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Learn more about Rehab, Sports Medicine & Performance

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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

 

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

 

The 2017 Australia Open Tennis tournament had an impressive finish.  At the age of 36, Roger Federer became the men’s champion, and 35 year old Serena Williams defeated her 36 year old sister, Venus Williams to become the women’s champion.  In the world of professional tennis, a mid-thirties champion is a rarity and to have it happen in both the men’s and women’s divisions is a sign of things to come.  Rehabilitation and conditioning science have improved the results athletes can achieve in the gym.  Athletes are staying healthier by eating better and training smarter.  Take a look at some other recent examples:

Oksana Chusotivina (photo by Zelda F. Scott)

Tom Brady, 39 years old. The quarterback for the New England Patriots will be leading his team in Superbowl LI.  He is confident he can continue to compete for another five years.

Drew Brees, 38 years old.  The starting quarterback for the New Orleans Saints feels he can play for several more years.

Kristin Armstrong, 43 years old.  Won a gold medal in cycling at the Rio Olympics at the age of 42.  This type of success is amazing in a competition that greatly favors youth.

Dara Torres, 49 years old.  This twelve-time Olympic swimmer medallist competed at 41 years of age and won a silver medal in three events at the 2008 Summer Olympics.

Oksana Chusotivina, 41 years oldOksana is gymnast from Uzbekistan that competed against teenage gymnasts at the Rio Olympics.

Meb Keflezighi, 40 years old.  Competed in the Marathon at the Summer Olympics in Rio.

These performances illustrate how proper training and nutrition can produce a high level of performance in athletes thought to be too old to compete.  We are all going to get older.  It does not mean we are going to get weaker, slower, and more sedentary.

Michael S. O’Hara, PT, OCS, CSCS

Kettlebell Swings and Push Ups

When designing programs for rehabilitation patients and fitness clients, I often pair up exercises.  This practice is commonly called super-setting and it has multiple benefits:
Train efficiently—You get much more work done during your training time.  
Abolish performance deficits—Most physical therapy and fitness clients need to work on glaring right vs. left movement asymmetries, postural restrictions, and stability limitations.  
Lose weight—Fat loss is a primary goal of most fitness clients.  Pairing exercises ramps up exercise intensity and creates the hormonal response that improves body composition.  
Move better—Training neurologically related movement patterns improves motor control.   

Swings and Push Ups

Strength coach Dan John got me started on kettlebell swings/push up sessions.   This pairing challenges core stability as the swings create an anti-flexion core stabilization demand and the push ups an anti-extension demand.  If your goal is fat loss, this exercise pairing produces a total body metabolic boost.  A hidden benefit is getting up and down off the floor during the training session.  It is a basic mobility skill we need to practice in order to maintain our independence.

Kettlebell Swings
kb_swingA swing is not a squat and a squat is not a swing.  A kettlebell swing is a hip dominant motion; the hips move a lot and the knees just a little.  The handle of the kettlebell should stay above the knees.  At the bottom of the swing, the forearms should contact the upper thighs.  You swing the kettlebell forward with an explosive contraction of the gluteal and hamstring muscles.  Do not lift the kettlebell with the arms.  Project, or throw, the kettlebell to shoulder level and no higher.  The swing is an exercise that is worthy of some coaching.  Find an instructor that can help you with proper performance.

Push Ups
Keep the shoulder blades down the back and tight against the rib cage.  Hold the head in a retracted position and relax the neck.  The shoulders should not ride up into a shrugged position. Start at the bottom of the push up (flat on the floor).  Place the hands under the shoulders and keep the elbows tucked in to the side of the body.  Grip the floor with the hands and activate the muscles in the back of the shoulder blades.  Brace the abdominal muscles, tighten the glutes, and maintain tension between the legs by drawing them together.  Push up while maintaining spinal and shoulder position.   Hold at the top for two counts and repeat the push up.

Swing/Push Up Sessions
The great thing about these sessions is that you need minimal equipment—just a single kettlebell and a willingness to work hard.

This is a good place to start.  You will need a kettlebell and a stopwatch.
Swings x 20 seconds
Push ups x 6 repetitions
Rest 30 seconds
Repeat for fifteen minutes
As you get stronger, increase the push up repetitions.

This is one of my favorite swing/push up training sessions.
20 swings
20 push ups
20 swings
15 push ups
20 swings
10 push ups
20 swings
5 push ups
20 swings
You will finish with 100 swings and 50 push ups.

Try a push up “countdown” session.  Follow this pattern:
10 swings
10 push ups
10 swings
9 push ups
10 swings
8 push ups
Work your way down to 7-6-5-4-3-2-1 push up.  You will complete 100 swings and 55 push ups and transfer up and down off the floor 10 times.  If that is too much, modify the program and start at five push ups.  You will complete 50 swings and 15 push ups.

View video of Mike performing these exercises here: https://youtu.be/Vq3VYg847Xs

-Michael S. O’Hara, P.T., OCS, CSCS

Hip Lifts and Roll Outs

When designing programs for rehabilitation patients and fitness clients, I often pair up exercises.  This practice is commonly called super-setting and it has multiple benefits:
Train efficiently—You get much more work done during your training time.  
Abolish performance deficits—Most physical therapy and fitness clients need to work on glaring right vs. left movement asymmetries, postural restrictions, and stability limitations.  
Lose weight—Fat loss is a primary goal of most fitness clients.  Pairing exercises ramps up exercise intensity and creates the hormonal response that improves body composition.  
Move better—Training neurologically related movement patterns improves motor control.  

Hip Lifts and Roll Outs

An intricate system of muscles holds the spine upright over the top of the pelvis.  This pair of exercises coordinates and strengthens this support system.  If you sit all day long, have postural problems, or a history of lower back pain this pair of exercises is worthy of your training time.

Hip Lifts
hip_liftThis drill coordinates hip extension and lumbar spine stability.  It is very beneficial when progressed to the single leg version.  Lay with your shoulders across a bench with the head supported.  Place your arms out to the sides.  Plant the feet on the ground with the knees bent 90 degrees and the shins perpendicular to the floor.  Drop the hips to the floor and then push back up with the gluteals and hamstring muscles.  Hold at the top for two counts and repeat.

Roll Outs
The roll out can be scaled to serve any fitness level.  Beginners can start with a large 65 centimeter physioball, and as they become more proficient, progress to a smaller 55 centimeter ball.  The closer the hands get to the floor the more challenging the exercise becomes.  If you get strong enough, you can perform the forward roll out with a Power Wheel or Sorinex roller.

Kneel on a mat to keep the pressure off your knees.  Your femur (thigh bone) is positioned perpendicular to the floor and the hips are hinged at 45 degrees.  Place the hands on the front of the ball and the elbows directly under the chin.  Brace the abdominal muscles and roll out onto the ball until you feel a challenge through your midsection.  Hold in the challenging position for three counts and then return to the starting position.
Perform twelve repetitions of the hip lifts, rest 30 seconds, and then perform ten roll outs.  Rest and repeat the cycle.  Work up to three sets through this exercise combination.

View video of Mike performing these exercises here: https://youtu.be/Xf08rFU7A4w.

-Michael S. O’Hara, P.T., OCS, CSCS

Crawl and Bearhug Sandbag Carry

When designing programs for rehabilitation patients and fitness clients, I often pair up exercises.  This practice is commonly called super-setting and it has multiple benefits:
Train efficiently—You get much more work done during your training time.  
Abolish performance deficits—Most physical therapy and fitness clients need to work on glaring right vs. left movement asymmetries, postural restrictions, and stability limitations.  
Lose weight—Fat loss is a primary goal of most fitness clients.  Pairing exercises ramps up exercise intensity and creates the hormonal response that improves body composition.  
Move better—Training neurologically related movement patterns improves motor control.   

Crawl and Bearhug Sandbag Carry

A finisher is a short but intense, high metabolic cost, training event performed at the end of an exercise session.  The best finishers create carry over to real life activities and can be made more challenging as you become more fit.  When linked to proper diet, finishers produce the “metabolic hit” that stimulates fat loss.  As the name implies, you always perform finishers at the end of your workout because, afterwards, you will not want to do anything else.

Crawl
Crawling is all about the spiral, diagonal force connection that happens through the middle of the body.  Crawling is the primal exercise that enabled us to stand and walk.  The “core muscles” neurologically connect the left hip with the right shoulder and the right hip with the left shoulder.  They stabilize the pelvis and spine so you can transfer force from the hips to the shoulders.  Crawling keeps that connection healthy and strong.

Bear Hug Sandbag Carry

sandbagThe bear hug sandbag carry is the cure for the epidemic of device disability syndrome (DDS).  This exercise reverses all of the weakness that is created by endless hours planted in a chair, staring into a screen.  Sandbag carries are functional core stability work.  The abdominal muscles interact with the muscles in the legs and shoulder girdle to hold a stable upright position.  Walking with a sandbag kicks starts your postural reflexes, the neural feedback mechanism that holds us up against gravity.  Do not go too heavy on the sandbag.  You should be able to stay tall and not stagger or lean forward.

The routine is simple:  Crawl for twenty yards—ten yards down and ten yards back.  Try to keep the knees close to the floor and the back flat.  Immediately after finishing the crawl, pick up the sandbag with a bear hug hold- no hands linked- and carry it for twenty yards.  Rest as needed and repeat.  Start out with three circuits and increase to five.  Try to keep the rest periods under thirty seconds.  Once you get up to five circuits, add a weight vest and then a heavier sandbag.  Modify the distance, load, and cycles to suit your needs.  Give the crawl/bear hug carry combo finisher a try and let me know how it goes.

View video of Mike performing sandbag carries here: https://youtu.be/Ygg2vbf-Uoo

-Michael S. O’Hara, P.T., 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.

Why Doing Just Enough Is Not Enough–Moving From Maintenance To Improvement

15-hotel-icon-has-gym-800pxWhen I worked in Texas, I had a client named Gail.  When we first met, she had recently turned 50 and was comfortable with her appearance.  She led an active lifestyle and worked out at the gym two days a week.  Overall, she was happy with her fitness level. She just wanted to maintain her routine.  Gail had been coming to the same class at the gym twice a week for 4 years.  The more I got to know Gail, she admitted to wanting to drop the 5-10 lbs which she said had settled solely in her mid-section.  She also mentioned mild knee pain while playing tennis.  In all the years she had been participating in her fitness class, her weight gradually increased and her knee pain only got worse, but these subtle changes hadn’t been enough of a red flag.  Gail needed to change up her routine, which she eventually did with positive results

I hear this word “maintenance” frequently.  Many gym goers are relatively satisfied with their appearance and just want to continue to be active in order to maintain their fitness level.  My experience has shown that maintenance is an illusion.  You either get better at something or you get worse.  Every action and decision you make brings you closer to your goal or takes you further away.  There are no neutral actions.  This is easily measured in the world of fitness and physical performance.  The first time you run a mile or bench press your bodyweight, a relatively high level of energy is used due to the inefficiency of all of the musculature and energy systems being used.  Every time that same mile is run or that same weight is lifted, your muscles fire in a more coordinated manner and your energy systems involved become more efficient, so less energy is used for the same task.  The hour workout that may have required 300 calories worth of energy to complete the first time you performed it may only require 280 calories after a couple of weeks, and perhaps only 200 calories after several months.

When you approach exercise with a “maintenance” mentality you often end up doing the same exercises, at the same speed, with the same loads, and over time this requires less and less work.  If you can no longer do what used to do, this “maintenance” mentality may be the culprit.  The only way to improve is to consistently perform more work or complete the same amount of work in a shorter period of time.  Do this consistently 2-3x per week for months and years on end and you will actually maintain something.  Do it 4-5x per week and you might actually get better.

Jeff Tirrell, CSCS, Pn1

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.  

Carry, Squat, Lunge, Hinge, Pull, Push– Every Week

005Most strength coaches divide human movement into 5-6 fundamental movement patterns.  These movements are what we are talking about when we call our training “functional.” Personally, I like to go with 6 patterns in the following order of importance: Carry, Squat, Lunge, Hinge, Pull, and Push.  These functional patterns include virtually all aspects of human movement.

The first two, carry and squat, are performed daily in real life while the other movement patterns are used less frequently.  Incorporating these movement patterns into your training program at least once per week will ensure that you develop a well-rounded physique, but more importantly, that your musculoskeletal system functions like the awesome machine it was made to be. Practicing these movement patterns should keep you free from asymmetry and injuries.  You will also become stronger and well balanced giving you the confidence to take on whatever life throws at you.  Just how frequently you train each pattern will depend on your current training status, movement quality, experience, and goals.  Following is a loose guide:
Carry: 3-5x/wk  (this can include traditional carries, crawls, Turkish Get Ups, or sleds)
Squat: 2-3x/wk
Lunge: 2-4x/wk
Hinge: 1-2x/wk, (Deadlifts, KB swings, or Good Mornings all fall into this category)
Pull: 3-5x/wk
Push: 2-4x/wk

-Jeff Tirrell, B.S., CSCS, Pn1

PDFThe September 2016 newsletter contains information on preventing ankle sprains.  Mike O’Hara, PT demonstrates exercises to prevent ankle inversion.  Meet Fenton Fitness member Gay Adams and read her story on staying strong during a difficult time, and learn about the suitcase carry–a better alternative to weighted sidebends.

Download Here

balanceFitness 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.

Improve Your Balance
Balance, just like functional mobility, strength, and muscle mass, starts declining at around age thirty, and unless you do something, it gets worse as you age. The older you get, the more likely you are to have some degree of balance impairment. As the American population ages, injuries from falls have become a bigger concern. The good news is that no other parameter of performance can improve as quickly as balance.

The recommendation from researchers and clinicians at Too Fit to Fracture (osteoporosis.ca) is that we perform some balance training every day. The training takes no more than five minutes, but to achieve the best results it does need to be an everyday event. My suggestion is to integrate balance training into daily chores. Practice standing on one leg while you brush your teeth. Perform three or four twenty second holds on each leg. Stand on one leg when you fold the clothes, iron the shirts, or wash the dishes. Another great reason to use a standing desk is that it gives you the opportunity to practice some single leg balance as you are working.

Balance is a team effort between the sensors in our joints, the inner ear, and our vision. You want to challenge all aspects of the sensory system during your training. When you go to the gym make sure you exercise in a standing position and always include single leg biased balance activities during your workout. Exercises such as step ups, lunges, and medicine ball drills will all help improve your balance.

-Michael S. O’Hara, P.T., OCS, CSCS

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