Tuesday 27 December 2016

How To Be Healthy In 2017

The New Year is around the corner and that means hoards of people will soon be flocking to the gyms, health food stores, and supplement shops with every intent that 2017 will finally be the year that they get fit, healthy, and lose weight.


By now, however, we all probably know that the ever-popular New Year's resolution is mostly fallacy. It's no surprise that a quarter of individuals don't even make it past their first week of working on their goals.

With that being said, January is still a fantastic time to kickstart new programs and lifestyle changes. Sure, most people don't follow through their goals by the time the year is over, but that still leaves adherence rates up compared the other eleven months.

So what can be done to keep to those goals? Here's a few tips..

1) Micro-Goals over the Big Resolution

The main issue you've all probably heard discussed before is the lack of realism or attainability that comes with creating that one huge, daunting resolution. You want to run a marathon? Lose all that weight? Do a bodybuilding competition? Well, great, but what about all the stuff between here and there?

Health and fitness professionals are taught a lot about the importance of creating short-term goals, but it's a facet that's still often overlooked. However, those micro-goals are really the only good way to maintain your motivation and create attainable stepping stones when it comes to the big end-result. So this year, sure, pick a resolution, but have weekly goals in the meantime to help you on the way there.

2) Chip Away Slowly

You used to deadlift three plates per side every day, so let's start with that after a year off from the gym. You want to eat healthier, so how about we flip that diet plan of your's completely upside-down? New to exercise? Time to start hitting the gym six times per week!

You know where we're going here. The best case scenario here is that you simply won't be able to maintain the volume of change (or weight) you've placed upon yourself in such a quick period. The worst case scenario is you throw out your back deadlifting or send your body into some sort of metabolic dysfunction by screwing with your food intake.

Make those changes slowly and gradually. Start small, build upon it, and modify as you go to suit your needs, not the internet's.

3) Address Your Deficits Before Removing The Vices

John Berardi posted a great article about fixing broken diet plans, and the first step in creating a healthy food program for his clients is to address nutritional deficiencies before removing unhealthy items. Doing so will help them maintain their energy, keep their hormones in check, and help with appetite.


I'm willing to expand this with other health habits as well. It makes much more sense for your psychology and motivation to add to your lifestyle early on rather than take away. In the grand scheme, it may be easier to hit the gym twice per week for a while before quitting smoking cold turkey. Add more vegetables to your diet before taking away cheesecake. Start biking to work before giving up alcohol.

It makes perfect sense once you think about it. Changes to lifestyle and habit should be positive. By adding good habits to the mix as a first step, even though it's work to do so, it creates more of a positive feeling than cutting things out will. And remembering our first-year psychology class (you know, the one that made you understand the world and everything in it), positive feedback produces the best outcomes.

4) Focus On Feeling Good

Lastly, I like to tell clients, whether through the gym or the ones seeing me for Athletic Therapy, to focus on how their body feels. Most people who are going into healthy resolutions have an image in mind; one of a slim body or big muscles. However, let's be frank. Those results are a long time coming, and the fact that they are can be demoralizing. Even when it comes to more attainable milestones, such as weight or circumference, you'll still typically see plateau's and results that are inconsistent with your true progress.


I'm not saying that you shouldn't track these results, though, but I like to ask clients if they can feel progress first and foremost. What's more, that's the question which is likely to produce the most immediate and consistent results. Is your energy up? Has your mood improved? Is your body in less pain? Do you feel stronger? When it comes down to it, those more-subjective ways of tracking progress are better indicators of your overall health than the mirror, scale, or measuring tape.

In the end, the whole New Year's resolutions deal will continue to forever be a crap-shoot. Many will make their goals, many more won't. Just remember to set yourself some realistic milestones, plenty of short-term goals, ease into the changes slowly, and give to your body before you take. And finally, make sure you feel good doing it.

Tuesday 20 December 2016

Muscle "Knots" (Are Not All Trigger Points)

We've all experienced knots, kinks, aches, and pains in our muscles. "Knot" is typically the predominant layman's term for specifically tight spots in muscle tissue. However, the term "trigger point" has also made its rounds through popular schools of thought, recently becoming a big thing in the fitness industry rather than solely in the therapy world.

We need to avoid trying to define all symptoms under one umbrella term, however. "Knot" is a catch-all, non-specific term while "trigger point" is a very specific condition that cannot be applied to all muscular pain. People commonly confuse the presence of fascial adhesions and scar tissue as well. How do we define it all?

Trigger Points

Firstly, let's tackle the well-known myofascial trigger point...as best as we can, anyway. You see, there's actually very little consensus on the cause or even the existence of trigger points. Nonetheless, there does exist a phenomena that clinicians define and treat as trigger points, and so here's the best explanation I can provide.

Trigger points are localized points in muscle and fascia that become tightened and hyperirritable. It's generally believe that they arise due to neural responses to injury and/or joint instability. Contrary to common belief, not every tender spot in muscle is a trigger point, the condition having a few requirements before we can consider its presence:

1) Trigger points cause and are found within a taught band or rope-like length of fibers within the muscle. 
2) Trigger points will cause referred pain away from the site of the point itself, such as one found in the back of the shoulder causing dull pain lower down in the arm.
3) The trigger point, upon stimulation, will cause localized twitching - but not contraction - of the muscle.



Not all trigger points are active enough to exhibit these symptoms until manual pressure is applied. However, this should be enough to help you stop identifying everything as the same and to cease trying to treat every bump in your muscles with a lacrosse ball. That being said, how do we define other tender, restricted spots of muscle tissue?

Scar Tissue and Adhesions

Whether it be a result from acute injury or repetitive stress, scar tissue and adhesions tend to form in the muscle and fascia as well.

If you've ever taken a close look at scarring on the skin, you have a good idea of what muscular scarring is like; irregularly formed, stiff, and lacking tensile strength. The same occurs in muscle after said damaged tissue heals. Areas where scar tissue has developed and not been addressed may cause dysfunction of the muscle itself, restrict range of motion, affect strength, and potentially be a cause for pain.



Likewise, fascia can become damaged as well. Being the layers of connective tissue that separate muscle from organs, muscle from skin, and muscles from other muscles, this damage can also affect kinetic function and be tender and palpable as well. As fascia attempts to heal, it does so in the irregular fashion that we see with scarring, and these adhesions develop that restrict the ability of muscle to glide effectively.

Being irregularly-formed tissue, simply applying pressure to these points like many of us attempt to do thinking that they are trigger points is an ineffective method. Scar tissue and adhesions must be "broken" apart and then the areas restrengthened by movement. However, when it comes to breaking down these points, even the the popularized self-massaging from foam rollers probably doesn't provide enough pressure to assert physical changes within the tissue.


Summarizing, trigger points are a thing, but can't be identified as every nodule you feel in the muscle. Scar tissue and fascial adhesions exist that must be considered. Foam rolling and self-massage techniques probably don't exert enough focal pressure to achieve therapeutic effects. And, as always, exercise and range of motion drills are likely going to be the most effective method for treating these irregularities within the muscle, supplemented when needed by therapeutic manual techniques.

Tuesday 13 December 2016

Hip Mobility for Spinal Health

We hear health and fitness professionals rave on about the importance of hip mobility all the time, but rarely hear much of an explanation for it. The ability for your hips to move through range of motion is crucial for the structural stability of the spine, though. I'll speak on the two most major movements at the hip - flexion and extension - and how dysfunctional range of motion here may negatively affect the back.

Flexion

An inability to reach optimal flexion at the hips is the most-commonly pointed out issue on this subject. Flexion is the movement that occurs at the hip when you bring your knee to your chest. When lacking in range, it can heavily impact your ability to properly perform many exercises at the gym, resulting in the amount of notice it receives.

The most major example of poor hip flexion affect the spine is during the squat. Normally, when sinking into a squat, the spine should maintain it's neutral lower curve. However, if the hips are not able to complete the movement themselves, the spine will compensate and round out into flexion itself - the entire pelvis rolling forward - to reach the bottom of the squat. We commonly know this as "butt wink".

This is the most obvious example of this dysfunction, but the thing to realize is that if this large mechanical error occurs at the gym, it's probably occurring at a lesser - but much more frequent - degree as well during the rest of your day. That means you have excessive spinal flexion when bending down to pick up boxes, when seated in chairs, and possibly even walking and running. 

(Let's side-step and remember that genetics may play a role here, and you may simply be anatomically unable to flex your hips as far as others. In these cases, you still want to work on maximizing the range you have, but may need to accept that your squat won't be as deep as some.)

Extension

The other major movement we see at the hips is extension - the leg pushing back and behind you. Just as with flexion, which a lack thereof can increase flexion of the spine, lack of extension at the hips can make the back compensate in the same way.

This habit isn't as often caught in your typical gym setting, as increased spinal extension isn't often perceived as looking dysfunctional like flexion. However, excessive compensatory extension of the back (most often seen with running athletes) can lead to lower back pain just the same; compression of the vertebral spaces and hyperactivity of the erectors of the spine being significant causes.


Increasing Mobility and Precautions

When it comes to hip flexion, the limiting factors of range tend to be soft tissue and bone. Restrictions of the ligaments as well as tension through the hamstrings are frequent barriers, as are the anatomical limitations that are discussed in the article that I linked to previously.

As for extension, there isn't so much a barrier to the movement, rather there being a lack of muscular stability for it. When the core isn't stable enough to hold the spine steady during the force created by extension of the hip, this is the case where you'll see the form break down and the spine move to follow. However, this is trainable.

As a final note, if you're thinking that you need to work on your hip mobility more now, let's remind ourselves to be gradual and that over-mobilizing can quickly lead to more injuries than it corrects for. Take it gradual, people!

Tuesday 6 December 2016

Your Tight Hamstrings

It seems like every other client and athlete that I see has a complaint about their tight hamstrings.

The tension that a lot of people feel is relentless and just won't let go. They stretch and stretch all day long. Bending down to touch their toes, sitting and reaching, on their backs with a band, but nothing works!

Why are these things so tight and why can't we get them to be flexible?!

Hamstring Tension

I read this excellent article by Eric Cressey on the true reasons for hamstring tightness. One of the most enlightening points that it makes is the fact that your hamstrings are very unlikely to be truly shortened.

You see, the hamstring muscle group performs two major actions: knee flexion and hip extension. If our hamstring tension was really caused by shortening of the muscles, then that would essentially require us to be in both of those joint positions (simultaneously) on the regular. Do you spend every day on your knees for hours? (No jokes, please.) No? Then you probably don't have a hamstring lengthening/shortening issue.


So that being said? What causes hamstring tightness? There are three main things: Protective tension (compensatory tightness), neural tension (most significantly, sciatica), and an injury to the muscle (whether it's an acute strain or tendinitis).

Most of my clients who have this issue have it due to the first option; protective tension. More often than not, they're lacking proper activation of the glute muscles to initiate hip extension and stabilize the hip joint. As a result, the hamstring has to not only compensate for the ability to extend the hip, but it also has to increase in tension to try and make up for the lack of stability that the body senses at the joint. As the fix, I spend a lot of time reeducating the action of gluteal hip extension. Obviously, this isn't the only compensatory mechanism for why the hamstrings are tight, but it's the most common one that I find.

Similarly, if the reason for the tension is neural or due to injury, we need to fix the root of the problem in these cases as well before the hamstrings will truly be able to release their tension. If there's sciatic involvement from either the hips or the lower back, then some sort of intervention to relieve the stress on the nerve is required. If there's been an acute hamstring strain or built-up scar tissue, then time, manual massage, and proper strengthening will help accelerate recovery. If there's a chronic tendinitis, then that brings us back to the compensation issue which needs to be corrected.

Hamstring Stretching

In the meantime, is there anything we can do to help decrease hamstring tension while attempting to correct these mechanics?

Well, from my experience, I'm finding that static stretching for this area is less and less effective. Like I touched on before, if the hamstring isn't truly shortened, then why bother trying to truly lengthen it?

Instead, I'm starting to employ more dynamic stretching (even after exercise) in order to promote the muscle to neurally relax under tension and let go during repetitive stretch rather than prolonged. My clients have reported feeling that these methods have made them feel like the muscle is under decreased tension and have relieved pain more than holding the stretch ever did.

 

All in all, this goes back to my philosophy that simply stretching and mobilizing is never the answer to the problem. The base mechanics always need to be addressed before the issue is resolved. So, if you fall in this category of someone plagued by chronic hamstring tightness, take a moment to consider the reason for it.