This editorial explains how I use the Functional Movement Screen (FMS) in my practice. Copy & paste the link:
This editorial explains how I use the Functional Movement Screen (FMS) in my practice. Copy & paste the link:
This single-blinded, randomized study found that older women with mild cognitive impairment displayed improved executive function after twice-weekly resistance training compared to a control group that worked on balance and toning.
Doing aerobic training only showed improved balance and cardiovascular capacity, but no change in memory function.
This was published in the April 23, 2012 issue of Archives of Internal Medicine.
Exercise continues to be the most promising anti-aging strategy.More
Here’s a link to an article on golfing I wrote in Dynamic Chiropractic magazine:
To Your Health December, 2011 (Vol. 05, Issue 12) Share | By Jeffrey Tucker, DC, DACRB
The most common injury sites for golfers are the low back, shoulder, knee, elbow and wrist. Golfers who have low back pain demonstrate a decrease in range of motion for hip internal rotation on the lead leg (left leg for a right-handed golfer) and lumbar extension, and decreased activation and/or timing of the abdominal obliques, erector spinae and knee extensors. A good golf swing uses the left side of the body as much as the right. The hips initiate movement into the ball. The feet pushing against the ground cause a ground reaction force that sequentially travels up through the hips, the trunk and finally out the arms. The most noticeable difference between pros and amateurs is trunk rotation. Trunk rotation and flexibility are enormously important in golf. Older and less skilled players tend to use less than half the trunk rotation of younger or more skilled players.
Golfers who are looking to maximize their performance and avoid and/or rehabilitate following common golf-related injuries should try these exercises in consultation with their doctor of chiropractic:
Active Warm-Up Exercises Bend forward at the hips to touch the fingers to the floor.
Step into a stride position, extending the right leg (lunge).
Lift the right arm, rotate the spine and the head – hold this pose for 10 seconds.
Return to the stride position.
With hands on the left thigh, drop the back knee toward the floor and reach both arms overhead.
Twist the torso toward flexed front knee and hold.
Return to the hip flexor stretch position then put both hands on the floor.
Go to push-up position.
Sweep the left foot across in front – sit into the stretch and hold for 10 seconds.
Return to the push-up position.
Step forward into a forward bend and hold.
Sit into a deep squat with open knees.
Lift hands overhead, stand up and bring arms back to your side.
Now repeat this on the opposite side: Bend forward at the hips to touch the fingers to the floor. Step into a stride position, extending the left leg (lunge). Lift the right arm – rotate the spine and the head – hold this pose for 10 seconds. Return to the stride position. Hands on right thigh, drop the back knee toward the floor and reach both arms overhead. Twist the torso toward flexed front knee and hold. Return to the hip flexor stretch position then put both hands on the floor. Go to push-up position. Sweep the right foot across in front – sit into the stretch and hold for 10 seconds. Return to the push-up position. Step forward into a forward bend and hold. Sit into a deep squat with open knees. Lift hands overhead, stand up and bring arms back to your side.
The shoulder is the key anatomical structure involved in every phase of the golf swing. If you’ve suffered a shoulder injury related to golf or are just looking to improve shoulder rotation and performance, ask your doctor of chiropractic about these exercises:
Wing stretch: Place the back of your right hand on the outside upper gluteal (buttock) region so the elbow sticks out to the side. The back of the hand touches above your “pants pocket” area. Grab the right elbow with the left hand and pull it the elbow forward, simultaneously resisting the pull by stabilizing your shoulder girdle backward on the stretching shoulder. Hold this stretch for one minute.
Open book: Lie on your left side with your knees bent and your arms straight out in front of you, palms together. Keeping your knees on the ground, take your top arm and rotate your upper body all the way in the opposite direction. Perform 15 reps. Repeat on the other side.
Thoracic rotation: Get down on all fours, place your right hand behind your head, and point your right elbow out to the side. Brace your core and rotate your right shoulder (think about moving through the shoulder blade) toward your left arm. Follow your elbow with your eyes as you reverse the movement until your right elbow points toward the ceiling. That’s one repetition. Do 20 reps right and left.
Band diagonal raise: Attach a band or handle to the low pulley of a cable station. Standing with your left side toward the pulley, grab the handle with your right hand in front of your left hip and bend your elbow slightly. Pull the handle up and across your body until your hand is over your head and your thumb is pointing up (a Statue of Liberty pose). Return to the starting position. Complete 10-15 reps and repeat with your left arm.
Scaption: Perform this exercise standing in front of a mirror to monitor their form. Hang the arms down by the thighs and rotate both hands to a thumbs-up position. Retract and depress the scapulae as you lift the arms up to shoulder-height at a 45-degree angle from the trunk. The arms should make a Y in front of them. Make sure that the upper trapezius isn’t pulling the shoulders into the ears. If it is, work on pulling the shoulders down in order to push the arms up. Perform two sets of 15 reps per set.
Lie face down on a bench with your upper shoulders off the bench to perform these exercises, which involve raising the arms / shoulders to mimic the shape of a Y, T, W and L (e.g., arms up over the head forms a Y; arms straight out to the sides forms a T; etc.). Standing Y-T-W-L exercises can also be performed using a stretch strap, which allows you to maintain a consistent arm position.
One More Great Exercise:
If you’re suffering from increased thoracic kyphosis (rounded upper back / shoulders), protracted shoulder blades and/or forward chin position, ask your doctor of chiropractic about this corrective exercise: Stand, feet together, looking straight ahead. The feet should remain in this position for the duration of the exercise. Put one hand beneath your collarbone and one hand on your belly button. Keeping your hands in that position, lift the chest with the hand under the collarbone while simultaneously pulling down with the belly button hand. This will help to lengthen the spine and reduce the slouched position. Holding the achieved position, level the pelvis by raising the middle of the pelvis with the lower abdominals. Lengthen the neck by slightly tucking the chin and imagining the crown of the head is being pulled toward the sky. Bend your knees very slightly, just enough to remove any tension from the posterior knee. Holding the achieved position, lean forward slightly to shift the center of gravity to the midfoot instead of the heel. Practice this frequently to improve posture. This opens the chest and allows for more natural breathing as well. While non-golfers may not realize it, the physical challenge of golf can be more daunting than the mental part of the game, particularly if you don’t use proper mechanics during every part of the swing. Injuries are common, which will either affect your game dramatically or stop you from playing altogether.
Talk to your chiropractor about these and other exercise strategies to improve your golf game and avoid injury. ——————————————————————————– Jeffrey Tucker, DC, is a rehabilitation specialist who integrates chiropractic, exercise and nutrition into his practice in West Los Angeles. He is also a speaker for Performance Health/Thera-Band, NASM and FMS.com .More
Co-enzyme Q10 – also known as ubiquinone – is a powerful antioxidant found in every cell of the body, where it has important functions within the mitochondria – the “powerhouses” of cells. Javier Diaz-Castro, from the University of Granada (Spain), and colleagues studied elite runners participating in a 50-kilometer run across Europe’s highest road in the Sierra Nevada. Twenty athletes participated in the study, who were divided into two groups: one group received one 30 mg capsule of Q10 two days before the run, three 30 mg capsules the day before the run, and one capsule one hour prior to the run. The other group received placebo at the same time. Whereas the placebo group displayed a 100% increase in oxidative stress markers, only 37.5% of the Q10-supplemented runners experienced the same stresses. Suggesting that Q 10 countered the overexpression of certain pro-inflammatory compounds after exercise, the researchers conclude that: “Co Q10 supplementation before strenuous exercise decreases the oxidative stress and modulates the inflammatory signaling, reducing the subsequent muscle damage.”More
Consumption of leucine-enriched essential amino acid supplements during endurance exercise may enhance the synthesis of muscle protein by 33%, says a new study from the U.S. Army.
In addition to the implications for sports nutrition, results of the randomized crossover study, published in The American Journal of Clinical Nutrition, may have implications for populations susceptible to muscle loss due to conditions such as sarcopenia.
“… increasing leucine provision during endurance-type exercise by dietary supplementation enhances muscle protein anabolism in recovery,” wrote researchers from the U.S. Army Research Institute of Environmental Medicine, Tufts University, and Louisiana State University System.
The effects of resistance exercise on the metabolism of protein in muscles and the effects of endurance exercise on protein metabolism is not well established. “Increasing the concentration of leucine within an optimal dose of EAA [essential amino acid] does not have an added stimulatory effect on resting and post-resistance exercise muscle protein synthesis,” explained the researchers, led by the U.S. Army’s Stefan Pasiakos.
“In contrast with resistance exercise, sustained endurance exercise is mainly catabolic, yielding simultaneous reductions in muscle protein synthesis and plasma leucine concentrations during exercise, which may be attributed to the metabolic demand for branched chain amino acids in exercising skeletal muscle.”
Eight volunteers consumed 10 grams of protein drinks with either 1.87 or 3.5 grams of leucine during a cycling test.
Results showed that the leucine-enriched beverage was associated with a 33% increase in muscle protein synthesis, compared with the control beverage. “[In addition] whole-body protein breakdown and synthesis were lower and oxidation was greater after consumption of [leucine-enriched essential amino acid supplement] than after consumption of [essential amino acid supplement],” added the researchers.
“These data indicate that increasing leucine availability during steady state exercise promotes skeletal muscle protein anabolism and spares endogenous protein,” wrote Pasiakos and his co-workers.
“Our findings indicate that increasing the leucine content of protein supplements provided for those populations susceptible to muscle loss, including proteolytic conditions—such as cachexia, sarcopenia and calorie deprivation—may warrant further exploration,” they added.
American Journal of Clinical Nutrition 94(3):809-181, 2011More
By Melissa Heyboer
There’s much more to rehabilitation than just improving what was once a painful injury. While recovering from muscle and joint pain is important, so is the need for improving a patient’s flexibility and range-of-motion (ROM).
Whether your patient is looking for relief from sprains, strains, disc injuries, or joint dysfunction, or if a patient simply wants to improve their overall well-being, bettering ones flexibility and ROM has unending benefits.
According to Gregory H. Doerr, DC, CCSP, ART, CKTP, developing better flexibility and greater ROM ultimately helps improve dysfunctions of the body — but it can also help prevent them.
“Inflexibility and loss of ROM leads to immobility of tissue, which leads to a number of joint and soft tissue dysfunctions,” said Doerr, “including fibrosis, tissue hypoxia, and the production of inflammatory markers including substance P and CGRP.”
Ultimately, he says, this can lead to pain and fear avoidance.
Steven Weiniger, DC, says the most important thing is that improving flexibility and ROM promotes symmetry of motion and, ultimately, helps the patient. ROM should be the first phase of rehab as you can’t advance to balance, strength and function until ROM is improved.
“Your body is made to move,” Weiniger said. “If your body is moving asymmetrically, your muscles will get strong in the way you’re training them to move.”
This creates added stress on the joints and they break down, he said.
“The chiropractor comes into the game when the person says my back or my neck keeps going out. That’s where the kinetic chain is buckling due to the asymmetric force from the muscles that have been trained to move asymmetrically.
This is where low-cost flexibility and ROM tools can come in handy.
“A person’s perception of how they are moving is often not accurate, which creates problems when performing exercises or treatment programs,” Weiniger said. “Even though the exercise is, in theory, designed to be a good exercise, it’s moving the body without symmetry. [Flexibility and ROM] tools facilitate the creation of that symmetry of motion.”
Fortunately, as a chiropractor, incorporating flexibility and ROM exercises and tools for the upper and lower extremities is not only easy, but can enhance your bottom line and broaden your patient base.
“I think providing these tools in your office can be used to differentiate yourself from other practitioners,” said Jeffrey Tucker, DC. “This type of system can help teach clients how to improve posture; and it helps neck and back pain patients.”
Tucker also suggests incorporating flexibility and ROM into a group class for your patients. “Clients want one-on-one motivation,” he said. “I sell higher quality lifestyle; it’s not about fitness. Emphasis is placed on practical, functional every day skills. It builds trust, it gives you an opportunity to have better communication with clients, and it creates value.”
Weiniger adds that with the right tools, patients can also reach their goals and improve the flexibility and ROM of both their upper and lower extremities from the comfort of their homes.
“Tools are nice because it provides structure and a point of responsibility,” Weiniger said. “They bought it, and they have it, and it lets them have an objective metric.”
Patients need to understand that at-home flexibility and ROM exercises have the same benefit as rehab elsewhere.
“We already know that our in-office methods of manipulation, mobilization, and modalities improve pain and function,” said Tucker. “If you do not teach clients to perform corrective exercises at home, you will miss the opportunity to allow patients to ‘turn on’ the nerves and muscles prior to workouts; enhance the excitability of the neuromuscular sequence; improve the recruitment of the muscle bundles and fibers; enhance muscle sequencing and movement patterns; improve coordination; and increase ROM.”
Weiniger says that adding flexibility and ROM exercises to your practice is not only beneficial for improving motion, but it helps build the doctor-patient relationship.
“Bottom line is that we are entering a time where people are going to be more responsible for their health,” said Weiniger. “By selling the patient an inexpensive tool to help strengthen their body, the person is going to value the doctor better.
“There are some residual benefits to selling it, but the goal is to build the doctor-patient relationship so the patient can see you as a coach and teacher as well as a doctor who values the patients own best interest.”
With so many inexpensive options out there, Doerr says it’s easy for chiropractors to embrace active rehab — like the tools needed for flexibility and ROM exercises — in their practices.
“As chiropractors, we have mastered the art of passive care,” Doerr said. “It is time we evolve to match the evidence currently available and move our practices into the evidence-influenced age.
“We often fail to realize that the key to new patients and more referrals is not associated with marketing teams, coaches, or gimmicks, but with positive outcomes in a faster time period. Active protocols assist us in achieving this.”
BIO] Melissa Heyboer is the associate editor of [ITAL]Chiropractic Economics[/ITAL]. She can be reached at 904-567-1540 or firstname.lastname@example.org.More
If we all agree that exercise is vital to health, then let’s figure out the best routine. The right mix of exercise can: Reduce the risk of premature death, reduce the risk of heart disease, reduce high blood pressure, reduce high cholesterol, reduce the risks of many cancers, including colon and breast cancer, reduce the risk of developing diabetes, reduce fat and optimize body weight, build and maintain healthy muscles, bones, and joints, reduce depression and anxiety, enhance performance in work and sport.
Believe it or not, running every day, won’t cut it. Going to the gym every day and working out with weights every day won’t cut it. The ideal exercise program includes cardio/aerobic exercise, strength training, weight-bearing exercise, stretching, breathing, and balance.
Cardio/aerobic exercise. This has to be some movement that is brisk enough that requires the heart and lungs to work harder to meet the body’s increased oxygen demand. Basically you are forcing the heart and lungs to work harder, and yet of low enough intensity to facilitate adequate oxygen transfer to the muscle cells so that no buildup of lactic acid is observed. Think repetitive movement of the arms, legs, and hips. Take your pick from running, jogging, and fast walking. Biking (either road or mountain), and swimming are also good. If you belong to a gym or have home equipment, there are treadmills, elliptical trainers, spin cycles, and rebounders.
Strength Training involves the use of free weights, kettlebells, weight machines, resistance bands or some other form of resistance to build muscle and increase strength. Its benefits include: Increased muscle strength, increased tendon and ligament strength, reduced body fat and increased muscle mass, better balance, lower blood cholesterol, improved glucose tolerance and insulin sensitivity. The key to strength training is to choose one you can do easily and are willing to do regularly.
Every patient of mine that wants to lose weight, I make sure that they are doing circuit weight training. Strength training builds muscle which increases your resting metabolic rate.
Weight bearing exercise is actually a subset of certain aerobic and strength training exercises. It helps slow down the rate of bone loss and osteoporosis. It is exercise in which you force your body to support weight (your own included) while exercising. The best weight bearing exercises are: weight-lifting, jogging, hiking with a back pack, stair-climbing, step aerobics, racquet sports, and other activities that require your muscles to work against gravity. Swimming and simple walking don’t do the trick. One exceptionally useful form of weight bearing exercise is rebounding. The act of rebounding makes use of g-forces, just like astronauts training in a centrifuge.
Stretching is the most over-looked area of fitness I have seen lately. Stretching reduces muscle tension and increases range of movement in the joints. I see tremendous tightness and restrictions in most clients bodies from a lack of variety of movement. Tightness and constriction cause a reduced blood flow to the muscles and soft tissues, this leads to a lack of oxygen to the tissues and this is a very painful situation. Yoga has become one of my pewrsonal favorites for stretching. Pilates works well too. If nothing else, just do 5-10 minutes of simple stretching after your daily exercise routine as part of your cool down time.
Proper breathing is often over-looked as much as stretching. The concept is simple: putting a device in your mouth that restricts (in a controlled manner) your inhalations and exhalations, which forces your lungs to work harder. This, in turn, strengthens the muscles that makes your lungs work and increases their capacity.
The last area is Balance. Balance diminishes with age unless we consciously exercise it. If you fall down and break your hip or wrist, the odds are you will have a long-slow recovery, if you fully recover.
The most simple balance exercise is to practice standing on one leg. If you need to hold on to a chair for support, with one hand, that’s fine. Slightly bend one leg so that the foot of the bent leg is projected out behind you. Get used to balancing on the one leg holding a chair or wall. Then take the hands off the chair and balance with one eye closed. Build up to balancing with your eyes closed for 30 seconds.
Please remember that you can not exercise your your way out of a bad diet. Increase your quality protein to build the muscles you are exercising. Avoid sugar but enjoy high quality fats such as Omega-3s.More