Tech Time

Although technology wont make you any more fit, they can provide you with a plethora of information and motivation.

Today we are talking tech! By now most people have heard of fit bit, my fitness pal, or one of the may other apps and fitness equipment that can be worn to track your level of activity. Although these utilities wont make you any more fit, they can provide you with a plethora of information and motivation.
This weeks post is inspired by Dr. Geier, an orthopedic surgeon I follow and highly recommend you do too. In an article for Reuters he, and others, talked about some of the benefits of fitness technology. Here are a few highlights:
According to the CDC, 30 minutes of moderate activity most days of the week can reduce the risk of obesity, cardiovascular disease, diabetes, and some cancers as well as help strengthen muscles and bones
In other words we are looking to walk about 10,000 steps a day
Although tech can’t necessarily help you reach that goal, it can be a great motivator and help you realize just how much (or little) you are actually moving throughout your day
When talking about smart phone apps and step counting, Apple tends to over count steps and android tends to under count steps
If you don’t have a smart phone, try investing in a $10 to $30 pedometer before you decide to buy a $100 fitness band
While these factor are important for self realization of activity, I think it is also important to harp on the nutrition side of things as well. In simple terms, when you are in a hypocaloric diet (eating less calories than you’re using in a day) following the minimal guidelines can result in fat mass loss as found by a recent study. I attached the study for those of you with an eye for scientific research, but I will say that these data are not conclusive for every individual.
The bottom line is that for most people hitting the minimum 10,000 steps per day while in a hypocaloric diet is enough to produce meaningful results over a few months. See the article for more on technology, and the research for information on diet and exercise combined (warning, it is not an easy read for all).

Hip Pain Part 2 – Fixing The Problem

Hip new ideas on dealing with that pain in the butt.

As we found out last week, lots can go wrong within the hips. And while figuring out the problem can be difficult, finding the right solution may be a little bit more simple. For many of the issues that we have discussed the solution may ultimately be a surgical or pharmacological intervention. However, today I wanted to go over some exercise interventions that may be worth a try. So let’s dive into some hip new ideas on dealing with that pain in the butt.
The Big Three
There are three main domains that are thought to lead to hip pain including sitting, muscular imbalances, and skeletal imbalances. Sitting for long periods of time can lead to the latter two issues, but in a more direct sense, it can cause problems all on its own. Primarily, sitting causes compression within the hip joint itself and can, in a sense, squish the muscles, nerves, and blood flow. If you have ever had a “dead leg” from sitting on your wallet too long or one leg crossed over the other then you will know how troublesome sitting can be. Muscular imbalances can be described as building strength in some muscles while neglecting others resulting in an unnatural amount of strain on particular muscles. Runners, for example, often ignore the muscles used to move the body from side to side. Finally, skeletal imbalances are the uneven stature or movement patterns that many individuals have due to things like genetic bone differences, old injuries, and leg-length discrepancies.
 
What Should You Do?
Every person and every issue is unique and deserves a unique solution. This is due to the fact that pain is complicated. Pain can be caused by the various tissues (sprains and strains), by the nerves (sciatica), and other issues that aren’t understood yet (fibromyalgia, chronic low back pain). More often than not, however, movement is paramount to success. So let’s take a look at what you need to do for the specific issues discussed in last week’s post!
Femoroacetabular impingement (FAI) – FAI is unique because it is a combination of bone structure problems and hip tissue problems (1). These issues are far from uniform so the specifics of what needs to be done to fix the problem will change from person to person. However, some keys to success include hip-specific function and lower limb strengthening, core stability and postural balance exercises (2).
Inline image 1
Piriformis Syndrome, Trochanteric Bursitis/Snapping Hip – These issues are common among runner, and as you can guess, are generally thought to be caused by muscular imbalances. You can try to alleviate these problems by foam rolling the piriformis, quadriceps and IT-Band, statically stretching the piriformis, biceps femoris and hip flexors, and performing exercises such as leg slidesfloor bridgelateral tube walking and ball squats.
 
Sciatica – Because sciatica can be caused by at least 6 underlying issues, there really is no one true way to best treat it (3). For best results, skip the exercise and talk to your doctor about medication options (4).
Strains – When it comes to strains of the groin and/or hip flexor, the general recommendation is to regain full range of motion, and restore full muscle strength, endurance, and coordination. You can prevent these injuries by doing programs similar to the one seen bellow (5).
Inline image 2
Summary
One of the best ways to avoid injuries of the hips is to strengthen the hips. Because we sit on our butts all day long, we tend to lose the ability to use our glutes. This can lead to all sorts of problems in the long run. This is why I recommend you start by strengthening the glute muscles. Here is a great resource for learning how to strengthen the glutes. If you’re looking for pain relief, your best chance of seeing results quickly is to consult your doctor.
References
1. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement
Br. J. Sports. Med. 2016;50:19 1169-1176
2. Wall, P., Dickenson, E., Robinson, D., Hughes, I., Realpe, A., Hobson, R., Griffen, D., Foster, N. (2016). Personalised Hip Therapy: development of a non-operative protocol to treat femoroacetabular impingement syndrome in the FASHIoN randomised controlled trial. Br J Sports Med, 50:1217-1223 doi:10.1136/bjsports-2016-096368
3. Verwoerd, A. J. H., Luijsterburg, P. A. J., Lin, C. W. C., Jacobs, W. C. H., Koes, B. W., & Verhagen, A. P. (2013). Systematic review of prognostic factors predicting outcome in non-surgically treated patients with sciatica. European Journal of Pain (London, England), 17(8), 1126.
4. Lewis, R. A., Williams, N. H., Sutton, A. J., Burton, K., Din, N. U., Matar, H. E., . . . Wilkinson, C. (2015). Comparative clinical effectiveness of management strategies for sciatica: Systematic review and network meta-analyses. The Spine Journal : Official Journal of the North American Spine Society, 15(6), 1461-1477. doi:10.1016/j.spinee.2013.08.049
5. Tyler, T. F., Silvers, H. J., Gerhardt, M. B., & Nicholas, S. J. (2010). Groin injuries in sports medicine. Sports Health: A Multidisciplinary Approach, 2(3), 231-236. doi:10.1177/1941738110366820

The 4 Pillars of Fitness

The 4 pillars of fitness that truly cover the basics of the gym.

This week I decided to go back to the basics. So often I find myself nerding out on scientific articles and the latest trends that I forget what fitness is all about. So this week I am talking about the 4 pillars of fitness that truly cover the basics of the gym. The blog post referenced today was sent to me by a friend, and was originally written by The Fitnessista.
So as you can guess the information shared today is not all inclusive by any means, but when done regularly these guidelines will put you far ahead of the curb. So lets get down to it:
1. Strength – Strength training is a must for all populations. Far too often I have women tell me “but I don’t want to get too bulky.” Well here’s the thing… The people you see who look “too bulky” work very VERY hard to get to that point. It takes a tremendous amount of effort to look like a body builder, so pick up some heavy weights. Why? Well there are many reasons. Aside for getting that toned look, and glamour muscles for the guys out there, lifting weights does a lot more. For instance it is imperative for bone health and maintaining bone density as we age. This means less chance to break bones and maintain independence. Read the blog post to learn more about keeping your weight lifting routine fresh!
2. Cardio – We all know what cardio is, and I’m sure we have all been bored to death while doing it at some point. But this component is extremely important for things like heart health, releasing those feel-good endorphins, and like NEAT it’s a great way to burn extra calories. To decrease your time on the treadmill, you can add in some intervals (like our wonderful new Les Mills Grit series Wednesdays at noon) to boost EPOC (our oxygen consumption post-exercise).
3.  Flexibility – This component is ignored too often. The goal of flexibility is to maintain full range of motion in your joints, prevent movement compensations and injury, and to have healthy posture and blood circulation. The key is to find a modality that you love and stick with it. Read the blog post for some fantastic ideas.
4. Rest – By far the most underrated aspect of exercise is rest. My favorite saying is that muscles aren’t built in the gym, they are built in bed (or the kitchen). The reason is that during exercise we are actually stressing and damaging our body so muscles aren’t able to adequately rebuild and repair themselves without proper down time. Not mentioned in the blog is the nutrition side of things, so I will add in that when we exercise we use nutrients. If they are not replaced then most people end up feeling more tired than they need to. Adequate protein and micro nutrients (vitamins and minerals) can be obtained through your diet, or via supplements. Not only do I take supplements my self, but I have spent a great deal of time studying the field so please don’t hesitate to ask me any questions.

Stopping DOMS

Today’s post is all about mitigating Delayed Onset Muscle Soreness (DOMS).

Today’s post is all about mitigating Delayed Onset Muscle Soreness (DOMS). Now I want to be clear that DOMS is neither a good or a bad thing. It is just a part of the exercise experience for all of us. However, no one wants to be disabled the day after a heavy exercise session. So in an attempt to help us all walk normally after leg day, I will do my best to explain what causes DOMS, and how to dampen it.
Speaking of leg day, I think we have all been there. Day 1 you squat. Day 2 you feel tight. Days 2.5-4  you feel like every step, stair, and leg movement will make you cry. Days 6-7 you start to feel better and you do leg day again. This problem is experienced frequently and more severely with the initiation of an exercise program in a previously untrained person or muscle group. There is debate as to the exact cause of DOMS, however it is safe to say that muscle damage plays a large roll in its causation.
Here are a few ways to prevent DOMS when starting a new program, brought to you by the NSCA.
1. Caffeine! That’s right, a cup of Joe can help relieve some of that muscle pain. But the dose and timing make this intervention difficult to nail down. Around 5 mg/kg before a workout is recommended, but that equation isn’t always right for everyone.
2. Cryotherapy – This fancy term for ice bath, is an intervention that has been used for years. But realistically it’s just not practical. No one likes to be dunked in cold water, and especially not for the 10 minutes suggested. But hey, I won’t stop you if you want to turn your self into a Popsicle to avoid a little pain the day after a heavy lift.
3. Branched-chain amino acids (BCAA) – I am personally not a big fan of this intervention. Research shows that it has modest effects, and there’s no consensus on how much to take or when. For me, the best option is to take a high quality protein before and after exercise. It’s cheaper, tastier, and has a multitude of additional benefits.
4. Aerobic exercise – This should already be a part of your exercise routine, so it should be easy to implement. Doing 10-20 minutes worth of cardio before resistance exercise, or using active rest between sets, can be a great way to off set some DOMS.
I hope you all learned about some new ways to decrease your DOMS. Be sure to check out the full article for more information about each intervention, and to check out some of the science behind it all.

How Much Should You Rest Between Sets?

In today’s post is I’m talking about doing nothing.

In today’s post is I’m talking about doing nothing. Well really I’m talking about how much time should you wait between your sets. As you could imagine, it depends on what your goals are. But for most of us the answer is “as little as possible.”
Well the following information is for those of you looking to lose weight and gain muscle. If these aren’t your goals then this information may not be for you. So here are some reasons why 1 minute is the target rest time for most of us.
 – Compared to a 3m rest, 1m rest intervals cost 36% higher energy expenditure!!!
 – The smaller rest time stimulates greater muscle growth which of course is needed to look toned and trim
 – You shorten your overall time training… and who wouldn’t want to do that?!?!
 – This short rest time, and other forms of HIIT have been shown to be way better than spending hours on the treadmill in the “fat burning zone”.

The Happy Healthy Traveler

Traveling will always throw you in a funk when it comes to your health and fitness habits. So today I wanted to go over some tips to help you stay on track with your goals.

It’s inevitable. During the summer we will all likely be doing some traveling for vacation, sports, or a friend who selfishly demanded to do a destination wedding. Of course these events are special, but they will always throw you in a funk when it comes to your health and fitness habits. So today I wanted to go over some tips to help you stay on track with your goals, but more importantly, I want to hear about your favorite tips and tricks for staying on target.

Health Before Fun, Food, or Fitness

Before we dive into the fitness and nutrition side of things, I think it’s important to address the health needs of the traveler. Depending on where you’re going, it’s important to keep a few things in mind. First, if you’re going outside of the country (or to Michigan), make sure you are aware of the water situation. If the tap water isn’t good for drinking, then you will need to game plan for buying bottled water, brushing your teeth, and to keep your mouth shut when you take a shower or hop in a swimming in a pool. Nothing’s worse than running a trip short due to the runs. Speaking of which, consider taking bismuth subsalicylate (sold as Pepto-Bismol and various store brands) before every meal to decrease your chances of developing diarrhea (1). Never eat undercooked foods — eggs, meat, fish or poultry — or any food sold by street vendors, and wash your hands before and after meals to ensure you have a pleasant trip. Finally, make sure you are all up-to-date on routine vaccines (measles-mumps-rubella, varicella (chickenpox), diphtheria-tetanus-pertussis, hepatitis A, typhoid, polio, an annual flu shot, and, if needed, a prescription for generic Malarone (atovaquone proguanil) to prevent malaria. Check out this link to know exactly what vaccinations you need depending on your destination. Be sure to pack an ample supply of sunscreen, insect repellent with 20 percent or more of DEET, and a first-aid kit of hydrocortisone cream, antibiotic ointment and a variety of bandages. When flying, be sure to get up and walk around to avoid blood clots especially if you’re over 40, obese or pregnant, or have limited mobility (for example, because of a leg cast) or have a personal or family history of clots. Although rare, blood clots can be a very serious problem that everyone should be aware of.

Nutrition No Brainers

When I think about traveling and nutrition, I think about how speed is the key. You want to get in and out fast so you can just get to where you’re going. Of course, this means stopping at a fast food place. To avoid the junk at fast food places, I have a few tips that may seem like no-brainers, but actually going through with them is key.

#1 Pre Travel Game Plan – My wife spends hours planning her outfits for any trip. She writes down what she will need for each day of the trip, lays out the clothes, and then makes sure they will all fit in her bag. This same technique should be applied to your nutritional needs for any trip! Make a game plan by writing down how many times you/your family will need to eat, make a note of whether it will be on the road, hotel, or at the destination, and pack a cooler accordingly. The food you make yourself will almost surely be healthier than a number 8 with a soda at a fast food joint. This is especially true if you or your kids will be on the road for sports competitions.

#2 On The Road Game Plan – If you know your travels will take you on the road/air for multiple meals, there Here are a few things you can do to help keep yourself fueled with the good stuff: ask the airline ahead of time for a special meal, request a room with a small fridge for healthy food storage, and pack foods that don’t need to be immediately refrigerated.

#3 The Destination – Wherever you go, there is no excuse for not eating well. There are grocery stores, local markets, and healthy restaurant options everywhere. With a few taps of the smart phone, you can find these locations with ease. Because most of us will opt for the restaurant option, you will want to look for healthy choices online ahead of time;

* Protein (grilled chicken breast, lean beef, shrimp tuna, beans, etc)

* Veggies

* Side dishes because you can make pretty good meal from a few side orders, such as a single egg or a cup of fruit

* Appetizers because ordering a small item or two instead of a table-crushing platter of ribs is always better option

* The classic soup and salad options are filling and familiar

* Eat slowly, put your fork down and take long sips of water between bites so that you aren’t rushing through your meal and filling up before you even notice you’re satisfied

#4 Snacks – I love to snack on long drives because it helps keep me focused. Naturally, there are better options out there than chips and soda to snack on. So here are a few thoughts on what to pack, or what to look for at the gas station, when on the move.

* Focus on portion control when packing your own food. You will eat more if you put everything in one big container rather than many small ones

* Fresh produce such as apples, bananas, oranges, grapes, clementines, celery sticks, edamame and carrot sticks

* Hard-boiled eggs are perfect for any time of the day, but are particularly better for you than a hotel waffle or muffin at breakfast

* Dried fruit/jerky because fruits are packed with potassium and fiber and jerky is an excellent snack that’s low in calories and high in protein.(just make sure they both are unsweetened)

* DIY trail mix with unsweetened dried fruit, nuts, whole-grain cereal and seeds packed them in little snack baggies with cinnamon, pumpkin pie spice or smoked paprika to kick it up a notch

* And my personal favorite, snack sized pickles. No calories (that’s right… 0) and the salt in them will help you retain a little water so you don’t have to make quite so many potty breaks

Exercise & Sleep

When it comes to your health, exercise and sleep are crucial. And traveling will always throw a wrench in the works for both of these. Click this link to learn everything you need to know about sleep and how to keep a regular healthy pattern while traveling. And when it comes to exercise, you should always be able to make time for a quick workout. Those 30 to 45 minutes in the gym during the week doesn’t make up for all the time on your rear. Crunched for time? Well then do a cool 15 minute core workout like this one. Outdoor workouts like a scenic walk or run from the hotel work wonders. In-room workouts offer challenges, but doing dips on a chair, push ups, resistance bands, tennis ball for self-myofascial release, a bag filled with water for resistance exercise, and even a towel can easily be used for a yoga mat. Heck, if you have a wall, you can have a workout! Bottom line, don’t make excuses, just get it done!

References

  1. DuPont, H. L., Ericsson, C. D., Johnson, P. C., Bitsura, J. A. M., DuPont, M. W., & de la Cabada, Francisco Javier. (1987). Prevention of travelers’ diarrhea by the tablet formulation of bismuth subsalicylate. Jama, 257(10), 1347-1350. doi:10.1001/jama.1987.03390100085031

Stretching The Truth

Today I wanted to talk about what stretching does. There are a lot of misconceptions about the actual effects of stretching are, and I am constantly asked about topic pertaining to stretching. Here are a few commonly asked questions; what should I stretch? how long/often should I stretch? what will stretching do for me? should I even stretch at all? Each one of these questions are important so I will address them one by one.
What should I stretch?
The answer to this is… it depends! There is no need to stretch a muscle that is at an already acceptable level of tonicity. Yes, a hamstring stretch feels nice but for most people the hamstring is not the problem. In many cases the hamstring feels tight because the hip flexors are putting them in a state of constant tension. This problem an even manifest as lower back pain! So, should you stretch the hamstring? No. You should stretch the hip flexors so that the hamstrings are able to get back to a normal resting length. This same situation, where one tight muscle causes another area of the body to have a problem, can happen throughout the entire body. In essence, if you want to know what you need to stretch you should probably take advantage of those free program design sessions to figure out what exactly is going on with your body.
How long/often should I stretch?
There is no definitive answer to these questions. However, a good rule of thumb to go by is stretch for around 30 seconds at least 5 days per week. The best time to stretch is after you’re done working out. “Not in the warm up?” you ask. The answer is no. Stretching the wrong area in the warm up can even be a bad thing in some cases. Like other forms of relaxation, stretching can also be the best thing for you when you feel stressed and anxious.
What will stretching do for me?
Let’s start with the things stretching DOESN’T help with. Stretching will not help with preventing delayed onset muscle sorenessinjury preventionenhancing performancealigning muscle/tendon fiberstrigger points, or increasing muscle length. Wait… what? Stretching does’t increase muscle length? No, but I’ll explain that in a little bit. What you should know is that stretching is good for the heart, the mind, and,most importantly, it’s good for the nerves.
Should I even stretch at all?
The answer is absolutely YES. General whole body stretching is necessary to stay mobile. You need to be able to move, so stretching is a must. Moreover, a targeted stretching program can be used as a way to enhance a workout (think back to the hamstring and hip flexor story). This is why almost all of my clients receive stretching as a part of their corrective exercise strategy.
So at this point you might be asking your self “WTFruit happens when I stretch? I mean won’t it make me more flexible?!?!” Well here’s how it works. We all adapt to the stresses we put on our bodies. In turn, our bodies try to make our life more efficient to those stresses (i.e. our hip flexors become short if we sit for long periods of time every day). This action happens the nerves in the muscles sending signals to the brain on what is a “safe” length for the muscles to be at through the stretch reflex. What stretching does is increase the tolerance, or muscle length until you feel, the stretching sensation. Thus, becoming more flexible through stretching is a result of decreasing the sensation of stretching. It’s the same reason why you need two cups of coffee now even though you used to only need one. Our brain, and our nerves, just need a little more stimulus (whether its stretching or caffeine) to get the same effect as when we first started.
Bottom line. If you want to have the right range of motion, your brain, nerves, and their connection to your muscles, must be in tune. Stretching will help keep homeostasis, but other than that… well, not much else. For more info you can check out the first brief link and more extensive second link.

The Cause Of, And Solution To, Back Pain

There are too many myths about what causes back pain, and far too many treatments for back pain to ignore (most of which are a waste of time and money).

Today I wanted to give a more in-depth look at causes and solutions to lower back pain. I have previously written about this in a more general sense, but I really feel like this topic deserves more attention. There are too many myths about what causes back pain, and far too many treatments for back pain to ignore (most of which are a waste of time and money). So let’s dive into some surprising factors causing pain, and some practical tips on how to deal with it!
Why Do I Hurt?!?!
I’ll start by saying that 80% of people will experience an episode of back pain during their lifetime. So it’s good to know you’re not alone in wondering what’s going on with your back. But the reason behind your back pain is surprisingly complicated. Aside from acute sprains and strains, the exact diagnosis of the root cause of the problem is often never made, or made incorrectly.
Imaging
We know that using techniques such as X-ray and MRI are often ineffective at catching the true problem (1). This is because most people, HEALTHY pain free people, already have some form of disc or spine degeneration (2). This simple fact can be very misleading when doctors are trying to interpret radiographic findings. The only exception to this rule seems to be for SI joint dysfunction, but even that has some major issues (3). Ultimately, this means that there is no evidence that back pain is caused by a bone or joint in the back being out of place, some change in spinal alignment, or your pelvis being out of alignment. . But on the bright side, we know that more pain does not always mean more damage! Here are two great podcasts going over in detail what types of examinations are often used, and which ones actually workONE TWO.
Inline image 1
Back Pain Exacerbates Itself
Often times pain can make someone afraid to move. This is called kinesiophobia and when it comes to back pain it can be terribly detrimental. This is because movement is key to preventing pain and getting your back better! We know that bending and lifting is not a problem, but rather that muscular fatigue during these tasks can be what causes back pain (4). And we know that stress and a lack of sleep can also cause low back pain (5,6). And if you read my previous post on back pain, you will know that sitting too long can cause back pain. So I hope by now you can see how back pain can make itself worse over time, and that it may not be caused by any physical issue that you may already have to begin with.
What To Do About That Back
DON’TS
Because there is generally no specific cause of back pain, there really is no specific way to treat it. However, we do have a good idea of what works and what doesn’t work. Let’s start with what’s on everyone’s minds… the core. Core training, is often the go to fix for back pain because one would think that a stable back/spine is what’s needed to fix a back problem. But as we know the spine is often not the problem so core training (e.g. targeted core training or Pilates) is not the solution (7). We also know that surgery,  orthotics, or focusing on “perfect posture”are not helpful as well. Finally, alternative methods such as massagetrigger point therapyglucosamine, and back crackin don’t work either (8)
DO’S
One great way to address the pain is by not freaking out and going to your doctor right away. The majority of people who experience back pain have their problems go away within 2-6 weeks of it’s onset. Even the dreaded disc herniation goes away on it’s own over time. Exercise your whole body to see the greatest benefits for both back pain and general health. Aside from making sure you have a strong tooshie (gluteus medius), there is no specific form of exercise that works the best but it seems that total body strength training does the trick (9). If you’re not up for that, then WALK!!! Walking has been shown to be just as effective, and walking backwards may even be a better way to go (10).
The key in all of this is to make sure you get a lot of exercise. Because when it comes down to it, it’s the quantity NOT the quality of exercise that you get that will solve your issues (10).
References
1. Chou, R., Qaseem, A., Snow, V., Casey, D., J. Thomas Cross, J., Shekelle, P.. . American Pain Society Low Back Pain Guidelines Panel. (2007). Diagnosis and treatment of low back pain: A joint clinical practice guideline from the american college of physicians and the american pain society. Annals of Internal Medicine, 147(7), 478.
2. Brinjikji, W., Luetmer, P. H., Comstock, B., Bresnahan, B. W., Chen, L. E., Deyo, R. A.. . Jarvik, J. G. (2015). Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR. American Journal of Neuroradiology, 36(4), 811-816. doi:10.3174/ajnr.A4173
3. Laslett, M. (2008). Evidence-based diagnosis and treatment of the painful sacroiliac joint. The Journal of Manual & Manipulative Therapy, 16(3), 142-152. doi:10.1179/jmt.2008.16.3.142
4. Seyed Hoseinpoor, T., Kahrizi, S., Mobini, B., & Naji, M. (2015). A comparison of abdominal muscle thickness changes after a lifting task in subjects with and without chronic low-back pain. Human Factors: The Journal of Human Factors and Ergonomics Society, 57(2), 208-217. doi:10.1177/0018720814544213
5. Truchon, M., Côté, D., Schmouth, M., Leblond, J., Fillion, L., & Dionne, C. (2010). Validation of an adaptation of the stress process model for predicting low back pain related long-term disability outcomes: A cohort study. Spine, 35(13), 1307. doi:10.1097/BRS.0b013e3181c03d06
6. Alsaadi, S. M., McAuley, J. H., Hush, J. M., Lo, S., Lin, C. C., Williams, C. M., & Maher, C. G. (2014). Poor sleep quality is strongly associated with subsequent pain intensity in patients with acute low back pain: Sleep quality and pain intensity. Arthritis & Rheumatology, 66(5), 1388-1394. doi:10.1002/art.38329
7. Wang, X., Zheng, J., Yu, Z., Bi, X., Lou, S., Liu, J.. . Chen, P. (2012). A meta-analysis of core stability exercise versus general exercise for chronic low back pain. PloS One, 7(12), e52082.
8. Hegedus, E. J., Goode, A., Butler, R. J., & Slaven, E. (2011). The neurophysiological effects of a single session of spinal joint mobilization: Does the effect last? The Journal of Manual & Manipulative Therapy, 19(3), 143-151. doi:10.1179/2042618611Y.0000000003
9. Cooper, N. A., Scavo, K. M., Strickland, K. J., Tipayamongkol, N., Nicholson, J. D., Bewyer, D. C., & Sluka, K. A. (2016). Prevalence of gluteus medius weakness in people with chronic low back pain compared to healthy controls. European Spine Journal, 25(4), 1258-1265. doi:10.1007/s00586-015-4027-6
10. Ferreira, M. L., Smeets, R. J. E. M., Kamper, S. J., Ferreira, P. H., & Machado, L. A. C. (2010). Can we explain heterogeneity among randomized clinical trials of exercise for chronic back pain? A meta-regression analysis of randomized controlled trials. Physical Therapy, 90(10), 1383-1403. doi:10.2522/ptj.20090332

Foam Rollin Rollin Rollin

Foam rolling is a form of self myofascial release (SMR) used on tight muscles. But the question remains… what does foam rolling actually do?!?!

Foam rollers… you see them, you may even use them, but what are they good for? That is the question I am hoping to answer today! Foam rolling is a form of self myofascial release (SMR). I use this modality with many of my clients who have tight muscles and reduced flexibility at specific joints in an effort to get those tight areas to relax before an exercise session. I go through great efforts to identify muscle imbalances in my clients that need SMR, stretching, or conversely, strengthening. But the question remains… what does foam rolling actually do?!?! Well a fantastic review came out recently using 118 research papers. So here is a summary of what is going on with the body when we use SMR techniques, and what it is useful for.
What happens when we foam roll
 
I think it is prudent to first look at what fascia is, because that is the targeted tissue of SMR. Well fascia is complex, but it can be described as force transmission system made up of connective tissue that permeates the human body. Some times tender spots in discrete, taut bands of hardened muscle that produce local and referred pain develop. These are spots are called trigger points. Subsequently, these trigger points are targeted during SMR before or after exercise.
Although we (i.e. the scientific literature) are still not sure on exactly why SMR works, the best evidence points towards a neurophysiological mechanism (like stretch tolerance). This mechanism involves changes in muscle activity acutely, which differs from the way stretching is effective. Other ways SMR may work include lowering tissue pH, releasing inflammatory mediators (reduce inflammation), and re-hydrating the tissue.
What foam rolling is good for
ACUTE (IMMEDIATE) EFFECTS OF FOAM ROLLING ON FLEXIBILITY
SMR causes an increase in short-term flexibility that lasts for >10 minutes. However, it’s not exactly clear how much SMR is needed to achieve this outcome. Unlike stretching, SMR does not affect athletic performance in the short-term. Static stretching, on the other hand, often causes a temporary reduction in muscle performance. Additionally, SMR may decrease soreness and increase pressure pain threshold as a result of DOMS (delayed onset muscle soreness) during the 48 hours following exercise.
CHRONIC (LONG TERM) EFFECTS OF FOAM ROLLING ON FLEXIBILITY
SMR can increase flexibility in a long-term program of >2 weeks with effects similar to traditional stretching programs. Research has also found SMR to improve arterial stiffness, improve vascular endothelial function, reduce cortisol (stress hormone) levels post-exercise, increase parasympathetic activity(high frequency HRV), and reduce sympathetic activity (low frequency HRV). Interestingly, SMR might also improve balance in chronic stroke patients.
Key takeaways 
 
There is a lot of information above but when it comes to YOUR exercise routine, here’s what you need to know. SMR can help with your flexibility immediately after foam rolling for a short time, and will have lasting results when done consistently. It will also help with DOMS so you don’t feel like crying the day after you do squats! Finally, it will tell your brain to release happy hormones so you leave the gym with a big ole smile 🙂
 
For more information, and to learn about the nerdy sciency stuff, you can access the article at the link here.

Shaking Things Up: A Guide To Periodization (AKA Muscle Confusion)

If you do the same workout all the time, you shouldn’t expect to reach greater exercise outcomes.

Today I wanted to go over workout periodization. This used to be known as muscle confusion, but I really hate that term. That’s because our muscles don’t have brains, and as research rock star Brad Schoenfeld puts it “Periodization is a concept, not a defined training model. It’s simply a way to manipulate training variables (load, volume, frequency, etc) over time to optimize a given fitness outcome while reducing the potential for plateau/overtraining. As such, there are an almost endless number of ways to structure a periodized routine to achieve individual goals.” This means if you do the same workout all the time, you shouldn’t expect to reach greater exercise outcomes. So let’s dive into how to shake things up!
Toolbox
One of the first steps that you can take is knowing different exercises. This means growing your toolbox of exercises! If you just go to the gym and hop on the same machines all the time, you can expect to only get better at what those machines offer. I have written about how to structure a basic exercise routine, and there are plenty of great resources online describing how to exercise. But the bottom line here is that you need to branch out and explore the gym for new ways to get strong.
Basic Breakdown
As mentioned before, shaking things up means changing the load (weight lifted), volume (weight x reps), and frequency (how often you target a muscle group). Whether you know it or not, your goal in shaking things up is to build more muscle. More muscle means more strength, more stability, greater sports performance, and general life performance. In the end this means by shaking things up through proper periodization you are enhancing your longevity. You won’t become huge by lifting weights (unless you put a LOT of effort in), but muscle growth is the ultimate goal for everyone in one way or another!
 
Perfecting Your Periodization
Depending on what your exact goals are, training experience, and current fitness levels, your periodization scheme will vary somewhat. However, here are some recommendations that everyone should follow (1):
All muscle groups should be worked out, including legs, back, abs, chest, shoulders and arms.
Do one set of 8-12 reps for each exercise.
2 hours and 30 minutes each week (total of 150 minutes) of moderate-intensity aerobic activity. That’s the 30 minutes a day Monday through Friday recommendation we’re all so familiar with.
Or, 1 hour and 15 minutes (75 minutes) of vigorous-intensity aerobic activity. That’s about 20 minutes of exercise 3-4 times a week.
Or, a combination of the above that gives you an equivalent result. For example, you can walk briskly for 30 min twice during the week and then jog for 20 min on two other days.
Boring recommendations, but they are a minimum for a reason. If you really want to see improvements, you should try a few different strategies. One great way to see a performance boost is to change up your rep ranges. For instance, lift near-max weight for two to four reps on the first workout day, moderate weight for 8 to 12 reps on the second day, and lightweight for 20 to 30 reps on the third day. By training in this alternating fashion you can see greater strength and muscle growth benefits (2)! To make your workouts easier to track, you can also alternate weights on a weekly or even monthly basis to see similar benefits.
Timing Is Everything
Changing things up is necessary, but there is more to consider. Two big factors are when to change, and when to rest! Rest is important because there is a benefit to instituting regular deload period, where a week of reduced frequency, volume, and/or intensity every month or so to facilitate recuperation and regeneration. But we do know that training a minimum of 2 days a week is needed to maximize muscle growth (3). Check out the table below for a great example of how to schedule your workouts (4).
Inline image 1
Changing your sets, reps, and frequency schemes will bring you results. So if you haven’t figured it out yet, tracking your workouts is extremely important. None of this information will be very useful if you don’t know how much volume you’re lifting per muscle group. So get yourself an exercise journal, or create an Excel spreadsheet to see the gains and avoid injury. Because even though you may have the secret to the building big arms, you won’t be able to know if you’re doing it right unless you write it down!