Tuesday, December 22, 2009

Exercise of the Day

Prone Exercises

In continuing with my back injury exercises I will advance the prone exercise plan. In the prone position add weights to the legs to increase the intesity or increase to count moving up to a minute at a time.

Also, instead of using a pillow use a stability ball under the abdomen and with you feet apart and toes on the floor in the push-up postion. Arms flexed at the shoulder and down to the floor. Roll forward on the ball until your trunk is in midair and maitain control for a count and return to start postion. Extending the arms parallel to the shoulder can be added, as well as supermans, swimming, prayer, and push-up postions.

Friday, December 18, 2009

Exercise of the Day

Prone Exercises

Similar to TYI's, prone exercise are very useful in rehabbing someone out of injury. thus they are a great exercise for someone with back pain.

Prone exercises are done laying on your belly, usually with a pillow underneath the abdomen. To perform, you tighten the trunk musulature into the neutral (usually pain-free position) while maintaining the arms and legs in extended position. You may need someone trained help show you how to do this properly--especialy if you have back pain.

You can adjust these to make them more difficult. Stay tuned for those.

Thursday, December 17, 2009

Exercise of the Day

Bridging

More spine rehab and core exercises:

Starting on your back, with the spine in neutral position, raise the hips 1 inch and maitain the neutral position for a count of 10 then return the hips.

Raise the hips further off the floor to maximal height, maintaining trunk control and not arching the back, hold to count of 10 and return to floor.

Raise the hips about 3 inches off the floor and hold for a count of 10 and return hips to the floor.

Raise the hips again about 3 inches and hold. Extend on leg while maintaining neutral position. hold for a count and return the leg to the floor. Repeating with the other leg.

These exercises are for those with back pain or an injury. However if one has no pain or injury they can be performed for counts longer than 10 to challenge yourself.

Wednesday, December 16, 2009

Exercise of the Day

Reverse Crunch with Swiss Ball

This is a great exercise and continues my core exercise posts.

To perform this exercise, lie on your back and grip a Swiss ball between your thighs and calves. Hold the ball just above the ground, being careful not to let it touch. Using your core, bring the ball up until your legs are straight above you and your hips are off of the ground.

The exercise ball is added to make the movement a little more difficult, but it is not needed.

Thursday, December 10, 2009

B.A.S.I.C.S

Please see my post on exercise and NSAIDs on the BASICS blog.

Exercise of the Day

Crunches

Sometimes called partial sit-ups these are also core stabilization.

Lay on the ground on your back and with knees bent and fett flat on the floor. Raise and hold the shoulder off the ground for a count of 5 seconds. You can hold the position for anywhere from 2 to 10 seconds and rest for 1 to 2 seconds.

To start try three sets of 30 times each. Weight may be added to the chest for additonal contracture in the neutral pain-free postion. You can place the arms behind the head, alternating right elbow to left knee and left elbow to right knee.

A bit old school but still a goody.

Wednesday, December 9, 2009

Exercise of the Day

Dead Bug

Dead bug exercises are often the start of a rehab program using spine neutral position core stabilization exercise. Core stabilization is slightly different than core strenthening. Both together consitute core training. Core stabilization is exercise aimed to minimize movement of the spine. In core strengthening move of the spine is incoporated into the exercise. All core exercises are used in spine injury and more recently injuries and injury prevention of the extremity.

Dead bug exercise are performed on your back, knees flexed, and feet on the floor. You push a mild to moderate force with your lumbar spine onto the floor. You must maintain this force throughout the exercise.

The exer consist of alternating leg movements:
  1. Raise one foot
  2. Raise the other foot
  3. Raise one arm
  4. Raise the other arm
  5. Raise one leg
  6. Raise the other leg
  7. Finally perform a leg extension, raising the leg with the knee extension on one side
  8. And the other

The same exercise can be performed with weights on the arms or legs.

Have fun

Tuesday, December 8, 2009

Exercise of the Day

Multi-Planar Hop With Stabilization

Link to Livestrong for a demo

Monday, December 7, 2009

Concussions--serious and to be respected

A repeat of the post on the basics blog:

First of all what is all the commotion about? What is a concussion anyway?

A concussion as defined by the 3rd (and most recent) International Conference on Concussion held in Zurich last November.
Concussion is defined as a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces.

Symptoms of concussion include headache, feeling like in a fog, emotionally labile, amnesia, loss of consiousness, irritability, slowed reaction times, drowsiness, sleep disturbances, photophobia, phonophobia, or mood disturbances.

The trouble with concussions is that they are underreported. In fact, doctors at McKay-Dee have studied this and have found that there may be 30 times more concussions than those that are reported in the Ogden,UT area. I think the same goes for me in Ithaca, NY The reasons for this are that kids don’t want to appear weak or they get peer pressured.

Also, examples of high school athletes feeling peer pressure are certainly reported.

Peer pressure isn’t just in highschool Hines Ward put some pressure on Ben Roethlisberger for his concussion.

For every concussion I see I say to athletes and their parents that three majors risks about going back to sport too soon.1. A rare but very serious condition called second impact syndrome, which causes brain swelling and death. It occurs in the US about once or twice every three years or so and you will hear about it on the news.2. Repeated concussion with less impact than the initial impact.3. Prolonged symptoms--called post concussive syndrome including headaches, irritablility, mood disturbances, and even suicide. Check out the hidden epidemic for more details.

So PLEASE lets treat this seriously. We only have one brain a piece.

Friday, December 4, 2009

Exercise of the Day

Romanian Deadlift

I quote from Delee and Drez, "The Romanian deadlift (RDL) or modified straight leg deadlift, is an extremely safe and benefical exercise when performed correclty with an approriate load. However, like the squat the RDL can be dangerous when performed improperly or with too heavy a weight."

Thus for inexperience weightlifting you should start with a dowel or weight bar until you have proper technique.

Modified from Delee and Drez:
  • Feet should be about hip width apart. Knees are slightly bent.
  • Keep the back arched, the shoulder blades retracted, and the chest up.
  • Important to bend from the hip and push the butt back, not leaning forward and maintaining an arched back.
  • while maintain your back position, slide the bar down your thighs until you reach the end of you hamstring range of motion. For dumbells RDLs, the dumbells are held with the palms in toward the thighs, and the hands should move down the outside of the thighs to the shin.
  • Return to standing position by extending the hips, not the lumbar spine. Concentrate on forcefully contracting the gluteal muscles and pushing the hips forward.

A great exercise for hamstring and gluteal muscle and isometric for the low back.

Thursday, December 3, 2009

Exercise of the Day

Single-Leg Romanian Deadlift

Single leg RDLs develop the entire posterior chain, enhance balance, and decrease loads and stresses on the the lower back than both-leg RDLs due to the lighter weight being used.

The dumbell is held in the stance opposite the stance leg. Lower the weightand extended the the free leg to the rear, staying in line with the torso.

Wednesday, December 2, 2009

Exercise of the Day

Military Press

I like to do these standing as it recruits some back and core muscle. This exercise is great for shoulder and back if done properly. One should be careful if yo have rotator cuff issues

Grasp barbell with overhead grip at shoulder level, with hands a bit wider than shoulder width apart. lift barbell until the elbows are locked out. Slowly return to start.

Concussions: What's the Big Deal

Thanks to B.A.S.I.C.S. for posting my concussion bit on their great blog.

Tuesday, December 1, 2009

Exercise of the Day

Walking Lunges

You perform a lunge and instead of returning to the start position, you step through with the back limb and proceed forward with a lunge on the opposite limb.

You should lunge far enough with the front limb that the knee does not advance beyond the ankle during the exercise.

Monday, November 30, 2009

Exercise of the Day

Kayaking/Canoeing

Kayaking is listed for today's exercise of the day because I have been kayaking last week in the surf of NC's Outer Banks. Battling the waves was exhausting and used muscles differently than other exercises.

Great for shoulders and back. Great for your core and hips. Kayaking is also listed as a Class IIIC exercise by the American College of Cardiology 36th Bethesda Conference.

Have fun.



Tuesday, November 24, 2009

Happy Thanksgiving

I will be taking a week off of posting for the Thanksgiving break.

technorati code: 6AX7C7S2MRYY

Friday, November 20, 2009

It is all in the mind

I turn your attention to an article written by the Association of Applied Sports Psychology with emphasis on injury rehab.

I quote from the article:

Research suggests that maintaining a positive attitude and using mental
skills are related to a shorter rehabilitation. In fact, when Ievleva and Orlick
(1999) compared slow and fast healers, they found that the fast healers:

  • took personal responsibility for healing
  • had high desire and determination
  • had more social support
  • maintained a positive attitude
  • used creative visualization
  • were less fearful of re-injury upon return to full participation

Having a positive mental attitude can behelpful in so many aspects of sport and thus life.

Think positive.

Happy Thanksgiving

Exercise of the Day

Jump Rope

Old school and great for your bones, hand eye coordination, and quickness.

Some would argue that jump roping is a sport as well as exercise.

Thursday, November 19, 2009

Exercise of the Day

BOSU Single-Leg Squat--Hold

The athlete assumes the single-leg stance on the flat sid of the BOSU and squats to a position with the knee flexed to 90 degress. Wth the torso straight up, hold the postion and return to starting postion. Tough.

Friday, November 13, 2009

Exercise of the Day

T-Drills

Four cones are placed in the shape of a "T". The athlete starts in the base of the "T" and sprints to the middle of the top of the "T". The athlete then shuffles to the left to the edge of the "T" and shuffles to the over end and back to the middle. At this point the athlete back paddles to the start and repeats.

Thursday, November 12, 2009

Can you be physically active and safely take a statin?

A recent review from the American Journal of Life Style Medicine asks: Are physically active individuals taking statins at increased risk for myopathy?

A great question especially because the call from the American College of Sports Medicine to use Exercise as Medicine.

Statin drugs are use to treat high cholesterol or hyperlipidemia. For the most part they are well tolerated. However they can be associated with skeletal muscle injury and rarely leading to severe myopathies. A few studies have been published that look at the relationship of skeletal muscle injury in patients who take statin medications and exercise compared with taking statin medications without exercise.

With the small number of patients studied there appears to be a connection with an increased risk of muscle breakdown in pateints taking statins. Also, in another study majority of professional athletes with a familial form of high cholesterol could not tolerate statin therapy.

This could be a problem because it would appear that patients would have to choose between a pill or exercise.

Until more conclusive evidence is published I am going to recommend pateints on statins exercise as tolerated. We need to be careful distinguishing between normal muscle soreness and a medication-induced myopathy, and this can sometimes be tricky.

A visit to your physician for good counsel in this matter would be a good plan, and sometimes a simple blood test can help with exercise design.

Exercise of the Day

Ladders

I hated these in high school.

A great sprinting exercise. This is when you sprint to a previously designated line and turn around as fst as you can and return to the start, then turn around and run to another designated line a little furthur off. You can make the distance short or long as desired.

A good cardio exercise and also a little agility drill as well.

Have Fun.

Wednesday, November 11, 2009

Exercise of the Day

Jump into Bounding

Begin by doing a single maximal effort broad jump and land on just one leg. Then immediately go into a single leg bounding exercise. The bounding should emphasize maximal vertical height with minimal horizontal distance.

Try to drive the non-weightbearing leg forward and vertically to help achieve the maximal vertical height. Also try not to move from side-to-side when bounding.

Tuesday, November 10, 2009

Exercise of the Day

Single-Leg Box Hop-Up

As all of you know, I think that single-leg exercises are the best. So here is another.

This exercise can be a warm-up, or the main course. It can be made more or less challenging by adjusting the height on the box. It can be more more challenging by combining it with Single- Leg Box Hop-Downs.

A good injury prevention exercise as well.

Have Fun.

The Female Athlete

Before the 1970s, the Olympics had the corner on the market for women’s sports, but the presence was relatively small compared to men’s sports. In 1972, Title IX of the Educational Assistance Act required institutions receiving federal money to offer equal opportunities to both men and women including athletics. This sparked a rapid growth in collegiate athletes, as well as high school and recreational female athletes. The percentage of women athletes in 1971 was 15.5% and it is now 42%.

Everybody know the Williams sister in tennis, Picaboo Street in skiing, Annika Sorenstam in golf, and who could forget Mia Hamm in the 2004 US gold medal winning women’s soccer team, just to name a few.

As women’s sport has taken on such prominent role in our society, also has the funding of studies for research on women’s sports issues. We have a good understanding of nutritional needs of women, proper conditioning and rehabilitation techniques, and also preventing and treatment of musculoskeletal sports injuries.

Women are at increased risk for patellofemoral issues, stress fractures, and anterior cruciate ligament injuries. The reason is because of a difference in metabolic needs and biomechanics or the shape and way women move their bodies different than men.

A female athlete may be deficient in iron and calcium intake and I often recommendation supplementation for my patients. For most women I recommend 1000mg of calcium a day, but for teenagers I recommend at least 1300 mg of calcium a day and sometimes more if there is a bone issue.

Also very important for a woman is making sure they have adequate energy intake in the form of calories. Energy deficit can lead to some serious medical problems.

There is a condition known as the female athlete triad which consists of three things:
1. Energy deficit/Disordered Eating

An imbalance between the amount of energy consumed and the amount of energy expended during exercise. The primary cause of the female athlete triad is energy deficiency. Often, this can involve a conscious restriction of food intake, problems with body image and a high drive for thinness. Sometimes, these conditions can lead to disordered eating, or more serious eating problems, like anorexia or bulimia.

2. Menstrual Disturbances/Amenorrhea

The most serious menstrual problem associated with the triad is amenorrhea, defined as no menstrual period for 3 months or more. However, athletes who have irregular menstrual cycles are also susceptible to the effects of the triad.

3. Bone Loss/Osteoporosis

Women with the triad are at higher risk for low bone mass leading to weakened bones, called osteoporosis in its severe form. This type of bone loss can cause an increased risk of fractures, including stress fractures.

If you have concerns about yourself or someone you know you should see someone trained to deal with athletes. Many physicians will simply put somebody on birth control pills to help regulate the menstrual cycle. This is not really treating the problem. Oral contraceptives do not restore bone density in amenorrheic athletes and a complete nutritional evaluation should be completed. Sometimes even a special x-ray of the bones needs to be taken.

The best treatment starts with prevention through education. Lets get the word out.

A good website http://www.femaleathletetriad.com/.

Keep Healthy.

Monday, November 9, 2009

Exercise of the Day

Side Lunges

This exercise also doubles as a warm up if you are just using your own body weight. For added resistance increase weight or even do these holding dumbells overhead.

Stand with feet wide, toes out at about a 45-degree angle and hold the medicine ball or weight at chest level. Lunge to the right, bending the knee and taking care to keep the knee behind the toe. Touch the ball to the floor while keeping the abs engaged and the back flat (don't round the shoulders). Stand up, bringing the weight to the chest. Repeat the lunge on the left side.

Tips:
Keep your knee in line with your toe as you lunge. If the knee angles in or out, adjust the angle of your toes. Press through the heel of you foot as you push up from the lunge to engage your glutes. Avoid letting the knee bend over the toe by sitting back into the heel.

Thursday, November 5, 2009

Exercise of the Day

Straight-Leg Dead Lift

Great for hamstrings strengthenig and preventing hamstring injury. Great for core, but exercise caution if you have low back pain.

Start by standing up straight with a slight bend in the knees. Keep your back straight and pivot at your hip joint until your body forms an upside down "L". It should feel like your heels are coming off the ground and your hamstrings are stretching, then push your heels into the ground and stand back up straight. That is one repetition, repeat for 10-15. Remember to keep your back straight, it should never round out!

Stay Strong

Wednesday, November 4, 2009

Exercise of the Day

Slalom Jumps

Slalom jumps help with speed, explosive power, and agility. They are a great drill for soccer players and skiers. They help to prevent injuries also by helping teach proper landing techniques.

To perform, stand with your feet together on one side of a line on the ground. If perfomed in a basketball gym you can use the foul line or a jump rope on the ground could also work. Jump over the line as fast as you can from side to side keeping you feet together. You can modify this exercise by increasing the distance you jump or by jumping to a goal and returning to the start.

Have fun

Tuesday, November 3, 2009

Exercise of the Day

Squats

Squats get a bad rep from some people who state they cause back pain and can increase patellofemoral pain. However squats, when done correctly are good for your back and can treat and prevent patellofemoral pain.

To start, stand with feet straight and shoulder-width apart with your knees slightly bent. Rest the barbell on your shoulders, behind your neck with your hands grasping the bar wider than shoulder-width apart.To perform the squat, do so keeping your feet straight and remember to stick your butt out. Keep your chest up and squat to the three-quarter position. when arising, squeeze butt muscles and press through heels to return to starting position.

Livestrong has a video demonstration.

Have fun.

Monday, November 2, 2009

Exercise of the Day

Swimming

For me there are fewers sports that are as tough. Swimming is a total body workout and it is nonweightbearing so it can be a great crosstraining exercise. I also recommend swimming as a part of recovery from ankle and foot injuries.

Thursday, October 29, 2009

Exercise of the Day

Jumping Jacks

Old school! No description needed. The first and ultimate plyometric exercise.

Wednesday, October 28, 2009

Exercise of the Day

Barbell Clean

A total body workout and as with prior posts. This is a sport--Olympic lifting.

Click on the title to link to the livestrong demonstration.

Tuesday, October 27, 2009

Exercise of the Day

Lunge to Balance

Lunges target the glutes, hips, and quads. A great workout. I always do a lunge variation during my workout.

Here is a link to one of those variations, this adds a component of balance to the routine.

from Livestrong.com.

Stay Strong.

Monday, October 26, 2009

The Iliotibial Band

Iliotibial band friction syndrome (ITBFS) is the most common cause of lateral knee pain and the second most common cause of knee pain that I see in my practice, follow by the closely related patellofemoral pain syndrome.

The iliotibial band (ITB) runs from the ileum or crest of the pelvis to the tibia or shin bone. As a result it crosses two joints--the hip and the knee. ITBFS results from repetitive friction of the band against the later femoral epicondyle and commonly happens with overtraining. Runners with this injury often have underlying weakness of the hip abductor muscles.

Treatment, at least acutely, is relative rest or at least some activity modification, Nonsteroidal anti-inflammatory drugs (NSAIDs), and sometimes injection with corticosteroid medications. Subacutely, I encourage stretching and soft tissue therapy to release tightened tissues. Final therapies are geared toward hip abductor strengthening and perhaps an analysis of movement patterns. Side planks are great for this.

When starting back into running you would want to start in an every other day pattern and gradually increase in intensity and frequency. Start with easy sprints and watch out for hills.

Reference:
Fredericson, Michael MD; Weir, Adam MBBS
Practical Management of Iliotibial Band Friction Syndrome in Runners
Clinical Journal of Sport Medicine:
May 2006 - Volume 16 - Issue 3 - pp 261-268

Exercise of the Day

Bicycle Crunch

A fast, tough ab workout. Great for the rectus abdominus.

Keep Fit

Saturday, October 24, 2009

Exercise of the Day

Single Legged Bent Over Row

All my patients and those who follow my blog know that I love single leg exercises for injury prevention and increasing athletic perfomance.

This exercise works the glutes, hamstrings, and lower leg. Any single leg exercise works the smaller muscles of thea nkle to allow for control and strength of the ankle, thus preventing ankle sprains. This exercise also works the lower back, middle and upper back, shoulders, and biceps.

Start by holding weights by your side and stand on one one leg, bending over until your back is nearl horizontal. At the same raise your back leg as high as possible and hold it. While maintaining balance and keeping the back as flat as possible, perform the row, and repeat for your desired reps. Don't forget the other leg. Link here for a picture.

Keep Fit.