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

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!

Being a Protein Pro

Nutritional protein is a HUGE area of research and controversy, so here’s attempt to simplify things.

Today we are talking about protein! The only problem is that the topic of protein is a HUGE area of research. So I will attempt to simplify things as best as I can, but be sure to shoot me an email if you have any specific questions.
 
What is Protein
Protein consists of chemically bonded amino acids. Many things that we eat contain some form of amino acids ranging from animal products, to plants, and even insects. The ways that proteins are used in the body are far too complex for this post. Simply put, protein and amino acids are the building blocks of life.
 
Well What Does Protein Do For Me?
Most people are looking to do 2 things. Gain muscle, and lose fat. Well take a guess at what protein does? THAT’S RIGHT! From athletes to couch potatoes high protein diets can promote weight loss and lean mass gains/preservation. (Nerds like me can check out the science herehere, and here)
 
How Much Protein Should I Eat?
Aside from a few medical conditions, there really is no upper limit to the amount protein you can consume. I’m not saying you should go out and drink 5 protein shakes a day because you can. In fact there is a certain amount of protein that is just right for you. For most people 0.45-0.68g/lb body weight is a good starting point. If you’re looking to find out exactly how much is right for you, feel free to give me a buzz.
Where Should I Get My Protein?
For most people, I recommend getting your protein from your regular diet. However, for most people it is difficult to get enough protein by food alone. Additionally, those are vegan/vegetarian, athletes, and/or want to maximize muscle growth certainly will need supplemental protein intake (Nerd alert). I personally take at least one protein shake per day. I use, and recommend, the SRX brand that we sell at O2 fitness (see me for a 10% discount). However, it’s always important to make an educated decision when choosing you’re supplements. This is why I attached some additional information to this email about the SRX brand.
When Should I Get My Protein?
Morning, noon, and night. Continued consumption of protein increases muscle growth. For most people it’s more important to get enough total protein than it is to worry about when you get it. However, if you absolutely must know, I would suggest having a little protein and carbohydrate before and after a workout.
Bit of a long email today, but I hope you found it useful. For more information check out the well written, and brief, article by examine.com linked bellow. Of course you are always free to contact me if you have any questions about today’s topic!

A Healthy Body Begins With Happy Feet

The foot and ankle complex provides a base of support for all of our upright movement, so why don’t more people do exercises to strengthen such an important part of their body?!?!

Today I wanted to address how your feet influence the movements of your entire body. Your feet play a critical role in many movements beyond just walking, running, and jumping. The foot and ankle complex (FAC) provides a base of support for all of our upright movement, and if the muscles within the FAC become imbalanced it can set off a chain of negative reactions. So why don’t more people do exercises to strengthen such an important part of their body?!?! Well, today I am going to lay out what what the FAC is good for, and how to best go about achieving arch strength and happy feet.
Inline image 1
FAC Facts and FAQs
 
The FAC is extremely complex because there are dozens of bones and hundreds of muscles, tendons, fascial components, and ligaments at play. All of these components come together within the FAC to provide stationary support while standing and dynamic spring while moving. So I will do my best to keep it simple, but please forgive me if my inner nerd comes out and I use too much technical jargon. When it comes to movement of the FAC, one major concern is the interaction between the arch of the foot and dorsiflexion of the foot (taking your foot off the gas motion). A lack of dorsiflexion in the ankle can be the caused by several factors, but frequently involves decreased strength of the tibialis anterior muscle (1). The decrease in shin muscle strength can then lead to flat feet, increased plantar flexion (pressing the foot down on the gas) during squatting motions and gait (walking). All in all, the arch can be placed under great amount of stress during the load acceptance phase of gate, if your foot is weak and there is limited dorsi flexion. That’s because during this phase of the walking/running cycle the shin and ankle muscles assist the arch in energy absorption (2). If the ankle is unable to properly dorsiflex, a huge amount of stress will be placed on the foots spring ligament, plantar fascia, and intrinsic muscles which can lower the arch. This lowered arch in turn causes tibial (shin) rotation, hip internal rotation, slight hip flexion, and hip adduction creating a valgus (knock knee) stress (3,4). So what does this mean for you? Well to sum it all up, when we don’t pay attention to the FAC we are more likely to have stiff hips, lower back paintight calves, weak feet, weak ankles, altered gait, plantar fasciitishallux valgus (a.k.a. bunions), patellofemoral pain, increased susceptibility to medial collateral ligament (MCL) injuries, and an increased likelihood of anterior cruciate ligament (ACL) tears.
There are also some other surprising aspects of foot strength that I’m betting most of you didn’t even think about. Having proper FAC strength means you have developed some proprioception (foot eye coordination in this case). In turn, this means you know where your body is at in space. This is extremely important if you think about it because it’s the same as knowing where my fingers are as I type each letter of this post. I don’t need to look down for each letter, I just know how to move my hands. So, if you practice strengthening your FAC you will know where your lower body is during each step you take. This leads to better performance for athletesenhancements in the standing and walking positions, and the ever crucial prevention of falls for seniors (5).
 
Foot Fitness
 
So I’m going to start this section by being a negative Nancy. To have healthy feet you SHOULD NOT use arch supports or supportive shoes. No, this does not mean you should take out those stinky old things you have put in your shoes for years and start walking around. What I mean is that the arch support is to the feet, what the weight lifting belt is to the back. Yes they are both supportive, but if you don’t let those underlying muscles develop you will end up with some limp noodles for muscles. So instead of opting for the all or nothing path, star weaning yourself off of the arch support and into regular shoes. Or if you’re ready for it, start weaning yourself onto more minimalist shoes. It’s really all about a gradual progression into a more barefoot environment… unless your feet stink like mine ;). You wouldn’t go from lifting 10 lbs dumbbells to benching  225 lbs, so don’t jump too quickly on the minimalist bandwagon especially if you have high arches to begin with (6).  
 
Okay, I know that if you have read this far you might be a little frightened of your weak feet. But I promise you that you don’t have to do that much to whip them into shape! This is because even though you use them all day long, the interaction between your nerves and your muscles may be the real underlying issue. So to re-learn your own feet, there are a few simple steps you need to take. Use your time wisely by standing on one foot as often as you can. This can be done while you wash dishes, make phone calls, eat Ramen noodles, or other things that people who aren’t poor college students do. You can also practice flexing your toes while you’re sitting down. This can be done by simple scrunching your toes together while at your desk, or by picking up objects and putting them into a container while you’re seated (7). Additional exercises include standing on one foot, bunny hops, walk heel to toemedial (inside) calf raises, resisted ankle inversion exercises, single-leg kettlebell swap, foam rolling the biceps femoris (outside hamstring) and plantar fascia, and walking in a straight line with one foot in front of the other. Finally, you should take care of your hips. The interaction between the hips and the ankles goes both ways. So stiff hips can mean stiff ankles and visa versa.
Resources
1. Chizewski M., & Chiu L. Contribution of calcaneal and leg segment rotations to ankle joint dorsiflexion in a weight-bearing task. Gait & Posture, 3685-89. doi:10.1016/j.gaitpost.2012.01.007
2. Spaich, E. G., Andersen, O. K., & Arendt-Nielsen, L. (2004). Tibialis Anterior and Soleus Withdrawal Reflexes Elicited by Electrical Stimulation of the Sole of the Foot during Gait. Neuromodulation, 7(2), 126-132. doi:10.1111/j.1094-7159.2004.04016.x
3. Hollman, J. H., Kolbeck, K. E., Hitchcock, J. L., Koverman, J. W., & Krause, D. A. (2006). Correlations Between Hip Strength and Static Foot and Knee Posture. Journal Of Sport Rehabilitation, 15(1), 12.
4. Simon, L., Christian, B., Peter, M., Richard, T., Roger, W., & Dylan, M. (n.d). The effect of anti-pronation foot orthoses on hip and knee kinematics and muscle activity during a functional step-up task in healthy individuals: A laboratory study. Clinical Biomechanics, doi:10.1016/j.clinbiomech.2013.11.015
5. Hashimoto T, Sakuraba K. Strength Training for the Intrinsic Flexor Muscles of the Foot: Effects on Muscle Strength, the Foot Arch, and Dynamic Parameters Before and After the Training. Journal of Physical Therapy Science. 2014;26(3):373-376. doi:10.1589/jpts.26.373.
6. McKeon, P. O., Hertel, J., Bramble, D., & Davis, I. (2014). The foot core system: a new paradigm for understanding intrinsic foot muscle function. British journal of sports medicine, bjsports-2013.
7.Siddiqi A., Kumar D., Arjunan S. Age-related motor unit remodeling in the Tibialis Anterior Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS, Volumes 2015-November, 4 November 2015, Pages 6090-6093

Weekly Workout Structure

Ways to structure your workout routine, variables to consider, and how to plan for those pesky, yet inevitable, life barriers.

While there may be more than one way to skin a cat, there are more than 1,000 ways to get in shape. No matter what your fitness goal is, there are loads of variables to take into account when we talk about exercise. So today I wanted to talk about ways to structure your workout routine, variables to consider, and how to plan for those pesky, yet inevitable, life barriers. For me, the crux of today’s topic really stems from a trip that I will be taking this week which will interrupt my regular exercise routine. I was briefly panicked by the thought of how much clothing I will need, the quality of the hotel gym, and planning around what I normally do. Then a sudden calm came over me as I realized that… it really doesn’t matter! Here’s why.
The Basics
For me, I want to train to be lean and have some muscular definition. Think Brad Pitt in fight club. So my exercise routine is intense, but not the best for maximizing muscle gain. Here’s my regular exercise routine; Monday – full body strength training barbell based exercises Tuesday– LISS training = running about 1 hour Wednesday – full body strength training dumbbell based exercises Thursday – HIIT I practice for the Grit class I teach as well as row/other high intensity stuff  Friday – full body strength training machine based exercises Saturday – Run club = 3 mile-ish run.
Does that mean your weeks worth of exercise should look like mine? NOPE! There are lots of reasons why not, but in short, I have worked up to this level of fitness and intensity. However, while you’re free to skin your fitness cat the way you like, all routines will in some way revolve around the FITT principle. FITT is an acronym standing for Frequency Intensity Time and Type. Each one of these components can be broken down into sub categories that would keep me at my computer for days. But instead of majoring in the minutia I will make sure go lay out the big rocks of each component.
Frequency is how often you perform the targeted health-related physical activity, and is by far the most crucial aspect of any workout routine. Consistency is king for all components of health. However, it is possible to over train so you need to find your own personal sweet spot. I will go over recommendations in detail in the “type” section, but what you need to know is that you should be doing some form of physical activity at least 5 days per week. 
Intensity is how hard you exercise during a physical activity period (measured in different ways, depending on the related health-related component). This component can not only make or break your chances of hitting your goals, but it can also make or break your body and mind. You need to record how intense your workouts are on some level. Whether it’s through writing down sets/reps/weight, heart rate, perceived excretion, mileage, or other forms of documentation. Because you can’t make adjustments without having some form of data on your own workouts.
 
Time is not only the length of the physical activity, but also the rest breaks. The former can be best described as time-under-tension (TUT)which refers to how long the muscle is under strain/resisting weight during each set (30s – 60s), duration of a stretch (30s > twice a week), or time spent doing aerobic activity (30m > per day). The latter is the amount of time recovering between set, between workouts, or between specific muscle groups. All of these factors can be manipulated for different goals but essentially if you want to get big and strong rest for 2-3m between sets. If you want to get lean, rest for only a few seconds.
 
Type or specificity, refers to the specific physical activity chosen to improve a component of health-related fitness. No matter what your goals are you should be training for strength (all muscle groups at least 2 x a week), aerobic fitness (2 hours and 30 minutes each week), and a form of balance and stability (daily). Throwing HIIT is a great idea because it will get you lean quickly and with shorter workout duration, but be careful. It’s easy to go overboard with HIIT and end up being “burned out” though over training or even hurting yourself.
Making Your Customized Exercise Program
To make your very own customized exercise program, you will need to start with a few basic self recognition tasks. Take a good look at your goals and ask yourself if what you need to work on. You may need to start with learning proper technique, asking your doctor if your heart is healthy enough for strenuous exercise, or maybe recognizing that you’re not working intensely enough. This step is best done with a fitness professional to guide you. However, if you feel you’re ready for some strength training (which most people don’t do even though they need it), here is a simple template to follow.
Because there are thousands of exercises to choose from, differentiating set and rep ranges, tempo selection, and dozens of other variable to choose from, I will just keep it simple. You want to focus on general body movements and place them in a sensible order to avoid injury and ensure progress. So here are the motions you want to consider and a few examples:
Upper Body Push – Barbell Press (Decline, Flat, Incline, Overhead) • Dumbbell Press (Decline, Flat, Incline, Overhead) • Single Arm/Alternating Press • Floor Press (Barbell or Dumbbells) • Pushup 
Upper Body Pull – Pullups/Chinups (weighted, bodyweight or assisted) • Lat Pulldown • Bent Over/Pendlay Row • Single-Arm Row (dumbbell or cable) • Chest-supported Row Note – I would advise choosing one vertical and one horizontal pull for the sake of evenly hitting all of your back muscles
Lower Body Push (Knees Bend) – Back/Front Squat • Safety/Cambered/Speciality Bar Squat (if your gym has these) • Box Squat • Paused Squat • Split Squat (Front or Rear Foot Elevated) • Walking Lunges • Leg Press/Hack Squat 
Lower Body Pull (Hips Extend) – Conventional and Sumo Deadlifts • Hip Thrust/Glute Bridge Variations • Single-Leg Deadlift/Romanian Deadlift • Two-Legged Romanian Deadlift • Reverse Lunge • Kettlebell Swing • Back Extension • Glute Ham Raise/Nordic Curls 
Beach Muscles – Upper Back Isolation (face pulls, pull-aparts, rear delt flys, YTWs) • Bicep/Tricep Isolation • Calf Isolation • Core/Abdominal Work
There are a few ways to structure your workout program based on how many times you plan on going to the gym. The most important part here is planning enough rest between each gym session. So if you plan to exercise on Monday Wednesday Friday like me, you can be confident there there is adequate recovery time in there. But if you’re going to strength train 4 days per week, well it will take some wise exercise choices. For the examples below, scattering in beach muscle exercises at your discretion is recommend to be done at the end of each workout. Leaving the gym with a good pump always feels awesome.
2-Day/Week
Upper Body Day  Push/Pull
Lower Body Day  Bend/Extend
or
Upper/Lower Day 1  Push/Extend
Upper/Lower Day 2  Pull/Bend
4-Day/Week
Lower Body Day 1  Extend
Upper Body Day 1  Push
Lower Body Day 2  Bend
Upper Body Day 2  Pull
Using a simple template to track your workouts is a great way to go. Simply write up your plan for the month, take it to the gym, and you’re on the way to muscle city. See below for an easy to use program design. You can use the exercise example seen above, but I encourage you to explore the gym and learn new exercises to love!

Day 1

Exercise

Sets

reps

weight

Lower Body Push Variation 1

4

4-6

Pull Variation 1

4

4-6

Lower Body Pull Variation 2

3

8-12

Press Variation 2

3

8-12

Beach Movment

3

8-12

Day 2

Exercise

Sets

reps

weight

Lower Body Pull Variation 1

4

4-6

Press Variation 1

4

4-6

Lower Body Push Variation 2

3

8-12

Pull Variation 2

3

8-12

Beach Movement

3

8-12

Summary
While there are a million different ways to go about exercise, there are also a million different excuses. Even if you’re busy, there will always time to exercise and improve your health. When you’re stressed it’s hard to breathe and your joints can feel stiff as a board, but there are ways to feel better and loosen up. If you feel the effects of jet lag and don’t feel like working out, there are ways around it. And even if you know you will struggle to find ways to complete your regular routine while on the road… well the occasional rest can do you right while you figure new ways to skin a cat 🙂

Take Control of you LBProbems

From young athletes, to chair bound adults, to golden year seniors, almost everyone will experience lower back pain at some point in their life. For this reason I decided to break down LBP into what it is and what to do about it!

Today I am talking about the dreaded lower back pain (LBP). From young athletes, to chair bound adults, to golden year seniors, almost everyone will experience lower back pain at some point in their life. For this reason I decided to break down LBP into what it is and what to do about it!
 
The Major Malfunctions
There are dozens of reasons why someone would have LBP. Even different illnesses can cause it. So to avoid writing a whole book I’m going to cover the biggies. 
In young athletes, the problem is often in the bones of the spine. In fact 47% will have a spondylolysis fracture with only 11% of LBP being caused by disc issue in this population. This differs from the adult population where 48% of LBP is disc related. So in young athletes the problem is often caused by repetitive extension and torsion of the spine, where as in adults the issue is typically due to sitting posture. Take a look at the picture bellow to see how changing your body position affects the load on you spine
 
Inline image 1
 
So clearly much of the problem has to do with… well… you! Do you sit too long? Do you sit with crap posture? Do you move well? All of these questions are important ones to ask yourself. But the good news is that you’re in control!
 
What To Do About It
Before I go into detail about exercises and stretches to help, I will tell you that you need to see a doctor if you experience any of the following issues:
Do you feel any tingling or numbness?
● Do you have any loss of sensation?
● Do you have any loss of motor control, such as an inability to raise your arm over your head?
● Do you have or have you ever had a loss of bowel or bladder function?
● Do you have severe immobility or an inability to walk?
Answered no to all of the above? wonderful, please read on at your leisure. In fact stand up, walk around, then sit back down and read on. Because Tip 1 is to start by sitting for no more than 30 minutes at a time. It’s the most simple and easiest way to help control that back pain. Now that you’re sitting Tip 2 is to now get into a proper sitting posture. So feet flat, chest up, core contracted, and eyes straight ahead. And finally Tip 3 breath from your belly. Not only will this help relieve stress (another cause of LBP) but it will engage that protective core musculature.
The Exercises
Here’s the problem with recommending exercises. Everyone has different needs!!!! Not everyone is going to be weak in the same areas. Not everyone is going to need stretching of the same muscles. For instance, if your back rounds out like a turtle when you sit down, you may need to stretch your hamstrings. However, if your back arches when you do a squat or sit down then that’s the opposite of what you want to do! So please come see me if you want some specifics on what to do to help correct your posture. In the meantime, you can try some of these exercises which are generally safe and effective for most people.
1. The Glute bridge. A simple and easy exercise that you can do anywhere. It activates the tooshie as well as the wonderful core muscles.

2. The hip flexor stretch. A wonderful pairing to the glute bridge is a stretch of the hip flexors. This stretch will allow the butts and guts do their jobs.

3. The plank. Abdominal bracing is all the rage this fall. So make the plank a part of your workout wardrobe.

4. Leg swings. This will help mobilize the hips so you can use your booty!

5. The fire hydrant. This exercise uses your mobilized hips to further strengthen them glutes.
When it comes to back health there is a lot to take into account.To be honest I have barely scratched the surface on this topic, but I feel like this post has gone on long enough as it is. So sit up straight, work on glute and core strength, and get out of that chair! 

Lifting For… Losses

Lifting for gains (muscle/strength) can also equal losses.

Today I wanted to talk about getting shredded to lose weight. Because I know everyone is concerned about how they are going to burn off all that BBQ they will be eating this weekend! So that’s why I wanted to talk about why lifting for gains (muscle/strength) can also equal losses.
But first, a clarification. Weight loss is not the main topic of today’s post. Why? Because weight loss can be achieved through amputation, osteoporosis, stomach flu (though intestinal parasites will do in a pinch), coma, chemotherapy, shaving all your hair off, lobotomy… you get the point. Weight is not a great indicator for health or fitness, so what we are really talking about is fat loss. Because we all know muscle weighs more than fat, we know that weight may go up while your pant size goes down. This is why all of my clients take more pride in their bio-electric impedance (fat mass) numbers rather than the numbers on the scale. They know that their body composition (lean mass compared to fat mass) is what’s really important.
Old-School
The old-school way of thinking was that low intensity cardio burns fat, therefore you lose fat. But we now know that this just isn’t true. Without getting into science nerdy stuff too much, burning fat only means your using fat as fuel source. And unless you’re an ultra marathon runner,this doesn’t really matter. Although cardio is beneficial in many ways, it won’t do a great deal to help you lose fat. Oh and fasted cardio? Well… listen to this podcast that reflects my thoughts on this ridiculous practice.
Why Weight Lifting is Better
Picking up and putting down heavy things does more than you know. It places large amounts of stress on not only your muscles and tendons, but your bones and nervous system as well. Everything has to adapt to stress. As a result of this adaptation, your muscles will store more myoglobin (sugars), bones will become more dense, and your body will know to send more blood to these areas to help with the repair/replenishment of nutrients. Although your weight may go up a bit from these adaptations, it in turn means your metabolism grows as your muscles do! So class. What do we burn when we are at rest and our metabolism is high? Fat! This scenario is how we lose fat. Research continues to show that placing greater amounts of metabolic stress (like weight training) will result in greater fat loss and muscle gains.
Where To Start
Now for some of you, I know that the thought of weight lifting is daunting. Images of bench pressing meat heads may even be dancing around in your mind. But getting started on a weight lifting program doesn’t mean you need to learn how to grunt like an animal while squatting. What is important, however, is that you get started and stay consistent. Here are some key thoughts on how to do this:
Make the Process Fun – Experiment around the gym. Find what you like to do, then do it. It’s that simple.
Set Mini Goals – Long term goals progress slowly. To avoid going crazy, set short term goals as well. It can be as simple as doing a real push up by the end of the month.
Have An Accountabilibuddy – Nothing gets you in the gym as easily as a buddy. It’s much harder to say “no” when there is someone to push you along the way.
Don’t Get Carried Away – The “more is better” approach is rarely a good thing. Layer things on slowly and you will stay sane and injury free.
Feeling stressed out? Who isn’t these days?! Check out this link for tips on how to train when stressed.
Final Thoughts
I’m not saying cardio is bad by any means. In fact, it should be a part of your training program. But if your trying to look strong and/or lose weight, it should not be the main strategy. It’s also important to remember that everyone will react differently to resistance exercise. There is no magic bullet to all of this. Make sure you are placing the big rocks first and results will come. A high protein diet and consistent metabolic stress from resistance training will get you the results. Just be patient and keep the faith and you will see your body composition change! Still need help getting started?

Pain In The Neck

The neck is really designed to balance the 10- to 14-pound pumpkin that sits on top of it. The problem arises when your head starts to drift forward.

One thing I take pride in, and greatly enjoy, about my job, is my ability to see dysfunction postures and movement pasterns. So this week I wanted to discus an issue that I see far too often these days. This issue is the forward head posture. So while you read this weeks post, make sure you sit up straight!
The Issue
The Cervical spine, the neck, can bend forwards, backwards, to the side, and rotates. It’s made out of seven vertebrae and dozens of muscles, both large and small. Some of these muscles never rest when you’re upright, otherwise your head would fall to your chest! The neck is really designed to balance the 10- to 14-pound pumpkin that sits on top of it. The problem arises when your head starts to drift forward. This is because for every inch the head juts forward, the neck takes on a load equal to roughly 10 additional pounds. In turn this can lead to neck pain, stiffness, cervical muscle strains, headaches, dizziness, early onset arthritis, decreased lung capacity, and pain or weakness in parts of the body that lie below the cervical spine.Yikes!
How Did I Get This Way 😥
By now I assume you’re all sitting up straight in your chair like Hermione Granger in class. But in reality, this posture develops over a long period of time. Most commonly, people who work long hours at a computer, professional drivers, cyclists, runners, baseball players, cell phone addicts, musicians, chefs, surgeons, dentists, and other people who lean over their work are likely to develop a forward head posture.
What To Do About It
So by now you should be able to tell that this issue doesn’t just develop over night. So don’t be a Goober and think simply sitting up straight more often will fix it. You spend your whole life getting into the posture that your in, so you will need to take a few more steps to overcome the postural dysfunction. The first step is to see a doctor if you’re experiencing numbness, pain that radiates toward the shoulder or arm, or a loss of strength in the arms or hands. If you don’t have any of these medical concerns then you can try stretching and foam rolling the thoracic spine, sternocleidomastoid, levator scapulae, and upper trapezius to start. Next, you need to be mindful of the muscles that are working during your exercise. If you’re doing a shoulder raise, but feel the muscles in the upper traps firing up, you will need to make adjustments to what you’re doing.

Cultivating Mass

The WHY and the HOW to cultivate muscle mass. If you don’t think this topic pertains to you, I will politely say stop being a jabroni. Ultimately, developing muscle mass is going to be one of the most important outcomes of exercise.

Today I want to talk about the WHY and the HOW to cultivate muscle mass. If you don’t think this topic pertains to you, I will politely say stop being a jabroni. Ultimately, developing muscle mass is going to be one of the most important outcomes of exercise. Whether you’re trying to lose weight, play sports, prevent/recover from injury, or even sport a bikini this summer, gaining muscle mass is critical.
 
Why
Building muscle is critical, especially as we age. Building, and maintaining, muscle mass becomes increasingly difficult as the dreaded sarcopenia starts to set in. So starting the muscle building process as soon as possible will do several great things now and for your future self. It will keep us looking and feeling young, increase our confidence, boost our sports performance, ramp up our metabolic rate (although not significantly), and promote bone health. This last point of bone health is particularly important for women as they are more susceptible to poor bone health with age. It’s crucially important for females to lift heavy weights and knock this “toning” crap out. Trust me, you won’t get “too bulky” or “manly” if you lift heavy. So before you move on to the next part I want you to do three things that I hope will get you inspired. Write down all the things you wish you could do, if you were fitter. Write the obstacles that are keeping you from getting there. Write down how you’re going to get around those obstacles.
 
How
The first thing you need to do is just start lifting things that are uncomfortably heavy. It doesn’t even have to be at the gym. Just start taking in groceries instead of having your husband do it (cough, my wife, cough), moving furniture, or even doing some body weight squats at home. 
The second thing you need to do is make a plan of attack. This is a crucial step for several reasons. Making and sticking to a set schedule will ensure you don’t suffer an over use injury. It also ensures you know what your weaknesses are. If you don’t know proper technique well maybe getting some professional help is in order. If you realize that you exercise schedule is missing a muscle group well then you can now make a place for it. More on this step later.
The third thing you will want to do is look at your exercise selection. This is where it gets tricky. Your exercises need to suite your goals, your fitness level, your skills/abilities, and should be enjoyable. In general, I recommend using compound movements and super sets for a quick efficient workout. For beginners this means you may want to start with partial movements (i.e. half squat/wall squat) to master technique. And of course if you’re looking to shake things up there’s always wild and crazy exercises out there to try.
< 18 years: 0.6-0.8 grams per pound of body weight
19-40 years: 0.8-1.1 grams per pound of body weight
41-65 years: 1.1-1.3 grams per pound of body weight
> 65 years: 1.3-1.5 grams per pound of body weight
 
Dos and Don’ts 
Here is my final list of some things to maximize your exercise efforts, and some things that are not so wise.
DO
Focus on progressively increasing our performance on a handful of movements, and actually track your performance. Consistency is literally the king of gains.
Base your training on big compound movements. For each lift, figure out which muscle is holding you back and add isolation or assistance work for these weak points.
Change the specific exercises/make slight variations often. Do this by either varying grip, stance, bar type, or the conditions you’re performing the lift in (tempo, pauses in the movement, using chains, etc.).
Aim to train muscle groups 2 to 4 times per week.
Just get into the gym. It doesn’t matter what time of day you go, just get it done.
DON’T
Bro split your routine (i.e. only training muscle groups once per week).
Put an unnecessary time-cap on your workout.
Train every muscle the same/train every muscle directly.  Not all muscles respond best to the same type of stimulation.
Do more than four intense sessions per week.
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Death Taxes and Sarcopenia

Starting around age 30 we all start to lose muscle mass and there is absolutely nothing we can do to stop it. Might as well accept your fate right? WRONG!

This week we are talking about how to minimize sarcopenia. What the heck is sarcopenia you ask? Well as the title of this week’s post implies, it is the inevitable decline in the strength and size of our muscles as we age. Starting around age 30 we all start to lose muscle mass and there is absolutely nothing we can do to stop it. However, several factors can exacerbate sarcopenia to extremes. In fact, it can cause loss of mobility and function, decline the ability to perform activities of daily living, increase risk of cardiometabolic disease, and increase chances of falls and hip fractures.
So the only things in life that are guaranteed are death, taxes, and sarcopenia. Might as well accept your fate right? WRONG! Here are a few key factors to keep your muscles, and consequently your lifestyle, from wasting away.
PROTEIN
I’ll start with protein because I know you all are protein pros! Protein is essential to muscle function. So it should come as no surprise that if you are under consuming amino acids, you will be at greater risk to suffer from advanced sarcopenia as you age. It’s important to note here that we need more protein as we age. So don’t be a part of the 50% of the elderly population who doesn’t get enough protein. Shoot for 1.2 grams of protein per kilogram of weight per day (calculate here).
ANTIOXIDANTS
Antioxidants are in the media constantly. They are touted as being the miracle source of all sorts of health. The reality is that they only play a role in our overall health. What they do is reduce oxidative stress. Oxidative stress is responsible for all sort of things, not all of them bad. So for some the key is moderation, and for others it is supplementation. So how does it affect sarcopenia? Well in several ways, but really the most important way is that it reduces or even can reverse anabolic resistance. Now this is extremely important because anabolic resistance basically means your muscles can’t use proteins, and thus they will wither away.
RESISTANCE TRAINING
By far the most important factor in reducing sarcopenia is resistance training exercise. I think this point is even more important for women because in addition to sarcopenia they are more likely to suffer from bone diseases like osteoporosis. What resistance training does is force the body to adapt to the stress placed upon it. So your muscles get bigger because they need to adapt to lift more weight, and bones get bigger to support the added stress from the muscles. This is why I always encourage women of all ages to lift weights. It’s also why I cringe when a women tells me “but I don’t want to get too bulky”. James Fell wrote a fantastic piece on this very topic and I encourage everyone to read it here.
So whether you need help on increasing your protein intake, antioxidants, or figuring out an exercise program, I’m always here provide assistance.