I used to be a vegetarian for about 15 years. I avoided red meat, poultry, and fish (because I never really liked it and because of mercury toxicity). Every now and then I’d have eggs. I ate a lot of pasta, grains, and vegetables. I started out as a vegetarian diet because I was experimenting with different diets for my clients. Being a vegetarian seemed to fit my “Chiropractic lifestyle”.
Then about 3 years ago I began to work out more vigorously with kettlebells and free weights. I knew I would need to increase my protein intake. One night after being at the movies with Maddy I said “I want a steak for dinner.” She practically fell out of her seat. I had already been recommending a ‘Paleo’ or Mediterranean diet for many of my clients because I knew those who ate a high-protein, low-carbohydrate diet were leaner, healthier, and more energetic. I saw it happening day in and day out in my practice.
As I increased my exercise intensity I maintained my protein shake in the mornings (like I always do) but I switched from a soy based protein to a whey based protein (Ultrameal from Metagenics). I actually got leaner and went from a 10 percent body fat to a my most recent test that revealed a 7 percent body fat.
I eat grass-fed beef, and hormone free chicken, and I still don’t like fish but I recommend fish for those who do! I make sure I take fish oil supplements. I eat organic vegetables, avoid fruit juices unless I dilute it with water, avoid grains, and limit sugar-laden desserts. I love the “paleo” or “primal” diet. Today, it is recognized by many as the healthiest diet in the world.
I make sure I take my Wellness Essential for Men vitamin packs from Metagenics.
Ideal treatment for joint pain should include Pycnogenol, a pine bark extract with anti- inflammatory effects. Pycnogenol has been shown to help knee osteoarthritis, conditions that need enhanced blood flow, symptoms of menopause, and diabetics manage blood sugar levels.
Dr. Tucker recommends combining Pycnogenol (150 mg of Pycnogenol daily), glucosamine and chondroitin sulphate ( 1500 mg daily), with omega-3s( 2-3 grams daily) to reduce inflammation related to knee OA.
by Jeffrey H. Tucker, DC, DACRB
The sun salutation in yoga is where you begin by standing on your mat with your feet together (toes and ankles touching) and your arms by your sides. Lengthen your spine upwards from the tip of the tailbone to the crown of your head. Inhale deeply. Exhale and bring the hands together in the prayer position. Inhale as you stretch your arms up beside your head, lengthening and arching your spine. Exhale and bend forward, hinging from the hips, with your arms stretched out in front. Place your hands flat on the mat beside each foot, bending your knees if you have to. Try to bring your forehead to your knees. STOP right here. The sun salutation continues on with other maneuvers, but I want to talk about the toe-touching portion. It’s this maneuver, whether during a yoga class, bending over in the shower or picking up an object on the floor that can cause so much trouble for our lower backs.
A forward bend does not require straight legs. The key is to aim for a perfect hinge from your hips no matter how straight you can press your legs. If you can touch the floor but the spine is bowing to achieve this, you leave the hip hinge open and the stress is carried in the back and knees. Short hamstrings are common and the body compensates for this restriction by increasing motion in the lumbar spine. In normal functional movement, the brain and central nervous system (CNS) have a variety of strategies available to perform any functional task or movement. During functional bending-forward movements, a relatively stiffer hamstring muscle tends to resist ideal movement, but function is maintained by excessively increasing lumbar spine flexion range. This is what is called “compensation.”
It’s not unusual for a person with tight hamstrings to compensate with resultant lengthening or overstrain of the lower lumbar spinal extensor muscles (lumbar spinalis and superficial multifidus). Once the lumbar spine has developed abnormal compensatory motion, the stabilizing muscles and supporting structures (e.g., ligaments) around the lumbar joints become too flexible, more lax or provide insufficient stiffness or resistance to motion. These joints are now poorly controlled by the muscles. This can cause pain in the low back region with daily activities and unguarded movements, as well as sitting, standing and lying postures.
The lumbar spine may be more flexible relative to the hips in flexion due to lengthened erector spinae and shortened hamstrings. The muscles that control excessive lumbar flexion (lumbar erector spinae) have more give than the muscles that limit hip flexion (hamstrings). In summary, if you repeatedly bend forward with tight hamstrings, the lumbar spine may give more easily than the hips. Excessive flexion will occur in the lumbar spine relative to the amount and timing of flexion at the hip joints. This results in compensatory lumbar flexion and potential lumbar spine instability.
A lumbar flexion instability does not require that muscle or connective-tissue structures are tight or short (e.g., hamstrings in the lumbar flexion dysfunction), although you may have a sense of the hamstrings being tight. It does matter that the hamstrings are less flexible and have less give than the muscles at the site of greater relative flexibility or those designed to control dysfunction (erector spinae). Likewise, it does not require that muscle or connective- tissue structures be weak at the site of greatest relative flexibility or overstrain (e.g., abdominals in the lumbar extension dysfunction). It only requires that they have more give or are functionally longer than the muscles at the adjacent segment (hip flexors), which may be very strong or short.
The hamstrings seem to have a clear function. They produce range-of-joint movement (flex the knee joint and extend the hip). The hamstrings are an eccentric resistor of knee extension in sprinting. Correcting the length of the hamstring may be important while simultaneously strengthening the lumbar region. The following procedures are not to be done if your low back is in the inflammatory stage.
Self Test: Bend over and try to place fingers or palms to the floor. Measure the distance of the middle fingers from the floor. Benchmark is the ability to have palms flat on the floor.
Dysfunction: Not able to touch fingers to the floor; you feel discomfort or pain in the low back; or your thoracic spine or lumbar spine are bowing, with the hip hinge wide open.
Solution: Think of a belt lifting the hips up and elongating the spine. Push your heels down and push your bottom up. Stretch the hamstrings with the back locked. Practice separating the tailbone from the chin while hinging at the hips.
Self Test: Bend over and try to place fingers or palms on the floor.
Dysfunction: The thoracic spine and the hamstrings feel tight.
Solution: Practice bending over at the hip hinge with outstretched arms over your head while simultaneously maximally tightening and squeezing the buttocks (gluteals) and fists (keep the arms outstretched). Continue bending over at the hip hinge, fists and buttocks as tight as possible, for eight seconds. Release the tension but don’t come back up yet. Repeat the squeezing of the glutes and fists for eight seconds. Practice this maneuver with your buttocks against a wall and then continue to get lower and farther away from the wall. Try to isolate the hamstring muscle and belly, not the attachments behind the knees. Repeat this maneuver five to seven times.
Self Test: You look at your posture and see that the thoracic spine is rounded. Your normal posture has rounded shoulders.
Dysfunction: You have restricted thoracic spine motion or you have kyphosis (loss of the normal spinal curvature).
Solution #1: Release the knotted tight tissue, joints or adhesions along the spine by lying on a foam roller and putting pressure on the knots for 20-30 seconds while breathing. Do this daily for five to 10 minutes.
After this, lie down on your stomach with your hands and arms along the sides of your body (palms up). Lift up the head, shoulders and torso as high as you can toward the ceiling. Build up to the same number of repetitions as your age.
Solution #2: Practice squats while facing a wall. Stand close to the wall so your nose almost touches it; try to move your feet closer and closer to the wall. Keep the feet straight forward, allowing the movement to occur in the hips and lengthening the spine.
To stretch the back and the hamstring: Use the bow maneuver. While the back is at 90 degrees, pry one hand to the opposite heel; keep prying side to side. An important principle of stretch is to spread the load. You can go further with less stress. Repeat the original toe-touch test.
Still can’t put your palms on the floor?
Solution #1: Thoracolumbar spine post-isometric relaxation (PIR): This definitely will allow the client to bend further in the toe touch. This maneuver requires two people.
- The client bends over with proper mechanics at the hips (push the heels down and the bottom up). Remind the person to “spread the load.”
- Tell them to keep their weight even from the toes to the heels.
- Place both flat palms on the client’s lower thoracic spine.
- Ask the client to lift the thoracolumbar region, initiating from the hips and elongating the spine (think tailbone-to-chin). Resist the client’s upward movement for approximately eight seconds. You are not pushing down; you are resisting their upward movement. You do not have to be heavy-handed to give the client’s back a nice release and stretch.
- Have the client release the upward push and simply follow them downward (lower).
- The client stays in the new lower position and repeats the process three to five times.
Solution #2: Long-sitting partner stretch with post-isometric relaxation (PIR) technique: This maneuver requires three people. One is the person being stretched and two assistants. Two people face each other on the floor. The third person is sitting back-to-back with the person being stretched. The client’s legs are straight in the long-sitting pose. The client must hinge in the middle. The first assistant’s legs are straddled to the outside of the client’s legs. The second assistant is gently leaning against the client’s back to prevent them from leaning backward.
The first assistant takes hold of the client’s wrists in a monkey grip. The client leans forward as if they were folding, hinging from the hips, lengthening the lower spine out of the hips, making the stomach as long as possible and bringing the back as close to parallel to the floor as possible. The first assistant leans backward taking out the slack in the arms. The client is using muscles to actively extend the spine and lengthen the back of the legs, moving them forward. Remind the client to keep the arms straight and “stretch the back, breathing into the tailbone.” Keep the head in alignment with the spine. The weight of both assistants supports the stretch. Repeat this maneuver three to five times, using the principles of PIR. To come out of the stretch, the client can bend their knees slightly as they come upright.
- Bergmark A. Stability of the lumbar spine. A study in mechanical engineering. Acta Orthopaedica Scandinavia, 1989;230(60):20-4.
- Cholewicki J, McGill S. Mechanical stability in the vivo lumbar spine: implications for injury and chronic low back pain. Clinical Biomechanics, 1996;11(1):1-15.
- Comerford M. Lumbo-pelvic Stability. Course notes. 2003 and 2006 Copyright Comerford.
- Hodges P. Transversus abdominus and lumbar multifidus muscle. Course notes. 2002 Copyright Hodges.
- Tsatsouline, Pavel. Stretch Course. 2007 Copyright Tsatsouline.
- Vermeil A. Sports & Fitness. Course notes. 2005 Copyright Vermeil.
- All the coaches and sports-medicine scientists who have shared their knowledge with me.
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.
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.
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.
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.
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. 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. 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.”
||Rest (Between Sets)
||30 seconds per tender point
||N/A (one-time warm-up)
||1 or 2 (build to 60-second holds)
||1 per side, 60 seconds each side
|Traditional Ab Crunch
||Build to 3 sets of 12-15 repetitions per set
|Glute Bridge on Ball
||2-3 sets of 10-12 repetitions per set
|Supine Ball Bridge
||2-3 sets of 10-12 repetitions per set
|Lateral Band Walk
||6 per side or until you feel fatigue
|Back Extensions on Ball
|Stability Ball Push-Up
||10-15 repetitions or until you feel fatigue
|Band Lunge Press
||10-15 repetitions per leg
|Swimmer Lat Pull
||1-2 sets of 10-15 repetitions per set
||1-2 sets of 10 repetitions per set
||1-2 sets of 10 repetitions per set
||2-3 sets of 10-12 repetitions per set
|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.