strap. And please, stop if you develop pain.

-Michael S. O’Hara, P.T., OCS, CSCS

PDFIn this month’s issue, Mike O’Hara presents tips for preventing shoulder pain and injury.  Jeff Tirrell addresses the secret to maintaining a successful workout program, and the benefits of single leg hip thrusts are described.

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Everyone needs to read the two part New York Times article on falls (see links below).  As a physical therapist who has worked with fall related injuries and fall prevention for the last thirty years, I applaud Katie Hafner.  For the last ten years, the number of emergency room visits and the number of deaths from fall related injuries has been climbing at an alarming rate.  Most people are unaware of how dramatically a fall can change their life.  The news we are not getting is that programs designed to prevent falls are very effective.  A properly designed fitness program can improve your balance, enhance your reaction skills, and make you less likely to fall.

Please Stand Up

If you want to improve your balance you must stand up.  There is specificity to exercise.  You will not get better at tennis with an exercise program of swimming.  Seated, supine, or prone exercise activities will not improve your balance, reaction time, or proprioception.

The Feeble Fall

Make strength training and the maintenance of muscle mass a priority in your fitness program.  The loss of muscle mass and strength is directly correlated to a higher incidence of falls.  It is good to improve flexibility and cardiovascular capacity, but they will not reduce your risk of falling.

Practice Reacting

If fall prevention is your goal, then your fitness training must make you move at quicker tempos.  Most of the training in fitness facilities is of the slow and controlled variety:  Slow seated knee extensions, slow down dogs, slow seated physioball leg lifts.  In life, much of what comes at you is fast and uncontrolled.  The time you spend training must focus on activities that make you move quickly.  Throwing a medicine ball, foot work on an agility ladder, or low hurdles and reactive resistance tubing drills are good examples of faster paced exercises.

Become a Better Shock Absorber

Your fitness program should make you impact resilient.   Fall events often occur because of an impact.  You get bumped or jostled and are unable to maintain your equilibrium.  The force of the impact causes just enough movement disruption that you topple over.  Just like any other physical attribute, impact resilience can be improved with proper training.

Ground Rules

Getting up and down off the ground enhances all aspects of balance, coordination, and positional awareness.  The capacity to transfer gracefully and safely from the floor to standing maintains independence.  Getting down on the ground and developing this skill should be part of your fitness program.

Fall prevention programs work, and they work better than most other disease preventative programs.  Most people start fall prevention training after they have tumbled over several times.  Whether it is heart disease, diabetes, or falls, it is far better to start prevention programs before problems develop.  My suggestion is that if you are over forty, you need to make fall preventative activities part of your exercise program.  Fear, denial, and the “old dog–new tricks” dilemma are the obstacles we keep tripping over.

To read Part I, click on the link below:

http://www.nytimes.com/interactive/2014/11/03/health/bracing-for-the-falls-of-an-aging-nation.html?_r=0

To read Part II, click on the link below:

http://www.nytimes.com/2014/11/04/science/a-tiny-stumble-a-life-upended.html

-Michael O’Hara, PT, OCS, CSCS

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