'Natalie's Recipe Of The Week'

Shrimp and Pesto Pizza

Makes 8 slices

With all its herbs, the pesto provides antioxidants—and a welcome break from plain-old-tomato sauce. The flax meal in the dough makes for a tasty, fiber-rich crust that boasts omega-3 fatty acids.

Pizza

INGREDIENTS:
• Nonstick cooking spray
• 1 recipe whole-wheat and flax pizza dough (recipe follows)
• 1/4 cup reduced-fat pesto
• 6 oz large raw shrimp, peeled and deveined (approx 20 to 24 shrimp)
• 1/2 medium-sized red bell pepper, sliced

INSTRUCTIONS:
Preheat oven to 450 degrees Fahrenheit. Set baking rack in top third of oven. Lightly spray a baking sheet with nonstick cooking spray. Shape dough into a 12-inch round pan on prepared baking sheet. Spread pesto over dough. Top pizza with shrimp and pepper. Bake for 12 to 15 minutes. Cut into 8 slices and serve.

Whole-wheat and Flax-Meal Pizza Dough

INGREDIENTS:
• 2 1/4 cups whole-wheat flour
• 1/4 cup flax meal
• 1 tsp instant-rising yeast
• 1 tsp sugar
• 1 tsp salt
• 1 cup warm water (100 to 110 degrees Fahrenheit)
• 1 tbsp extra-virgin olive oil

INSTRUCTIONS:
In a large mixing bowl, combine flour, flax meal, yeast, sugar and salt. Stir in water and oil with a wooden spoon. When the dough starts to hold together, remove from bowl and knead by hand for 8 minutes (a standard mixer fitted with a dough hook makes this process much easier). Shape dough into a ball and return to bowl. Cover bowl with plastic wrap and let dough rise for one hour in a warm spot (70 to 80 degrees). Before baking, remove and knead dough for 5 or 6 strokes, then shape.

Nutrients per slice:
Calories: 201, Total Fat: 6 g, Sat. Fat: 1 g, Carbs: 28 g, Fiber: 6 g, Sugars: 1.5 g, Protein: 11 g, Sodium: 386 mg, Cholesterol: 34 mg

Call The Diet Busters For Your FREE Nutritonal Consultation 480-212-1947 or fax 623-399-4199 or visit WWW.MyFitnessElements.com

P.S. Fitness Elements Guarantees 2-3 Pounds per week & 1% Body-fat per week Guaranteed!

P.S.S. Your Success Is Our Suceess So Your Results Are Our Guarantee!

"The Art Of Flexibility Training"- Part 1

"The Art Of Flexibility Training"- Part 1

We as fitness professionals have long learned that flexibility is one of the four components of fitness, along with muscular strength, muscular endurance and cardiovascular endurance.

There is much evidence both for and against the benefits of various flexibility training or stretching protocols. This article is not intended to delve into the pros and cons but to present specific kinds of stretching protocols in a practical manner. Stretching major muscle groups will be discussed. The goal is for the personal trainer to start developing a competency in stretching as a vital component of a comprehensive training program.

Components of a professional personal trainer’s approach to flexibility training.

Trainer Responsibility: We must assume the responsibility of "touching" someone. Whether stretching or working with a client in any capacity, we must be certain that we are being safe and thorough in our documentation regarding health history (PAR-Q) postural assessment and movement/flexibility assessment. It is, therefore, assumed that the trainer:

* Has completed a health history questionnaire - with medical clearance if necessary.
* Has completed an assessment to ascertain pain free range of motion around the joints and to assess flexibility of individual muscle groups.

Warm up: The question "how much time is necessary for a warm up" illicits many answers. Perhaps instead of a specific, designated time, we as trainers should adhere to the goal of a warm up (i.e., increase in core body temperature, lubrication of the joints, etc). Therefore, a person getting out of a cab at 6am in the morning would need a different (and more of) a warm up than a client who moves throughout the workday and comes to the gym at 6pm.

Range of Motion: Although defined many different ways, I use Range of Motion to refer to the maximum movement around a joint. There are many things that can contribute to the range of motion around a joint. Scar tissue, inflammation, muscle bulk, fatty tissue, bony landmarks and weak muscles can all decrease the range of motion around a joint. Another contributing factor to the range of motion around a joint is the inflexibility of an individual muscle. Herein lies the difference between range of motion and flexibility

Flexibility: The degree to which an individual muscle will lengthen. Again, this is but one of the contributing factors to the range of motion around a joint. It is important for the trainer to appreciate the relationship between range of motion around a joint, and the flexibility of individual muscles that surround that joint. Range of motion, again, refers to the movement around the entire joint, and includes many factors. Flexibility refers to an individual muscle, and the lengthening of the muscle fibers and surrounding fascia.

What about hypermobility? If the ligaments that surround a joint are too lax, the joint can be hypermobile, and many times presents itself as unstable. It is then our decision of whether the individual muscle around that joint should be stretched or not. This is a question of risk versus benefit, and is greatly determined by the client’s goals and overall condition.

Endpoint: The point at which the client begins to feel a stretch. This is the point at which the muscle fibers are at their longest, at which some other mechanism is necessary to increase this endpoint, e.g. gravity, a towel, or the personal trainer. The trainer’s ability to detect the endpoint requires a great deal of sensitivity. A muscle’s endpoint will not be the same for everyone-or even for the same person at different times of day. The ability of a trainer to stretch a muscle far enough for it to be beneficial, but not so far as to destabilize a joint, or injure the muscle, is largely dependent upon the trainer’s ability to feel a muscle’s endpoint.

Core Stabilization: To be efficient at stretching, the bones at which the muscles originate must remain still. For example, when holding a rubber band in your left hand, and lengthening it with the right hand, you get to the point where you feel the rubber band is stretched as far as it can be. If you then move the left hand further towards the right, the rubber band decreases in stretch. That is exactly what happens during stretching when one of the bones at which the muscle originates. For the lower body, the pelvis must remain still; and for the upper body the shoulder girdle must remain still. Keeping the core muscles of the body engaged will help keep the pelvic girdle and shoulder girdle still.

Discomfort: There should never be any discomfort while stretching. The client must be able to distinguish a stretching feeling from a tingly, or radiating feeling, or sharp pain. The trainer must then stop the stretch, reassess the alignment, and perhaps discontinue until medical clearance is obtained.

PNF: Proprioceptive Neuromuscular Facilitation: PNF is a broad term that describes the neurological principles of the body. For example, if you stand on one leg, you will feel lots of movement around your ankle, your foot, perhaps your knee, and further up the chain. It is not necessary for you to actively engage any individual muscles to maintain balance; your body is "reacting" to the situation, and making the necessary adjustments. The sensory organs located in and around that joint are responsible for this (1,2). This is an example of PNF in practice. These principles are the intricate coordination of movements and reactions to the environment around the joints. In very brief review, two automatic responses that are responsible for joint and muscle protection are the muscle spindle, and golgi tendon organ. The muscle spindle is located in the muscle belly, and senses when a muscle is stretching too far, or too fast. Its protective reaction is to cause the muscle to contract, i.e. the myotatic stretch reflex. The golgi tendon organ, by contrast, is located in the muscle tendon, and senses too much tension. Its protective reaction is to cause the muscle to relax.

When we teach someone how to do static stretch, we tell him or her not to "bounce" or move too quickly or forcefully into the stretch. This is to prevent the myotatic stretch reflex from being triggered, by the muscle spindle. Then, after holding the static stretch for 15 seconds or so, there is a relaxation of the muscle fibers, i.e. the "inverse stretch reflex"; initiated by the golgi tendon organ.

The same thing happens when there is a contraction of the elongated muscle fibers, e.g. the golgi tendon organ causes a release; this is also called post isometric relaxation.

Since most fitness professionals learn static stretching, what will be presented here is "post isometric" stretching or "contract relax." There are many ways to manipulate the PNF principles of the body, and the trainer is encouraged to continue with further research and education. The knowledge of anatomy is crucial when stretching. Since there are many muscles that perform similar actions at a specific joint, only the major ones are named.

Hip Flexors and Quadriceps: these muscle groups are presented in sequence since the rectus femoris crosses both the hip and the knee, and can only be effectively stretched if done so at both joints.

Major Hip flexors: psoas major/(minor), iliacus, rectus femoris

Stable points: pelvis

The client sits at the end of the stretch table, with the right thigh almost off the table. Instruct the client to hold the left leg, while lying down on the table. Make certain that the client does not lie down without the left leg, as this is very stressful on the low back.

Assess the following:

* If the right thigh comes up off the table, the hip flexors could be tight.
* If the right knee extends, then the quadriceps could be tight.

Always be sure that you are practicing good biomechanics (i.e., back flat, abs engaged, good posture).

Spot the client by facing the table. Take the client’s left foot and place it on the front of your body so the client does not have to hold the leg.

Ask the client:

* "Does your low back feel okay?"
* "Are you feeling pinching or discomfort on the left side?"

It is important to keep the left leg relaxed and alleviate any discomfort, as this takes the focus and effort away from the stretching on the right leg.

If the client feels pinching in the hip flexors of the left leg, you can try to ease up on the degree of hip flexion on the left side or change the angle slightly at which the left hip is flexed.

Assess if the client feels a stretch in the right hip flexors. Be certain they tell you what they feel, and point to where they feel it - as they may be feeling discomfort in the low back, which is not what we want!

In this position, you have gravity assisting in the stretch. Be very conservative in increasing this stretch. If the client’s thigh is below the level of the table and he or she feels no stretching with minimal assistance, it is highly probable that this muscle group does not need to be stretched.



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Post Isometric Relaxation (Contract/Relax)

Hold the client’s right leg at the endpoint of stretch. Cue the client to push the right thigh up into your hand with 50% effort for approximately 6 seconds. At the end of the 6 seconds, you should feel a "release" of the hip flexors, allowing the right thigh to fall further towards the floor. Then repeat this sequence 3-5 times, always starting at the new endpoint.It is very important to not force an increase in the stretch. If the muscle fibers do not release, simply try it again.

Client cues: cueing is obviously a huge component in achieving the desired movement we want from our clients. Tell the client to push the right thigh (or you may get an unwanted push with the left leg!) Cue the client to push, or press, but not to resist your efforts. It is important to have the client initiate the effort, and you are resisting it with an isometric contraction.

Quadriceps:

While holding the right hip in the stretched position, cue the client to flex the right knee, or bend the right knee, or bring the right heel towards the buttocks. This lengthens all of the quadriceps towards the endpoint. Do not assist in this movement, as you want to be sure the client does not feel any knee discomfort. Reassess:

* "Does your low back feel okay?"
* "Does your right knee feel okay?"

If someone’s rectus femoris is extremely tight, they will experience an intense stretch; you will also feel that the right thigh tries to lift up, thereby easing the stretch at the hip. You may have to reduce the stretch at the hip in order to stretch the quadriceps successfully without being too severe of a stretch.

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The client may also report knee discomfort if this muscle is too tight to allow being stretched over both joints. If this is the case, reduce the stretch at the hip, and work only at the quads; over time as the rectus femoris increases in resting length, you will be able to increase the stretch over both the hip and knee.

Take your left leg and hold the client’s right leg in the stretched position by placing your shin right up to the client’s shin. This is a biomechanically advantageous position for the trainer, and very easy to maintain.

wpe6.jpg (4697 bytes)

Cue the client to push the right shin into your left one with 50 percent effort for about six seconds. Tell them to either release, or relax; you should feel the muscle fibers relax, and the thigh may drop closer to the floor or the knee may flex more. Repeat the sequence at this new endpoint three to five times.

Stretching at Both the Hip and Knee Joints

Cue the client to simultaneously push the right thigh up into your hand, and push the right shin into your leg, with 50 percent effort for about six seconds. Repeat the sequence at the new endpoint three to five times. This is very difficult for the client as it is a deeper stretch and requires coordination and focus.

References:

1. Adler, S., Beckers, D., & Buck, M. (1993). PNF in Practice. Berlin: Springer-Verlag.
2. Alter, M. (1988). Science of Stretching. Champagne, IL: Human Kinetic Books.
3. Brotzman, S.B., (1996). Handbook of Orthopedic Rehabilitation. St. Louis, MI: Mosby-YearBook.
4. Handel, M., Horstmann, H., Dickhuth, H.H., & Guelch, R.W. (1977). Effects of contract-relax stretching training on muscle performance in athletes. European Journal of Applied Physiology and Occupational Physiology, 76(5), 400-408.
5. Lund, H., Vestergaard-Poulsed P., Kanstrup, IL, & Sejrsen, P. (1998). The effect of passive stretching on delayed onset muscle soreness, and other detrimental effects following eccentric exercise. Scandinavian Journal of Medicine and Science in Sports, 8, 216.
6. Pollard, H., & Ward, G. (1997). A study of two stretching techniques for improving hip flexion range of motion. Journal of Manipulative Physiological Therapy, 20, 443.
7. Annette Lang

Forwarded By,

Natalie Pyles

Fitness & Nutritional Expert, Author, Speaker, & Wellness Coach
Call Me For Your FREE Consultation Today! 480-212-1947 or e-mail fitnesselementsassociates@yahoo.com
WWW.MyFitnessElements.com

"The Art Of Selecting a Wellness Coach"

Related:

* Consumer Education

How is your wellness? That is, how is your optimal physical and mental health? Just as you need to continually invest to grow your financial savings account, you also need to make small daily investments in your wellness account to live your best life.

What would you like to attain to feel really well in your life? High energy? Calm and balance under stress? A positive and optimistic mindset? A fit and strong body? A wellness coach can help you make the changes you most desire.

What should you look for in a coach? Margaret Moore (Coach Meg), MBA, chief executive officer of Wellcoaches Corporation and lead author of the forthcoming Coaching Psychology Manual for Physical & Mental Health Professionals (Lippincott Williams & Wilkins), explains below.
How a Coach Can Help

Wellness coaches are energizing in their commitment to help you live your life with high energy, clear focus and a positive and confident outlook. Coaches don’t make it easy by giving you answers. Rather, they are skilled partners; they join with you in creating an inspiring vision for your life, together with a pragmatic plan to move you closer to that vision. In the process, they help you dig out your strengths and insights from life’s clutter.

Typically, coaching is conducted via 30–45 minute telephone sessions every week or month.
Qualities of an Effective Coach

What skills does a coach need? Look for someone who

* is a great listener and enjoys your stories;
* fosters self-acceptance and self-respect;
* arouses, engages, energizes and challenges you to reach higher at the right moment;
* has a bird dog’s ability to sniff out your strengths, values and desires;
* takes risks and asks courageous questions;
* doesn’t rescue you from emotional muck (sometimes you need to sit in it for a bit to energize your desire to change. He or she knows that your life is at stake if you don’t take care of yourself);
* is playful when appropriate; and
* knows how to celebrate your successes.

Wellness coaching is not therapy. A therapist treats diagnosable mental disorders. A wellness coach assumes that you are already doing some things well and that you wish to do them better or to develop other aspects of your life.
Training for Coaches

Wellness coaches are practitioners of the new field of coaching psychology that helps people implement the theories of positive psychology, which is the scientific study of happiness and well-being.

Reputable coach-training programs require 6 months to 2 years of training and coaching practice, followed by a certification process that measures core coaching competencies. Becoming a master coach, even for those with natural coaching talent, requires months of training and years of practice.

Over the past 20 years, dozens of life and corporate coach-training schools, as well as university programs, have trained more than 20,000 coaches worldwide; in the past 5 years, health and wellness coach-training programs have emerged.
SIDEBAR: Interviewing Coaches

When talking to potential coaches, ask questions such as the following to determine whether a coach is the right fit for your needs:

1. What licenses or credentials do you have, and what type of training do these licenses or credentials entail?
2. What type of background do you have? (Certified wellness coaches come from diverse backgrounds such as personal trainers, exercise physiologists, nurses, dietitians, physicians, psycho­-therapists and more.)
3. What aspects of wellness coaching do you specialize in? (Different coaches cover diverse areas of well-being, such as stress management, healthy sleep habits, weight management, work issues, family or relationship issues and smoking reduction.)
4. What would be a typical format for one of your coaching sessions? What support would you provide? What would I be responsible for?
5. What do you charge?

Your Friend In Health & Fitness,

Natalie Pyles

Fitness & Nutritional Expert, Author, & Speaker


Call Me For Your FREE Consultation Today! 1-800-681-9894 or e-mail fitnesselementsassociates@yahoo.com
WWW.MYFitnessElements.com

"10 Reasons To Hire A Certified Personal Fitness Trainer, Nutritionist, & Fitness Coach During The Holidays!"

"I don't believe in a fate that will fall on us no matter what we do. I do believe in a fate that will fall on us if we do nothing."

- Ronald Reagan, 40th U.S. president

"10 Reasons To Hire A Certified Personal Fitness Trainer!"

1. Motivation
Personal Trainers wear many hats, serving not only as coach, but also as an educator, confidant role model and a major source of motivation and encouragement.
2. Consistency
Do you find it difficult to stick to your program? Scheduling regular appoinments with a personal trainer helps eliminate any excuse you may come up with for not exercising.
3. Safety
Are you unsure about how to use the chest press machine at the gym, or how to perform walking lunges without hurting your knees? A personal trainer will show you how to exercise safely (including which exercises to avoid), and instruct you on the proper and safe use of exercise equipment.
4. Individualized Instruction
An exercise program that works for one person may not work for another. A personal trainer will develop the most effective program for you based on your fitness evaluation results and personal goals.
5. Effective Workouts
Today's hectic lifestyles mean you don't have to waste on ineffective exercise routines. Personal trainers help maximize your time by providing workouts designed to meet your goals quickly and efficiently.
6. Supervision
Personal attention during exercise is the primary function of personal trainers. Need someone to spot you while you do pull-ups? Looking for feedback on your running form? Thats what your personal trainer is for: to observe, assist and if necessary, correct as needed.
7. Sports-Specific Training
Many amatuer and professional athletes work with a personal trainer during off-season to prepare themselves for in-season competition. Whether you want to shave some strokes off your golf score or beat your brother-in-law at tennis, a personal trainer can tailor your program to your sport of choice.
8. Injury Rehabilitation
Injuries and accidents can prevent you from participating in your favorite activities. An experienced personal trainer, however, can make the road to recovery a smooth one by reccomending exercises that emphasize overall muscular balance to prevent future injuries.
9. Special-Needs Training
Research confirms that individuals with health challenges such as diabetes, asthma, osteoporosis, or heart disease benefit greatly from regular physical activity. These conditions, however, can make exercising safely a challenge. Many personal trainers are experienced in designing programs that address the special needs of these and other conditions.
10. Ego Boost
It's a fact- feeling good makes you look good, and vice versa. Not only can personal trainers help you achieve your health and fitness goals, they provide you with positive feedback on your performance and bolster your confidence to take on new challenges.

By,

Natalie Pyles
Owner & CEO of Fitness Elements & Associates LLC.

Fitness & Nutritional Expert,Wellness Coach, Author, & Speaker

1-800-681-9894 Or 480-419-6462 Or Fax 623-399-4199 Call For Your FREE Personal Training Session, Nutritional Consultation & Motivational Coaching Session FREE Today!

Happy Holidays From Fitness Elements!

"How To Use Corrective Exercise That Is Functional - Part 2"

This article is a continuation from Part 1....

Although working with clients in pain for the purpose of “treating” or “fixing” their pain is outside the scope of practice of the fitness professional, this does not mean that our clients do not have active symptoms. Many clients feel they have exhausted treatment options or have plateaued with their care. Managed care and capitation that has limited visits for physical therapy has created a new demographic seeking personal training. Add the aging baby boomer generation and the health history profile of many personal training clients is increasingly more complex. These individuals still want to be healthy, physically active, functional and productive. The appropriate training progressions can help them do that.

There is a critical point here I would like to emphasize. In my observations, many fitness professionals have adopted the "Far Right (FR)" philosophy, not recognizing the full complement of tools that a physical therapist or chiropractor - who also uses the FR philosophy - utilizes as part of their intervention. Aside from having a more in-depth education on joint mechanics, tissue tolerance, etc., physical therapists and chiropractors also apply joint mobilization, joint distraction, manual resistance and even orthotics to enhance what they will do with fully integrated, multiplanar exercises.

Following comprehensive assessments on their patients, these medical professionals will use these various other “tools” to prepare the patient’s body for fully integrated, multiplanar exercises. These tools are used to address dysfunctions at the local level to improve the global response. The fitness professional who applies exercise strategies from the FR philosophy without addressing the local segmental dysfunctions first provides the body an environment to perpetuate compensatory movement patterns.

The appropriate application of corrective exercise can produce benefits similar to many manual interventions. In fact, from a motor learning perspective, the benefits of corrective exercise can be even superior to manual intervention because the client can reproduce the benefits independently of the health professional. This allows for more frequent and proactive changes by the client that can not occur with manual interventions performed two or three times a week. This is assuming the fitness professional has the prerequisite knowledge of functional anatomy and application of specific corrective exercise.

A fitness professional who does not assess musculoskeletal function or who does not have a thorough understanding of the results of an assessment may incorrectly believe that getting an exercise done is the same as getting an exercise done right. Or that if an exercise does not produce immediate pain, it is not doing any harm. The reality is that cumulative mechanical stress from inappropriately applied functional exercises is the same as cumulative mechanical stress from any other activity.

Proprioceptive Flow Following Injury

The ligaments and joint capsules contain mechanoreceptors that provide feedback on joint position and acceleration. Certain mechanoreceptors also contain pain receptors. When a ligament or the joint capsule is injured, the amount and quality of proprioceptive information is reduced. During the healing process, scar tissue forms. The properties of scar tissue are not the same as the original ligament tissue. Therefore, proprioceptive information remains reduced, unless the injury was followed by a comprehensive rehabilitative process that challenged the local proprioceptive system.

Unless you are working with high level athletes, how many of your clients have gone through comprehensive proprioceptive training following an injury? Many people won’t even go to a doctor for a diagnosis following a sprain, never mind therapy.

Muscle spindles will adapt to injury as well. Edgerton et al. studied the muscle activation of spinal muscles during a variety of motor tasks in whiplash patients. Their research showed an under activity of agonists and over activity of synergist. They concluded that the nervous system can detect a reduced capacity to generate force from a specific muscle or muscle groups and compensate by recruiting more motor neurons. This compensation is achieved by recruiting more motor units from an uninjured area of the muscle or from other muscles capable of performing a similar task (synergist).

Babyar looked at a population that had experienced shoulder pain. As part of the patient’s compensation strategy, they elevated their scapula when the arm was raised. Patients were reevaluated after the shoulder pain was gone. Babyar observed that the scapular elevation continued even in the absence of pain.

Janda also describes muscles that have a low irritability threshold. These are posturally shortened and hypertonic muscles. These muscles will create a bias of the motor neuron pool and are prematurely active (or overactive) and exert inappropriate influence on selected movements.

Interestingly, joint range of motion (ROM) may return to pre-injury levels after the ligament or joint capsule heals. But ROM does not correlate directly with proprioceptive flow from the mechanoreceptors. Therefore, even if a previously injured joint has normal ROM, it may not be “feeding” the necessary proprioceptive information to the CNS during activity. Our internal feedback systems are based on the quality of the proprioceptive information we receive. Therefore, poor proprioceptive flow from the periphery will negatively affect the quality of the motor response based on that poor proprioceptive information.

For example, the client or athlete with a history of ankle sprains that were never rehabilitated properly will have poor proprioceptive flow from the damaged ligaments. The body will not sense the “stuck” talus that is inhibiting adequate dorsi flexion during midstance in gait. The body unconsciously figures out the best way to maintain equal stride lengths is by prematurely lifting the heel on the affected side during the stance phase. This creates biomechanical changes at the hip and lumbar spine.

Also associated with joint injuries are two muscular responses resulting from disruption of the joint integrity. Both are unconscious and neurologically based. One response is reflex spasming. This is a response to pain in which the muscles splint via co contraction around the joint to protect it by reducing movement and minimizing additional damage. Motion required at the protected joint must be transferred to joints proximal and distal to the protected joint.

An alternate response by the CNS is reflex inhibition. This is the complete opposite of spasms. As the result of the arthrogenic reflex, the muscles surrounding the joint become inhibited. This often follows distention of the joint due to effusion (swelling). Inhibition prevents the body from using that joint, thereby avoiding any potential additional harm. Biomechanical compensation is therefore necessary to compensate for the weak link.

An often overlooked example of this is the role a blocked sacroiliac (SI) joint has on the function of the ipsilateral gluteus maximus, internal oblique and multifidus. If the appropriate movement of the sacrum on the innominate does not occur, the activity of these three vital lumbo-pelvic stabilizers is delayed due to inhibition by the CNS. Force production is secondary to appropriate timing of muscle activation for joint stabilization. The role of the SI joint is critical in load transfer of forces from the ground to the upper body. Poor load transfer through the SI joint requires compensatory reactions at the knee, hip and lumbar spine, compromising optimal lumbo-pelvic stabilization.

Therefore, it is questionable if, for example, an anterior lunge with the trunk flexed forward can improve gluteus maximus function if the SI joint is blocked on the same side. According to Hungerford’s study, there is more likely to be an earlier onset and increase in activity of the biceps femoris, also a hip extensor. Clearing the SI joint with the appropriate corrective exercises prior to lunging will facilitate appropriate timing of gluteus maximus function in the lunge.

Stay tuned for the third and final part of this series... coming soon!

References:

1. Babyar SR: Excessive scapular motion in individuals recovering from painful and stiff shoulders: causes and treatment strategies, Physical Therapy 76:226, 1996
2. Brooks, VB The Neural Basis of Motor Control. New York: Oxford University Press 1986
3. Edgerton, VR., Wolf, SL., Levendowski, DJ., Roy, RR. (1996). Theoretical basis for patterning EMG amplitudes to assess muscle dysfunction. Medical Science in Sports and Exercise 28: 744-51.
4. Hungerford B, Gilleard W, Hodges P 2003 Evidence of altered lumbopelvic muscle recruitment in the presence of sacroiliac joint pain. Spine 28(14):1593
5. Jeansonne, J, (2004). Motor skill learning looks beyond outcomes. Biomechanics Magazine Online. Retrieved June 2004.
Keele, S.W. Summers, JJ (1976). The structure of motor programs. In G.E. Stelmach (Ed.), Motor control: Issues and Trends (pp. 109-142). New York: Academic Process.
6. Lee, Diane (2001). An Integrated Model of Joint Function and Its Clinical Application. 4th Interdisciplinary World Congress on Low Back and Pelvic Pain. Montreal, Canada, 137-151.
7. Laskowski ER, Newcomer-Aney K, Smith J, (2000). Proprioception. Physical Medicine and Rehabilitation Clinics of North America. May;11(2):323-40, vi.
8. Magill, RA, (2001). Motor learning: Concepts and applications. New York. McGraw-Hill, 2001
9. McGill, Stuart (2002). Low Back Disorders: Evidence-Based Prevention and Rehabilitation. Champaign, IL. Human Kinetics.
10. Myers, T. (2001). Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists. New York, NY: Churchill Livingston.
11. O’Sullivan PB, Twomey LT, Allison GT. (1997). Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine;22:2959-67
12. Anthony Carey

Forwarded By, Natalie Pyles

Fitness & Nutritional Expert, Author, Speaker

Call Me For A FREE Fitness Consultation OR Functional Fitness Training Session

1-800-681-9894 or 480-419-6462 or go to

WWW.MYFitnessElements.com to request a Consultation

"How To Use Corrective Exercise That Is Functional - Part 1"

"The only thing that interferes with my learning is my education." - Albert Einstein




As the evolution of the fitness industry continues, perhaps one of the greatest benefits to emerge is the “discussions” it has generated. With all of the gains in research that have expanded our understanding of human anatomy and physiology, there are still vast differences in the interpretation and application of the available information. And this is understandable, since that is the nature of research meeting practical application.

Perhaps no other topic has created more “discussion” than that of function and functional training. And with the overwhelming varieties in human bodies and what they are used for, is it any wonder?

Corrective exercises are of growing interest in the fitness industry, and they are part of this discussion on function. This three part article will attempt to provide a clear understanding of what corrective exercises are and demonstrate the vital role they play in the functional continuum.

The approach and application of corrective exercises I use and teach are often quite different than the perception many professionals have on the topic. This article will further differentiate the functional contribution this approach and application has to optimal health and performance.

I am a proponent of and use all forms of what most consider functional training. This includes but is not limited to multiplanar movements using multiple segments as well as unstable surfaces. But perhaps instead of calling it functional training, we should call it training for function since function is ultimately defined by the individual. This may seem like pure semantics, but it is not. Functional training implies a specific mode of training. Training for function implies an objective.

Corrective Exercise vs. Post Rehab Exercise

It may be useful to first draw a distinction between corrective exercise and post rehabilitative exercise. Corrective exercises are not dictated by symptoms or a current pathology. They are based purely on positively influencing the neuromusculoskeletal system. Exercises will always involve areas of the body far removed from the site of pain or past injury. In a symptomatic client such as those I work with, the symptoms do not dictate what we do. They only place certain limitations on what we do because we do not want to exacerbate the symptom(s).

Post rehabilitation exercises are dictated by a specific objective related to prior treatments by a licensed medical provider following an injury or medical intervention (e.g., surgery). Technically, a fitness professional should not be doing post rehab without directives from the treating professional. Post rehab is most commonly a continuation of the medical providers’ treatment plan.

Post rehabilitative exercises are often body part or quadrant specific. For example, post rehabilitative exercises for a knee procedure would include attention to the quadriceps and hamstrings. And then ideally, it would include the joints above and below the effected knee (ankle and hip).

As the outcomes of the post rehab plan are met, it would be prudent to move on to a more global corrective exercise strategy, realizing that any disruption to the motor system will have consequences far removed from the site of the procedure or pathology.

Whose Function?

Two questions that always drive my training paradigm are: “For whom?” and “For what?” When we ask these two questions, differing philosophies on function inevitably move closer to common ground. Once we’ve answered these two questions, in order for our training approach to be functional, it must be transferable to the unique characteristics and needs of that client/athlete.

To further expand and perhaps cloud the discussion on function, I’ll use one of my clients with chronic lower back pain as an example. This woman can not sit for more than 15 minutes and can no longer work. For her session, I dance around her in a dimly lit room waving incense and singing The Smiths’ song “Girlfriend in a Coma.” She finishes our session with no back pain and proceeds to drive for two hours to Los Angeles still pain free. Was that a functional training session? If you asked my client, she wouldn’t care. She had a functional outcome.

And that may be a critical point: function is determined by output and not necessarily input. In the hypothetical example, the client’s back pain would not be gone long unless it was completely psychosomatic. Therefore, an appropriate functional exercise program would follow.

But what is functional for this client and at this point in her progression? Here is where the divergence occurs in philosophies. One end of the spectrum might involve floor work that is purely cognitive driven motor re-education. We’ll call this the Far Left (FL) of the spectrum. The other end of the spectrum would include completely vertically loaded multi planar exercise including squats and lunges. We’ll call this the Far Right (FR) of the spectrum. Which is “right” or more effective?

I believe they both are. I believe that they are not mutually exclusive and are both in fact part of the total functional continuum. The goal ultimately is to minimize cognitive input and move to the far right of the continuum as quickly as the client is capable. “Capable” means the client has demonstrated a level of competency (quality of movement, stability, endurance, etc.) that justifies moving her to the next stage in the continuum.

There are many practitioners who would agree with me on this, and this approach is supported by many researchers (including McGill, O’Sullivan and Lee) in the area of spinal rehabilitation. But what many practitioners don’t realize is that the continuum I am speaking of does not necessarily span weeks or months. It spans minutes.

Why Corrective Exercise?

When used with specific functional objectives in mind, corrective exercises can be progressed to multiplanar and/or proprioceptively challenging exercises within a given one hour session. This is what I do every day. I use corrective exercises to create an environment where the client can be most successful, performing exercises that are vertically loaded, multiplanar and/or on labile surfaces.

The body is cued to move differently through the stimulus of the corrective exercises. The corrective exercises are ascended, progressively linking together more complex movements. Even as the program is progressed to movements of the FR, we continue to apply exercises that challenge the client’s individual functional needs versus generic multi planar exercises. By following this programming strategy, we facilitate changes to the individual’s biomechanical constraints and motor control strategies.

Corrective exercises are applicable to every client and athlete. They are not limited to clients currently experiencing pain. We can be reasonably confident that most, if not all, of your clients have been in pain at some point in their lives. Show me a client or athlete older than 15 years of age who has never had an injury that created pain avoidance, and I’ll show you someone with a very short memory.

Pain is the single greatest stimulus to enter our body. Through resulting changes in the central nervous system (CNS), the influence of pain is reflected in biomechanical characteristics. Even if pain is no longer present, its effects are. To quote Doctor Janet Travell, the former White House physician and pioneer in trigger point work: “Tissues heal, but muscles learn. They readily develop habits of guarding that long outlast the pain.”

Pathological or disrupted proprioceptive information from the periphery (skin, muscles, joints, tendons, connective tissue) results in functional, adaptive processes through the whole motor system. The symptoms might be felt locally, but the response is experienced globally.

Far Right (FR) on the Functional Continuum

The FR approach has its basis in stimulating the proprioceptive system through “natural” movements that most often require eccentrically controlling gravitational forces. This elicits an appropriate concentric contraction to overcome gravitational forces such as in walking or to produce acceleration and power for a movement such as throwing. The mass and momentum of various body segments are manipulated through verbal instruction from the trainer or therapist to dynamically produce desirable biomechanical reactions of other muscles and joints. For example, changing the orientation of the trunk in a lunge relative to the gravity vector will alter the muscular and joint responses throughout the body.

For these reasons, the FR approach elicits a more integrated and higher level of musculoskeletal function than a floor based, cognitive approach that is to the far left (FL) of the continuum. Assuming the client’s existing biomechanical constraints have responded to the designed stimulus (exercises), the CNS is able to assimilate a more comprehensive catalog of improved movement strategies.

The FR approach assumes, however, that the proprioceptive system will respond in a predictable manner and thereby produce the desired biomechanical response. In the case of the client currently experiencing pain or with pain events in her health history, the proprioceptive system may be “rewired.” And even in cases where the dysfunction is pre-pathological, adaptations/compensations are already underway that will eventually lead to exceeding tissue tolerance and manifesting as regional symptoms.

It can also be argued that exercises from the FR actually use more cognitive processing than the appropriate application of corrective exercises. The complexities of many of the multiplanar, multi joint exercises are completely foreign to many people’s motor systems and are therefore novel movements. This unfamiliar exercise requires a higher level of cognitive processing to both understand and execute than a corrective exercise would. The more complex the unfamiliar movement is, the more likely it will initially produce inefficient co-contractions at many joints, potentially blocking degrees of freedom at those joints. This results in stiff and awkward movement patterns.

Even if the desired proprioceptive response is produced in the CNS, the body must still deal with any possible biomechanical constraints (myofascial adhesions, trigger points, scar tissue, osseous obstructions, etc.). Excitation of the motor nerve from the spinal cord determines how frequently the muscle is excited, but how it actually contracts and relaxes is determined by the properties of the muscle tissue.

Stay tuned for Part 2 of this fascinating series... coming soon!

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13. Anthony Carey

Forwarded By, Natalie Pyles

Fitness & Nutritional Expert, Author, Speaker