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Biomarker Reminder

Drs. Evans and Rosenburg are Tufts University researchers interested in the measurable parameters that keep humans healthy and fit over an entire life span.  They have determined that the top four biomarkers are:

  1. Muscle Mass.  The percentage of your body that is made of muscle.
  2. Strength.  Can you use that muscle to push, pull, lift and carry.
  3. Basal Metabolic Rate.  The number of calories your body expends at rest.
  4. Body fat Percentage.  What percentage of your body is composed of fat.

The authors named these top four biomarkers, the decisive tetrad.  They are the prerequisites to maintaining healthy numbers in all of the other essential biomarkers.

  1. Aerobic Capacity
  2. Blood Sugar Tolerance
  3. Cholesterol / HDL ratio
  4. Blood Pressure
  5. Bone Density
  6. Internal Body Temperature Regulation

Drs. Evans and Rosenburg coined the term age related sarcopenia in their 1991 book Biomarkers.  It refers to the gradual loss of muscle mass that occurs as we age.  The keys to aging well, staying durable–no injuries, and maintaining control of all health parameters is maintaining or improving muscle mass / strength and eating properly.  An ongoing program of strength training and nutritional discipline are the foremost components of fitness and health.

Michael S. O’Hara, PT, OCS, CSCS

Less Is More

Understanding The Requirements Of Rest

The weight room at my high school was small and had only basic equipment.  It consisted of two Olympic weight sets, some mismatched dumbbells, a squat rack, and a chin up bar.  In the gym, we had a pegboard and a rope for climbing.  No bench press, curl bar, or pulldown machine.  It was the ultimate blessing in disguise.  We did not have the temptation of exercise variety for variety’s sake.  What we did have was solid instruction on basic lifts.  We performed the same exercises repeatedly and became more proficient at squats, hang cleans, overhead presses, and pull ups.  Four simple activities performed consistently with an effort to add weight to the bar on a regular basis.  The results were magic.

The television fitness gurus have brought forth the latest craze of “muscle confusion”.  You change your exercise activity often in an attempt to stimulate a greater adaptation response.  The problem is that you never get the chance to practice the exercise long enough or with enough resistance to get stronger.  Getting stronger is the performance parameter that preserves muscle mass, speeds up your metabolism, and makes you more durable–less likely to get hurt.

I never want any of my muscles, nerves, joints, or any other part of my body to be “confused” when training.  I want the bodies of the athletes I train to perform better at every session.  My suggestion is that you pick five or six exercises and set a goal of getting better at each of them over the next six months.  The exercises you chose do not have to be a barbell or dumbbell exercise.  Bodyweight exercises will work just as well and are a better choice for most fitness clients.  Keep a record of your performance and work on improving the number of inverted rows, pull ups, or push ups you can perform.  Single leg strength training is a good choice for nearly everyone and works wonders for athletes. Athletes should choose exercises that not only improve strength, but also mobility—front squats.  Long term dedication to the mastery of an exercise will reward you with better body composition, enhanced mobility, less pain, and the strength you need to perform in athletics and daily activities.

This training approach requires mental toughness and a willingness to at times be bored.  Toughen up and get after the challenge.  Read this recent article in the Wall Street Journal, “We Need To Relax Like Roger Federer”.   Better yet, go out and buy the book Starting Strength.

Michael S. O’Hara, PT, OCS, CSCS

A Plea For Your Knee

In our physical therapy clinics, we treat patients with knee pain on a daily basis.  It has become more common to train younger clients with a history of knee injury and ongoing knee pain.  Jane Brody’s recent *article in the New York Times has some excellent advice on the care and management of knee pain problems.  I have some further suggestions and clarifications.

Less Mass

The mass portion of the Force = Mass x Acceleration formula needs to be at an appropriate level for your knees to stay healthy.  Carrying extra body fat creates an environment that invites knee wear and tear.  The common knee pulverizing mistake is to perform high impact exercise activities in an effort to lose fat.  If you are twenty pounds overweight, do not run, stadium step, soccer, tennis, or pickleball.  Start with strength training and low impact cardio.  Lose the fat first, and even then, the lower impact activity will be healthier for your knees.  From the overweight client limping into the clinic I get the “I need to move around to lose weight” protest.  I am sorry, but fat loss is primarily a function of dietary alteration.  Exercise has very little impact on body fat levels if you do not eat properly.

Train the Way You Wish to Play

A properly planned fitness program makes your knees more durable (fewer injuries) when you participate in your favorite recreational activity.  The training must be tailored to your activity goals.  If your goal is to play tennis, then you must perform three dimensional deceleration / acceleration activities as part of your training program.  Yoga will not prepare your knees for tennis.  If you want to water ski, then you must perform strength training for your back, hips, and knees.  Distance running will not prepare your knees for water skiing.  If hockey is your recreational past time, you need to be strong, well conditioned and competent in all planes of motion.  Long duration recliner intervals will not prepare your knees for hockey.

Look Above

If your hips do not move well, your knees will pay the price.  In this age of all day sitting and minimal physical activity, hip function is at an all time low.  Physical therapy patients with knee pain nearly always present with glaring restrictions in hip range of motion and strength.  If your knees hurt, dedicate some training time to restoring hip rotation and hip extension movement.  Learn how to perform some remedial gluteal activation drills.  Learn a proper hip hinge, squat and a pain free lunge pattern.

Think First

Participation in a single inappropriate activity can produce a lifetime of knee trouble.  That box jump workout of the day- maybe not.  The warrior, electric shock, mud hole, death run–bad idea.  Trampoline with the grandchildren–what were you thinking!

Be Proactive and Seek Treatment For Knee Pain

“Training through the pain” can take a graceful athlete and turn them into a lifelong speed limper.  The presence of pain changes the way your brain controls movement.  Left untreated, it can permanently alter neural signals and produce movement patterns that linger long after the pain has resolved.  Live with enough cycles of inefficient movement and you develop early breakdown in the knee.

Michael O’Hara, PT, OCS, CSCS

*What I Wished I’d Known About My Knees, Jane Brody, New York Times. July 3, 2017

Read the NY Times article here: https://www.nytimes.com/2017/07/03/well/live/what-i-wish-id-known-about-my-knees.html?_r=0

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Hamstring injuries are on the rise.  In this month’s newsletter, Mike O’Hara, PT provides information on preventing hamstring injuries and includes videos of the recommended exercises.  Learn what it is to be “farm boy strong” and what you can do to become a “functional farmer”.

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Fitness Freedom For All

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This election marathon drones on, and neither of our present candidates has expressed an interest in the health or fitness of the average American citizen.  “Making Americans Strong Again” is the slogan of my candidacy and this is my platform.  All of these programs would cut the costs of health care, battle the obesity epidemic, and more equitably share the fitness wealth.

TOBACCO PLAN
Triple the tax on all tobacco products.  Nicotine is the most addictive chemical on the planet and it produces a tremendous burden on the American health care system.  Use the tobacco tax dollars and the health care savings achieved with a reduction in the number of addicts to pay for all aspects of my program.  Currently 19% of the USA population admits to smoking and conservative estimates are that tobacco users add another 210 billion dollars a year to our health care costs.

Outlaw every aspect of tobacco advertising–no exceptions.  Tobacco is a horror that should have been dealt with years ago.  Spend some time with a patient afflicted with esophageal, tonsil, tongue, or oral cancer and you will understand.

PHYSICAL LITERACY PROGRAMS
I thank Dr. John Ratey the author of the 2008 book Spark: The Revolutionary New Science of Exercise and the Brain for the Brain Function Equation.

Consistent Exercise + Healthy Metabolism = Better Mental Function

More of the brain is devoted to movement than language.  If we wish to fully develop our intellectual capacity, we need to work on maintaining optimal “physical literacy”.  Dr. Ratey has documented how school programs use consistent exercise to produce better test scores in all academic subjects.

The healthy metabolism portion of the above equation is driven by nutrition.  Ask any coach who has worked on body composition goals with fitness clients and they will tell you that meal preparation is a lost art.  Cooking classes, instruction on portion size, and how to use an appliance other than a microwave would go a long way to improve the average American’s health.

The government should support the participation of its citizens, young and old, in health promoting activities.  The school systems are too stressed with the demands of teaching standardized math, science, and the latest version of history.  Americans should be given a tax incentive or vouchers toward instructional classes and training programs that are supplied by private businesses.  As physical literacy improves and the average citizen’s metabolism becomes healthier, perhaps we will become capable of picking better candidates.

America’s military readiness is impacted by the physical weakness of our citizens.  It is estimated that only one in four Americans between the ages of 17 and 24 meet the requirements for service.  The big barriers are obesity and fitness related health concerns such as hypertension and diabetes.  The US Army and Navy scaled back the physical performance requirements and are still unable to find soldiers that can pass the new standards.  As a nation, we need to address the profound loss of fitness in our youth.

FITNESS AND TAXES
Allow all Americans to fully deduct the cost of gym memberships for themselves and their families.  Permit businesses to fully deduct the cost of memberships for their workers.  We know citizens that exercise stay healthier, require less medical care, and place less fiscal stress on the American health care system.  Gym attendance makes health care in America more “affordable” by keeping citizens fit.  The government should reward the good behavior of the citizens attempting to take care of their health.

Our elected officials in Washington are provided with access to fitness facilities and trainers.  Separate facilities for the House and Senate complete with pools, basketball courts, saunas, and steam rooms are provided for past and present politically elected officials.  Our Senators and Representatives utilize state of the art fitness centers and their constituents (you and me) subsidize the payment for these facilities and services.  Our political leaders value fitness and have deemed it a necessary occupational benefit.  Let them help their fellow countrymen share in the benefits of fitness.

THE END OF DRIVING DEVICE DISTRACTION
The technology exists that will turn off a mobile phone if it is moving in a car.  Please read the recent article in the New York Times* by Matt Richtel.  As your new president, this app would be beamed into every automobile.  The most dangerous thing an average American does in their day is climb into a car.  Mobile phones have made automobile travel much more dangerous.  For many people, the mobile phone is an impulsive addiction they are unable to control.  We will never get compliance without blocking the device.

I know, I am a technophobe, social media hater, and an old geezer who is just now using e-mail.  What I do hate is the driver who kills or injures a fellow American because they are distracted by the twitterverse.  Blocking the mobile phone while traveling in a car may have the unintended consequence of restoring the lost art of conversation–you remember talking, don’t you?  While cruising along on this brief bit of magic we call life, you do not want the final sound you hear to be the beep or ring from your cell phone.

FITNESS VOUCHERS
There are many professions in which a person’s physical fitness is directly related to job performance.  Fire fighters, police officers, emergency medical technicians, and construction workers all have physically demanding jobs that require a higher level of strength and mobility.  It seems logical that maintaining a strong, well functioning body would be an occupational expense not dissimilar to many of the other permissible tax deductions currently available to business.  A yearly fitness voucher for these professionals would decrease the cost of worker’s compensation, improve job performance, and enhance productivity.  These vouchers could be used to hire fitness professionals or pay for gym memberships and fitness programs.

FITNESS INFRASTRUCTURE CONSTRUCTION
A “shovel ready” project that requires little in the way of engineering and creates ongoing health benefit is bicycle path construction.  A bicycle path keeps riders and runners a safe distance from cars and encourages a fitness activity that is also very “eco friendly”.  Most European countries have invested heavily in this infrastructure, and the use of bicycles is far more prevalent in areas that have developed a bicycle path system.  I propose a USA Pathway Project that would create jobs, make Americans healthier, improve bicycle rider /pedestrian safety, and reduce our carbon footprint.

Many Americans live in what I call “fitness deserts”.  There is no safe place to walk, no park, no gym, and no recreational facilities.  I was fortunate to grow up in a town that had a city run summer recreation program.  We had access to basketball courts, tennis courts, and playgrounds with swings, monkey bars, and slides.  Elect me your next president and construction would begin on day one.

PRESCRIPTION FITNESS
If exercise could be packaged as a prescription pill, it would be the most widely utilized medication in the history of health care.  Doctors, nurse practitioners, and physician assistants counsel their patients that they need to exercise, but they are unable to provide the type of instruction and support the patient needs to be successful.  Our health insurance companies face mandates for medical coverage of many diseases and illnesses that would be reduced or alleviated with consistent exercise.  Insurance companies should have to pay for the medically prescribed exercise programs as part of our new “mandatory health care coverage”.

HEALTH CARE EQUALITY LEGISLATION
The elected representatives that have given us mandatory health insurance coverage should have to live with the same plans now available to the average American citizen.  Let them enroll in the programs available in the states they represent.  Let them pay yearly 15 – 25% increases in premiums.  Let them carry a $4000 – $8000 deductible for each member of their family.  Let the Congressman and Senators families wait for a pre- approval of diagnostic tests and specialists.  Instead, they are provided with a lifetime of the finest medical coverage while the citizens they represent must figure out how to manage shrinking benefits and rising costs.  This simple piece of legislation would greatly improve the level of attention given to the quality of health care coverage in this country

I have been sharing these ideas with politicians for years but have never gotten any response.  They are probably very busy working out at the gym.

*The New York Times, “Phone Makers Could Cut Off Drivers. So Why Don’t They?” by Matt Richtel, September 24, 2016. View the article here: http://www.nytimes.com/2016/09/25/technology/phone-makers-could-cut-off-drivers-so-why-dont-they.html?_r=0

-Michael O’Hara, P.T., OCS, CSCS

I have been a standing desk evangelist for the last six years.I have converted hundreds of seated apostates to the virtues of the standing workstation. Physical therapy patients and fitness cliestanding_desknts testify to the resolution of pain, restoration of function and a new belief in all things movement. Indeed my time on this earth will have been well spent if I can just get more people standing during their workday.

If you have a boss that controls expenditures for office equipment, he or she should read Daniel Akst June 2, 2016 article in the Wall Street Journal, “Want To Get More Done at the Office? Just Stand Up.” The author discusses recent research from Texas A & M on the use of standing desks in the work place. The big take away is that the subjects in this fairly large and long-term study were 46% more productive than their seated workmates.

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Nothing slows down your progress toward greater fitness and better performance than an injury. Bad combinations of exercises during a training session can set you up for a big crash. Poor exercise programming produces the joint overload or connective tissue stress that produces pain. Lumbar flexion activities combined with an exercise that compresses the lumbar spine is one of the more Hernaited_Disccommon killer combinations.

Here are some examples of lumbar flexion activities combined with exercise that increase lumbar intervertebral pressure. I am seeing these killer combos more frequently during my visits to the gym.

-Ten GHD sit ups followed by fifteen American Swings.

-Twenty medicine ball rotational crunches followed by a sixty yard farmers carry.

-Rowing machine for 500 meters followed by barbell on back walking lunges.

-Five toes to bar and then five barbell cleans.

-Five minutes of super slumped power texting followed by three heavy deadlifts.

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In a recent article on interval training, I mentioned my preference for “Crash Free” training modalities. Since that article, I have gotten several requests for more information on training methods that produce an optimal metabolic response with limited biomechanical wear and tear. The long-term goal of any fitness program should be to enhance movement and keep you in the fitness game for a lifetime. Training should never accelerate joint breakdown or destroy your ability to move. Take the time to read the May 16, 2016 Wall Street Journal article by Allan Ripp, “The Accidental Running Guru.” These are my top five Crash Free Cardio choices.

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single_leg_deadlift_landmineThe hip hinge (maximal hip motion and minimal knee motion) is the most powerful human movement pattern. It is usually taught with bilateral exercises such as the deadlift, glute ham developer, or the kettlebell swing. A frequently overlooked, and in many ways better, method of training the hip hinge pattern is the single leg deadlift. The landmine is a simple tool that can make learning the single leg deadlift easier. Take a minute to read this article and then give this exercise a place in your training program.

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landmine_squatThe squat (equal knee and hip motion) is an essential movement pattern that should be a part of everyone’s fitness program. Improving your squat in the gym produces carry over to better performance during activities of daily living. The ultimate goal of any training program is to move better, stay functional and maintain independence for all your days on this planet. Many people lack the balance, mobility, coordination, and strength to perform a squat with a barbell or kettlebell. They need a modification that helps develop better squat mechanics and at the same time creates a training effect in the muscles. A Landmine Squat is one of the best modifications you can add to your training program. Take a minute to read this article and then give this exercise a place in your training program.

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