Core Coordination?

While there is no shortage of "core" exercises, there is a shortage of common sense. I still find many patients doing outdated exercises and still injuring themselves in the process. This effectively sabotoges their health and exercise ambitions, and sends them back to the drawing board. Frustration builds until they just give up, and quit exercising altogether. They hurt because they are out of shape and don't exercise, but if they do exercise they hurt even more.

So, for the record, I am suggesting that the "sit-up" or "crunch" are not a good exercises for most people. One big problem is that the body's "core" is designed to RESIST motion, not CREATE motion. This goes back to my previous post about firing a canon from a canoe. It just doesn't work. The canoe moves just as much as the cannonball. Strengthening your core muscles to resist motion effectively locks down your cannon to dry ground.

But there is another problem with the typical person doing a "core exercise". That problem is core coordination. Not only are the core muscles meant to stabilize the spine and resist motion, they are also inherently involved with breathing. The external and internal oblique muscles, the abdominus rectus, and the quadratus lumborum muscle are all involved with forced expiration. That is considered exhaling when you are NOT "at rest".

If you watch the average person doing the crunch or sit-up or any core exercise for that matter, you will likely see this person holding their breath. You also may have noticed this pattern in yourself when you bend down to tie your shoes. This is because your body senses that it should be firing up the core muscles, but these muscles are weak, so you just hold your breath to achieve the same effect of stiffening the spine. This is called the "Valsalva maneuver", and is often used by powerlifters to lift maximum weight. Whereas it may be useful in stiffening the spine during a maximum lift, it should be avoided in other situations. It is known to cause an unhealthy spike in the blood pressure. I feel that it is cheating (except in heavy lifts) as it allows you to avoid full activation of the core muscles when completing simple movements of daily life.

So to teach the body to coordinate the activation of the core muscles with active breathing is the goal. The more you can coordinate these the more you can exercise. Obviously if you are continuously holding your breath (Valsalva maneuver), then you will not able to accomplish much. You will be too out of breath. An example of this is holding a "plank". Count your breaths instead of seconds. This is the only way some of us will actually breathe. Yoga is another good way to go, but then again I have seen many people nearly pass out in class because they were not breathing properly. Make breathing the primary consideration when choosing ANY core exercise. As much as I would like to think we would just naturally breathe through them, I am not holding my breath.

Weak Core + Running = Low Back Pain

The diagram above represents the trigger points that arise from the superficial longissimus thoracis muscle. If these areas look similar to any pain you experience I would not I be surprised. The pain pattern was identified recently in a research study published in the Journal of Biomechanics as the most likely injured due to a weakness in the deep core muscles. Multifidus, quadratus lumborum, psoas, and deep fascicles of the erector spinae are considered part of the deep core for this study. Note that the "abs" were not included! Because the superficial LT was most often the muscle overcompensating for weak deep core muscles, it may be “most at risk for fatigue or injury” if deep core muscles are not functioning properly.

If you are a runner, and experience low back pain, you are in good company. Up to 14% of American runners experience it each year. "Muscular compensations may increase risk of muscular fatigue or injury and increased spinal loading over numerous gait cycles may result in damage to spinal structures. Therefore, insufficient strength of the deep core musculature may increase a runner's risk of developing LBP."

How do you know if your deep core muscles are weak? If you have a job that requires you to sit, it is very likely. The best you can do is seek the advice of a health care professional with experience in recreational runners. Call us at (616) 301-3000 and set up an appointment for a free consultation to find out for yourself.

STOP STRETCHING!

Just kidding, sort of.
There is alot of hoopla these days about how stretching is supposedly a waste of time.

It's funny how fads come and go. And often come back again. Is high intensity cardio or low intensity cardio better? What about barefoot running? Wasn't that the hottest trend 8 years ago? Why are there so few "barefoot shoes" in the stores now? So-called experts will often become insistent that the newest research study is the final word or any given topic. But when you've been around awhile you start to see the patterns. A new study is much more likely to get published if it contradicts existing beliefs.
If you have been around the fitness industry you may have noticed that the trend has been very anti-stretching lately. In reality, there have been a few recent studies to suggest that stretching is pointless or even detrimental to athletic performance. But these studies need to be looked at in context to be understood.
A few studies suggest that stretching BEFORE exercise decreases strength. These studies mostly focus on peak effort. If you are a legitimate competition athlete then perhaps this applies to you. And it even makes sense. A powerlifter is a good example. If I were a powerlifter, I would not try to completely stretch out my pectoralis major muscles BEFORE a single rep maximum weight bench press. Or perhaps a long jumper in track and field. If I were a longjumper, I would not stretch out my hamstrings fully before a long jump competition. Warming up with a lower weight bench press would make much more sense for a powerlifter, as would light running or jumping rope for a long jumper. In reality this applies to a small percentage of people, as most of us do not earn a living by bench pressing or long jumping. The net detrimental affect that was observed was so small, it would not be noticed much by the average person exercising.
Separately, there are more studies which looked at larger populations of non-professional athletes, and the relationship between stretching habits and injury rates. They could not find any direct connection to decreased injuries with those who stretched regularly. This surprised a lot of people. But consider that there was no instruction given to these people on how to stretch correctly. There are dozens of different ways to stretch, and hundreds of different muscles to stretch. So it is possible that a correlation may have been found if specific instructions had been given?
It important to keep in mind that these studies are in contrast to decades of research suggesting that stretching is beneficial, and that it could help prevent injuries. So where does that leave us?
In truth these new studies really matter little to me. My business is pain relief. These studies don't look at specific stretching techniques on specific muscles to decrease pain. Pain levels can most certainly be affected if the ultimate problem is due to a shortened muscle.
Notice I said shortened and not tight. "Tight" can also mean "taught", or "high-tension". "Shortened" means it needs to be longer. NOT ALL PAINFUL MUSCLES ARE SHORT! Pain in a muscle can result from being overused, being under-used, being too short, or being too long. That means that if stretching does not help the pain you are experiencing, stop stretching. There is a good chance the muscle that is hurting is not truly "short", and therefore stretching it will do nothing. AGAIN, NOT EVERY PAINFUL MUSCLE IS SHORT!
The take-away message here is:
1. Don't stop stretching if you feel like it is helping you.
2. Don't assume every painful muscle is short, and therefore needs to be stretched.
3. If you are stretching a muscle and yet it keeps hurting, consult a professional. A Chiropractor or a physical therapist with good knowledge of sports injury is a good start.

Running Resolution

If your New Year's resolution is to start running, you will likely need help. Runners are particularly at risk for injury. Recent studies indicate that half of ALL runners are injured each year. And if you are training for your first marathon, you actually have a 90% chance of sustaining an injury. We can provide you with a treadmill gait analysis to help reduce the chances of injury.

You may be asking yourself why you should see a chiropractor for a running gait analysis. It all boils down to experience. I started seeing an uptick in running related low back and hip pain about 10 years ago, just as the popularity of running surged. All of these patients also had one or more of the following: knee pain, IT band pain, ankle or foot pain. These were also directly related to their back pain. The only way I could resolve a runner's low back pain is to assess and correct all of these dysfunctions. The best way to asses is with gait analysis.

All too often people have been seeing a podiatrist for their foot pain, a knee specialist for their knee pain, and a physical therapist or chiropractor for their low back or hip pain. This rarely works because there is no integration. A knee does not work in isolation, so why treat it as such? The same goes for the foot and ankle. Only when you can assess, align, and integrate the whole body will you be back on your feet and running again.

Or if you are smart, you can correct the problems before they give you pain.

When pain is the road block to your fitness resolution

As a chiropractor, I frequently hear from my patients how they hurt because they don't exercise, but when they exercise they hurt even more. Often times they will have already been to a personal trainer and/or a physical therapist and/or another chiropractor. The problem is that many personal trainers don't understand common dysfunctional movement patterns, and many physical therapists (and other chiropractors) will only look at the site of pain, and not consider how a painless dysfunction in one area (usually core muscles) will result in pain in another area.

As an example, let's look at the shoulder. Many patients have told me that they have a rotator cuff syndrome and therefore CAN'T and SHOULDN'T raise their arms over their heads. In reality they will NEVER get better UNLESS they raise their arms overhead (with good form, of course). Teaching them how to use their deltoid and trapezius muscles to perform this motion will spare their rotator cuff muscles. Just training the rotator cuff muscles is not the answer.

Your body is efficient, sometimes too efficient. It will often try to conserve energy by taking shortcuts. For example, watch someone pick up a pencil off the floor. We all know it is best to bend the knees and squat the butt as low as possible. But is this what we do in reality? Usually not. Most people, when unaware of anyone watching, will contort their bodies in all sorts of strange ways to forego using the core muscles and the big muscle: gluteus maximus. Previously I would have considered this a form of laziness. Now I consider it the body's attempt at efficiency. Using the gluteus maximus and core muscles takes more energy. But if the body continues to avoid using the big/core muscles, it will eventually shut them down and only use the smaller ones. This reminds me of a saying in my family - in order to find the most efficient way to do something, get the laziest person to do it. The only problem is they always complain about it. Your smaller muscles and joints will also complain. Unfortunately, not everybody understands the language.

Any shortcuts that your body takes will eventually result in painful road blocks. Road blocks such as pain in the neck, the low back, the hip, the shoulder, the knee, the foot, and the elbow. Many have been previously diagnosed as spinal disc bulges, sciatica, radiculitis, patellofemoral tracking disorder, plantar fasciitis, IT band syndrome, rotator cuff syndrome, or tennis elbow to name a few. But these are only names. Just naming something does not answer the question "why?". And why is it that most patients with tennis elbow don't play tennis? These shortcuts are the "why?". We can show you how to get to your fitness destination by taking the main roads and using the big muscles/ core muscles. So if someone has told you that you CAN'T or SHOULDN'T squat, lift, run, walk, bicycle, swim, or do any exercise that you want to do, get a second opinion before you give up on exercise.

The Importance of Failure

“I didn't fail the test, I just found 100 ways to do it wrong.”
― Benjamin Franklin

I can't tell you how many times people have told me that they quit exercising because it hurts. Yet they know that they hurt because they don't exercise. Such is the dilemma of modern man. Our occupations often force us into limited positions for extended periods of time. New research indicates that even those that exercise when they can still have adverse physical effects if they sit too much. My advice is: keep trying.

You may know that I have registered for the Reeds Lake Triathlon next month. My intent is not to brag but to inspire. Too many people have said to me "I couldn't do that". I tell them that under the right circumstances, I know they could. I failed last year when preparing for the same Triathlon. I failed by not giving myself enough time to increase my distance in swimming. I was nowhere near the 1/2 mile needed to complete the race. To enter the race would have been suicide.

My first experience with failure was when I joined the football team as a junior in high school. My parents were convinced that I was going to seriously injure myself, but by junior year they gave in to my pleading and they said "go for it". On the very first day of weight training, we were told to do various exercises including bench press, squats, overhead press, dips, and pullups. We paired up so that everyone had a spotter to help with the lift when needed. As a novice, I feared what would happen if I went too far. Would I really hurt myself? We started with pullups, and my spotter was trying to help by pulling up my feet while standing behind me. He was stronger and more experienced than I, so I trusted him. After the tenth pullup I was exhausted. He kept encouraging me to push myself, which I did. I did one more with his help. I wanted to try one more to get to twelve, which was our goal. My spotter helped, but it wasn't happening. My hands gave out and I lost my grip. I fell face down as my spotter was holding my feet. I expected the room to erupt with laughter. It did not. My teammates respected my effort more than my accomplishment.

My message is do what you can when you can and keep pushing to failure. Not that you have to fail all the time, but if you don't occasionally test your limits, how can you know where they are?

Try and Tri again

As my training for my first triathlon continues, I would like to share with you a few mistakes I have made along the way. My first big mistake was made last year. I did not give myself enough time to train. I started in May for a race in Early September. I underestimated how long it takes for me to go from no swimming at all to a half mile distance. My running and bicycling training seemed to go smoothly. As I have stated before, I have a large frame. My weight hovers around 200 lbs. even though I am only 5'9" tall. My bodyfat is around 15% which is where it should be for a male. I am convinced my genetics makes it more difficult to swim, but I will not use this as an excuse to fail. The best we can do is learn from our mistakes.
This year I started in January. By March I felt great, and got up to 10-12 laps, whereas I need to be able to do 15-17 laps comfortably. So being about 2/3 of the way there with plenty of time to spare I thought I would try something different. Something to lower my bodyfat even more. This is where I went wrong. Greatly reducing carbohydrate intake initially felt great. I felt lighter and leaner. But within a few weeks my training suffered. All I could muster was 4-5 laps. I continued through April and May, but I could not increase my distance in swimming. Now even my biking and swimming started to suffer. Eating a low carbohydrate diet depletes the body of glycogen stores, limiting cardiovascular endurance. I could tell that my muscle strength was not effected, but this did not help me. I needed endurance.
Now I am back up to 8 laps, or about half the total swim distance needed. I have done a complete turnaround now and eat a high carbohydrate diet. I am fairly certain that my body can catch up in time for the Triathlon in September. At least nothing will stop me from trying.