All Posts tagged Core training

Low back & pelvis core strength & stability

The basic message I want to get across to my patient’s with low back pain is about your personal responsibility to support the muscle system of the spine. Have you heard of Core Stability? If you are into Pilates, yoga or strength training you have experienced core strength training and stability training.

If you are my patient you have heard me talk about the fascia and the joints. In particular for the low back, I talk about the fascia, muscles, and joints around the  sacro-iliac joints. These are part of your low back stability system. Contrary to what old rheumatologists will tell you, the sacro-iliac joints – which connect the fused section of the lower spine (the sacrum) to the pelvic/hip bones on either side – do need to move during normal daily activities such as walking and running. These bones were meant to move. On the other hand the lower lumbar vertebra were not meant to move very much. These lower lumbars usually need stability training to get them to “hold” in place better.

You will feel me touching and testing the motion of these joints and the surrounding fascia. It is both necessary and desirable that the sacro-iliac joints move, because they need to act as shock absorbers between the lower limbs and spine, and also as a way of providing proprioceptive (body positioning awareness) feedback for co-ordinated movement and control between the trunk and lower limbs.

As the SIJ is capable of movement, that movement needs to be properly controlled, as with any of the body’s joints. Some control comes through the natural architecture of the low back and pelvis, but more is possible by using the surrounding muscle, ligament and connective tissue system (fascia) to provide compression on the joints. This is important because we can influence the effectiveness of the compression through exercise and re-training after injury.

I will give you exercises to support the muscles and fascia  that help to stabilise the pelvic girdle:

  • For the back side I like arch ups;
  • For the front side I like abdominal curls or planks: 
  • For the sides I like the side bridge.

If you practice just these three core exercises and train every day for three weeks it will help you improve the fascia system of support.  These are just the beginner poses. I will progress you to the intermediate and advanced exercises.

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Stiffness

Sometimes patients have to take a step backward to move forward, and sometimes their voyage is not so much about discovery as rediscovery. Stiffness is not the major chief complaint I hear from clients, but it is often checked off on their intake forms. Stiffness can be associated with pain, inflammation, fatigue, and any other complaint that bring clients in my office. The most common reason for stiffness is the effects of immobilization of the joints and muscles. The spinal joints, hip joints, knee joints, shoulder joints, and ankle joints are the most commonly involved. Muscle and joint pain commonly originates from bad habits of sitting, standing, sleeping, and walking. Stiffness has real consequences if ignored.

A Functional Workout

It doesn’t matter if my client is young, middleaged, or a senior citizen; I use the functional training approach as part of my treatment, especially for relief of stiffness. I  start my rehab recovery teaching patients body-weight maneuvers and floor exercises. Then, I progress patients to use bands. I incorporate Thera- Bands for rehabilitation, functional movement training, sport-specific conditioning, and group classes. The next progression I use is to free weights and Kettlebells. Our profession was inundated with laser therapy and decompression tables, while the strength-training world was invaded by Kettlebells. I like to think that I have access to every kind of equipment out there, but through it all, I am still a big proponent of the minimal and inexpensive need for equipment in “authentic” functional training, like Thera-Bands. Thera-Bands can provide the basis for an authentic functional workout limited only by the imagination and knowledge of the practitioner. Functional exercise is based on its outcome, not how the exercise looks. Don’t ask me how to activate specific muscles (that question was answered years ago). Instead, ask: Why did this person lose the movement pattern in the first place?” Thera-Bands help me get rid of stiffness and improve functional strength, which is usable strength. Functional strength is hard to measure. That’s why I attempt to identify it by using many unorthodox movements, such as assisted posterior reaches. his exercise is one of the best methods of developing functional abdominal strength in overhead athletes, or athletes in sports that bring the arms overhead, such as tennis and basketball. Stand on both legs (eventually progress to one-legged stands) facing away from a Thera-Band firmly held in place. Hold the band in both hands, and extend your arms straight up above your head. Bring the hips forward and the hands back. Lean backward as far as you can without feeling pressure in your lower back. Engage the lower abdominals to return to the starting position. Using the Thera-Bands, I teach movements that train the body to do what it was meant to do. These  can simply be broken down into four pillars: 1) Standing and locomotion (gait). One of my favorite exercises that improve the hip rotator stabilizers (gluteus) is to have clients wrap the Thera-Band (usually the green band) around the ankles and walk sideways across the room or down a hall to activate the gluteus. This one maneuver alone has helped more patients improve altered gait than any other. 2) Movements that lower or raise the body’s center of mass, such as squatting, lunging, and climbing. I have clients stand on a band and hold the ends of the band in their hands while doing squats, and perform an overhead press on the way up. 3) Pushing and pulling, such as standing rows and pressing maneuvers. 4) Rotation. These are changes in direction. For example, torso rotation and proprioceptive neuromuscular facilitation (PNF) band chops are a functional way to train the abdominals.

Everyone talks about the core, which includes the major muscles attached to the trunk, above the ischial tuberosity, and below the superior aspect of the sternum. Approximately 87% of the core muscles are oriented either diagonally or horizontally and have rotation as one of their actions. Our body was made for rotation,  yet very little rotational training is addressed in today’s standard training protocols. Thera-Bands make rotational training easy. The most annoying things about the bands is getting the latex powder on your clothes and occasionally the bands break while you are in the middle of a set. An advantage to band assessing and training is the observation of symmetrical or asymmetrical movements. The link between uncontrolled spinal and joint intersegmental translation or uncontrolled range of motion, and the development of musculoskeletal pain and degenerative pathology, is well-known. Often, patients are not even aware of the bad movement pattern that they are doing over and over that is causing the stiffness. Sometimes, it is only clearly seen when the muscles fatigue and pain sets in. The inefficient control of muscles and bones, poor movement habits, and poor posture give rise to very subtle and unique imbalances in the body-stability system. This puts mechanical stress and strain on the joints; and the muscular, neurological, and connective tissue systems of the body. This leads to cumulative microinflammation, which leads to pain and pathology. This predisposes joints to early aging and stiffness. A significant amount of injuries and stiffness occurs in clients with right- to left-sided strength and flexibility imbalances. My recommendations with the Thera-Band are to put the core first and to look for the following asymmetries:

Core Stability 

 

 and realizes how critical it is for the inner core of the body—namely, those joints closer to the spine, to be supported by the postural muscles designed with strength. You can create strength using the tubing made by Thera-Band. If you don’t tend to strengthen, the natural progression is for the body to lose it.

 

 

Stretching

I usually recommend that stretching is the last thing a person does once he or she is pain-free. I see many patients that injure themselves from overstretching in yoga class and with Pilates. Stretch to increase flexibility, but don’t overdo it. I encourage patients to feel the muscle barrier and don’t go past that point. Otherwise, you start pulling on the ligaments and these were not meant to be pulled apart. Neuromusculoskeletal function involves a complex integration of proprioceptors facilitating; muscles reacting and joints moving simultaneously in sagital, frontal, and transverse planes of motion in a groundforce kinetic chain reaction response. This is facilitated by the moving body in relation to the ground and gravity. Use Thera-Bands to put patients through movements that allow you to see how an individual can control outside forces that are irregular in intensity, speed, load, symmetry, nd direction, just like sports and real life.

Flexibility

The purpose of flexibility varies for the different muscles around the joints. For the major power muscles, it is important that flexibility allows freedom of movement for the pelvis, hips, trunk, scapula, and humerus. Freedom of movement needs to be symmetrical.

General Muscle Strength

Once the foundational issues of consistency, core stability, flexibility, and balance control are being implemented, I then look at the bigger picture of the “outer core.” The rest of your body will need strength to carry you into your 80s and 90s. Performance as you age will be improved

 

 

Jeffrey Tucker, DC, DACRB

has been in continuous private practice for over 25 years in Los Angeles. His practice includes stretching,  yoga, Kettlebells, & FMS training. He teaches courses in rehabilitation. Contact him at www.DrJeffreyTucker.com 

 

www.cchirooppub.ccoom

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What is the “core”?

To build a better core you need to exercise the different layers of muscle. The Deep Layer muscles consist of very small muscles that connect each of your vertebrae and control the movement of the individual bones that make up your spine. These muscle are attach right on to the spine and run vertically, diagonally and horizontally. You may have heard of the multifidus, interspinalis, rotatores and intertransverserii muscles. These often get weak, especially in low back pain patients.

 The Middle Layer or inner unit is made up of four major muscles that contract inwardly to create intra-abdominal pressure and spine stability. Intra-abdominal pressure, or ‘IAP’ for short, supports your spine from the inside in much the same way that pumping air into a football gives it shape and makes it solid.

We use these muscles when we ‘brace’ our midsections when we move. Bracing and the ability to brace strongly is vital for all physical performance, midsection appearance and spinal health and is something you need to learn how to do.

 A strong inner unit will a) enhance spinal health, b) improve your midsection performance and c) contribute to your appearance by creating a much tighter waist line.

The key muscles of the inner unit are the ‘diaphragm’ – your primary breathing muscle, your ‘transverse abdominus’ which encircles your abdominal contents, the ‘multifidis’ which runs up your spine and the muscles of the pelvic floor which supports your internal organs from below. These muscles form a cylinder with the diaphragm at the top, the pelvic floor at the bottom and transverse abdominus and multifidis at the sides.

The Outer Layer is responsible for gross spinal movements, and the ones that are generally thought of as the ‘6 pack’ muscles. There are three main outer layer muscles:

Rectus Abdominus: The rectus abdominus is the muscle located on the front of your abdomen and is responsible for that six-pack appearance. 

The six-pack appearance comes from the ligaments that criss-cross the abs dividing it vertically and horizontally. These ligaments, called ‘linea alba’ (or white lines), become more visible as you get leaner. The rectus abdominus is responsible for flexing your spine forwards e.g. when performing crunches and also works when you bend to the side in an action called ‘lateral’ flexion e.g. when performing dumbbell side bends.

Erector Spinae: Running up either side the rear of your spine, the erector spinae is actually eight individual muscles that overlap one another and extend form the base of your pelvis to the nape of your neck and skull. These muscles are responsible for extending your spine backwards and also lateral flexion. The erector spinae, although not an abdominal muscle, makes a big contribution to the appearance of your core by holding you upright in good posture. or spinae muscles also help promote spine health, especially in your lower back or lumbar vertebrae.

Obliques: These muscles make up the sides of your midsection and are best thought of as your waist muscles. You have three sets of oblique muscles – ‘external’, ‘internal’ and ‘transverse’ – on each side of your waist which start on your spine and curve around to your ribs and pelvis. The obliques work together to rotate your spine and to flex your spine laterally i.e. sideways and also contribute to forward flexion by assisting your rectus abdominus.

Come in to find out which are the best exercises for you to do correctly to build your core (and avoid injury).

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Core Training On Stability Balls Part 2

Most people will  benefit from  both free weight and instability training (on unstable surfaces) to promote spinal stability. It’s important to remember to decrease resistance loads on exercises performed on unstable surfaces.

During rehabilitation, unstable surfaces can be effective at improving muscle reaction time and co-contractions that protect joints. In addition, resistance training on unstable may provide localized muscle endurance training, beneficial for the high proportion of Type I “aerobic, slow-twitch” muscle fibers found in core muscles. Core endurance training exercises generally can be performed at higher repetitions (greater than 15 per set), while athletes requiring more strength and power perform less than 6 repetitions per set.  Unstable surface training can provide musculoskeletal health benefits such as decreased injury risk and increased spinal stabilization as opposed to using free weights alone.

In summary, unstable exercise devices such as Thera-Band Exercise Balls and Stability Trainers should be included as part of a well-rounded conditioning program for athletes and non-athletes, but not for increasing primary strength and power. In addition, resistance exercises performed on an unstable surface should be performed at a reduced intensity level because of the reduction in force output.

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Core Training On Stability Balls Part 1

 Are you seeing more people train on balls while working out in the gym? Training with unstable surfaces such as Thera-Band® exercise balls, stability trainers, and balance boards do promote activation of core muscles. The “core” can be defined as the axial skeletal and its muscular and fascial attachments, including the pelvic and shoulder girdle.

Canadian researchers David Behm PhD and colleagues published a comprehensive review on the use of instability to train the core. Research has shown that exercises performed on unstable surfaces produce higher levels of muscle activation in both the core and extremity muscles compared to stable surfaces. However, force and power outputs are decreased while exercising on unstable surfaces, sometimes up to 70%. Interestingly, increasing levels of core muscle activation can also be achieved with free weight exercises such as squats and Olympic lifts without added instability.

In their article, the authors made several recommendations for both athletes and non-athletic conditioning based on their review of the literature. Dr. Behm et al. noted that athletes should emphasize “higher-intensity ground-based lifts” (such as Olympic lifts, squats and deadlifts) while including resistance exercises with unstable devices, as well as unilateral exercises that provide “transverse stress to the core musculature.” Furthermore, they stated that “unstable exercises should not be used when hypertrophy, absolute strength, or power is the primary training goal.”

Similar recommendations were made for the general population, noting the benefits of both free weight and instability training on promoting spinal stability. It’s important to remember to decrease resistance loads on exercises performed on unstable surfaces.

During rehabilitation, unstable surfaces can be effective at improving muscle reaction time and co-contractions that protect joints. In addition, resistance training on unstable may provide localized muscle endurance training, beneficial for the high proportion of Type I “aerobic, slow-twitch” muscle fibers found in core muscles. Dr. Behm and colleagues recommend core endurance training exercises generally be performed at higher repetitions (greater than 15 per set), while athletes requiring more strength and power perform less than 6 repetitions per set. The authors further noted that unstable surfaces can provide musculoskeletal health benefits such as decreased injury risk and increased spinal stabilization as opposed to using free weights.

In summary, unstable exercise devices such as Thera-Band Exercise Balls and Stability Trainers should be included as part of a well-rounded conditioning program for athletes and non-athletes, but not for increasing primary strength and power. In addition, resistance exercises performed on an unstable surface should be performed at a reduced intensity level because of the reduction in force output.

REFERENCES:
Behm DG, et al. The use of instability to train the core musculature. Appl Physiol Nutr Metab. 2010 Feb;35(1):91-108.

Behm DG, et al. Canadian Society for Exercise Physiology position stand: The use of instability to train the core in athletic and nonathletic conditioning. Appl Physiol Nutr Metab. 2010 Feb;35(1):109-12.

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Do I Perform Core Training?

Absolutely, positively. yes! A weak core makes you susceptible to lower back pain, poor posture and a whole host of muscle injuries. Strong core muscles provide the brace of support needed to help prevent such pain and injury.

Andrew van Rensberg states:

“By strengthening the core trunk muscles, we are, in effect, improving the efficiency with which sporting movements are carried out. Up to a 10% increase in efficiency has been noted in top swimmers. A 10% improvement in an elite athlete is a massive achievement – one that could take years of strength training and technique modification to achieve.

And all this can be achieved by a process as simple as allowing the correct muscles to carry out the correct tasks, without compensation.”

 I teach core training as part of my rehab protocols.

The benefits of core training include •Better posture More control Improved, more powerful performance Injury prevention and rehabilitation Increased protection and “bracing” for your back A more stable center of gravity A more stable platform for sports movements

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“What else can I do for my abs”

I get this question several times a week. I recently wrote an article about ab exercises for To Your Health magazine that will be published soon. Once it’s published I’ll put it up on the site. But until it is published I’ll share this exercise maneuver with you. Use your kettlebell or dumbbell and hold it over-your-head with your arm locked out.  Simply stand tall (think tall spine) and walk around for 60 seconds. To make this movement even more challenging for your core, try holding different weights in each hand–for example, a 5-pound dumbbell in your left hand and a 15-pound kettlebell in your right hand. This exercise loads the abs, core and arms.

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It Starts With The Core

The core is the center of the body, where all movement begins. When you lift a heavy grocery bag, reach for a suitcase, pick up one of your children, move a bookcase or throw a ball, the core muscles should activate even before your limbs are in motion. Healthy core muscles will provide your body with the structural integrity and support to your spine for everything from walking and running to lifting to standing to sitting.

During most activities, do you feel that the way you are using your body is efficient and coordinated or inefficient and uncoordinated? The core should work in an efficient and coordinated fashion to maintain correct alignment of the spine and pelvis while the limbs are moving. As you move your arms and legs, the core muscles create a solid base of support to hold the spine still. If you feel uncoordinated and have a weak core, you are susceptible to lower back pain, poor posture and a whole host of muscle injuries. Strong core muscles act as a “brace” or support to help prevent pain and injury. Strong core muscles increase the recruitment efficiency of the smaller, deeper “stabilizing” muscles around the abdominals, low back, hips and pelvis. They protect your back from potential injury. Strengthening weak core muscles can reduce existing back pain problems. Core training will help runners avoid hamstring and knee injuries; gymnasts, soccer, football and rugby players avoid groin injuries; dancers, golfers and weight-lifters avoid back injuries; and help you become stronger, fitter and healthier.

Read More… http://www.toyourhealth.com/mpacms/tyh/article.php?id=1251&pagenumber=1

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Winning Without Weights

No-Nonsense Exercises to Build Core Strength and Tone Your Entire Body

by Jeffrey H. Tucker, DC, DACRB

Your core is your center of gravity, located around your trunk and pelvis, and having a strong core is vital to good posture, muscle control, injury prevention, maximum athletic performance and even basic activities of daily living. There are a variety of ways to work the core muscles, and these days, it’s not always necessary to use free weights or weight machines. Body weight, foam rolls, stability balls, bands, tubing and medicine balls are tools that can be used at home, on your own, to create a solid foundation for developing dynamic strength in your torso, shoulders, arms and legs.

For example, body-weight exercises such as squats, lunges, push-ups, and pull-ups can target the small and large muscles that influence the spine. Working out with balls and bands can help develop a lean torso and abs, build muscles in your pelvis, lower back, hips, abdomen, arms, and create flexibility. And using a foam roll can relieve tension in tight, overactive muscles.

Winning Without Weights Couple It doesn’t take very much equipment to get started. In my own experience working out at home on a daily basis for the past 15-plus years, a disk used to move furniture becomes the perfect tool to perform sliding lunges. A chin-up bar replaces a lat machine. A chair or a bench becomes a platform to perform step-ups and step-downs. An 8 lb medicine ball can be thrown against an outside wall while performing a chest press. A padded surface or a rocker board/ balance board can be used to perform single-leg stance movements and improves joint stability. A band with handles works just as well as barbells or dumbbells. (Band training provides variable resistance to the popular exercises we use machines or free weights for, such as pressing, rowing, squatting and many others ). A stability ball can be used instead of a flat bench.

What exercises should beginners start with? The National Academy of Sports Medicine recommends starting a workout using the foam roll for what is known as “self myofascial release.” Pressure placed on tender points within the muscle are held for 30 seconds. This allows for optimal muscle lengthening and acts as part of the warm-up phase. Next are lengthening or stretching maneuvers. After stretching only tight, overactive muscles, you then perform basic exercises and progress to advanced strength movements. Maneuvers requiring co-contraction of the small stabilizer and larger mobilizer muscles, such as the”plank” exercise (see below) are great for the abs. Pick exercises that target the front, rear and side muscles of the trunk.

Body-Weight Exercises

Plank: Start to assume a push-up position, but bend your elbows and rest your weight on your forearms instead of your hands. Your body should form a straight line from your shoulders to your ankles. Pull your abdominals in; imagine you’re trying to move your belly button back to your spine. Hold for 20 seconds, breathing steadily. As you build endurance, try to do one or two 60-second sets.

Side Bridge: Lie on your side with the forearm on the floor and your elbow under your shoulder. For beginners, start with your knees bent 90 degrees. For advanced exercisers, start with your body forming a straight line from head to ankles. Pull your abs in as far as you can, hold the abs stiff throughout and raise the hips off the floor. Hold this position for 10 to 60 seconds, breathing steadily. Relax down slowly. Repeat on your other side. If you can do 60 seconds, do one repetition per side. If not, try for any combination of reps that gets you up to 60 seconds.

Winning Without Weights Push-up Traditional ab crunch: Lie on your back with your knees bent and your hands behind your ears. Slowly crunch up, bringing your shoulder blades off the ground. Perform 1-3 sets, 12-15 repetitions per set.

Ball and Band Exercises

Everyone wants to learn more “butt” or gluteals exercises. The gluteus maximus and gluteus medius are important muscles of the body and often need extra work. The following are good exercises to target the gluteals:

Gluteal ball bridge: Lie on the ball with your head and upper back resting on the ball, feet on the floor with knees bent. Squeeze your gluteals and then push your hips up until there is a straight line through the knee and hip to the upper body. Shoulders remain on the ball. Beware of rising too high or flaring the ribs, which will push the back into hyperextension. Hold the “up” position for two breaths. Let your butt come down and then repeat. Perform 2-3 sets, 10-12 repetitions per set.

Winning Without Weights Supine Ball Bridge Supine ball bridge: Lie on your back with your heels on the top of a stability ball, hip-width apart to aid stability. Suck in the abdominals and squeeze up from your gluteals, lifting your hips until there is a straight line from heels to upper back. Shoulders and head stay firmly on the floor. Take care not to lift the hips too high or flare the ribs so your back hyperextends. Hold for 30 seconds and lower. Perform 2-3 sets, 10-12 repetitions per set.

Lateral band walking: With elastic tubing around both ankles, stand with toes straight ahead, knees over feet and hands on hips. Draw abdomen in and step to right while maintaining upright posture. Don’t rock your upper body when stepping. Step again with the right foot, bringing your feet back to shoulder-width distance. Winning Without Weights Lateral Walking Repeat for six steps to the right and then six steps to the left. This exercise strengthens the glutes, core, and abductors and adductors (the muscles of the outer and inner thigh, respectively). Perform sets of six steps to each side until you feel a slight burn in the gluteal muscle.

Ball back extension: Training the important posture muscles of the thoracic (middle) and lumbar (lower) portions of the spine also can be done on the ball. Position yourself with your chest on the ball and hook your feet under a leg anchor, or put them up against the bottom of a wall. Hold your arms straight out in front of you. Your body should form a straight line from your hands to your hips. Raise your upper body until it’s slightly above parallel to the floor. At this point, you should have a slight arch in your back and your shoulder blades should be pulled together. Pause for a second and then repeat. You can perform this exercise with the arms in a 10 o’clock and 2 o’clock position or a 3 o’clock and 9 o’clock pose. Perform one set of 12-15 reps.

Stability ball push-ups: If you want to build big arms, especially the triceps, stability ball push-ups will take you to next level. Do a push-up with your feet on a stability ball. Keep your body straight – don’t let your hips sag or stick your butt up in the air. Switching positions and having your feet on the floor and hands on the ball challenges the core further. The instability of the ball increases the level of trunk muscle activation. Do as many as you can with strict form, until you feel fatigue; at least 10-15 repetitions.

Band lunge press: If you want more intensity, working with the bands performing pull and push moves is ideal. The band lunge-press helps develop strength, endurance, balance and coordination; there’s not much this exercise doesn’t hit. With a band securely in place behind you, grip the handles and hold them at shoulder level, palms facing toward each other and elbows bent. Feet should be shoulder-width apart. As you step forward into a lunge position, press the handles forward and finish the press with outstretched arms. Return to the starting position. Form is key: Make sure your front knee is aligned over the heel in the lunge position and concentrate on keeping your upper body erect, chin up, eyes staring forward throughout, as if you were trying to balance a book on your head. Do 10-15 lunges with each leg.

Swimmer’s lat pull is a back exercise you’ll feel throughout your entire body. Use an anchored resistance band. With feet shoulder-width apart and knees slightly bent, lean over at the hip – don’t roll your back – until your upper body is almost parallel with the floor. Extend your arms in front of you and grab the band handles. Dynamically draw your arms down and extend them in back of you until they’re at hip level. Winning Without Weights Swimmer Lateral Pull Think of the motion of a swimmer doing a butterfly stroke – the arm breaking the surface of the water and then continuing down and back. Slowly reverse the motion. Perform 1-2 sets, 10-15 repetitions per set.

Up-chop kneel develops excellent core stability and trunk rotation strength. Kneel with a band or tubing handle attached below hip height. Grasp the handle in both hands to the side of the hip nearest the band. Lift the arms up and at the same time, rotate the shoulders away from the anchor, keeping hips facing forward and arms straight. Complete 1-2 sets of 10 reps on each side.

Down-chop kneel is the opposite of the up-chop. Begin with the handle attached above head height, grasping the handle in both hands above the head to the side of the band. Keeping the hips facing front and the arms straight, pull the hands down and turn the shoulders away from the band. Perform 1-2 sets, 10 repetitions (each side) per set.

Medicine ball slams are a great ab exercise. This exercise involves complete integration of the total body. It will also teach you power development from the ground up and get your heart racing. Take a medicine ball and get in an athletic-ready position (knees slightly bent, ball held with both hands in front of you, as if you’d just caught it) . Bring the ball overhead really fast and slam it down to the floor or ground as hard as you can. Make sure you do a few slow reps first to get a feel for the bounce of the ball, since you have to catch it. Perform 2-3 sets, 10-12 repetitions per set.

Other Tips to Maximize Results

If you work out with another person like your kids or a spouse, you can practice speed and agility drills. Speed is the rate at which something is done or occurs. Agility is the ability to move our body quickly in many directions and speeds with great control. All forms of tag and chase games improve reaction time.

Diversifying your workout will provide new stimulus to muscles and variety of movement. It’s important to change your workout program every 8-10 weeks. One of the biggest mistakes I see my patients do is repeat the same workout over and over again. Show me variety! Often time’s client’s workouts were the first workout they ever learned and it’s the same workout they were doing several elections ago.

Whenever you work out, check yourself for muscle weakness and imbalances from the right side to the left side. Asymmetries cause problems. Exercises that balance your muscles help to avoid injuries, especially those involving the back, groin, hamstrings and knee. A combination workout consisting of foam rolling, band and tubing exercises, medicine ball training, and stability ball exercises can improve your spine and help increase power and performance.

Most people are familiar with Pilates and yoga; these are systems that provide stretching, strength training (especially for the core area), balance training and endurance.

Home exercise programs should include the same fitness challenges and include cardiovascular training (walking, bike, elliptical), reactive training, and speed/agility training.

Getting fit and, training without actually going to the gym is possible when you follow a proper progression and give yourself enough variety of exercises. Becoming your own personal trainer, identifying and fixing muscle weaknesses will benefit your core strength and overall fitness. Your doctor can give you more tips on which exercises and equipment will best help achieve your individual fitness goals.

The Power of the Exercise Band

A recent study published in the Journal of Strength and Conditioning Research suggests a short-term resistance exercise program utilizing exercise bands is as effective as a weight-machine program in increasing strength and reducing fat. The study, which compared the effects of each type of exercise program in 45 previously inactive women (average age: 51-54) for 10 weeks, yielded similar results in terms of functional capacity (assessed by knee push-up and 60-second squat tests) and loss of fat mass. The study authors concluded, “[Exercise bands] can thus offer significant physiological benefits that are comparable to those obtained from [weight machines] in the early phase of strength training of sedentary middle-aged women.”

Exercise Repetitions/Sets/Duration Rest (Between Sets)
Foam Roll 30 seconds per tender point N/A (one-time warm-up)
Plank 1 or 2 (build to 60-second holds) None
Side Bridge 1 per side, 60 seconds each side None
Traditional Ab Crunch Build to 3 sets of 12-15 repetitions per set None
Glute Bridge on Ball 2-3 sets of 10-12 repetitions per set None
Supine Ball Bridge 2-3 sets of 10-12 repetitions per set None
Lateral Band Walk 6 per side or until you feel fatigue None
Back Extensions on Ball 12-15 repetitions None
Stability Ball Push-Up 10-15 repetitions or until you feel fatigue None
Band Lunge Press 10-15 repetitions per leg None
Swimmer Lat Pull 1-2 sets of 10-15 repetitions per set 30-60 seconds
Up-Chop Kneel 1-2 sets of 10 repetitions per set 30-60 seconds
Down-Chop Kneel 1-2 sets of 10 repetitions per set 30-60 seconds
Medicine Slams 2-3 sets of 10-12 repetitions per set 30-60 seconds
Note: Total workout time should be approximately 30-45 minutes. Be intense! Be consistent! Change your workout routine every 8-10 weeks. You can complete the entire program three to four times per week, or pick a few each day to create a daily 20-minute workout.

Dr. Jeffrey H. Tucker graduated from Los Angeles College of Chiropractic in 1982. He is a diplomate of the American Chiropractic Rehabilitation Board and teaches a 14-hour postgraduate diplomate series on cervical and TMD rehab and lumbar spine biomechanics and rehab. Dr. Tucker practices in West Los Angeles and Encino, Calif.

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