Fitness

What Physios don’t want you to know

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And osteopaths, chiropractors or any other manual therapist.

Unless they are making special claims for their technique,  which they can back up with evidence,  the truth of the matter is that all manual therapies are doing one of three things-

  • Breaking down adhesions, scar tissue and restrictions, whether in fascia, muscle or connective tissue
  • Resetting the joint position sense and neural signalling around the affected area
  • Improving fluid flow and drainage of the tissue.

That’s it, that’s all we do. However, the reason you need to keep a good osteopath or physiotherapist on speed dial is because the real trick is knowing which one needs to be done, what tools and techniques should be used when, how and where, as the true cause of the problem may not be at the place it hurts.

One classic example of this, that many have suffered from and lots fail to treat effectively,  is plantar fasciitis. The too familiar pain lancing into the sole of your foot when you first stand up, it is caused by inflammation and microtearing in the fibrous tissue running along the foot, generally near the heel. Traditional treatment is to brace, stretch and possibly inject cortisone, all of which take time and often fail to address the question why it failed in the first place.

A better complete approach, using the above concept,  is to not just treat the foot locally,  but look away for restrictions and signalling issues elsewhere as well. Only then,  once the underlying issue is addressed,  can real recovery and progress be made.

Gym free exercise of the day.

2 minutes breathing practice while swinging arms and legs to open the joints.

3 X 30 seconds skipping on the spot, imagining a rope if space / equipment restricts.

5 x 1 minute Burpee superman interupt. 30 secs recovery between sets.

Squat down, thrust legs back to pressup position,  lower your chest to the floor then take hands up above the head to full extension. Raise opposite hand and leg off the floor. Repeat for the other side, then hands to chest, push up, legs back in to squat position and jump up.

2 minute breathing practice, with stretching.

Notes-

The objective of the warmup is to check and prepare joints for range of motion,  followed by getting the cardiorespiratory system ready.

The core of the workout is to get every muscle in the body firing to stimulate a high level of intensity. By lifting the arms and legs off the ground,  you break the fascial tension that can be used as a spring rebound mechanism,  so it becomes harder.

Scaling if you are unable to do burpees or pressups would be 3 standing air squats with a pause at the bottom, followed by 3 kneeling pressups with hand / leg lift. If the pressups are still too challenging,  wall pressups (pushing off the wall) followed by arm / leg extensions. If in doubt, try the one you think you might fail at to push yourself.

Here’s why your six pack won’t make you a better runner. 

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Most core exercises are a waste of time. They will not make you a better athlete. In fact, they could be slowing you down and creating injuries. 

Why? Because for athletic performance in any discipline, one of the most important functions is the ability to connect your upper and lower body effectively and efficiently without shortening your front. 

The function of the abdominal muscles is to link upper and lower body, provide stability to the lumbar spine and pull the rib cage down during certain motions. 

A short anterior (front) from too many crunches or planks will reduce your hip mobility, create an unwanted curve in your back and reduce the power you can produce. 

To overcome this, by all means do your stability and integration work, preferably under professional guidance to give dynamic feedback but then lengthen and mobilise the front again (for example cobra stretch or warrior poses if you have no spinal or other issues). 

By having a long and fluid front, to work with a strong back, you’ll be closer to optimising your performance and breaking that PB. 
And of course, if in doubt, seek guidance from an experienced professional. 

Stability and Mobility

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Picture a runner on the track, an image of power ready to be released at every stride. If we were to snapshot them mid activity, we would see that:

  • The foot, as it contacts the ground, needs to provide a stable platform
  • The ankle, resting on the foot, requires dynamic mobility
  • The knee, for optimal power transfer, requires both mobility in the ankle below it and the hip above.
  • The hip, being a joint with a high potential range of motion, should be mobile enough to support the function of the knee below and the pelvis / lumbar spine above.
  • The pelvis and lumbar spine, one of the biggest force transfer areas in the body, needs a high amount of stability.
  • The thorax responds to load and stress by restricting, when a more fluid movement pattern would benefit
  • The scapula, floating over the potentially stiff thorax, becomes unstable as a compensation
  • The shoulder joint itself, due to posture and poor use, will be restricted
  • The lower cervical spine may become unstable as a response to the restriction in the thorax
  • Finally, and balanced on top of the stack, the head and upper cervical spine stiffens.

Looking at the above list (initially drawn from the work of Gray Cook) it is possible to see why, if one area is not functioning as optimally as we might like, the areas around it will adapt their own function to compensate, which can eventually lead to the risk of injury.

As athletes and professional practitioners, we can help reduce this risk by reversing the process with a well considered mobility and strength training plan, allowing us help the areas that don’t move and should, as well as strengthening the unstable zones.

From a practical perspective, it is generally faster and more effective to get a restricted area moving successfully, since it tends to respond more positively, as well as naturally allow the unstable areas to relearn their correct function,

It can therefore be recommended that we focus on:

  • The ankle, using ankle circles, calf stretching and getting any old twists or sprains reset
  • The hip, by stretching the glutes, lengthening the hip flexors and ensuring the joint is well aligned
  • The thorax, needs three dimensions of movement, flexion, sidebending and rotation
  • The shoulder, the most inherently unstable joint in the body, often needs professional assessment to ensure it is not guarding a hidden injury to the joint, and can be helped by improving the function of the internal and external rotation most effectively

By improving the range of motion in these, we can support dynamic development in the rest of the body automatically.

Total body circuits for injury detection and prevention

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There are a few simple exercises that, if carried out correctly, can help prevent injury in other areas of training by allowing you to spot where and when you are weak.

Amongst my favourites are:

Kettlebell swings. Preferably a full range of motion. http://www.catalystathletics.com/exercises/exercise.php?exerciseID=251These work pretty much everything and can be used for strength, conditioning, warmup, incredibly useful.

Turkish getups. http://www.catalystathletics.com/exercises/exercise.php?exerciseID=255 They look simple but demand huge range of motion and coordination of all the major joints to be successful.

Single arm overhead squats. http://www.catalystathletics.com/exercises/exercise.php?exerciseID=236 Another all over body exercise which will make everything fire in the correct sequence.

Dead hang pull ups http://www.catalystathletics.com/exercises/exercise.php?exerciseID=39

Mountain climbers, just to finish off http://www.youtube.com/watch?v=1J4hRICVjRo Focusing on maintaining a stable trunk throughout the movement.

By doing these as a circuit, ensuring good form at all times, they should prepare you for any other, more focused gym work or training you wish to do. Or, if you’re time compressed, just doing a 10 minute of a few of them (not everybody has a suitable pull up station in their home) will bring huge benefits.

One of the best resources for improving mobility is Mobility WOD, which has hundreds of excellent videos for fixing all the areas you may feel are restricted.

And if in doubt, come and see us for a full assessment of the issues.

80:20

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There is an idea called the Pareto law. This says that 80% of the work takes 20% of the time. It can be used in almost any situation, from business management to problem solving, personal training to writing a book. I use it to illustrate a patients recovery plan (and will try to cover this in a post soon).
I also think it applies to our area, not just in terms of treatment processes, but in terms of techniques.Far too many people don’t use their training, expertise and experience sufficiently when working with clients. Instead they fall back on what they know works and do the same thing for everybody. (80% of problems can be solved with 20% of our skill). But every body is not the same. Each client is unique and each time we see them they have changed.

From a therapeutic perspective, this means that we need to reassess and reinterpret them each time, not just do the same thing and hope it will work.

When carrying out a fitness program, this also stands. We can draw up a framework for the series of sessions but need to be flexible enough to modify it as necessary. We should and need to concentrate on what they are saying, how they are responding and whether we are achieving their goals. In either mode, we especially need to take into consideration current research and thinking to ensure we are up to date with what the experts are doing. As with every other part of life, we need to remember the loop: observe, think, apply. Only then will we be doing the best for our clients and ourselves.

Program design in fitness

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Following some recent research, I have been thinking about the way we approach fitness training.There is some evidence that there are 2 modes in the body and we need to activate both for the best output. There is the short time, high intensity work and then the long, slow output.The problem is, when we train with people, we don’t focus on these, we fall onto the middle ground. It’s easy. We don’t need to work hard, we don’t need to push the client. But then they don’t improve, they get disheartened and our reputation isn’t enhanced.

Instead of taking them for a jog around the park, change it up. Make them sweat, push them hard. Use the primal patterns, look at complex movements if they are capable of them. And if they’re not, get them ready.

And then guide them to being more active every day (the long slow stuff). Help them change their diet so they eat clean.

They will see changes and you will enhance your reputation too!