Month: June 2013

The Importanct of Evidence-Based Practice: The Example of Exercise for Osteoporosis

Osteoporosis and osteopenia are common issues that affect the life expectancy and quality of life in nearly 40 million Americans. These conditions, which both indicate a decrease in bone mineral density, which we can consider as bone strength, occur in men and women of all ages but are most predominate in post-menopausal women. People affected with osteoporosis or osteopenia have reduced strength and resiliency in their bones leading to an increased likelihood of fractures. Fractures are linked to significantly increased all-cause mortality in older women as well as impaired mobility and quality of life so it is imperative that bone health be maintained.

One of the best ways to accomplish this is through exercise. With every muscle action and every contact with the ground, bones have some force exerted against them and they respond by becoming stronger. Increasing the amount of activity and exercise is therefore a viable way to increase bone strength. But what type of exercise will work best? A review of randomized, controlled trials evaluated various types of exercise to see which would have the greatest impact. The results varied based upon the body part. We will discuss the impact on two common sites of osteoporosis: the spine and neck of the femur. In the spine, bone mineral density responded positively to two types of exercise: Weight-bearing low force activity such as walking or Tai Chi and non-weight-bearing-high-force exercises. In the neck of the femur, a positive effect was observed in response to non-weight-bearing high force exercises. Non-weight-bearing high force exercises include exercise machines (such as the leg extension, leg press, hip abductor, hip adductor and hamstring curl) performed with almost as much weight as possible.

Look at that list of non-weight-bearing high force exercises again. If you have read my other posts or talked with me before, it is obvious that I am not a fan of those machines. In fact, some of them are on my list of top things to avoid at the gym. The motor patterns reinforced by these machines seem unproductive to me and they develop strength in very limited, non-functional actions. Worst of all, these machines allow you to develop more strength than your body can handle, which can lead to terrible movement habits and possibly injury.

In my mind, well coached and well-performed squats, deadlifts, hip hinges and farmers walks would be way more helpful for developing bone density. But, the evidence is right there, pointing at me, saying that these much-maligned-machines may have some usefulness after all. Perhaps the machines were only helpful for the subjects tested because they didn’t have good coaching. Perhaps the researchers simply found it easier to compare exercise machines. Perhaps I am a good enough coach that I can overcome these obstacles and increase my clients bone density without using the machines. So, I find myself in a quandary: Follow the evidence and use the machines or trust my own education, intuition and instinct. The question is best answered with humility. I honestly don’t know if better results can be obtained without using the machines. It seems likely to me but at the end of the day, there is not evidence to directly support it. So, I would like to take a moment to apologize to all machine advocates out there and also endorse the use of these machines for increasing bone mineral density in the spine and neck of femur.

If you have osteoporosis, osteopenia or are at risk, this discussion was likely very useful for you. But if you don’t, it still offers a valuable lesson. No expert can know everything. Even strictly within the field of exercise, there are countless complicated decisions that cannot be answered through logical reasoning and intuition. When it comes to your health and fitness, you deserve to know that you are making the best decision. Always ask your trainers, instructors and health care providers why they are doing what they are doing. Ask about the evidence they have supporting them. There are a lot of things that don’t have clear evidence-based answers but it never hurts to ask. It will make you a better client and make us better trainers.

When it Comes to the Spring Just Play

What is the one thing we often forget to do as we get older…play. Look around at children, they are our best examples of how to play…and sometimes, even when we should play. Yes, I said it, much of the time adults find that children’s spastic movements or loud boisterous play is out of place or distracting to what they are doing. Instead, I challenge each of you to take a moment in your day to stop what you are doing, smile, and be playful. There is no reason we cannot work hard AND enjoy what we are doing at the same time. You are having a rough day and have nothing to smile about? Then I challenge you to create something to smile about. Humans are creative, energetic, dynamic beings with a natural curiosity to be playful.

What is one of the best ways to play? Go outside. Once you are outside, here is something really fun to add…get dirty. I don’t care if its sweat or mud, sand or salt water…get dirty and stay present in what you are doing. It doesn’t count if you go run stairs outside SAC with your trainer and all you think about is the report or edit you need to finish by 2 PM when you get back. The best thing you can do for yourself is to be present in where you are, who you are with, and what you are doing. Have fun. Smile. Play. Here are some ideas for you this month as we dive into a gorgeous spring!

• Take a walk with a friend…but ten minutes in, start skipping, then do a cartwheel. Just because you can.
• Play hide and go seek with your dog.
• Mountain bike at Duthie Park…don’t know how? Take a class from Me, believe me, I’ll make you laugh, smile, and play on the trails.
• Ride around the city with trainer Thomas’ Urban Bike rides.
• Go run stairs outside SAC, then sit on the pig in the market until one of the Flying Fish guys talk with you.
• Go on a hike, at the top, try yodeling…don’t know how? That’s why I said try.
• Garden in your bare feet.
• Climb a mountain (you can do Baker with SAC this summer!)
• Buy the random person in front of you at the coffee shop their drink.
• Commit to learning one new activity this summer, maybe it’s climbing, maybe it’s riding a bike, maybe it’s swimming, maybe it’s a pull up…just smile knowing you are learning something new for yourself.

Have fun out there! Remember to play and stay present…you never know what you might find. Connect with me if you need help remembering how or where or when to play…I’d love to get you started again! broark@sacdt.com

It’s Plyo Time!

This morning instead of my typical run, I decided to get a plyo workout in! It went a little something like this:

Warm – up:
20 knee skips to chest
20 outward knee skips to the side
20 butt kicks
20 knee to chest, kick outs (hamstring stretch)

Workout!
30 sec walk (4.0 speed)
1m sprint (7.0 speed)
30 sec walk (4.0 speed)
1m sprint (7.0 speed)

20 squat jumps
20 wide jumps
20 narrow jumps
25 crunches on bosu ball
Repeat 3 times

20 squat throws with medicine ball on the wall (8-10 pounds)
20 side step squats (with bands around thighs)
20 switch lunges
25 bicycle crunches
Repeat 3 times

Cool down on treadmill
1m Walk 4.0 @10 incline
1m Walk 3.8 @7 incline
1m Walk 3.5 @5 incline
1m Walk 3.0 @0 incline

Give it a shot & let me know what you think! If you have any questions about this workout or getting into the figure and fitness competitions look for Stephanie at our Tuesday night professionals from 6 pm to 8 pm.

Importance of a Strong Core

The core has most often been thought of as “abdominal” muscles. However, recent scientific research has caused a shift in that perspective of thinking to include several stabilizing muscles surrounding the torso known as the lumbo-pelvic hip complex or simply, the “core” complex. This complex comprised of; abdominal, spinal, pelvic, gluteal and hip girdle muscle groups, act as a corset around the mid-section to stabilize the spine, hip and pelvis and act as an integral link in the kinetic chain during body movements.

Research conducted by Hodges & Richardson in the journal, Physcial Therapy in 1997, examined the sequence of muscle activation during whole-body movements discovered that specific core complex muscles were consistently activated prior to any limb movements. All movements incorporate the transfer of energy from one segment to the next in the kinetic chain. Force generation and distribution, movement control, stability and initiation of the kinetic chain, began in the core complex before progression to the extremities.

When the core complex muscles operate efficiently, the result is maximum force generation and proper force distribution, optimal movement and energy control, with minimal compressive, translational or shearing forces of the joints involved in the kinetic chain of the movement performed. This can translate to improved athletic and sport performance, enhanced daily activities; create better overall balance, stability and posture and prevent injuries, strain and compensatory movement patterns that lead to muscular imbalances.

Athletic movements require a strong core complex for postural control in order to transfer optimal energy to the limbs. A more efficient transfer can mean injury prevention because no compensations are made in attempt to make up for the lack of force production. Although core stability is essential to athletics, this can also directly translate to daily living by improving more functional actions such as walking, climbing or lifting etc. When the core complex muscles operate in a unified fashion, the strength combined can provide the spine, pelvis and other extremities with more balance, stability and a correct natural posture. With an improved posture and movement awareness; injuries, strains, lower back pain and other compensations are less likely to occur.

Core complex efficiency requires coordination and integration of the essential muscles, joints and neurological systems for order for optimal functioning. Although muscular strengthening may be required, reawakening of inhibited muscles may be the primary step to develop the core complex. When developing a training program, it is recommended to progress in gradual stages. First, it may be necessary to restore initial core muscle contraction and mobility, followed by activation of the integral core muscles through specific exercises. Once mastered, more advanced exercises can be added. Eventually, a transition to more functional movements that promote balance, coordination, precision and skill are to be achieved. Ultimately, the goal of a good core complex program is to train movements and positions rather than isolated muscles.

For further information on the core complex, please feel free to contact personal trainer Kendra Kainz. Resourced from the American College of Sports Medicine, p 39-44. Physical Medicine and Rehabilitation Clinics of North America, p 669-689. Physical Therapy, p 132-142.

Back to the Basics

Sometimes more is better. Sometimes flare is good. Sometimes getting nuts is totally the thing to do. But sometimes none of those things are the answers. When is that the case? When you stop and ask yourself, “Am I getting any stronger, faster, healthier, fitter, am I making progress?” When you answer no to any and all of those questions then it’s time to dial back and get back to basics.

Here are a few examples of what I’m talking about, first, moving up in weights. If you haven’t been able to add that extra 10lbs to your squat and press weight the answer may lye more in technique than it does in actual strength. It’s time to break down that complex movement and focus on better full range of motion squats (weighted or just plain old air squats), and then practice your shoulder press form. Breaking down complex lifts so that you can put more energy into each piece so that when you put them back together you are stronger in both aspects of the lift is the best way to be more efficient in your movements as well as increase strength.

Same rules can apply to less complex lifts; take the bench press for example. If you feel like you are really struggling to improve your bench press and even more so really struggling to get the bar to your chest at the bottom (lets be real, it’s not a bench press if you aren’t doing the full range of motion) then perhaps adding more weight or doing more reps is not your answer. The best way to improve your strength, especially in the full range of motion of the bottom position is to do the old basic push-up. Teaching your body the path of motion and touching your chest to the floor in your push-ups (let’s be real, it’s not a push-up until you touch your chest to the floor) will increase your joint strength and flexibility 200% more than a heavy bench press to 90 degrees.

Maybe you don’t care about how much weight you can lift, maybe you care about how well you do during the swimming leg of your next triathlon. You’ve been doing all these super cool exercises with a band, you started adding in some crazy new bag full of sand, or you decided using the strength ropes during every workout for 30 minutes was going to get you faster and stronger. You know what makes you a better swimmer…swimming. Will more strength help you? Sure, but unless you are an efficient swimmer with great technique you can only get so far creating stronger muscle fibers.

Sometimes my clients ask me, “How do I get strong enough to do a pull-up? What kind of exercises should I do to improve my pull-up strength?” Easiest answer ever…do some pull-ups. If you are looking to improve your running, run. I don’t think rowing and bicep curls are going to do anything for your 5K time.
Sometimes we get sucked into the new craze, the new in thing. There’s been Abs of Steel, Tiabo, standing on exercise balls, standing on Bosu Balls, Kettlebells, Strength ropes, and the list goes on and on. But when all of these fads come and go or at least stop being the “cool new thing” what keeps you ahead of the rest and improving? Knowing the basics. If you can swing a 50lb sandbag around like it’s your job but you can’t do a proper full range of motion squat you are going to have trouble doing much else besides swinging a sandbag around. To be a good athlete, a well rounded athlete, a strong, flexible, powerful, healthy, uninjured athlete you need to start from the ground up. Good training has nothing to do with how hard you sweat, what kind of crazy equipment you use, what kind of protein shake you ingest; good training comes from good movement and good smart progression.

As the saying goes, you have to learn to walk before you can run. Learn the basics, if you’ve learned them but let some things slide in order to move up in weight, do more reps, sweat more, etc. maybe it’s time you take a step back and get back to basics.

Wait! Are you rock climbing this summer? Here’s what you need to know:

The sun is finally out here in the beautiful Pacific Northwest. People are taking full advantage of the vitamin D and exploring new adventures outside. Rock climbing can be a really unique and challenge way to experience the Cascades as long as you are prepared. Before you tackle some vertical rock face, here is some helpful information regarding rock climbing both indoors and out!

Rock climbing has been around for hundreds of years. Traditional alpine mountaineers used the skill to scale impossible mountain faces that otherwise could not be traversed. What started as a need-based skill quickly evolved into more of a sport in England in the late 1880s and only grew from there. Several different types of rock climbing exist today, ranging from indoor, traditional to outdoor, big wall extreme! Listed below are just a few possibilities:

Big Wall- Think El Capitan in Yosemite. Or Half Dome also in Yosemite Big Wall climbing is exactly what it sounds like: climbing a huge wall, over 1,500 ft. Climbers spend multiple days camping in portaledges that can be attached to the side of the cliff and slept in like a hammock.

Bouldering- This is a style of rock climbing most people can get their hands on. If you are afraid of heights and don’t like the idea of dealing with a lot of gear, bouldering may be the best solution. These routes are normally small and closer to the ground with a crash pad or ‘bouldering mat’ beneath the climber. They normally consist of climbs 3 to 5 meters high to reduce risk of injury from falls. Bouldering requires more powerful, dynamic movements in short bursts, whereas sport climbing or traditional climbing usually requires more endurance. Bouldering is typically graded on a scale of V0 to V16 increasing in difficulty as the number climbs.

Crack- Crack climbing involves the climber ascending long, technical cracks in the rock face using specific techniques. The cracks vary greatly in size and accessibility. Some climbers choose to wear gloves to allow for more friction and less injury to the hand.

Free/Speed- For the more advanced climbers, free climbing is a way to test their skills. Free climbing is performed without the assistance of climbing equipment such as ropes. Speed climbing has been associated with free climber where the climber attempts to scale the wall as quickly as possible. This challenges the climber to make quick decisions and has been described as ‘dancing’ up the wall. Bouldering is a more common form of free climbing.

Indoor Climbing- Indoor climbing has made rock climbing more accessible to the general population. Climbing gyms rent equipment that would otherwise be expensive to buy, and set up designated routes for climbers to solve. Both sport climbing and bouldering can be found at indoor climbing gyms. Sport climbing will require one person to belay which is a system for lowering the person climbing and catching them when they fall. Climbs are graded on a scale of: 5.5-5.14d, although each gym and route is rated slightly different.

Climbers of all levels will often use chalk to gain more friction and help to absorb the sweat as they climb. For most forms of climbing, participants will wear a harness and climbing shoes which are designed to be form fitting and assist with protecting the feet. Specific queues and rope knots must be known before someone can effectively belay a partner during indoor or sport climbing. Once these are mastered, you’ll be scaling walls in no time!

If you are interested in learning more about rock climbing contact Outdoor Recreation Coach Thomas Eagen at teagen@sacdt.com.

Let’s swim quickly

The below workout is one of my favorites because I think it is important to have a variety in the workout. It’s good for your body to changes things up a bit. Move your arms in different directions to avoid repetitive motion. A rotator cuff injury is hard to come back from especially as we age. If we sit at a desk working on a computer all day typically leaning forward and then swimming all freestyle (crawl stroke) keeps you in the same position. Pull those shoulders back be proud of who you are!

Warm Up
140 swim & drill, 120 kick, 200 pull

Main Set
4 x 100, 1:35/1:45
3 x 200, :10 – :15; rest descending 1 – 3
5 x 160, :10 rest; fly/free/back/free/breast/free/free/free
10 x 40, :05 rest; 1, 3, 5, 7, 9 kick / 2, 4, 6, 8, 10 pull (sprint)

Cool Down
200

The truth about saturated fats

Have you ever avoided eating saturated fat, fearing it would hinder your weight loss goals and cause heart disease? If you said yes, or if had crossed your mind, you may want to see some newer data that shows this is not the case. Do not be afraid of fat. You should take pride in eating the fat off that juicy steak; below are a few reasons why to include saturated fat in your diet.

  1. Saturated fat does not cause heart disease:
    A meta-analysis was published in 2010 of 21 studies totaling 347,747 people. There was no association between saturated fats and increasing the risk of heart disease. (Patty W Siri-Tarino et. al 2010).
  2. Saturated fats can take the heat:
    Saturated fats do not oxidize as easily as unsaturated fats. When unsaturated fats are introduce to high heat and oxygen the fat becomes rancid and the oil is stripped of nearly all nutrients. Instead of using olive oil for eggs in the morning try using butter or coconut oil for a more satisfying and nutritious meal.
  3. Diets high in saturated fat are good for weight loss:
    Eating fat does not make you fat. Eating poorly makes you fat. A meta-analysis was carried out to study the effects of a low carbohydrate diet on weight loss and cardiovascular disease. Low carb diets, which are usually high in saturated fat, actually make you lose more weight than diets low in fat. LCD was shown to have favorable effects on body weight and major cardiovascular risk factors (F. L. Santos et. al 2012)

Bottom line… eat saturated fats, but in moderation as saturated fat is okay to eat and is necessary to have in our diets. You never want too much of anything. When I personally increased my saturated fat intake after I revamped my diet, I went from ~12.5% body fat to ~8.5% body fat. Not only do you have the data from the published articles to give you some guidance, but you also have my own experience and recommendation to add more saturated fats into your diet. Give it a try yourself and see how your body adapts to eating some bacon.

Variations of Jumping Jacks

Many people think of jumping jacks as an activity people did for fun when they were younger, just like jump roping. This is true, but they are still known as great cardiovascular exercises. I will be going through nine different types of jumping jacks to add some variation to your workouts. Some are more difficult than others, but most can be used for all fitness levels.

  • Standard Jumping Jack
  • Modified Jumping Jack
  • Cross-Jack
  • High Knee Jack
  • Split Jack
  • Squat Jack
  • Hop Jack
  • Plank Jumping Jack
  • Push up Jack
  • Burpee Jack

If you are bored of the standard jumping jack, here are some other types you might like to try within your workout. If you have any questions please contact Amber Gruger.