Fitness FAQ’s from your resident CSCS

How do I lose my arm or stomach flab?

I think I get asked this question more than any other question in my professional career! My wife alone has asked me this question about fifty times and she is always dissatisfied with the answer. It’s a simple answer to a simple question that people usually don’t want to hear. This is my fat loss golden rule:  To lose fat anywhere, you must lose fat everywhere! It really is that simple. It’s physically impossible to lose fat locally without total body fat loss. You can do 1,000 crunches a day and you will not see any stomach fat loss unless your calorie intake is less than your calorie output. Meaning, that what you eat (calorie intake) has to be less than what you put out during your daily life and exercise (calorie output). A recent study has shown that it is not just about exercise but that diet contributes most to weight loss.

[Small tangent: Women have a tendency to pool fat in certain areas of their body in subcutaneous fat (below the skin). These areas are the upper arms, stomach, thighs and buttocks. Men have a tendency to pool fat viscerally (below the muscle, around organs in the abdomen) Subcutaneous fat is harder to lose than visceral fat… Sorry, ladies.]

How do I lose weight?

So let’s get one thing straight. You should not just aim to “lose weight.” Instead, you should aim to lose fat mass in relation to lean body mass (muscle). There are plenty of very, very unhealthy “skinny” people. Take for example, an anorexic female that has very low fat mass but also has critically low muscle mass and is malnourished. Although the anorexic female may be skinny, she is also incredibly unhealthy. Your focus should be on being fit and healthy—NOT skinny!

Losing fat mass and gaining muscle mass is critical to achieving health and fitness. Losing fat mass and gaining muscle mass does not only improve your aesthetics,  but also improves blood chemistry, reduces the risk of certain heart conditions, improves bone density, and increases overall strength, along with a whole laundry list of other benefits. Therefore, exercise is critical to overall health—although your diet is most important factor in losing weight.  With that said, I think it’s important to note that you should not just cut your calorie intake by eating less or simply not eating.

How should I diet?

Crash diets will work in the short run but will always fail! I do not say “always” lightly. The reason why these diets always ultimately fail is because the body is designed to require nutrition and will always seek it out. If you think of an engine, it is designed to require several elements to run. The engine requires gasoline, air, a spark, coolant and oil among other things. If any of these elements are eliminated, the engine will not run correctly or fail to run at all. The same goes for the human body. If you’re not eating correctly and you’re lacking elements of nutrition, your body will not run correctly. Likewise, if you’re consuming all the necessary elements but you’re not consuming them in the correct ratios, your body will not run correctly. These elements at the basic levels are the following: Protein, Carbohydrates, Fat and Fatty Acids, Minerals, Vitamins, and the most often forgotten—WATER!!! (Coffee and diet coke DO NOT COUNT.)  If you’re finding that you’re lacking in some of these areas, a good place to start is our Maven Shake, which combines the basics with a little extra something that’ll give you an extra boost. (Note: This isn’t just a shameless plug. I started drinking the Maven Shake every morning and I notice a legit difference.) 

My Achilles Heel! Is my Achilles heel…?

So as the weather warms I am seeing an influx of Achilles related injuries. So I wanted to shed some light onto what the Achilles is and what injuries are associated with it. 

What is the Achilles tendon?

-          The Achilles tendon (calcaneal tendon) is the common tendon of the ankle that attaches the calf to the foot. The “calf” muscle is comprised of 2 major muscle groups of the gastrocnemius (gastroc) and the soleus. These two muscles are in charge of flexing the foot down towards the floor or technically referred to as plantarflexion. You can feel your Achilles tendon by touching the back of your ankle and feeling for the large cord like tendon that extends down to the heel.

Why is the Achilles often injured?

-          

     The tricky part about Achilles issues is that it can caused by many things. The Achilles plays a major function in all weightbearing movement from standing to sprinting. Any issue with the Achilles will drastically affect ones function throughout a normal day. Some problems with the Achilles are the following:

o   Located in a vulnerable area susceptible to injury from outside forces such as a slide tackle.

o   Takes the majority of the load during jumping activities.

o   Used constantly throughout day and exercise.

o   Relatively small tendon for girth of muscle it attaches to.

o   Tendon attaches to calcaneus (heel) but also shares tissue with bottom of heel and effects plantar fascia.

What are some common injuries?

-           Some common injuries sustained to the Achilles tendon and possibly associated with the Achilles tendon are:

o   Achilles tendinitis or tendinosis – Inflammation of Achilles tendon. This is indicated by pain when touching the Achilles and pain with all running and jumping activities. May see slight swelling of tendon.

o   Achilles rupture – Tendon ruptures are very painful and require immediate medial attention. Full Achilles ruptures are immensely painful and require surgical repair and can be diagnosed by use of the Thompson test. The Thompson test is when the effected calf is squeezed and a positive finding is when the foot does not flex down (plantarflex).  Partial tears can be seen when a dip in the actual tendon (looks like a pothole in the tendon).

o   Achilles apophysitis (mostly just children) – Also called Severs Disease, Achilles apophysitis is when the Achilles tendon pulls away from the heel causing pain and swelling. Much care must be taken to avoid over stretching.

o   Heels Spurs (secondary) – Tight Achilles will sometimes contribute to heels spurs which are boney growths are an attachment of a plantar fascia.

o   Plantar fasciitis (secondary) – Inflammation of the plantar fascia of the foot (arch of the foot). Tightness of the Achilles will contribute to plantar fasciitis by placing the foot in poor alignment and causing increases stress across the plantar fascia.

What are some causes for injury?

-          Some causes for Achilles injuries are often preventable

o   Over use – Weekend warriors and avid runners with poor running technique will sometimes develop Achilles tendinitis.  See my last post about running technique.

o   Tight calves – Stretching is very important. One way you can tell if your calfs are tight is if you are unable to flex your foot towards your head >90 degrees. Be sure to warm up >10mins before stretching any muscles.

o   Improper footwear – High heeled shoes and flip flops do not support your foot properly and could eventually cause Achilles injuries. 

Running Tips For the Dog Days of Summer

As the temperature rises and beach season approaches we see more and more runners come into the office. Not all complain of the same issue but most boil down to the same root causes, poor running form. You might think to yourself, “I know how to run! You just go out there and run!” Although running may seem intuitive there is more to it than you might think. Here are a few things you should look out for:

1.       

• Wear the right shoes: So many people don’t understand that footwear is of the utmost importance. Get yourself fitted for the correct shoes at places like…

a  .     Road Runner Sports - http://www.roadrunnersports.com

b.      Jack Rabbit - http://jackrabbitsports.com      

      

These stores will be able to fit you for the proper shoe for your foot and your running level

• Heel – Toe is wrong: Traditionally we think we should be running on our heels but actually you shouldn’t. Running heel to toe actually puts a large amount of force on the shins and the lower leg and can possibly lead to “shin splints” or knee problems. You should land on your mid-foot or slightly behind the balls of your feet.
  
•  Running not jumping: There should be very little vertical movement with proper stride length. Next time you take a run, pass by a store front and look at how much your head bobs up and down, I think you’ll be surprised.
  
• Running surface: Running on asphalt and concrete all the time will eventually take its toll on your knees, hips and back. Change up your running surface every now and then. Try running on a soft track or grass every now and then.
  
• Treadmills are not always good: Running on treadmills all the time can sometimes lead to alterations in stride length, poor body mechanics and poor posture. This is mostly due to the fact that treadmills do half of the work for you by propelling your body. 

Hopefully these tips are helpful! But if you are currently in pain because of your running get assessed by a qualified PT or specialist. Happy running everyone!

David Kwon, PT, DPT, CSCS

SNOW SNOW SNOW!!!

As the northeast has been slammed with snow this winter, I have seen an increase in patients coming in with snow removal related injuries. Obviously snow doesn’t remove itself (unless you live in an apartment building) thus snow removal is necessary. Shoveling snow is an extremely strenuous activity that could lead to several injuries.

Possible Injuries:

•           Strained back muscles
•           Herniated discs
•           Impingements syndrome
•           Bone fractures (from falls)
•           Torn rotator cuffs
•           Shoulder strains
•           Wrist and hand ligament tears
•           Neck strains

With all the possible injuries that can occur with shoveling there are some very simple tips a physical therapist can use to help avoid injuries.

TIPS:

Know your limits! You may think you can move two tons of snow at once but maybe it’s not necessary. Take breaks and avoid long bouts of shoveling at a time. Over loading your muscles for a prolonged period will almost always lead to injury. During breaks make sure you rehydrate and eat something. Dehydration and hunger will lead to weakened muscles and injury.

“Lift with your legs!” When shoveling you must first remember that your legs are stronger than your arms.

     Step 1: When lifting that heavy shovel full of snow first use your legs to push the shovel.

     Step 2: Before lifting re-grip hands so that one hand is closer to the actual shovel.

     Step 3: Get the shovel close to your body.

     Step 4: TIGHTEN YOUR STOMACH! This is the most overlooked step. When you tighten you stomach       you stabilize your “core” this will protect your back.

     Step 5: Lift the shovel parallel to the ground keeping the snow as close to your body as you can. This will  decrease the torque on your back.

Avoid throwing snow. Walk snow over to where you want to put it. Throwing snow will almost always end in shoulder injuries.

BEST WAY TO AVOID INJURY! Hire someone else to do it! But if you can’t, please follow these guidelines. 

New Year Resolution… MORE PAIN!

As the clock strikes 12 on December 31^st, millions of people around the globe make resolutions to “lose weight” and to “get back into shape”. With this resolution come a few dangers that everyone should be aware of.  

Did you know? According to some sources there are more gym related injuries in the first month of January than all other months combined?

Common Mistakes that lead to injury

Being too aggressive: It is possible that injuries are prevalent in the month of January because people will be too aggressive when they return to exercises.

TIP: If you have not worked out in a few weeks (months or years!), progress your exercises. Start out slowly and don’t expect to be able to lift as much as you did when you stopped working out.

Your body requires a few weeks of consistent exercise and activity before your body is “re-educated”, meaning, that the mind and the body must accommodate for this new level of activity. Being too aggressive at the start of therapy could lead to injury simply because your body is not “used to it”.

Not warming up: When first starting any exercise it is imperative to “warm up”. Warming up increase peripheral blood flow to extremities (e.g. Legs, hands, arms) and increases tissue extensibility (ability to stretch). Imagine that your body is a car on an icy winter day. You have to warm your car up before you redline it! Same goes for your body.

TIP: Brisk walking on the treadmill for 10 mins, should be sufficient. If you are not sweating slightly after your warm-up, you did not warm up! If you are performing upper extremity exercises try a row machine.

Not stretching: Stretching is not only one of the most neglected activities; it is also the most incorrectly performed activities. Stretching should be performed after a warm up. Stretching should be specific to the body part that is being exercised that day. Stretches should last at least 15 seconds.

TIP: Do not bounce during stretching activities. There are little sensors in your muscles that detect rapid stretching, which compensate and increase muscle contraction. When you bounce and stretch (as seen in many Jane Fonda work outs) you can activate these sensors, meaning you are essentially making your muscles tighter!

Hopefully 2011 will be a healthier, stronger, injury free year for all of you! Good luck!

PT Frequently Asked Questions (FAQ):

When people come into my clinic there are some common questions that people ask. Being that Maven Clinics are all found inside gyms, we get a few questions that other clinic may not hear that often. Here are a few examples.


PT Frequently Asked Questions: 

1. When do I know that I need therapy?
Usually I recommend that patients receive therapy when their injury (or condition) is inhibiting their normal daily activities such as walking, sleeping, running, exercising, cooking, driving. Often times people will ignore their problems until it starts to interfere with their everyday life, which leads to the next question.

2. My pain isn't stopping me from my normal activity but it still bothers me, do I need therapy?
Yes! Why live your life in pain?? Prevent the injury from getting worse, get treatment so that you can move on with your life. Pain is a signal from your body that something is wrong. It is usually a good idea not to ignore signs, like a red light at an intersection. Consider pain a big red light for your body.

3. Do I need a prescription? I don't have time to go back to my doctor.
Depends, most of the time no, you don't need it. But certain plans DO require it, but 90% of insurance plans in NJ DO NOT require a prescription. NJ is a Direct Access state, which means it is legal to go straight to a PT without a prescription. Medicare patients, unfortunately, DO need a prescription.. sorry!

4. What exercises or machines can I use out here that wont hurt me? How do I use them? (One of those MAVEN only questions)
That really depends on what you are looking to gain from the exercises and how you are performing the exercises. All MAVEN PT's are either CSCS (Certified Strength and Conditioning Specialists) or in the process of being certified, so we are a great resource for you. Also we will be having a....

INJURY FREE RESISTANCE TRAINING WORKSHOP
700 Palisadium Dr.
Cliffside Park, NJ 07010
Dance Studio 1
January 15th, 2011
12:30PM - 1:30 PM

The seminar will be taught by Taylor Lee DPT, CSCS. With over 10 years of training and fitness experience! The seminar will be fun and interactive and is absolutely free! Come and bring your friends!

What is spinal stenosis?

Spinal stenosis is one of the most common conditions that effect the older population. Spinal stenosis is a narrowing of the spinal canal that causes pinching of the spinal cord. The spine is comprised of bones call vertebrae. The vertebrae are like bricks that make a pillar (the spine). 

This pillar keeps your body upright and is the foundation of your skeletal system. The spine also protects your spinal cord. Most of you know that your spinal cord carries your nerves which carry information such as pain from your body to the brain.  Over time, the part of the vertebrae that encases the spinal cord becomes narrower and with eventually begins to compress on the cord itself. This results in pain and possibility numbness and tingling in one or both legs.  

Signs of spinal stenosis:

1.  Pain with back extension activities (leaning back).
2. Standing is more painful than sitting.
3.  Pain goes away with sitting or lying down.
4. Pain and/or numbness extends down legs, most of the time into both legs.
5. Pain relief medications are not effective.

Treatment for spinal stenosis:

1. Conservative treatment: NSAIDS (Tylenol, Aspirin, ice)
2. Changing sleeping positions – Sleeping on side.
3. Medical treatment – Surgery, medications, injections.
4. Physical therapy – Therapist will teach core strengthening, postural control, body mechanics and pain management with manual therapy. 

Spinal stenosis is a difficult thing to treat but there are some patients that respond very well with treatment. The therapist and the patient must work hard together to return the patient to his/her normal life.