Calling All Kettlebell Kittens!

Core, Cravings, Curves and More...


How to Cut fat by attacking the Core and More



I am Natalie Pyles, owner of Kettlebell Kittens Workout in Phoenix, Arizona and creator of the “Art of KettleBell training the Core and more” workout series. I’ve seen, studied, and used almost every quality fitness tool and worthless infomercial gadget introduced to the marketplace over the last couple decades. Quite a few of them get regular use at Golds Gym… but I’d need three times the gym space to hold what’s been tossed in the dumpster out back!

I’m quite open-minded and will try just about anything with my clients. After all, mainstream folks need variety more than anything to stay motivated. We use bands, barbells, medicine balls, rings, punching bags, dumbbells, stability balls, spinning bikes, bosu balls, and about a dozen other fun tools.

My favorite tool (and the core of most of my training) is now the kettlebell. A kettlebell looks like a cannonball with a suitcase handle welded to the top. It’s a hunk of iron with a long, rich history that is virtually unknown in America. Kettlebells have been used for centuries in Eastern Europe and are beloved for the strength they impart. The kettlebell might seem completely unfamiliar to you… but think back to early childhood. Most people have a fuzzy recollection of the circus strongmen in Bugs Bunny cartoons tossing them about. Are you with me now?

I was originally drawn to the kettlebell because of its simplicity and unique shape. It is an undeniable chunk of iron. I can’t imagine anyone hanging the “infomercial gadget” sign on a kettlebell. This is clearly a serious strength tool. As I began to study this simple, utilitarian looking implement, I discovered a deeper training philosophy surrounding its historic use.

For hundreds of years, kettlebell use has focused on muscle integration rather than isolation. Nearly every drill recruits multiple muscle groups to work in unison. The body is trained as a whole and particular emphasis is focused on the core and back muscles. Isn’t it interesting to see the “new” paradigm in American fitness shifting to a radical “new” philosophy of functional training? Kettlebells represent functional training in its purest sense… and have been doing so since before the discovery of electricity.

You don’t technically even need a kettlebell to experience some of the philosophy surrounding it. The variety of kettlebell drills is staggering. Many of the more advanced drills simply aren’t possible to perform with a dumbbell. Two of most basic, fundamental drills can be (to some degree) experienced with a dumbbell if you haven’t purchased a kettlebell yet. To avoid turning this introductory article into a novel, I’ve prepared 5 short videos of a fellow fitness expert demonstrating the kettlebell swing and Turkish getup. Please watch each in its entirety. Then grab a dumbbell and give it a try. The swing will certainly feel awkward compared to using a proper kettlebell… but you should get the idea.

I recommend you then purchase a kettlebell or two and watch this training zone for future tips and articles.

View all article campanion videos.

P.S. Here is Melissa's Success story and this workout program is dedicated to her for all her hard sweat & tears! I love you girl!

Are You Ready For Functional Flexibility?

How Functional Flexibility Will Enhance Effective ways to allow for more resilience throughout the Pelvic Core Neuromuscular System (PCNS)

Mobility in three planes of motion is an effective way to allow for more resilience throughout the Pelvic Core Neuromuscular System (PCNS) and to wake up the neurological system propriopceptively. Traditionally, stretching has taken place in one plane of motion. By integrating triplanar stretching, you effectively stretch muscles from different angles.

For example, take any traditional stretch and add gentle motion in the sagittal, frontal and transverse planes. To stimulate the PCNS from a traditional runner’s calf stretch against the wall, turn the back foot inward approximately 45 degrees and drive the hips front to back (sagittal plane), side to side (frontal plane) and then clockwise and counterclockwise (transverse plane). Perform each motion for 30–60 seconds. This will allow for mobility throughout the lower girdle, including the PCNS.

Figure 1: The Pelvic-Floor Muscles

Breath and Core Support

When training a client with PCNS challenges, one important task is to teach her how to breathe using the respiratory diaphragm for core support against low resistance. Sounds arbitrary considering that we must breathe to live, but as we know, clients do not always know how to inhale and exhale appropriately upon exertion.

Your client may feel that holding her breath provides stability by locking down the core. Actually, it does not provide functional mostability (mobility and stability); what’s more, it doesn’t feel very good. Breathing through pursed lips provides greater stability, while slowly letting the system adjust through rhythmic, three-dimensional decompression and unloading. The following simple exercise shows how to integrate core stability into breathing.

1. Have your client stand with feet shoulder width apart with hands at shoulder height, elbows flexed to sides (you mirror her).
2. Instruct the client that she will take a deep breath in, and on the count of three you will give her hands a gentle push as she holds her breath.
3. Compare stability.
4. Do the same sequence—only this time instruct your client to exhale forcefully as you gently push her hands (compare with task 2).
5. Repeat the sequence, but now instruct your client to exhale through pursed lips (like blowing through a pinhole) as you provide gentle, increasing resistance to your push.
6. Compare stability.

Know Your Healthcare Professionals

Urogynecologist: specializes in the care of women with pelvic-floor dysfunction. This professional has completed medical school and a 4-year residency in obstetrics and gynecology. A urogynecologist has additional training and experience in the evaluation and treatment of conditions that affect the female pelvic organs and the muscles and connective tissue that support the organs.

Gynecologist: a physician who has completed specialized education and training in the health of the female reproductive system, including diagnosis and treatment of disorders and diseases.

Obstetrician: a physician who has completed education and training in the management of pregnancy, labor and puerperium (the time period directly following childbirth).

Obstetrician/Gynecologist: a physician who provides medical and surgical care to women and has particular expertise in pregnancy, childbirth and disorders of the reproductive system. This field includes preventive care, prenatal care, detection of sexually transmitted diseases, Pap test screening and family planning.

Physical Therapist: licensed professionals who work with people who have impairments, disabilities or limitations in their overall physical function. Physical therapists examine, evaluate and develop treatment plans on an individual basis. They use manual therapy, functional exercise and other modalities to restore function, improve mobility and decrease pain with the goal of re-establishing a patient’s prior level of function.

Women’s Health Physical Therapist: a physical therapist who has specialized skills and education in the care of the female patient. Areas of focus include pregnancy and pelvic-floor dysfunction.

Fellow of Applied Functional Science: a physical therapist, personal trainer, medical doctor or fitness professional who has specialized training in applied functional science through the understanding of functional principles, strategies and techniques appropriate for use with patients and clients of all types and for all purposes, including prevention, rehabilitation and performance enhancement. This professional will also be certified in functional manual reaction.

Pelvic-Hip Complex Pivot Shift Matrix

The following test (remember, tests become exercises and exercises are tests) assesses and exercises the functional flexibility, mobility and stability of the entire pelvic-hip complex. This is a “Pivot Shift Matrix,” in which we load from the bottom up.

1. Have your client demonstrate her ability to perform single-limb balance (SLB) on both lower extremities.
2. Start with the more successful side (in this case we will describe standing on the right leg, moving the left leg through space).
3. Sagittal Plane: In right SLB, instruct the client to swing the left leg, intentionally and with control, pivoting forward and back at the hips. Let her use the upper trunk to counterbalance. If this is difficult, allow her to toe-touch down in front, then in back.
4. Frontal Plane: In right SLB, instruct the client to toe-touch as far to the left as possible and then return to midline. After a brief pause, instruct her to reach the left leg to the right, across the body. Again, let her tilt the torso to counterbalance the full loading and unloading of the hip.
5. Transverse Plane: In right SLB, have the client rotate at the right hip, turning the body as a whole to the right and then turning across the body to the left. Again, if balance is deficient, instruct the client to toe-touch at the threshold of each rotation.

This exercise assesses glutes, hamstrings and calf muscles in the sagittal plane; hip abductors and adductors in the frontal plane; and hip internal and external rotators in the transverse plane. It also submaximally and subconsciously stimulates the pelvic core from the ground up. Synergistically you have allowed the abdominals to contribute by decelerating, loading and unloading the upper torso to counterbalance the excursion of the hips.

SIDEBAR: Recognizing Pelvic-Floor Dysfunction

While it is clearly not within the scope of practice for fitness professionals to diagnose pelvic-floor dysfunction, there are questions you can ask that will help in the allied health professional referral process. The answers will also help with program design.

• How often do you urinate during the day? (Every 2–4 hours, or 6–8 times per day is considered normal.)
• Do you get up at night to go to the bathroom? If yes, how many times? (Zero times to once per night is considered normal.)
• Do you ever have accidental leakage of urine during activities such as coughing, sneezing, laughing, running, exercising or lifting?
• Do you ever have accidental leakage of urine associated with a sudden strong urge to urinate, or do you have trouble reaching the toilet in time?
• Do you do a lot of “just in case” toileting?
• Do you have trouble controlling gas?
• Have you ever lost bowel control?
• If you are sexually active, do you have pain during or after intercourse?
• Do you have pain before, during or after urination or bowel movements?

Source and References: Idea Fit
Forwarded By, Natalie Pyles

P.S. Natalie Pyles the owner of Fitness Elements is Now offering a New service and added value to all clients, and New customers the Integrated Flexibility Specialist - NASM. Call for your Muscular imbalance assessment today 480-212-1947 or fax assessment request to 623-399-4199 or e-mail fitnesselementsexpress to set up an assessment at your preferred time.

Are You ready for All Purpose Push Ups - Part 1?

It’s most likely the first exercise you learned and the one fitness novices do almost instinctively when they try to work out. Yet the push up remains one of the most valuable and effective movements, provided you know how to use it to its fullest potential.

Although the push up is well known and commonly practiced in the world of strength training, it’s still very misunderstood and under utilized among performance and fitness professionals. In this article, you will learn how to use creative push up progressions and variations to:

• Assess and correct muscle imbalances
• Build hypertrophy
• Increase strength
• Develop torso stability
• Increase power
• Improve metabolic endurance (power endurance)

The goal of this article is to give you a new appreciation for the push up and help you to understand that it’s much more than just another “horizontal pushing” variation.

Re-thinking the Kneeling Push Up

Performing push ups on the knees is not for everyone. The issue has nothing to do with mechanics or safety. In that respect, the movement is okay. The issue is one of progression, or in this case, a lack thereof.

In the past, the kneeling push up was used as a regression strategy in the hopes that it would eventually lead into normal push ups. Unfortunately, there has been little to no carry over from the kneeling push up to the regular push up. The reasons for this include lever arm length, angle difference, etc. I personally have seen hundreds of people perform endless reps of kneeling push ups but still couldn’t even come close to performing a single regular push up. For this reason, the kneeling push up is what I call a “dead end” exercise. Keep doing them, and you will go nowhere!

Luckily, there is a much better regression/progression strategy when it comes to push ups.

Incline Push Ups



The concept here is pretty simple. Because you are at an incline, there’s less force on the moving muscles and torso stabilizers, which makes the push up easier to perform.

The best place to do this is on a Smith machine because it’s simple to adjust and easy to keep track of the bar depth from session to session.
Once someone can perform 20 quality reps at one height, simply lower the bar one or two pegs. The lower the bar gets, the harder the push up becomes.

As mentioned earlier, just because your client can easily perform kneeling push ups doesn’t necessarily mean she can do any real push ups. However, if someone can perform 20 reps at a low bar setting, she can definitely bang out a few good reps from the floor.

Simple Solutions to Complex Problems

Over my years as a performance coach, I have performed thousands of postural/movement assessments. In doing so, I have successfully used push ups as both an assessment tool and as a corrective exercise. Here are the two most common movement flaws I’ve seen during the push up and simple ways to correct them.

Common Flaw #1 - Faulty Spinal Alignment



This type of flaw is very common and normally caused by a lack of general body awareness, torso strength and postural stability.
Faulty spinal alignment can appear as:

• Sagging head
• Sagging back (lordosis)
• Hunching back (kyphosis)
• Any combination of the above

In some cases, people will begin with ideal alignment and gradually lose alignment as the exercise progresses and fatigue sets in. In other cases, they will start out right away with poor alignment. Regardless of when the fault happens, this is a muscle imbalance that needs to be corrected!

The imbalance I’m referring to is that the mover muscles (chest, shoulders, triceps, etc.) involved in pushing the body away from the floor are stronger and posses more endurance than the spinal stabilizer muscles that are responsible for maintaining ideal alignment. In other words, you’re unable to control the movement and force that you can create. This can put you on the fast track to injury.

It’s for this reason that I usually do a max rep test on the push up during my performance assessments. This allows me to see if an athlete’s stabilizers give out before his prime movers.

The solution to this alignment problem lies with a very high tech piece of gym equipment: a dowel rod. There is a three step progression we use to correct faulty spinal alignment issues using the dowel rod.

Step 1 - Build Awareness

This quadruped position shortens the lever arm (bent legs) and takes most of the load off the system while still keeping the torso and arms in a very similar position to the push up. The dowel is placed along the spine and is kept in contact with three points: the back of the head (not the top), thoracic region (between shoulder blades) and sacrum (tail bone). This forces you to understand and become aware of proper alignment.

Step 2 - Static Control

The elbow plank takes what was learned in step one and lengthens the lever arm (straight legs). This increases postural stability and endurance in a manner necessary to perform the push up successfully. We try to progress everyone to be able to maintain this position for at least one minute without deviation. The hold time we choose for each individual is usually double the number in seconds of their max push up reps. For example, if your rep max is 30 push ups, then you should be able to hold the elbow plank for 60 seconds. We use this standard because the average push up is performed at a 1-1 tempo, which translates into each rep taking two seconds. At 30 reps, that would take 60 seconds.

Step 3 - Dynamic Control

Once awareness is created and strength/endurance is built, the final step is to integrate both components into the actual movement itself (in this case, the push up).

The dowel push up is much more challenging than it looks because so much effort is dedicated to maintaining alignment. Eventually, as your postural endurance improves, this push up will become easier.

We try to get everyone to achieve the same rep max with the dowel rod as without it. Once you can do this, the dowel is no longer needed.
A few additional notes on the above progression:

1. During all three progressions, the dowel should remain in contact with the back of the head, T-spine and sacrum.
2. Begin with neutral spinal alignment, and stop the exercises when spinal curvatures change or the dowel falls.
3. The worse your alignment is, the harder these exercises will be, and the longer it will take to progress through them.
4. Use a mirror at floor level to help with visual feedback, body position and awareness.
5. In the case of a hunch back (kyphosis), I recommend you perform some additional anterior abdominal stretches because the rectus abdominals is most likely overactive.

Common Flaw #2 - Scapular Winging

Scapular winging can be much more complicated than the previous flaw and therefore may be beyond the scope of even the most experienced trainer or coach. However, there are some cases in which a few simple, well designed corrective exercises are all you need.

In order for you to understand how to successfully address a winged scapula, you must first understand what it is you’re dealing with. A winged scapula is a shoulder condition in which the scapula (shoulder blade) sticks out at the back, particularly when performing pushing exercises like the push up. Common symptoms of a winged scapula include the following:

• Pain and limited shoulder elevation
• Difficulty in lifting weights
• Pressure on the scapular from a chair when sitting

A winged scapula can be caused by one of two reasons:

1. Damage to the long thoracic nerve of the shoulder. If the long thoracic nerve is damaged or bruised, it can cause paralysis of the serratus anterior. Damage to the nerve can be caused by a contusion or blunt trauma of the shoulder, traction of the neck and can also sometimes follow a severe illness. In this case, I would highly recommend consulting a skilled orthopedic professional before engaging in any exercise or sporting activities.
2. General weakness in the serratus anterior muscle. In this case, the winging scapula can be improved with some specialized exercises designed to build strength in the weak serratus anterior muscle.

There are a few corrective exercises shown below. Important note: If you’re dealing with a winged scapula and are unsure of its causative source, I recommend playing it safe and getting an evaluation from a skilled professional. As they say, “It’s better to be safe than sorry.”

Corrective Exercises

There are three exercises you can use to help correct and prevent scapular winging through strengthening the serratus anterior muscle. During all three movements, careful attention should be paid to scapulohumeral rhythm and symmetry. Also, effort should be made to maintain a stable pelvis and neck.

Each of these exercises achieves essentially the same thing. However, it’s important to utilize a variety of methods in order to find what is best for the specific situation or individual.

1. Hand Walks

The pattern is one hand up, next hand up, one hand down, other hand down, repeat. Adjust the height of the box for added difficulty.

2. Arm Shuffle

Begin with your hands very wide. Shift your weight back and forth while simultaneously touching one hand on top of the other as shown.

3. Push Up Plus

Once you have completed a standard style push up, add the “plus” motion by protracting your scapula as much as possible without changing your spinal alignment. This can be difficult for some people to dis-associate their scapula from the rest of their body. When performing the push up plus, we like the hands to be no wider than the shoulders. Sometime I will even keep the hands together (thumbs touching). This allows for increased ROM and increased demand on the serratus muscle.

Each of the above exercises is normally performed for a timeframe of 20 seconds to one minute.

Now that we have effectively set the stage for building and rebuilding the push up, the next article in this series will look at how the push up can be incorporated to help build hypertrophy, strength, power, power/endurance and torso stability.

References: Nick Tumminello

Forwarded By, Natalie Pyles

Fitness & Nutritional Expert, Author, Speaker

Call Me For Your FREE Consultation Today! 1-800-681-9894 480-212-1947 or e-mail fitnesselementsassociates@yahoo.com

"Are Riding Two Horses at Once Is Really Possible"

The danger of riding two horses at once is that you can easily get split in half! To ride two horses at once, not only must the rider must be skilled, but both horses must be in controlled and must be comfortable running next to each other... in tandem.

Like a horse and its rider, we all have needs that must be met if we are to maintain the wealth of health. First, we must care for our “self.” The self is our idea of who we are and our idea of our body and its needs. In essence, these needs are:

1. Optimal food
2. Optimal water
3. Optimal rest
4. Optimal movement or exercise
5. Safe shelter
6. Optimal warmth (energy)

These needs are also the needs of a business, which must be seen as a living entity if one is to be successful in the development, management and growth of any business. The same is true for those working within a business, for they either create safety and security in a business or diminish it.

If we look at these needs as they apply to a business, they convert as follows:

1. Optimal availability and use of resources
2. Optimal flow (incoming and outgoing of resources and the ability to adapt)
3. Optimal work/rest ratio to keep ownership, management and staff healthy
4. Optimal use of effort and skill within the business and marketing of the business
5. Enhanced stability within owners and employees (which creates stability of the business)
6. Consistent cash flow, working capital and revenue

Would it be a good idea to try and ride two horses, before you’ve mastered riding one?

The first horse we need to learn to ride is the horse of self. Only when we’ve achieved a level of self love and self awareness that produces a surplus of life force and internal resources are we ever likely to have what it takes to energize a business endeavor.

Anyone with experience riding horses knows that an unhealthy horse doesn’t like anyone on its back! An unhealthy horse is a dangerous horse to ride and is potentially risky to be around. It would be a mistake to hitch a sick horse to a wagon or a plow. To do so increases the likelihood of not getting the hay in before it rains, not preparing the fields for new crops, etc. Forcing a sick horse to be productive may actually kill it!

I repeatedly find myself coaching sick, tired and burned out people who own businesses and who manage staff. When I look into my clients' lives (how they manage themselves), it is obvious they don’t know how to care for the (animal) body. Yet, they work earnestly to care for and improve a second horse.

When we care for ourselves intelligently, we manage our lifestyle such that it creates inner wealth, abundant energy and a genuine sense of freedom. These are necessary qualities for success in any endeavor. A healthy body is a prerequisite for a healthy mind. No business owner, manger or employee can create a healthy business without a healthy mind! Each horse (self and business) has needs. However, it is the horse of “self” that feeds the horse of business every time. When we come to work tired, poorly fed, dehydrated, lacking sleep, rest or non essential (play) time, we are far more likely to find ourselves repelled or repulsed by people and the challenges natural to any business. This is burnout.

The horse (body) is a strong animal. Yet, managed gently by instinct and intelligence (mind), the horse responds gracefully to its rider’s cues. This is a healthy partnership. Managed poorly, the horse is pained and may throw you off (addiction, obesity and diseases)!

Now, let’s take a look at the two horses. One horse represents the horse of “self” or the female part of you. She needs the rest (moisture), energy (movement) and (self) time to create a nurturing home environment in which she may cultivate the necessary life force to feed and manage the second horse, which is the natural complement in a personal/professional relationship. The second horse represents the male part of you, which is expansive, logical, constructive, warming, divisional and self expressive. If the female (horse of self) is overworked, under rested, poorly fed, inadequately watered or lacks safety and security, she dries out, and the male (horse of self) has to over compensate in order to create balance. The rider then has a very hard time controlling and working the horses.

Likewise, when we come to work, it is our function to foster partnerships with both staff and customer. Yet, if one shows up depleted, dried out as a prune (you certainly can’t re-create a plum), things cannot flow. By the very laws of nature, dryness absorbs moisture around it. This means that a problematic paradox emerges. Those that are burned out and who should be managing and maintaining their business avoid their employees and don’t connect with their customers. They begin drawing precious, vital energy, moisture (flow) out of the business, their employees and their customers... not a sign of health, is it?

What does this look like? We have all seen it:

* Physicians who are more unhealthy than their patients.
* Teachers who resent their students.
* Firemen who can’t hold the hose or carry victims down the ladder to safety.
* Policemen too fat to run after a bad guy.
* Business owners who isolate themselves through preservation and who become unwilling and uninterested in meeting the needs of staff and customers.
* Personal rainers who look and feel worse than their clients.

In order to ride two horses at once, each horse must be healthy and feel safe with the rider. If this does not happen, any other horse is a potential threat to it’s safety, resources become limited and survival behavior leads to over investment in self (one horse sees the other as a threat to it’s own survival). A sick horse is a liability!

The rider must have mastery riding one horse before attempting to ride two horses, or disaster is inevitable. Each horse must have a common tandem objective, or the rider will become split in half! Each horse must be felt and seen as an extension of “self” and cared for as such. Anything else leads to one horse feeling abandoned, even though the other is standing right next to it. Any horse that feels deserted is unlikely to comply with the wishes or direction of the rider or the other horse. Abandonment creates a sense of absence: there but not there. Each must be groomed, cared for and treated as a unique individual. Two healthy halves equal a strong and healthy whole. You and you become one: two horses working as a functional unit sharing the load.

I encourage you to bring your horses together in harmony with clearly defined core values, goals and objectives. When we do this, we successfully ride two horses at once. One who successfully rides two horses at once enjoys more than double the satisfaction, safety and security and joy of working together in tandem. The whole is greater than the sum of it’s parts. When we ride two horses together successfully, each horse has the satisfaction and joy of companionship from the other. And we more than double our horsepower!

My dream for all of us working together is that we all ride safely in harmony with both our individual and professional goals and overcome the challenges of balancing self and business. My success is your success, and your success is my success. The world benefits greatly when we come together in love and synergy. To do this, we must cultivate our instincts, feed our intellect and ultimately nurture our relationships with self and other. The rest is natural and easy. Then we will ride two horses at once!

Photo Credit: R. Michael Tonnesen, www.adirondackminute.com

References: Pual Chek

Forwarded by, Natalie Pyles

Fitness & Nutritional Expert, Author, Speaker

Call Me For Your FREE Consultation Today! 1-800-681-9894 or 480-212-1947 or e-mail fitnesselementsassociates@yahoo.com
WWW.MyFitnessElements.com

'New Program Luanch Fitness Now'

Function Now

Function, Food, Flexibility

Working out for Real Life Functions


Functional fitness may be among the latest buzzwords in gyms these days, but for good reason. It's about training your body to handle real-life situation

Yesterday you had a great workout at the gym. You're bench-pressing more weight than ever before, and pulling enough weight on the seated rowing machine to try out for the Olympic sculling team.

Today, you lift a 60-pound suitcase to carry it downstairs -- and throw your back out. What happened? In all likelihood, you're not paying enough attention to your functional fitness. You might be toned, tight, and ready for the beach, but are you ready to lift your toddler out of his car seat or hoist the spring-water bottle onto the dispenser?

Functional fitness and functional exercise are the latest gym buzzwords. They focus on building a body capable of doing real-life activities in real-life positions, not just lifting a certain amount of weight in an idealized posture created by a gym machine.

Making Muscles Work Together

"Conventional weight training isolates muscle groups, but it doesn't teach the muscle groups you're isolating to work with others," says Greg Roskopf, MS, a biomechanics consultant with a company called Muscle Activation Techniques who has worked with athletes from the Denver Broncos, the Denver Nuggets, and the Utah Jazz.

"The key to functional exercise is integration. It's about teaching all the muscles to work together rather than isolating them to work independently."

So what's an example of a functional exercise? Think of a bent-over row; not the kind of row you do on a seated machine, but the kind you do leaning over a bench, holding the weight in one hand with your arm hanging straight down, and then pulling the weight up as your elbow points to the ceiling, finishing with your upper arm parallel to the ground.

"That's an exercise that will build the muscles of the back, the shoulders, the arms, and because of its nature will really work your whole body," says exercise kinesiologist Paul Chek, MSS, founder of the Corrective High-performance Exercise Kinesiology Institute in California who has advised the Chicago Bulls and the U.S. Air Force Academy.

"Compare that motion to a carpenter bending over a piece of wood, a nurse bending over a bed to transfer a patient, or an auto mechanic bending over to adjust your carburetor. Anyone doing a bent-over row will find a carryover in things you do in normal life."

Contrast that with the seated row: You're sitting in a chair with your chest pressed against pads, and you pull two levers back. "You may be strengthening certain muscles, but your body's not learning anything, because you don't have to activate your core stabilizer muscles or the stabilizers of your arms and shoulders. The machine's doing it for you," says Chek.

"In functional fitness, most of the time, you should be standing on your own two feet and supporting your own weight when you lift anything."

References: Gina Shaw

Forwarded By, 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

"Health & Fitness Before the Core" - Part 1

As the words "core" and "function" have taken center stage in the arenas of health, fitness and strength and conditioning. Many professionals are making the terms mutually exclusive. In other words, they are using both words to mean the same thing. Is core training and functional training one in the same? The answer is "no."

Core training and stabilization is agreed upon by most authors and researches to refer to the lumbo-pelvic complex and spinal stabilization. Functional training refers to training the body to optimally perform "real world" movements involving acceleration, deceleration and stabilization, using biomechanically efficient and coordinated movements.

The critical differentiation to make here is that a complete functional training progression must include core training and stabilization. However, core training and stabilization do not always equate to complete "functional training." In fact, many exercises that have been labeled as "core strengthening" exercises can contribute to perpetuating an individual's existing dysfunction.

By dysfunction, I am referring to existing muscular imbalances and altered sensory perception that create faulty movement patterns. It is often not the exercise that is at fault but rather the execution of the exercise by the individual. This can occur when an individual is placed in a position or positions that require static or dynamic stabilization utilizing the core musculature. During this stabilization, the strategy that their motor system uses may be biomechanically inappropriate. The individual in this case will resort to their unique position of strength. For example, the person in Figure 1 is keeping a neutral spine and eccentrically loading their abdominals to avoid excessive lumbar extension. Figure 2 depicts the same individual demonstrating a stabilization strategy for someone with weak lower abdominals and tight hip flexors. Notice how the individual in Figure 2 flexes through their middle thoracic back. They have sought to stabilize themselves using the superficial upper rectus abdominus, pecs and abducting their scapulae. The flexion in their thoracic spine is their strategy to indirectly minimize excessive lordosis in the lumbar spine in this position.



Figure 1


Figure 2
A movement strategy occurs high up the decision making process of planning a movement. According to Massion, strategy implies the existence of a choice in attaining the movement goal. Therefore there is some cognitive input by the individual and the response is not purely reflexive - happening below the cortical level.

A strategy is created when a movement synergy or synergies is repeated enough times that it is learned. A movement synergy is a coordinated pattern of muscle activity that produces force, reduces force or stabilizes against force.

The individual in Figure 2 will eventually become more stable on the ball using this kyphotic positioning. His balance will improve using this strategy but this balance will come at the expense of the biomechanics of his shoulder girdle. As he further trains his core in this manner without correction of the substitution patterns, he will develop what Kibler calls a sub-clinical adaptation complex. The adaptation is the use of a compensatory mechanism utilizing thoracic flexion for indirect lumbar stability. It is categorized as sub-clinical because there is no pathology present – yet. However, it is only a matter of time before this individual exhausts his body's ability to compensate and pathology will be present.

Why would someone use an inappropriate strategy when you, as a professional have clearly explained and demonstrated the desired outcome? Hanna refers to this as "Sensory Motor Amnesia." He describes this as a condition in which a person's ability to voluntarily contract or relax a muscle(s) is directly dependent on the degree to which a muscle can be sensed or felt. Therefore, our peripheral output (the way we move) is directly dependent on the quality of our proprioceptive input. Computer programmers have a saying for bad software: Garbage in equals garbage out. If the code (proprioceptive input) you place in your software isn't accurate, your program (your movement) will crash.

Another contributing factor to this thoracic flexion example is that tight muscles have a low irritability threshold. They will become active or overactive during instances when they are not the prime movers. Janda did a study in which subjects with lower back pain were given abdominal curl up exercises. EMG recordings of the lower back erectors showed that these lower back muscles actually fired prior to the abdominals at the initiation of the curl up. Does this imply that the subjects' lower back musculature contributed to lumbar flexion? Absolutely not. Instead it demonstrated the low irritability threshold of this muscle group. The individual who is represented by the example in Figure 2 would likely be tight through the muscles of the chest and anterior shoulder. With the upper extremities placed in a weight bearing position, these muscles immediately became the dominant stabilizers.

You may repeatedly tell your client to engage the abdominals and allow the thoracic spine to passively drop into extension and they can't. They might be able to do one or the other but not both. And they certainly can not do this on an unstable apparatus.

Prior to putting your client in the position of Figure 1, use a modification of the exercise (i.e., Prone Plank on Knees, Elbows on SB). This exercise reduces the overall demand on the body by shortening the body as a lever. In addition, the gravitational vector pulling the pelvis into an anterior tilt is lessened. With the elbows flexed on the ball the individual’s use of the biceps for stabilization is minimized. This improves their ability to extend the thoracic spine and reduce the tendency toward scapular abduction.

What happened in Figure 2 can in fact happen with any exercise or any movement. But because of the way the industry has gravitated toward core training, it is very important for health and fitness professionals to understand that that the application of an exercise categorized as addressing the “core” does not give one cart blanche to use it with anyone anywhere at anytime.

I am continually asked by professionals at my seminars about this stabilization exercise or that stabilization exercise. It is usually a "sexy" new exercise that they saw at a workshop or in a magazine. And my first question is: "For who?" And my second question is: "For what?"

Responding with a question is my attempt to have the individual realize the uniqueness of each and every one of his or her clients. And the only way to differentiate uniqueness is to assess. A simple postural screening can provide a wealth of information to begin the assessment process. This combined with extensive health history is an excellent starting point. Of course, what you do with the information gathered is what really counts.

In Part 2, I will expand on the need for using corrective exercises for all of your clients, regardless of their current level of musculoskeletal health.

References: Anthony Carey

Forwarded By, Natalie Pyles

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

WWW.MyFitnessElements.com

Health & Fitness Expert, Nutrition Expert, Wellness Coach, Author, Speaker

"Corrective Exercise Is Functional - Part 3"

This article is a continuation from Part 2....

Kinematic Redundancy

Kinematic redundancy is the ability of the kinetic chain to complete a movement task using numerous combinations of joint motions and levels of contribution from various muscles. This is evident even in a motion as repetitive as walking. If we were to evaluate sophisticated gait analysis data (ground reaction forces, EMG, joint angles and displacement), we would see that no two sequential strides are exactly alike. There are patterns and ranges within the data, but they will not be exactly alike. Interestingly, those ranges could involve desirable kinematics or undesirable kinematics. Just because a motion falls with a given kinematic range does not mean that it’s the range we want.

With kinematic redundancy, the more variables (i.e., joints) involved, the greater variability in the muscle activation pattern and greater variability of motion at the involved joints. A standing one arm cable row with lunge, for example, could produce different responses on each repetition at both ankles, knees, hips, lumbar spine, thoracic spine, scapulo thoracic joint, gleno-humeral joint, elbow joint, radio-ulnar joint, wrist and even the interphalangeal joints.

This presents a challenge for the fitness professional who assumes the client is engaging the appropriate muscle groups at the optimal time in the movement sequence with the optimal force contribution. In the one arm cable row, the goal would be to extend the ankle, knee and hip of the front leg prior to extending the lumbar spine. This allows the gluteus maximus to fire and contribute to force closure, along with the contralateral latissimus dorsi of the S.I. joint. The preferred firing sequence of the involved muscles produces the desired movement sequence.

If the lumbar spine extends prior to the hip, the desired stability from the gluteus maximus is late. Lumbar extension prior to hip extension increases lumbar stresses and places the lumbo-sacral region at greater risk of injury. If the fitness professional is not accurately assessing these motions during the exercise, the “functionality” of the exercise is questionable.

Another biomechanical consideration is that of limited motion in a link of the involved chain. Limitations in motion of one joint in the involved chain will transfer the responsibility to another joint, and motion will occur first in a more flexible joint. The body will produce motion at the more mobile segments in the chain first. For example, in our cable row, if the client is kyphotic, during the eccentric phase of the exercise, the thoracic spine will flex prior to the hips and lumbar spine. This decreases the mechanical line of pull of the thoracic extensors with tendinous attachments on the lumbar spine and thereby reduces their contribution to lumbar stability. It then increases stress on the passive soft tissue structures of the lumbar spine as the flexion moment is more concentrated in the lumbar spine because there is no flexion left to give in the thoracic spine.

A corrective exercise program that addresses these dysfunctions by improving thoracic extension and proprioceptive awareness of spine/hip motion can enhance the overall quality of the more integrated movement.

Myofascial Slings

The gluteus maximus is linked with the contralateral latissimus dorsi via the thoraco-dorsal fascia making up the Posterior Oblique System. The Posterior Oblique System is one of multiple myofascial slings present in the human body. Recent advancements in the understanding of force transmission through muscle, fascia bone, tendons and ligaments have shed new light on how the body maximizes mechanical efficiency through these slings. Thomas Myer’s book “Anatomy Trains” is an excellent resource on this topic.

A myofascial sling is formed when any of the previous mentioned structures (i.e., muscle, fascia, etc.) lie in series and parallel to one another. They are anatomically connected and functionally related. Myofascial slings can cross multiple joints and can be “active” during certain movements and “inactive” during other movements based on the relationships of the body parts during the given movement. They allow the body to store kinetic energy from ground reaction forces in motions like walking or the above cable row example when the trunk and arm are rotated in one direction and the contralateral hip and pelvis are rotated in the opposite direction. When they contract, they act as one continuous muscle. This provides the body with an enormous advantage for stability and force production. The Posterior Oblique System literally connects the hip and opposite shoulder. Other myofascial slings throughout the body will be active in the sagittal plane, frontal plane and transverse plane motions.

The structures that give myofascial slings a mechanical advantage may also contribute to disruption of normal movement patterns. Any dysfunction in one part of the sling will have an effect on the rest of the sling. For example, we often see clients with shoulder girdle issues that are directly related to hip issues on the opposite side of the body.

In our cable row, if the dysfunction in the posterior hip was not addressed prior to performing this exercise, the resulting muscle activation patterns would be much different at the shoulder girdle than expected. This would stress the lumbar spine as previously mentioned but would also increase stress on the entire upper extremity of the rowing arm due to poor ground reaction force transfer from the lack of contralateral hip stabilization.

Corrective Exercise Application

I use corrective exercises prior to introducing the cable row to promote the desired movement sequence and minimize an environment for compensation. The number one purpose behind using corrective exercises is to improve the quality of overall movement, not to isolate joint movement or a muscle or produce artificial movement. Cognitive processing is used to reinforce movement patterns by accessing another part of the brain during the execution of the exercise.

Corrective exercises create the road map for the body to follow on its route to producing improved movement patterns. The fundamental goals of the corrective exercise program to enhance movement are:

* Activate latent muscles
* Release hypertonic muscles
* Create proprioceptive awareness of enhanced segmental motion
* Improve postural alignment and the body’s center of gravity
* Improve osteokinematics and the path of the instantaneous center of rotation of the joints
* Functionally integrate the responses across multiple segments in the kinetic chain
* Create a baseline for improved movement strategies

This methodology of corrective exercise follows the well established motor learning approach of "segmentation." Segmentation consists of taking a complex movement and practicing it in small parts. The small parts are progressively linked together, producing the more complex skill. Segmentation is similar to Keel’s Gearshift Analogy. When learning to drive a stick shift, initially each of the individual actions are independent motor tasks. With practice, similar tasks are linked together, decreasing the overall number of tasks. Eventually, the process is automatized and becomes one independent motor task, allowing the driver to add other tasks involved with driving (i.e., turn signals, climate control, etc.)

When working with clients and athletes that have active symptoms or chronic injuries, corrective exercises allow the fitness professional to progress the client safely. Corrective exercises avoid end range loading of joints and exceeding tissue tolerance thresholds. Exercises are progressed as the client successfully meets the objectives within the exercise program. If a client is apprehensive, unable to perform an exercise or the exercise produces pain, the exercise can be changed with less chance of injury.

In a more comprehensive and loaded exercise from the FR, there is a much smaller “buffer” zone. If an unsafe exercise is mistakenly given, the risk of injury is much higher. If a client has been asked to do a transverse plane lunge with an ankle level reach and their lumbar facets didn’t cooperate, the damage would be done if the client could not control the acceleration of his body. You can’t “un-ring” the bell. If an unsafe corrective exercise is mistakenly given, the movements are slow enough and the ROM is controlled enough to allow the client to stop the exercise before any damage is done.

All exercise is about manipulating the environment to produce a desirable change in the client or athlete. Sometimes that requires going backwards to ultimately move forward. We cannot mistake being effective for being efficient. Corrective exercises are functional because they are part of the safest and most influential continuum for many clients and athletes.

We should be cautious in adopting a single thought process that is applied to all our clients and athletes all of the time. And we should be equally cautious not to discount the value of other thought processes being used by others. Because one will soon discover that the process that they have become dogmatic about, will not work for all of the people all of the time. The true craftsman always chooses the best tool for the job... not his favorite tool.

Corrective exercises should not be left out of the conversation on “function” just because at first glance they don’t look like an activity of daily living or an athletic movement. If the result of a corrective exercise sequence is transferable to improvements in activities of daily living or athletic movements, then there is a functional result. And a functional result is the ultimate goal.

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.
6. 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.
7. 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.
8. Laskowski ER, Newcomer-Aney K, Smith J, (2000). Proprioception. Physical Medicine and Rehabilitation Clinics of North America. May;11(2):323-40, vi.
9. Magill, RA, (2001). Motor learning: Concepts and applications. New York. McGraw-Hill, 2001
10. McGill, Stuart (2002). Low Back Disorders: Evidence-Based Prevention and Rehabilitation. Champaign, IL. Human Kinetics.
11. Myers, T. (2001). Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists. New York, NY: Churchill Livingston.
12. 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
13. Anthony Carey

Forwarded By, Natalie Pyles

Fitness & Nutritional Expert, Author, Speaker

Call me For Your FREE Cosultation & FREE Report Today! 1-800-681-9894 or visit WWW.MyFitnessElements.com

"Corrective Exercise 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

Fitnes & Nutritional Expert, Author, Speaker

Call me For Your FREE Cosultation & FREE Report Today! 1-800-681-9894 or visit WWW.MyFitnessElements.com

"Corrective Exercise 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!

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.
6. 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.
7. 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.
8. Laskowski ER, Newcomer-Aney K, Smith J, (2000). Proprioception. Physical Medicine and Rehabilitation Clinics of North America. May;11(2):323-40, vi.
9. Magill, RA, (2001). Motor learning: Concepts and applications. New York. McGraw-Hill, 2001
10. McGill, Stuart (2002). Low Back Disorders: Evidence-Based Prevention and Rehabilitation. Champaign, IL. Human Kinetics.
11. Myers, T. (2001). Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists. New York, NY: Churchill Livingston.
12. 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


Forwarded By Anthony Carey

By,

Natalie Pyles

Fitness & Nutritional Expert, Author, Speaker

Call me For Your FREE Cosultation & FREE Report Today! 1-800-681-9894 or visit WWW.MyFitnessElements.com

"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