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Skeletal Strengthening

Exercise Training That Prevents Osteoporosis

bending_the_age_curveI recently heard a talk by Dr. Joseph Signorile on the latest and greatest research in regards to exercise that prevents and reverses osteoporosis.  Dr. Signorile is a professor of kinesiology at the University of Miami.  He is an expert on fitness for older adults and conducts research in the field of geriatrics.  Based on what field proven research is telling us today, Dr. Signorile has these suggestions:

Bone reacts best to dynamic mechanical stimulation.  The best bone building exercises create a stress that changes as we move, rather than a static force.  Progressive resistance training involves moving your body against a resistance.

If a bone is to respond to training, the stimulus must be at a suprathreshold level.  The participants in the studies that got the best results carried, lifted, pulled, and pushed some serious loads.  “Suprathreshold level” means it has to be physically challenging.  Elliptical training and those five pound chrome dumbbells will not produce a bone building response.

Optimal bone building skeletal loading.  What the research studies have found is that the best gains occurred with forty repetitions of loading at each skeletal region per training session.  Less than forty is less than optimal.  More than forty repetitions have no further bone building benefit.  Two or three properly executed exercises can take care of loading the entire skeleton.  An appropriate skeletal training session can be made up of 80-120 repetitions.  You can get that done in fifteen minutes.

The response of bone to exercise is improved by brief but intermittent exercise.  Loading your skeleton more frequently creates a stronger mineralization response in the bone.  Five or six training sessions per week will produce more bone density than two or three sessions per week.

Bone responds best when you employ a loading pattern that differs from the usual loading pattern.    I have been ranting about this for years.  Bone only adapts–gets stronger–when the exercise stimulus is a challenge beyond what you have subjected the bone to in the past.  If you have been performing the same activity at the same load for months on end, the bone building stimulus is minimal.   To improve bone health, you should alter the exercises you perform every three to four weeks.

What the research recommends….
Based on what the research is telling us, Dr. Joe recommends you perform a program of dynamic weight training that delivers forty repetitions of loading at each section of your skeletal system.  You will see better results with more frequent training sessions and consistent alteration in exercise activities.  Pick two or three exercises and load them aggressively for forty repetitions each.  Perform your exercise three to five times a week and change your exercises every month.  To learn more, talk to our trainers for some bone building exercise suggestions.
Michael S. O’Hara, P.T., OCS, CSCS

Natural Testosterone Boosters

RaisinThe drug companies are spending millions of dollars in marketing to get us guys started on the latest lifestyle drug for men.  Testosterone replacement therapy is producing big gains for the pharma industry.  Unfortunately, the side effects with taking supplemental testosterone appear to be far greater than expected.  The latest studies have found substantial risks in prescribing testosterone to middle age and older men.  If you are over sixty five, the risk of heart attack doubles, and if you are middle age with a history of heart disease, the risk triples.  The best article I have read on the topic appeared in the New York Times Editorial section on 2/4/14—take some time and read it over.  The good news is that with a little effort you can change your testosterone levels with out resorting to medications.  These are the time tested and risk free methods.   (The NY Times article can be seen by clicking this link: http://www.nytimes.com/2014/02/05/opinion/overselling-testosterone-dangerously.html)

Lower Your Body Fat
This is the reason most guys say they “feel better” when they drop twenty pounds.  Higher levels of body fat are correlated with lower total and free testosterone levels.  Lowering your body fat levels down from 30% plus to less than 15% has been shown to produce a consistent jump in testosterone levels.  The biggest side effect to losing body fat is that you will be less likely to have a heart attack.

Get Adequate and Consistent Sleep
Human and animal studies have demonstrated drops in testosterone levels with short periods of sleep restriction.  Chronic sleep deprivation has a huge effect on your hormonal profile.  If you think you have sleep apnea–big time snoring and always sleepy– get a sleep study and take steps to remedy the problem.  Sleep apnea is implicated in the development of hypertension and heart disease.  A stroke or heart attack will produce a very negative effect on your testosterone levels.  Read the book Getting a Good Night’s Sleep by Nancy Foldvary-Schaefer and develop better sleep habits.

Change Your Training
Exercise duration and intensity have an effect on hormone levels.  Low intensity, long duration exercise (think distance running) has the effect of producing a catabolic hormonal response; while high intensity and short duration exercise (think sprinting) produces an anabolic response.  Testosterone levels rise with the anabolic response of short and intense workouts.

Optimize Vitamin D Levels
We know Vitamin D helps with immune system function, bone health, and appears to be protective for some types of cancers.  There is increasing evidence that vitamin D can increase testosterone levels.  You can have your vitamin D levels checked when you get your yearly physical exam.  During the winter months, when sun exposure is at a minimum, some vitamin D supplementation is even more important.

Less Alcohol
About four hours after your first drink, you get an increase in the stress hormone cortisol.  Cortisol inhibits the production of testosterone.  The hormonal impact of alcohol consumption lasts up to 48 hours.  The maximal drop in testosterone levels is produced twelve hours after you have stopped drinking.  If your goal is to increase your testosterone levels then abstaining from alcohol will help improve your numbers.

Eat Healthy Fats
Low fat diets inhibit sex hormone production.  Keep walnuts, salmon, avocado, and olive oil in your daily diet.  If you exercise on a regular basis, adding a quality fish oil supplement can help you recover between training sessions.
Michael S. O’Hara, P.T., OCS, CSCS

A $2500 Coat Rack

treadmillA past physical therapy patient of mine recently brought in a newspaper article that discussed the merits of different types exercise equipment you can purchase for your home.  She wanted my advice on the piece of machinery I would recommend for her and her husband to purchase for their home.  Should they get a $1600.00 elliptical machine, a $2500.00 treadmill, or $1100.00 recumbent bike?  My answer was that none of these machines are likely to be a good choice as most large cardio machines become an expensive coat rack in less than four months.  If you are starting out on a fitness program, my suggestion is to purchase the following:

Note Pad and Pen $10.00
In advance, you will write out your monthly “plan of exercise action”.  Set down in writing the date, time, place, and exercise activity.  The written plan is a commitment to keep on schedule.  Record your exercise sessions in a training log.  Write out the exercises you perform, the number of sets, repetitions, and loads.  Your initial successes with exercise will come in the form of better strength and work capacity—not pounds falling on the scale.  The training log will help you recognize your progress and this reinforces the exercise habit.

Tape Measure $1.00
A good exercise program is going to increase your muscle mass, hydrate your body, and add some bone to your skeleton.   In the beginning, the numbers on the scale may go up instead of down and this can frustrate many exercise newbies who are looking to “drop twenty pounds in four weeks”.  Put the bathroom scale away and record girth measurements.  Men measure around the belly button and women around the hips. These are the regions that are quickest to change with proper training.

Alarm Clock $25.00  
Research at the University of Michigan department of psychology demonstrated that individuals who are successful with long term exercise compliance get out of bed and do it in the mornings before other aspects of life have a chance to interfere with their plans.

Kitchen Scale $50.00
Ask any trainer or dietician who works with clients on body composition goals.  The general public has no food portion awareness.  Knowing the number of calories present in a portion of food is critical to reaching body composition goals.  You will never be able to exercise enough to counterbalance the effects of a poor diet.  Consistent use of a kitchen scale will educate you on portion size and total calorie consumption.

Home Exercise Equipment $200.00
One hundred dollars for a Lifeline suspension trainer.  Thirty-five dollars for a physioball.  Two sets of all-purpose resistance tubing at fifty dollars and two furniture sliders at five dollars.  You can get all of this from performbetter.com.  Shipping is about ten dollars.  My recommendation is that most people should not purchase any home fitness product that they cannot lift overhead with one hand.
Pedometer $55.00
A pedometer is a small device you wear to record the number of steps taken in a day.  Pedometers have become less expensive and more accurate.  Increasing daily step count is the easiest way to produce big changes with individuals returning to fitness activities.
Record your daily step count in your training log and work on increasing that number.  Ten thousand steps a day is a good goal for most people.

Professional Assistance $600.00
If you have been away from exercise for some time, hire an educated and qualified trainer to assist you in designing and implementing an appropriate program.  Numerous studies have shown that individuals who use trainers are more successful in reaching fitness goals.  The trainer will teach you how to properly use the home exercise equipment you have purchased.  No one performs exercises correctly after only one training session.  You need ongoing evaluation and progression on proper exercise performance.  Older and physically limited individuals need the assistance of a trainer more than any other group.

Total Cost $941.00
You will have more space in your house, more money in your pocket, and you will be much more likely to succeed in reaching your fitness goals.  Two years from now, you will sell that $2500.00 treadmill on ebay for $200.00.

Michal S. O’Hara, P.T., OCS, CSCS

How To Score Your First Push Up

Improving Performance Of A Fundamental Fitness Activity

Improving push up performance enhances spinal stability from the base of the skull to the pelvis, as well as strength in the shoulder girdle.  Push ups are a valuable exercise that improves multiple aspects of fitness in a short amount of time.  Various types of push ups can be used to achieve different goals such as better rotator cuff coordination, power production, or muscular endurance.  Many people have never been able to perform a single solid push up.  Getting better at performing push ups is easy.  The trick is breaking the push up into pieces.

Push Up Planks
The biggest limitation for beginners is limited core and shoulder girdle stability.  The torso and hips sag and the shoulder blades wing off the rib cage.  To remedy these problems, work on improving isometric stability with push up planks.  Set up in the top position of the push up and hold for thirty to sixty seconds.  Get a mirror or have a training partner check your position.  Keep the gluteal muscles tight and pull the shoulder blades down the back.  Elevate the feet on a bench or box to increase the challenge.

Eccentric Push Ups
The most difficult portion of a push up is the eccentric or the lowering phase.  You often see “half push ups” performed in the gym because the trainee is unable to maintain control if they drop any further.  Start from the top of the push up and lower in a controlled fashion all the way to the floor.  You will probably find that the bottom half is difficult to control–keep trying, it will get better.  Perform two or three sets of three eccentric push ups.

Dead Stop Push Ups  
The neural link up between varying muscle groups needs to be turned on to make a push up happen.  Starting your push up from a dead stop off the floor improves these connections.  Lay prone and place the hands on the floor directly adjacent to the armpits with the elbows back.  Your upper arm should be no higher than 60 degrees from your side.  Set your body by tightening up the shoulders, pulling in the chin, and bracing the abdominals and gluteal muscles.  Think about moving quickly off the floor.  Return to the floor, recharge your neural system with a ten second rest, reset, and perform another repetition.  Once you get up to five good dead stop push up repetitions, move on to a full push up from the top position.

BOSU Leverage Push Ups
If you are not able to perform a push up from your toes instead of dropping onto the knees, I recommend using a BOSU under the thighs.  It will produce a higher core stability demand, and I have found it has far more carry over to a true, full push up than the kneeling “girls push up’.

Avoid Training To Failure
Getting better at push ups is more neural than it is muscular.  You make better progress if performing fewer repetitions with good technique rather than dozens of bad push ups.  If you want to improve your push up performance, do not train your push ups to the point of failure.  Stop the set with one or two repetitions “still in the tank”.  If six repetitions is your maximum, stop at four, rest, and then repeat for another sub maximal set.  Try laddering your sets of push ups; perform a five repetition set, and then a four repetition set, and then a three until you reach one repetition.  You will increase the total work volume–more practice, without exhausting the nervous system.

Michael S. O’Hara, P.T., OCS, CSCS

30 Minutes Of Fitness

Remember, You Asked For It

“I don’t have enough time” is the big excuse people give for not exercising.  At Fenton Fitness,  we can get you in and out of the gym in thirty minutes.  Our movement based training sessions produce excellent results with minimal time commitment.  We program in high value exercise activities in a layout that produces optimal gains.  This is the first of six, 30 Minutes of Fitness, sessions.  The best workouts are short, intense, and frequent.  Intensity is usually the missing factor in most gym goers’ training sessions.

Session One
1.    Moving knee to chest mobility drill x 20 yards
2.    World’s Greatest Stretch x 20 yards
3.    Sled Push x 100 yards
4.    A. Push ups 3 x 8-12 repetitions
B. Inverted row or TRX row 3 x 6-10 repetitions.
C. Kettlebell Goblet Squat 3 x 6-10 repetitions.
5.    Medicine Ball Overhead Throws off wall 3 x 5 repetitions.

One and Two:  Perform the two basic movement preparation drills for twenty yards each.
Three:  Load your sled up with +/- 20% of your body weight and give it a push for 100 yards.  You can rest as needed, but try to get the entire 100 yards completed in less than five minutes.
Four:  You should be warmed up, breathing faster, and ready for some strength training.  Perform the next three exercises in a circuit fashion.  A set of push ups followed by a set of rows and then a set of goblet squats.  Between the different exercises, rest as little as possible, and then after you get through an entire circuit, you can take a longer 90 second break.  Repeat the circuit three times.
Five:  Work on power production with three sets of overhead medicine ball throws.  Use a weight that lets you throw a line drive and not a lob.
Choose the appropriate exercise variation and load for your strength exercises.

Session One Synopsis:
Effective mobility training.
Total body conditioning.
Twelve sets of strengthening exercises.
Explosive power training.

See the video for more information.

Michael S. O’Hara, P.T., OCS, CSCS

The Lazy Man’s VO2 Max

You’re In Pretty Good Shape For An Old Guy

VO 2 Max testing is a very useful assessment of fitness.  It is a measure of peak oxygen uptake and has been shown in large-scale studies to closely correlate with longer life spans.  Unfortunately VO 2 Max testing requires a physiology lab and a session on a treadmill that I can only describe as a nausea-inducing, up hill run while wearing a gas mask.  Recently a group of Norwegian researchers created a very accurate on-line calculator of VO 2 Max and fitness age.

The mathematical algorithms the calculator is based upon are from the physiology lab assessments of over 5000 Norwegians of every age from 20 to 90.  You simply plug in your age, sex, exercise frequency and intensity, resting heart rate and waist size in centimeters.  The computer will give you your VO 2 Max number (bigger is better) and fitness age (lower is better).

I have run the Norway VO 2 Max evaluation on several friends, fitness clients, and family members.  The results have been an education for everyone.  The need to exercise at higher intensity levels and reduce waist size was a surprise to many who took the test.  Take the time to plug in your data and get your score.

Evaluate your score here: http://www.ntnu.edu/cerg/vo2max

Michael S. O’Hara, P.T., OCS, CSCS

Huffin’ And Puffin’

Conditioning Sessions: Better Results, Less Time, And Fewer Injuries

sledFor most of the fitness clients I work with, long duration cardio training—thirty minutes on the treadmill, forty minutes on the elliptical, and any time on a recumbent bike is a waste of training time.  It does nothing to move them toward their fitness goals.  A far better choice is to perform strength training followed by a conditioning session.  Conditioning sessions are very different than long duration “cardio”.  Conditioning work is performed for short durations at high intensity.  You link different drills together in a series to produce a metabolism boosting session that lasts ten to twenty minutes.

Conditioning Benefits
Conditioning sessions speed up your metabolism–your body uses more calories just walking around, sitting, sleeping, etc.
It improves your capacity to perform functional tasks such as lifting, carrying, pushing, and pulling.
It is never boring–changing the stimulus changes your body.
Conditioning sessions maintain the physical properties we lose as we age–muscle mass, bone density, and power production.
Conditioning is time efficient–a properly designed session takes ten to twenty minutes and you are done.
You are far less likely to suffer an injury because you are not performing the same movement patterns for multiple hours every week.
Proper programming of a conditioning session will allow you train around an injury.
Conditioning can be scaled to any fitness level.
It is fun.

Conditioning Drawbacks
It will never–and should never–get easy.
You will need a new wardrobe because all of your pants will get looser.
You will not be able to watch TV while you exercise.
It will get you kicked out of Planet Fitness.

Since most gym goers are unfamiliar with conditioning training, we will be posting information on our favorite tools and a monthly conditioning session.  Give these a try and let us know how you do.

Michael S. O’Hara, P.T., OCS, CSCS

Everything Works–For Six Weeks

“The world hates change, but it is the only thing that has brought progress.”–Charles Keating

One of the most frequent complaints from gym members is that they exercise but see no results.  They ride the elliptical, lift weights, and Zumba three days a week, but they make no progress in how they look, move, or feel.  The common feature to almost all of these clients is that they have done the same activity at the same intensity for a prolonged period of time.  The human body is a master at adaptation, and the only way it will change is if you alter your exercise activity on a regular basis.

Novices can stay on the same exercise program for eight to twelve weeks and still see results.  More experienced trainees should alter their routine every three to four weeks.  Increase the weight you lift and lower the number of repetitions–four sets of five repetitions instead of three sets of eight.  Add in some balance challenging single leg training and discontinue the bilateral exercises you have used since high school.  Take a month and work diligently on improving a movement pattern that gives you difficulty.  If your conditioning is below average, program in a series of high intensity sled activities for four weeks.

Most programming changes make training more difficult and produce greater delayed onset muscle soreness.  This is all part of creating a new stimulus that the body finds challenging.  In a few sessions, the soreness will be gone.  In three or four weeks, the sessions will be less demanding and you will be ready for another alteration in the training cycle.

Many athletes and fitness enthusiasts would do well with taking two or three weeks away from training and focus on recovery and regeneration activity.  Elite athletes often schedule two or three periods of recovery into their yearly training plans.  Do not lift any weights, run, jump, or compete for a period of time.  Get plenty of sleep, and spend that time working on your soft tissue restrictions by using a foam roller or massage stick every day.  If you have tight hips, shoulders, or thoracic spine, dedicate this time to restoring motion at the restricted area.  A fourteen day rest period is often enough time to permit full physical recovery, but not so extended that you lose strength or endurance.  With full recovery, all systems will be able to respond much better once you return to training.

Change is good, but frequently neglected.  The best results will be produced with regular alterations of fitness programming.  See our trainers for information on a Functional Movement Screen Assessment and training program design.

Michael S. O’Hara, P.T., OCS, CSCS

Fitness Reinforcement

An Olympic Quest

As a society, we do not do enough to reward positive fitness habits.  I think the Russians are on to something with this novel method of earning a subway ticket.  As a country, we need to get into the fitness incentive technological race and expand on this advancement.  We aren’t going to let the Russians beat us.

I am sure Google has the software and hardware that would permit us to record our exercise activity and earn fitness credits.  Americans could use their earned credits to purchase health care, reduce income taxes, or bank them in their health care accounts.  This would be a non-mandatory incentive that would do more to lower health care costs than putting trans fats under FDA control or minimizing the size of our soft drinks.  It would reward good fitness behavior.  We could even link the program to the government Affordable Care web site…

Michael S. O’Hara, P.T., OCS, CSCS

November Is Diabetes Awareness Month

The big thing to remember about diabetes is that it is a 24 hour a day, seven day a week disease that slowly and steadily robs your body of vitality.  The good news is that diabetes (especially type 2-the most common) can be managed with proper diet, exercise, and medication.  Read the information listed below and take the time to visit the website stopdiabetes.com.

Tragic Trend
•    Nearly 26 million adults and children in the USA have diabetes.
•    Another 79 million Americans are what is called “prediabetic”.  They are at risk of developing full blown diabetes.
•    If we remain on our present trend, by the year 2050, one in three Americans will be diabetic.

Health Consequences
•    Two out of three people with diabetes die from heart disease or stroke.
•    Diabetes is the leading cause of kidney failure.
•    Diabetes is the leading cause of blindness in adults.
•    About 60-70 percent of people with diabetes will have nerve damage (diabetic neuropathy) that can cause pain, disability, and digestive problems.
•    The rate of amputation among diabetics is ten times higher than in the general population.
•    A woman’s health is more intensely impacted by diabetes.

Exercise and Diabetes
A 2006 concensus study by the American Diabetic Association gathered together the most recent research studies on the effect of exercise on type 2 -adult onset diabetes.  The latest research finds that exercise activity that increases muscle mass and facilitates coordination / motor control produced the best blood sugar levels and at the same time, enhanced mobility.

Muscles take circulating sugar out of your blood stream and store it as glycogen.  If you have more muscle, you are more efficient at managing blood sugar levels.  Exercise selection that enhances motor control creates a neurologically enriched environment that permits the diabetic person to make the most of their neural connections.  While walking on the treadmill is a nice start, if you wish to optimally manage your diabetes, you need to start some strength training that challenges your balance and coordination.

I am convinced that most people are unaware of how effective exercise is in the management of diabetes and the elimination of prediabetic symptoms.  You can dramatically improve blood sugar levels with as little as six weeks of training.  Most diabetic patients think they have to exercise for months before they see any results.  You have to convince them that the proper activities, performed three times a week, for thirty minutes can work wonders.  They complete eight weeks of consistent training and blood sugar levels get better and medications are eliminated or reduced.  All of them are surprised at how quickly they improve.  We need to get this message out.

Michael S. O’Hara, P.T., OCS, CSCS