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Chair Check Up

How Functionally Fit Are You?

Image chair testCoaches, trainers, and scouts all want the number of inches in an athlete’s vertical leap test.  The athlete simply jumps up and taps a lever that indicates how many inches he or she can jump straight up off the ground.  This test has proven to be an excellent indicator of how well an athlete will perform in the competitive arena.  NBA players hit impressive vertical leap numbers, so we understand how simple it must be for them to elevate over the rim.  The equivalent test for the 60-year plus population is the Chair Stand Test (CST).  The score you get on the CST is a very reliable indicator of how well you will perform in the game of life.  

Leg power, strength, and lower extremity functional mobility are measured with the CST.  The ability to repeatedly move through the sit to stand transfer without the assist of the arms pushing down on the legs or the armrests of the chair is an important skill everyone needs to maintain an independent lifestyle.  An improved CST score creates carry over to other functional skills. Patients who improve their CST scores develop better gait patterns and standing balance.  

Chair Stand Test: You need a stopwatch, a stable chair with a 17 inch high seat, and an evaluator to monitor your performance and start and stop the timer
1.    Sit in the middle of the chair.
2.    Place your hands on the opposite shoulder with the arms crossed over the chest.
3.    Keep your feet flat on the floor.  
4.    Keep your back straight and your arms against your chest.  
5.    On the order “GO”, rise up to full standing and then sit back down.  
6.    Repeat for as many repetitions as you can in thirty seconds.  
7.    If you are halfway to a standing position when time expires, count that as a repetition.  
8.    Record your results and be concerned if you score below average.

The age adjusted scores for the CST listed below are a composite of the data gathered from several research studies since 2001.  The CST has proven to be a reliable assess-ment of fitness in older adults for over a decade.  Individuals who score below average on this test are more likely to suffer falls and require assisted care in their advancing years.  For the older fitness participant, knowing your Chair Stand Test score is just as important as knowing your blood pressure numbers. 

Men’s Results
Age                    Below Average       Average       Above Average
60-64                       < 14                   14 – 19                > 19
65-69                       < 12                   12 – 18                > 18
70-74                       < 12                   12 – 17                 > 17
75-79                       < 11                    11 –17                  > 17
80-84                       < 10                  10 – 15                 > 15
85-89                       < 8                     8 – 14                  > 14
90-94                       < 7                     7 – 12                  > 12

Women’s Results
Age                    Below Average       Average       Above Average
60-64                       < 12                   12 – 17                > 17
65-69                       < 11                   11 – 16                 > 16
70-74                       < 10                   10 – 15                > 15
75-79                       < 10                   10 –15                 > 15
80-84                       < 9                      9 – 14                > 14
85-89                       < 8                      8 – 13                 > 13
90-94                       < 4                      4 – 11                 > 11

Michael S. O’Hara, P.T., OCS, CSCS

Stand Up, Walk Around, And Read This Article

I have been ranting about how damaging hours and hours of sitting is for our fitness and overall health.  More research is validating my belief that all the driving, computer time, and television watching is going to keep physical therapists, cardiologists, and surgeons working overtime for the next twenty years.  It appears that going to the gym three times a week is not enough of a stimulus to counteract the bad that happens when you sit for eight hours a day.  What we need is more general physical activity interspersed throughout our day and less sitting.  Take the time to read this article, The Marathon Runner as Couch Potato written by Gretchen Reynolds from the New York Times, October 30, 2013.

Link to article: http://well.blogs.nytimes.com/2013/10/30/the-marathon-runner-as-couch-potato/?_r=0

Michael S. O’Hara, P.T., OCS, CSCS

The Lunge Matrix

Three Dimensional Leg Training

Twenty-five years ago, I participated in a three day “functional movement” seminar given by physical therapist, Gary Gray.  Gary got the entire class involved in a morning exercise class he called Pump and Praise.   One of the activities he taught was the lunge matrix.  I was 30 years old and had been exercising fairly regularly, yet I found the lunge matrix much more challenging than expected.  Since that time, I have used the lunge matrix with physical therapy patients, fitness clients, and in nearly every session of my own training.  Almost everyone can benefit from a little lunge matrix training.

The muscles in our trunk and hips are inter-twined, aligned in a spiral and diagonal fashion.  They are neurologically connected and work as a team to drive movement in three dimensional patterns.  The lunge matrix neurologically activates all of the muscles in all of the possible movement patterns.

The lunge matrix is ideal for anyone involved in a multi-directional sport.  Tennis, volleyball, basketball, soccer, and football require efficient transition in all directions. Injury prevention is the most important aspect of any athletic training program.  Your gym program should make you more bullet proof on the field of play.

The lunge matrix can be used as a movement preparation activity with just bodyweight (my favorite) or as a stand-alone strengthening exercise.  When performed as a strengthening exercise, use functional level loads, dumbbells, or medicine balls that equal the weight of the bag of groceries or the grandchild you are going to lift.  The loads should not alter the quality of movement or shorten the range of your lunges.  Choose shoes with flatter soles as some of the more cushioned running shoes can make lateral and rotational movement patterns difficult.

Lunge Matrix Series
1. Anterior lunge R / L
2. Lateral lunge R / L
3. Rotational lunge R / L
4. Posterior lunge R / L

Watch the attached video, and then give the lunge matrix a try.

Michael S. O’Hara, P.T. OCS, CSCS

Throw Old Gracefully

Powering Up The Older Athlete

Exercise is like medicine—administer the correct prescription at the proper dose and the patient thrives.  Different patients require dramatically different medications.  The “exercise medicine” for older adults is a consistent dose of power training.

Fitness Age Changes
Between the ages of 65 and 89, explosive lower limb power production declines at a rate of 3.5% per year.  Strength, on the other hand, declines at a slower 1-2% per year rate in this same group.  Power is the ability to create force in a short period of time and is different than raw strength.  Power is the component of fitness that makes you able to react to a fall or sudden disturbance in balance.  As power recedes, falls and injuries increase.  As falls and injuries increase,  mobility and independent living decrease.

Speed Specific
The implication for older athletes that want to prevent falls and remain independent is that training is speed specific.  You must find exercise activities that make you move at faster tempos.  Seated or supine, slow-paced activities may be beneficial in other ways (strength, cardiac endurance), but they will not improve muscle contractile speeds.

Medicine Ball Wall Throws  
Adding a velocity component to your training is not complicated.  Nearly everyone can throw a medicine ball at a wall.  Throws will improve your balance, proprioception (positional awareness), core stability, power production, and overall coordination.  Watch the accompanying video of some of our favorite wall throws.  Choose a medicine ball of appropriate weight—most people go too heavy—and add three or four sets of throws to your gym program.

Michael S. O’Hara, P.T., OCS, CSCS

 

The Best Training Partner For Endurance Athletes

A Stronger Immune System With Probiotics

A study published in the International Journal of Sport Nutrition and Exercise Metabolism* found that athletes who took a probiotic supplement during the winter had fewer colds and other upper respiratory tract infections.

LactobacillusThe study included 84 athletes that trained an average of ten hours per week in endurance sports such as running, cycling, or swimming.  They were divided into two groups: a probiotic group and a placebo group.  Over the course of sixteen weeks, the frequency of upper respiratory tract infection (URTI) was measured, as well as markers of immune function in the blood and saliva.

Research Findings
People in the probiotic group had far fewer cases of URTI (66%) than the placebo group (90%).

When they did get an URTI, the probiotic group reported fewer days with symptoms and spent less time on medications for the symptoms.

People taking probiotics who did get sick were less likely to have their training schedule interrupted by the URTI.

The probiotic group had higher levels of infection- fighting antibodies in their saliva.

The probiotic bacteria that was used in this study was lactobacillus casei Shirota.  There are 125 known lactobacilli species and many of them have been studied for their positive effects on health.  How can you get and keep more of these helpful training partners in your gut?

Eat foods that are cultured or fermented with lactobacilli.  These include yogurt, beer, wine (yeah!), cider, sourdough bread, and some sauerkraut (bleah!) and kimchi.  Eat foods that lactobacilli thrive on–the fibers in fruits and vegetables.  Lactobacilli are especially vulnerable to antibiotics, so take them only when necessary.  If you are going to supplement with probiotics, choose a quality product.  Keeping bacteria alive in a store and on its pathway to your gut involves some special handling.

*International Journal of Sport Nutrition and Exercise Metabolism 2011, 21:55-64

B. O’Hara RPh

Stripe Hype

The Good And Bad Of Kinesio Taping

In 2008, Kinesio tape (KT) was donated to 58 countries for use during the Olympic games.  Since that marketing effort, its presence in televised sports has exploded.  The athletic fashion statement found at many competitions is the brightly colored strips of tape across elbows, knees, shoulders, and hips.  At Wimbeldon, Novak Djokovic had green tape on his elbow.  Many of the soccer players at the last Euro competitions had tape on shoulders and hips.  Female beach volleyball players seem to be wearing more tape than clothes.

Kinesio tape was invented by chiropractor Dr. Kenzo Kase in the 1970s.  KT is made of cotton with an acrylic adhesive that permits it to stretch 40-50% of its resting length.  The website for Kinesio tape claims that it can alleviate pain, reduce inflammation, relax muscles, enhance performance, and help with rehabilitation.  Rock tape, a competing product, makes similar claims and uses the slogan Go Stronger, Longer.

Does Kinesio Taping work?
Serena Williams with Kinesio TapeA meta analysis performed by Wilson in 2011 looked at all of the studies performed with KT and found some evidence that it helped improve range of motion, but no evidence that it helped reduce inflammation, relax/activate muscles, or improve performance.  There is no evidence that it “off loads sensitive tissues” or improves “lymph drainage”.  The number of high quality studies was small.

How Might Kinesio Taping Work?
What we do know is that the elastic, compressive nature of any band, brace, or tape placed on the body stimulates receptors in the skin.  The receptors modulate the perception of pain and as a result, pain decreases.  An example is a research study in which the patients that wore a neoprene sleeve during a series of tests 12 months post anterior cruciate repair produced significantly more force and had better balance than without the neoprene sleeve.  The sleeve created a constant pressure on the skin surrounding the knee.

Should You Use Kinesio Tape?
If you have a minor ache or pain and no structural musculoskeletal damage, then go ahead.  The KT can make you feel better, and this will make exercise and activities of daily living easier.  The tape can provide some control over the symptoms, and it has no side effects other than occasional skin irritation.

Remember that your body sends pain signals for a reason.  Any type of musuloskeletal damage should be dealt with more comprehensively than just KT.  It is a bad idea to use KT to reduce pain and then participate in activities that create even greater tissue trauma.  A small and easy to rehab rotator cuff tear can become a big, full thickness, surgical repair tear if you tape it up and practice your tennis serves.

We do lots of things in medicine that have no solid, double blind research that proves efficacy.  The manufacturers of KT products need to spend more money on research and less on marketing.  I am hopeful that in time, more evidence will develop for the use of KT.  If some strips of KT make you feel better, go ahead and use it.  The best approach is to get to the cause of the problem and enact a treatment plan that resolves the pain or functional limitation.

Michael S. O’Hara, P.T., OCS, CSCS

If Frankenstein Had Glutes, He Could Have Run Away

Get Fit With Monster Walks

Frankenstein in chainsMost of the exercises performed in the gym emphasize the sagittal (front/back) plane of motion.  Squat, lunge, elliptical, and treadmill are all sagittal plane activities.  In athletics and life, we must be able to move efficiently in all planes of motion.  Our gluteal muscles are the primary producers of lateral and rotational movement in the lower extremities.  Strong and responsive gluteals keep your knees and lower back safe from injury during athletic activities.  A simple exercise to improve gluteal function and move better in the often-neglected frontal plane is a band monster walk.

You will need a mini resistance band or a lateral resistor.  Place a mini band loop around your ankles.  Assume an athletic stance with the feet straight ahead, knees bent, and hips flexed.  The band should be held taught throughout the exercise.  Try to keep the hips and shoulders level throughout the exercise.  Your torso and pelvis should not wobble side to side.  Move the right foot 12 to 18 inches to the right, and after planting the right foot, follow with the left.  Remember to keep some tension on the band.  When you have completed the prescribed number of repetitions, rest and then lateral step back to the left.

As you get better at this exercise, try performing the drill moving forward and backward.  The backward monster walk is an excellent gluteal activation exercise for runners.  Try performing one or two sets of eight to ten repetitions.

Michael S. O’Hara, P.T., OCS, CSCS

Grip, Rip, And Lift

An Introduction To Sandbag Training

Every training tool in the gym is solid and fixed.  Kettlebells, dumbbells, and barbell implements are symmetrical, balanced, and have handles that make for efficient maneuvering of the load.  In life and athletics, the forces you face are asymmetrical and come at you from all directions.  No convenient handles are attached to your opponent, bag of groceries, grandchild, or grandma.  Fitness activities that carry over to real life are what you need in your gym programming.  Sandbag training meets all of these needs.

Farm Boy Strong
An implement that is unstable in your hands is more valuable than an implement that is unstable under your feet.  Sandbags are inherently floppy–the load moves as you maneuver the bag through space.  This requires coordinated recruitment of the core, shoulder, and pelvic girdle stabilizers.  Central nervous system (brain) neural recruitment also increases as more muscular coordination and co-contraction is brought into play.  Lifting, carrying, and gripping a sandbag is the same type of training that makes the farm boy strong.

Ageless Grip
Gripping a sandbag works all of the muscles of the forearms and hands.  In real life, you must be able to maintain a strong grip in order to express any of the strength you have gained in the gym.  Research has linked grip strength to longevity.

All Angles Are Covered
Josh Henkin has created a superior product called the Ultimate Sandbag.  These modern sandbags come in a variety of sizes and have a durable vinyl covering.  The shape of the bags and the multiple handles enable movement of the bag through all planes of motion.  Unilateral and triplanar loading are what happen in the real world.

Be A Better Shock Absorber
In life and athletics, the ability to absorb an impact and remain upright, stable, and uninjured is crucial.  Sandbags are much softer than any other implement in the gym.   When they impact your body, they do not produce pain or tissue trauma, but your body feels the force as it travels to the ground.  Sandbag shouldering, cleans, and snatches are just some of the drills that require you become more efficient at absorbing an impact.

Starting With Sandbag Activities
Start with one or two exercises and work on perfecting your technique.  Sandbags work well for metabolic complexes–you perform multiple exercises in a row without putting the bag down.  Watch the attached video for some examples of my favorite sandbag training exercises.

At Fenton Fitness we have 20, 30, 40, 50, 60, 70 and 85 pound sandbags.  Start with an easy weight and work your way up.  See the video for demonstration of Sandbag Training.

Michael S. O’Hara, P.T., OCS, CSCS

Front Squats

Stability, Mobility, And Better Posture

The squat has been described as the king of all exercises.  The large amount of muscle recruited during squatting makes it a very metabolically demanding exercise.  In athletics, the capacity to perform a full squat with proper torso, hip, and knee position has been correlated with greater durability–fewer injuries.  The overhead squat test is one of the patterns assessed in the Functional Movement Screen and is used in physical therapy and athletic training.  Squatting with the load placed on the front of the body is an excellent way to enhance mobility, stability, and strength.  Compared to leg presses, seated leg curls, and knee extension, front squatting creates much more carry over to activities of daily living and athletics.  The problem is most people do not know how to get started with front squats.

When you squat with the load across the front of the body instead of on the upper part of the back, the stress on the spine is reduced.  You can “cheat” a back loaded squat by leaning forward, but you cannot lean forward with a front squat.  Leaning forward on the front squat causes the load to fall from your shoulders or hands.  Front squatting creates a greater core stability demand and reduces shear force on the lower back.  Full depth front squatting will improve your posture and restore mobility in the hips, shoulders, and thoracic spine.

Front squatting is an exercise that is more equivalent to daily tasks and athletics.  Lifts in real life rarely place the load across your shoulders.  When you lift the grandchild, carry the groceries, or hoist the wheelbarrow, the load is in front of the body.  During athletics, the opponent is in front of you, and you must stay upright and tall to dominate the activity.

Front Squat 101
Before loading the squat, practice bodyweight squats to a depth target.  I like to use a 12 inch box or a Dynamax ball (12 inches in diameter).  You should be able to perform a body weight squat to a thigh below parallel position with a stable spine before attempting a loaded front squat.  When you perform a loaded front squat, initiate motion from the hips by sitting down and back.  Push the knees out and descend so the thighs travel to below a parallel to the floor position.  Keep the chest up and torso tall as you push back up.  Finish at the top by contracting the gluteal muscles and keeping the front of the rib cage down.

Choose A Proper Implement
While the barbell offers the greatest loading capacity, many individuals do not possess the shoulder mobility to hold the bar on the shoulders.  The Goblet Squat position with a kettlebell or dumbbell works just as well.  A sandbag hugged close to the body in the high Zercher position or bear hug hold has a high degree of athletic carry over.  Avoid the Smith machine variation.  You end up leaning on the machine and this eliminates much of the core stability demands and exposes the spine to greater shear force.

Michael S. O’Hara, P.T., OCS, CSCS

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