(810) 750-1996 PH
Fenton Fitness (810) 750-0351 PH
Fenton Physical Therapy (810) 750-1996 PH
Linden Physical Therapy (810) 735-0010 PH
Milford Physical Therapy (248) 685-7272 PH

Learn more about Rehab, Sports Medicine & Performance

therapy

1 2 3 25

8 Reasons Why You’re Sore–#3 Protein

One of the most common complaints I get from new trainees (most often these come from middle aged men who are just now getting back into strength training) is that of being sore all of the time.  Many people associate muscular soreness with getting a good workout or getting results.  However, the research does not necessarily support this thought process.  Muscles tend to get sore anytime a new stimulus is introduced (new exercise, activity, etc), but this should typically subside within 2-3 weeks of starting the activity.  Anytime a new exercise is introduced, it is expected that some level of soreness will occur.  However, a good program will actually have an introduction phase where weight and volume are intentionally reduced in order to avoid excessive soreness, as this can negatively impact future workouts.  If you are chronically sore beyond the initial 2-3 weeks of starting a strength training program, there are eight areas that you may need to pay attention to.

Jeff Tirrell, CSCS, CSFC, Pn1

#3–Protein

Protein is responsible for making up at least part of every structure in all humans.  It is responsible for the repair of muscles, tendons, ligaments, and organs.  Protein is most commonly found in animal products such as meats, eggs, and dairy.  Despite popular belief, vegetarian dairy substitutes (such as almond milk) tend to be a poor source of protein.  Soy and pea along with a variety of vegetable-based protein powders are the best bet for vegans to increase protein intake.  For optimal recovery, protein intakes should range from 0.62 grams per pound of bodyweight up to 1 gram per pound of body weight.  For very lean individuals who are very active or trying to lose body fat, amounts may need to be even higher.  Protein intakes of up to 2 grams per pound of bodyweight have been studied and found to be safe in healthy individuals.

8 Reasons Why You’re Sore–#2 Hydration

One of the most common complaints I get from new trainees (most often these come from middle aged men who are just now getting back into strength training) is that of being sore all of the time.  Many people associate muscular soreness with getting a good workout or getting results.  However, the research does not necessarily support this thought process.  Muscles tend to get sore anytime a new stimulus is introduced (new exercise, activity, etc), but this should typically subside within 2-3 weeks of starting the activity.  Anytime a new exercise is introduced, it is expected that some level of soreness will occur.  However, a good program will actually have an introduction phase where weight and volume are intentionally reduced in order to avoid excessive soreness, as this can negatively impact future workouts.  If you are chronically sore beyond the initial 2-3 weeks of starting a strength training program, there are eight areas that you may need to pay attention to.

Jeff Tirrell, CSCS, CSFC, Pn1

#2–Hydration

Hydration or water intake is probably one of the easiest ways to improve health, recovery, and performance.  For most people in the general population, we want to focus on calorie free fluid with minimum caffeine (this means water).  Water acts as a solvent, transporter, catalyst, lubricant, temperature regulator, mineral source, and assists in anabolic processes.  Water helps bring nutrients to cells and removes waste.  It is used in the production of proteins and glycogen, helps facilitate and speed up many chemical reactions (many wouldn’t occur without it.  It also lubricates joints and acts as a shock absorber for our eyes and the spine.  Water intake should range from 1 Liter per 1000 calories consumed (need to know your caloric consumption) up to ½ ounce per pound of bodyweight.  In very hot or humid conditions or when activity is very high, larger amounts may be needed.

8 Reasons Why You’re Sore–#1: Sleep

One of the most common complaints I get from new trainees (most often these come from middle aged men who are just now getting back into strength training) is that of being sore all of the time.  Many people associate muscular soreness with getting a good workout or getting results.  However, the research does not necessarily support this thought process.  Muscles tend to get sore anytime a new stimulus is introduced (new exercise, activity, etc), but this should typically subside within 2-3 weeks of starting the activity.  Anytime a new exercise is introduced, it is expected that some level of soreness will occur.  However, a good program will actually have an introduction phase where weight and volume are intentionally reduced in order to avoid excessive soreness, as this can negatively impact future workouts.  If you are chronically sore beyond the initial 2-3 weeks of starting a strength training program, there are eight areas that you may need to pay attention to.

Jeff Tirrell, CSCS, CSFC, Pn1

#1–Sleep

Sleep is one of the most neglected areas of health, fitness, and recovery.  It can have some of the most dramatic impacts on improving any of these areas, but can also be one of the most difficult areas to improve. We only have 24 hours in a day and we must divide this time between sleeping, eating, work, family/social time, leisure activities, and training.  Your priorities will dictate which areas you spend the most time on.  One thing that is often overlooked however, is that increased sleep (both quantity and quality) can help in many of these areas.  It has been shown that better sleep improves cognitive function (better function at work), makes you more efficient, improves mood (better for friends and family), improves hormonal profiles (better for health), and improves performance and recovery.  If you struggle to get enough sleep, try to set a better schedule for yourself to allow for earlier bedtime and/or a later wake time.  If you struggle with sleep quality, try to establish better sleep hygiene practices.  Common recommendations are to sleep 7-9 hours per night (kids need more like 9-12 hours/night).  However, some research suggests that hard training individuals may need 9-10 hours of sleep for optimal results.

100 Steps Per Minute

Step Cadence and Fitness

Exercise researchers have been studying gait cadence for years.  A cadence of 80 steps a minute is a stroll.  100 steps a minute is considered a brisk walk.  At 130-140 steps a minute, you move into jog or slow run.  Recent high tech evaluations of gait cadence has been able to predict the onset of dementia in older people.  For many people, walking is their primary form of exercise.  Gretchen Reynolds has written an excellent *article on the walking cadence that produces optimal health benefits.

A compilation of many studies has found that 100 steps per minute is the sweet spot for walkers under the age of sixty.  The data for older walkers has yet to be fully evaluated, but it appears a slightly slower cadence is a good goal.

I like evaluations of performance.  Evaluations tell you if you are getting better or getting worse.  The human body is in a constant state of adaptation and never stays the same.  Keep track of your cadence by counting your steps for twenty seconds and then multiplying by four.  Use that information to track your fitness level.  Ideally it should get easier to walk, at faster pace over a greater period of time.

15 x 4 = 60 Pokey Joe.

20 x 4 = 80 Still too slow.

25 x 4 = 100 Good job.

Michael S. O’Hara, PT, OCS, CSCS

*Walk Briskly for Your Health.  About 100 Steps a Minute, Gretchen Reynolds, New York Times, June 27, 2018

View: https://www.nytimes.com/2018/06/27/well/walk-health-exercise-steps.html

You Have A Social Media Disease

There Is No App for Thumb Pain

Your thumb is made up of an intricate system of tendons that enable very precise movement.  The joints of a thumb are fairly small and yet we are able to produce an amazing amount of force with this single digit.  In this age of all things digital, the modern American thumb has been subjected to greater workloads.  Problems with thumb pain, numbness, and limited function are becoming more common complaints in physical therapy.  I have some suggestions on how to manage pain and limit the damage and embarrassment of excessive social media thumb exposures.

Thumb Tendon Troubles

Dr. De Quervain was the first to clinically described thumb tendonopathy, and we call thumb tedonosis De Quervain Syndrome.   The test for De Quervain Syndrome was created by a clinician with an equally odd name and it is called the Finkelstein test.  Place your thumb in the palm of your hand.  Make a fist with the finger around the thumb.  Hold the wrist in neutral and then deviate the wrist toward the pinkie finger.  If you feel pain it is a positive Finkelstein test.

Resolution of thumb tendonopathy pain happens quickly when you give in to the symptoms of pain and modify your activities.  Rest the thumb tendons by using your fingers instead of your thumb on that smart phone.  Avoid fitness activities that put stress on the thumb.  Lifting in front of the body with the palms facing inward is often the lift that new mothers perform and develop painful thumb tendons.  Early on in the pain onset, icing is often helpful.  In physical therapy, we are successful with soft tissue mobilization, ultrasound, and manual therapy.  A gauntlet type thumb splint you wear at night is an unattractive but provides aviable position of rest for severely aggravated thumb tendons.

The Numb Thumb

Irritation of the median nerve in the carpal tunnel of the wrist will create thumb, second, and third finger numbness and pain.  An injury of the recurrent median nerve in the front of the palm will produce numbness in the thumb and limited strength during thumb opposition–thumb to pinkie finger.  Patients with neural irritation often develop numbness, weakness, and then pain.  The pain often wakes them from sleep and disrupts hand function.

Once again, you will resolve a numb thumb with rest.  Once neural irritation gets fired up, it takes longer to resolve than an aggravated tendon.  Giving in to the numbness and resting the hands will produce better results if you start early.  Two weeks of avoiding the aggravating hand activity produces good results.  Night splints for the wrist and thumb are often helpful.  A carpal tunnel release is a common surgical alternative that takes pressure off the median nerve.

Gumbie Thumb Beware

Every joint has a certain degree of stability and certain degree of mobility.  Our spine, knees, hips, shoulders, and elbows must move enough to produce motion but not so much that they fall apart.  The amount of movement in our joints is largely an inherited characteristic–you can blame Mom and Dad.  The person at the extreme end of the scale (“double jointed”) needs to take certain precautions with their thumbs.

The Beighton Score is a popular screening technique for joint hypermobility.  It has been around for thirty years and is used in research all around the world.  The scoring is based on eight passive range of motion assessments and one active range of motion assessment.  One point is assigned for each of the following.

A pinkie finger that can be passively bent backward more than 90 degrees.

A thumb that can be pulled down to the front of the forearm.

Elbows that passively hyperextend to 10 degrees.

Knees that passively hyperextend to 10 degrees.

The subject can place the palms on the floor during a straight leg, forward bend.

Researchers disagree on the score that should be a threshold for concern about systemic joint hypermobility.  I have found that fitness clients and physical therapy patients that score a 5/9 or higher require modification of their training programs.  It is not uncommon to encounter physical therapy patients that have a Beighton Score of 9/9.  Hypermobile individuals need to take more precautions when they perform repetitive tasks such as texting on a smart phone.

Kimberly Salt wrote an excellent article on social media induced thumb pain in the May 19, 2018 issue of the New York Times.  Take a minute and read, Me and My Numb Thumb: A Tale of Tech, Texts and Tendons.

Michael S. O’Hara, PT, OCS, CSCS

Lumbar Spine Fitness Guidelines

Janet injured her lower back while exercising in her local gym.  She was taking a trip through her favorite “ab ciruit” when she felt a snap in her lumbar spine.  The next day she was unable to stand up straight.  Two weeks later, we met her in physical therapy for her initial evaluation.  She was ready to return to her fitness program three weeks later.  Janet was very concerned she may suffer another exercise induced back injury and requested some advice.  These are the simple guidelines I give to physical therapy low back patients returning to exercise.

Mobilize the Thoracic Spine and Hips

Movement is supposed to happen at the thoracic spine and hips.  Unfortunately, prolonged sitting, deconditioning, and poor training choices tends to restrict mobility in these areas.  If you are unable to rotate and extend at the hips and thoracic spine, your brain will use other joints to make up for the deficit.  Pushing extra rotation and extension forces into your lumbar spine is never a good thing.  Dedicate some training time to improving thoracic spine rotation and hip extension / internal rotation range of motion.  If you sit for a living, work on your mobility everyday.

Make the Lumbar Spine Stable

Most fitness clients believe that more lumbar spine movement is a good thing.  They perform toe touches, back twists, and the many breeds of up and down dogs.  Unfortunately, greater lumbar spine range of motion is positively correlated with a higher incidence of lower back pain.  The incidence of low back pain escalates even further when we move those hypermobile lumbar spine segments against a resistance.  What does keep lumbar spines healthy is high level of lumbar spine strength endurance.  Can you hold the lumbar spine stable and prevent movement from occurring at the pelvis and five lumbar vertebrae.  Your lumbar spine stays happy and healthy when you focus training efforts on planks, roll outs, crawls, carries, and Pallof press exercises.  Avoid the sit ups, crunches, sidebends, toes to bar, and other assorted “ab” exercises that create lots lumbar spine motion.

Avoid Muscle Isolation Exercise Activities

The muscles that support the lumbar spine work together as part of a neurally connected team.  Training activities that support better communication between the team members will create optimal performance.  The neuroanatomy saying is “What fires together, wires together”.  Ditch the “upper abs”, “lower abs” baloney and sprint away from anyone who trys to strap you into a machine in an effort to “isolate your obliques”.

On her discharge from therapy, Janet was unable to perform a single roll out and fatigue fairly quickly with a twelve pound suitcase carry.  For the last three months, she has followed the guidelines and her progress has been excellent.   Janet is currently performing a suitcase carry with fifty pounds and has worked up to ten full reps on an ab wheel roll out.

Michael S. O’Hara, PT, OCS, CSCS

World’s Best Diet Part 9–Fasting

If you google the word diet, you will come up with over 200,000 results.  Every week, month, year, and decade a new study or article comes out claiming certain foods are killing us, or that some other food or nutritional approach will lead us to the promised land.  Unfortunately, articles are written to create traffic, so scientific research is often misreported or spun to sell magazines or generate website traffic.  The truth is, there are many ways to skin a cat.  All of the evidence on nutrition (in regards to weight loss) points to two undeniable truths.  First, that dietary adherence is king.  It doesn’t matter how perfect or evidence based a nutrition plan is, if you can’t follow it, it doesn’t matter.  Before starting any eating plan, you must ask yourself how easy it will be to maintain long term.  Second, you must achieve an energy deficit to lose weight (eat less energy than you expend each day).  Though “calories in, calories out” may be slightly over simplified, it is still the underlying rule to any weight loss success.   For any weight loss plan to work, you must consistently follow the pla, and you must be in a caloric deficit.  This series will highlight the nine most popular current nutrition approaches, and the pros and cons of each.

Fasting

Claims: There are a ton of different approaches to fasting.  The most common are ADF (alternate day fasting) and IF (intermittent fasting).  ADF simply means that one day you eat nothing, followed by a day of standard eating.  IF is a restricted eating format where you don’t eat for a given period of time (16 hours being the most popular) followed by a feeding window where you eat regularly (8 hours in the 16 hour example above).  Every person fasts when they sleep by default, the various fasting protocols simply extend this fast one way or the other.  Purported benefits include improved insulin sensitivity, improved heart health, weight loss, better brain function, and some eve claim better performance.

Reality:  There is nothing magical about fasting.  When calories are controlled for fasting protocols seem to offer many of the health benefits that other diets show (improved heart health, improved insulin sensitivity, weight loss, etc.).  One unique potential benefit is that of life extension.  Several animal studies have shown this to be the case, but more research is needed.

Pros:No off limit foods.  Even without tracking food directly many people will eat less food by reducing the window of time in which they eat food.  This is probably one of the simplest plans to follow in concept.  If you can tell the time you can follow this plan.

Cons: No emphasis on food quality, or protein intake.  May not get enough vitamins and minerals in if you aren’t sure to emphasize getting a large amount of whole and unprocessed foods since you aren’t eating on a daily basis.  May be harder to maintain muscle mass (though research hasn’t shown this yet).  Could lead to binge eating behaviors during the feeding window in some individuals.  If this is you, this plan is not right for you.

Jeff Tirrell, CSCS, CFSC, Pn1

World’s Best Diet Part 8–The Mediterranean Diet

If you google the word diet, you will come up with over 200,000 results.  Every week, month, year, and decade a new study or article comes out claiming certain foods are killing us, or that some other food or nutritional approach will lead us to the promised land.  Unfortunately, articles are written to create traffic, so scientific research is often misreported or spun to sell magazines or generate website traffic.  The truth is, there are many ways to skin a cat.  All of the evidence on nutrition (in regards to weight loss) points to two undeniable truths.  First, that dietary adherence is king.  It doesn’t matter how perfect or evidence based a nutrition plan is, if you can’t follow it, it doesn’t matter.  Before starting any eating plan, you must ask yourself how easy it will be to maintain long term.  Second, you must achieve an energy deficit to lose weight (eat less energy than you expend each day).  Though “calories in, calories out” may be slightly over simplified, it is still the underlying rule to any weight loss success.   For any weight loss plan to work, you must consistently follow the pla, and you must be in a caloric deficit.  This series will highlight the nine most popular current nutrition approaches, and the pros and cons of each.

Mediterranean

 

Claims: This diet emphasizes plant based foods such as fruits and vegetables, whole grains, legumes and nuts.  You are encouraged to use oils instead of butter, spices/herbs instead of salt, limiting red meat to 2x/month, and moderate to low red wine consumption.  The claims are that you will see reduced mortality rates, lower many cancer risks, and improved heart health.

Reality: This is another sensible eating plan that has been around for a long time.  Emphasizing whole foods such as fruits, veggies, whole grains, nuts,  and beans should be a no brainer.  There is a body of literature (albeit correlative in nature) that shows majority of health markers improve on this style of eating plan.

Pros: Fiber rich diet focusing on veggies, fruits, grains, olive oil, nuts/seeds, and legumes.  Encourages the social aspect of eating, and doesn’t directly forbid any food.

Cons: de-emphasizes lean protein consumption  by recommending fish/poultry only be eaten 2x/week, and read meat less than 2x/month.  Following this approach could lead to inadequate protein intakes.  No emphasis on food quantities, which may lead to some people over eating these “healthy” foods.

Jeff Tirrell, CSCS, CFSC, Pn1

World’s Best Diet Part 7–Paleo

If you google the word diet, you will come up with over 200,000 results.  Every week, month, year, and decade a new study or article comes out claiming certain foods are killing us, or that some other food or nutritional approach will lead us to the promised land.  Unfortunately, articles are written to create traffic, so scientific research is often misreported or spun to sell magazines or generate website traffic.  The truth is, there are many ways to skin a cat.  All of the evidence on nutrition (in regards to weight loss) points to two undeniable truths.  First, that dietary adherence is king.  It doesn’t matter how perfect or evidence based a nutrition plan is, if you can’t follow it, it doesn’t matter.  Before starting any eating plan, you must ask yourself how easy it will be to maintain long term.  Second, you must achieve an energy deficit to lose weight (eat less energy than you expend each day).  Though “calories in, calories out” may be slightly over simplified, it is still the underlying rule to any weight loss success.   For any weight loss plan to work, you must consistently follow the pla, and you must be in a caloric deficit.  This series will highlight the nine most popular current nutrition approaches, and the pros and cons of each.

Paleo

Claims: This approach purports to mimic the way of eating during the paleolithic era.  Also known as the caveman diet, the claim is that with the agricultural revolution over the last 2000 years, our diets have outpaced our evolution.  Proponents claim that that many of our health ills today are due to the fact that we have rapidly introduced too many new foods to the homosapien diet such as grains.  The benefits claimed range from reduced disease, weight loss, more/better muscle, improved performance, no need to track intake, and pretty much everything else under the sun.

Reality: Like everything else that over promises, this meal plan falls short.  Though there is nothing inherently bad or wrong with this diet plan, there is also nothing magical.  The whole premise of the meal plan according to Christina Warinner, who is an expert on ancient diets, is false as seen in this Ted Talk.

Pros: Increases protein intake in many individuals, encourages fruit and vegetable intake.  Often time leads to weight loss due to the fact that it eliminates many foods and thus calories from the diet.

 Cons: Needlessly eliminates grains, dairy, and many starches from one’s diet. This can lead to compliance issues long term and may lead to some nutrient deficiencies.

Jeff Tirrell, CSCS, CFSC, Pn1

World’s Best Diet Part 6–Vegetarian/Vegan

If you google the word diet, you will come up with over 200,000 results.  Every week, month, year, and decade a new study or article comes out claiming certain foods are killing us, or that some other food or nutritional approach will lead us to the promised land.  Unfortunately, articles are written to create traffic, so scientific research is often misreported or spun to sell magazines or generate website traffic.  The truth is, there are many ways to skin a cat.  All of the evidence on nutrition (in regards to weight loss) points to two undeniable truths.  First, that dietary adherence is king.  It doesn’t matter how perfect or evidence based a nutrition plan is, if you can’t follow it, it doesn’t matter.  Before starting any eating plan, you must ask yourself how easy it will be to maintain long term.  Second, you must achieve an energy deficit to lose weight (eat less energy than you expend each day).  Though “calories in, calories out” may be slightly over simplified, it is still the underlying rule to any weight loss success.   For any weight loss plan to work, you must consistently follow the pla, and you must be in a caloric deficit.  This series will highlight the nine most popular current nutrition approaches, and the pros and cons of each.

Vegetarian/Vegan

Claims: These diets claim to be healthier because they eliminate animal products as a food source.  Claims are vast and include: reducing cancer risk, improved bone health, lower mortality rates, protecting against chronic disease, etc.  Vegetarian diets are those which do not include flesh/meat of animals (though some do include fish) but will typically do include dairy and eggs.  Vegans on the other hand do not consume any products that come from animals (in some cases even excluding honey).

Reality: All of the claims from Vegans and Vegetarians on superiority for health come from correlative studies which do not control for confounding variables.  They simply take a survey and use correlations to draw conclusions.  Correlative research cannot draw conclusions, it can only direct us toward areas that need further study.  Of the 6 studies to ever look at health outcomes among vegetarians and vegans, 3 showed reduced mortality for meat eaters, while 3 showed reduced mortality for non-meat eaters.  The 3 studies that showed advantage to vegetarians all compared religiously motivated groups to general population (who tend not to be overly concerned about their health).

Pros: Tends to encourage the consumption of more whole grains, fruits, and vegetables.

Cons: Often leads to inadequate amounts of protein being consumed.  Anytime entire food groups are removed, there is an increased risk of deficiencies.  In this case, the following nutrients may be compromised: B12, Vitamin D, Calcium, Iron, Zinc, and Iodine.  Protein is the most satiating macronutrient, meaning it tends to fill you up more than fats or carbohydrates.  If protein levels drop, as is often the case in these diets, the chances of over consuming calories rises.  Low muscle mass levels are a risk due to inadequate protein intake.  In my experience, I have only met 2 (out of around 30) vegetarians over the last 20 years who were not either overweight and/or under muscled.

Jeff Tirrell, CSCS, CFSC, Pn1

1 2 3 25
Categories