All Posts tagged exercise therapy

Are you going to sign up for a lifetime of statin use?

Here’s my plan. Load patients up with high quality, powerful medical foods, improve food plans, and get them moving around more. We’ll watch the positive results happen and celebrate when clients can decrease the medication they are on.

See, I don’t see serious adverse side effects from the medical foods I recommend. I have lots of patients with type 2 diabetes and narrowing of the arteries. Many of them are able to decrease there dosages of the cholesterol-lowering statins and ACE inhibitors. My recommendations and efforts help get the numbers there doctors want: lower LDL and lower BP.

I am treating human beings, not a compilation of numbers. I don’t think high drug doses is the answer. I am not opposed to drug therapy but I know type 2 diabetes, high cholesterol, and high blood pressure can be helped with three months of adjusting to proper doses of protein, fats, carbs and exercises.

Are you going to sign up for a lifetime of statin use? Or are you going to try alternative therapy?

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I love being a health & fitness professional.

What continues to amaze me is the extraordinariness of the human body: its complexity, efficiency, ingenuity, adaptability, diversity, sensitivity, toughness and softness.

I am very clear that I want all my clients to spend time exercising and eating better. I get to work with kids, teenagers, and adults, including quite a few octogenarians and nonagenarians. I train people in fitness for health, not world records. I keep up-to-date on sports science and the latest research related to nutrition.

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About Gymstick

by Jeffrey H. Tucker, DC, DACRB

My background is in Chiropractic, helping people get out of acute and chronic pain. I have spent twenty five years in private practice teaching clients how to decrease pain and improve their health. It has been a great job, and it is something I see myself going for the rest of my life and career.

About fifteen years ago I started taking a post graduate program at my Chiropractic College to pursue my first passion, which was musculoskeletal rehabilitation. I continued to work as a Chiropractor, but I started including more exercise therapy and nutritional therapy into my practice. In essence, I strive to become a Wellness Consultant rather than just dealing with people in pain.

Many of my clients are not ready for the gym yet and need a program that could transition them to the gym. Many of them get injured while working out and training. Sometimes clients have to take a step backward to move forward and sometimes their voyage is not so much about discovery as rediscovery of lost flexibility, strength or speed. I developed a progression of core exercises that I was teaching to my patients to help them get out of pain, create muscle balance, symmetry and strength. Eventually, I started teaching an exercise class at Dance Studio No.1 in west Los Angeles. Many clients needed a class to progress to stronger levels. I started teaching with the intention of preventing future back problems and prepare them to get into better shape and fitness. The people that came for help in improving their fitness levels for everyday life really liked the way that I presented things. So, I have continued with this program over the past four years.

There are two distinct yet interdependent muscle systems in the body, the stabilization system (stabilizers = local muscle) and the movement system (mobilizers = global muscle). Both the local and global muscle systems must integrate together for efficient normal function. Neither system in isolation can control the functional stability of body motion segments (vertebrae and bones). The stabilizers assist postural holding, anti-gravity, and joint stability (support) function. These are prone to inhibition and weakness. The mobilizers assist rapid accelerated movements like we use when training with Kettlebells. The mobilizers are large and superficial muscles (the ones we see on our body). They provide range of movement, and produce high force or power. The mobilizers are prone to over activity and tightness. Once a movement segment has lost functional stability and has developed abnormal compensatory motion, stabilizing structures (both connective tissue and contractile) around these joints become less stiff and more flexible, more lax and have more “give” thus making these segments at risk of abnormal stress and strain.

There are specific indications for low load training of the muscle system. Clients will present with mild discomfort to intense pain during normal daily functions; unguarded movements cause sharp pain; they have very specific pain and/or stiffness in muscles and joints; symptoms associated with static positions and postures (sitting, standing and lying). Some clients come knowing they have unstable backs; some have a history of bad backs. The name of my exercise program is Progressive Body Movement (PBM). PBM is actually a priority system of building strength and flexibility. It’s a very rational method for getting people out of pain, and keeping them out of pain by creating spinal stability and strength.

Many of my clients need to learn what exercises they can do without hurting themselves. As soon as they would start yoga, or Pilates or weight training exercises, they would get a flare up in there low back, shoulder or neck. They had become afraid to exercise because they always hurt themselves afterwards. These clients needed to exercise just so they could get ready to exercise. I learned how to progress people from low load body weight exercises to bands and free weights and Kettlebells.

My tag line is, “We were all given a lifespan, let’s create a healthspan.”

My clients enjoyed the way that I was teaching because it was very much back to old school stuff, low tech floor work, bands, balls, and bodyweight maneuvers. I don’t use any fancy gadgets or machines. I progress them to free weight and Kettlebells. They really liked that, and I made it fun for them.

The key to helping clients and what you can do on your own is practice form before function, and uni-planar motions before multi-planar motions. I have learned to see simple compensations when evaluating client’s movement patterns. I use isolation for innervation of the system and to improve function. But, isolation is great for testing & rehab, not training.

We need to physically train the stability muscles. Strengthening exercises alone will not likely affect the timing and manner of recruitment of muscles during functional activities. With proper stability it makes using heavy weights such as Kettlebells safer and enhances performance.

Recently, a band exercise device called the Gymstick has come in to my rehab and wellness practice. I was in San Francisco at a workshop on the hip, being taught by a British instructor. I asked him if he had any new equipment that he was using in his rehab facility. He said that they were doing a lot of creative exercises with a device called the “Gymstick” and that it was great for core training.

So, when I got home I did my research and ordered the Gymsticks on-line. When they came I started using it for five to ten minutes as part of my own workouts. The Gymstick came with a visual poster of exercises, and I ordered a DVD. I liked it so much I ordered more for my clients and to use in my classes. My clients and students really like it. So, I thought, “I want to become a distributor of this and create an opportunity for groups of people to have Gymstick classes.”

I have been to many workshops and conferences over the years. I have heard some of the best trainers and coaches in the U.S. and none of the presenters I met ever mentioned the Gymstick. It is popular in Europe and just not known here in the United States yet.

To have a great foundation for weight lifting I recommend band work as well. I recommend slow, low effort repetitions and only move through the range that the weak link can be actively controlled. Perform 20-30 slow repetitions or approximately 1- 2 minutes of a given exercise. Initially, when these low load exercises ‘feel’ difficult or high-perceived effort is used then it is likely that that muscles slow motor unit is inefficient and you need to do these maneuvers. If an exercise with body weight, Gymstick, or other bands looks easy and feels easy, then it means there is better facilitation of slow motor unit recruitment. It is best to do local muscle dominant recruitment (Gymstick) on different days than strength training days. This makes it a good tool for rest days.

I have personally taken it on to get the word out there and really promote Gymstick, and the way of training with them. In fact, I don’t feel like I have to sell Gymstick. They sell themselves. As soon as you get someone to come to a class, they are hooked. It’s amazing. The results are quick and fast for stretching, strengthening, and functional training!

One of my clients, she came into my program a size 12 and she’s an 8 now. She feels very happy wearing clothing she hasn’t fit into in a long time. She enjoys feeling healthier and more flexible.

Gymsticks are going to be a great tool for me to make a niche in the market and offer new classes among those training in Los Angeles. It has always been my passion and goal to educate people about diet, nutrition, body work, and training. Los Angeles is very much a Pilates and Yoga town. We have lots of hard core gyms as well. I applaud all of these, but I think the Gymstick offers a good balance for motor control training and increasing a muscle recruitment challenge, as well as improving flexibility, thus increasing the potential to generate force and power.

I am into minimal equipment and basics. I like floor work, Kettlebells, dumb bells and bands for overload training, power and endurance.

Why am I hoping to go to get people more into Gymstick and kettelbells or even body strength training, opposed to using machines? I have never been a proponent of weight machines. I encourage people to get off the machines and get into functional fitness where you are standing and you need to ground yourself and you need to use your core strength and stability. It’s NOT about sitting in a machine and pressing as hard as you can, because that’s not going to do anything except if you are sitting down and pressing against somebody. That’s not real life. Real life is: you’ve got to chase a child around a park or mall; you need to lift and carry heavy objects; and you have sit to long in awful chairs. Gymstick provides low load training and exercises that can optimize slow motor unit recruitment; efficiently teach you to really internalize your power and bring it out when you need to.

Gymstick will help you activate the deeper, more local muscles of the body that help you achieve increasing the segmental stiffness of the spine and decreasing excessive inter-segmental motion and maintaining muscle control during low load tasks and activities. In contrast, using the Kettlebells will help you achieve high physiological load. Both the local muscles and the outer muscles contribute to both stability and mobility roles. The combination of Kettlebells and Gymstick repetitions will help give you endurance and stamina. There is no longer a need to rely on machines, every training session can be done at home.

I think the combination of Gymstick and Kettlebells is so functional. Clients are creating their own drills that are sport specific.

“Gymsticks are here and you don’t know what they are right now, but I am an instructor and I will show you!” (See info for class schedule)

Dr. Jeffrey Tucker: “I have studied with some of the best teachers in the musculoskeletal and nutrition world. I continue to take post graduate courses and seminars and get some more certifications.” You can visit Dr. Tucker at www.DrJeffreyTucker.com where you can purchase the Gymstick he mentions.

My classes have progressed to a more general fitness population that wants to have a more challenging work out. They know that I push them quite hard, but with what I call “my watchful eye” making sure that they maintain good form. They know that I want them to succeed at their goals. Whether their goal is to get out of pain from a sports injury, loss weight, or to become fit, I am going to give them my undivided attention in getting them their safely and uninjured, but I don’t expect anything less than one hundred percent of their effort.

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Principles of a Rehab Specialist: From Fat Loss to Performance Ready, Part 2

Metabolism and the Benefits of Interval Training

by Jeffrey H. Tucker, DC, DACRB

In the previous article, I introduced you to Sheldon, who has been diagnosed with a pre-insertional tear of the Achilles tendon. Sheldon is now out of acute pain and has to start his exercise training in preparation for playing basketball in the upcoming Maccabi Games.

Eliminate Conventional Aerobics

What led Sheldon to an ankle injury was his personal choice in preparation for the games. He started spending about an hour on the treadmill three days per week and then played basketball another three times per week. He did not properly stretch or warm up prior to his activities. The probable mechanism of injury to his ankle was repetitive stress and faulty movement patterns. Sheldon’s diagnosis was a pre-insertional tear in the Achilles tendon. Initially, walking and running were painful. However, he could ride a stationary bike.

One of the first changes I make to a cardio program is to have my clients eliminate conventional aerobics. For example, if a client is spending 60 minutes on a treadmill or elliptical machine, I recommend they spend that hour of time performing: 10 minutes on the foam roll; 10 minutes isolated stretching; 20-25 minutes doing a combination of body-weight exercises, resistance exercises and/or lifting free weights; and 15-20 minutes of cardio training, especially using interval training techniques.

The foam roll is used as an inhibitory technique to release tension and/or decrease activity of overactive neuro-myofascial tissues in the body. After using the foam roll, clients are instructed to participate in static stretching of muscles to increase the extensibility, length and range of motion of neuromyofascial tissues in the body.

The next phase of the workout is muscle-activation techniques, often performing body-weight exercises. These exercises are used to increase intramuscular coordination and strength. Squats, lunges, push-ups and step-ups are examples of dynamic movements. When I train my clients to lift free weights, I want them to lift heavy weights. When I teach free-weight training, I recommend creating circuits of five exercises, performing six repetitions of each exercise and then performing the circuit three times. The sixth rep of each set should be difficult to complete if you are using the correct amount of weight.

In three separate half-hour, in-office sessions, (once per week for three weeks) I can teach my clients approximately 15 different resistance, body-weight and/or free-weight exercises. At the end of the three sessions, they have learned and practiced enough to perform a 15-minute, 30-minute or 45-minute whole-body, customized workout routine. The amount of time they work out and spend on the home program depends on the number of sets they perform. They can adjust this to their own schedule.

If clients are not ready to lift free weights, I use a fitness tool that combines a stick and exercise bands into one effective workout. You can do hundreds of different exercises and combination movements to improve strength and flexibility. Every Tuesday and Friday morning, I teach a small-group exercise class. My experience has shown that resistance-band or resistance-bar exercises can be performed for one-minute intervals and then changed to the next exercise for the next minute. This routine can be continued for 20-45 minutes. This provides a great cardio, strength and flexibility workout.

Teach Interval Training

Sheldon needed to get cardio fit and “court ready” for the basketball tournament. The best choice of training for his cardio is interval training. Interval training is broadly defined as alternating brief periods of very high-speed or high-intensity work, followed by periods of rest or very low activity. Simply put, interval training is based around the concept of “Go fast, then go slow, then repeat.” You can perform interval training routines on pretty much any machine you want, such as a treadmill, bike or elliptical machine, and it can apply to almost any sport (swimming, cycling, running).

In interval training, high heart rates during work periods and low heart rates during recovery follow each other. This not only results in increased cardiovascular strengthening, but also increases the energy expended per minute, increasing thermogenesis and thus resulting in increased fat loss. Just remember, the concept of interval training is to go fast and then go slow.

If you are dealing with an unfit client, I don’t recommend they run to get fit. They need to start a walking routine first. Once they are fit, they can run. Typically when a person decides to start an exercise program, they usually think of walking as the major form of exercise. Walking is an ideal place to start. How do you apply interval training? If you’re in good shape, you might incorporate short bursts of jogging into your regular brisk walks.

In my home gym, I have an elliptical machine for my interval training. For example, I warm up at a speed of 5.5 for five minutes and then perform short, fast (speed of 8-10) bursts for 30-60 seconds. I slow down for a minute or two and then repeat the fast burst again. This is performed for 15-20 minutes. If you’re less fit, you might alternate leisurely walking with periods of faster walking. For example, if you’re walking outdoors, you could walk faster between certain landmarks.

Have you ever noticed when people continue to do the same walk, day in and day out, and do not add periods of short bursts to increase metabolic activity to improve their fitness level, they simply stay at the same weight, BMI and body composition? If clients are just beginning an exercise routine, I also suggest they include bicycling in their routine. Since bicycling allows for maximum metabolic disturbance with minimal muscular disruption, metabolic rate and exercise activity efficiency easily can be increased. To apply interval training to cycling, you could pedal all out for 60 seconds and then ride at a slower pace while you catch your breath for the next two to four minutes. Try to keep the bursts of speed at around 90 percent to 100 percent of maximum effort.

An example of an interval routine for runners is to sprint for 20 seconds, rest 10 seconds, repeat four to eight times; or sprint 15 seconds, rest 5 seconds, repeat four to six times.

The Benefits of Interval Training

Major increase in fat loss. In a study done by Tremblay, et al., two groups were assigned different training regimens.1 Group A performed regular moderate intensity cardio (like jogging or bicycling) for 20 weeks and Group B performed interval training routines for 15 weeks. The results of each group were recorded. Group B lost nine times more fat than Group A in five weeks less time.1

Increased lactic acid threshold. Lactic acid threshold indicates how fast your body can remove the lactic acid in your muscles. When your body can remove lactic acid more efficiently, you can work the muscles at a higher intensity for a longer period of time before they become fatigued.

Shorter workouts. If you crank up your exercise intensity using interval training, you can work out in less time and accomplish more compared to performing steady-state cardio. It appears interval training burns more fat than regular moderate-intensity cardio. The rationale is that recovery of metabolic rate back to pre-exercise levels can require several minutes for light exercise and several hours for hard intervals. This phenomenon is called excess post-exercise oxygen consumption (EPOC). Intense exercise of a significant duration may cause EPOC or afterburn. This means extra calories are burned after an intense exercise bout. This indirect expenditure of energy has been shown to last from 30 minutes to many hours post-exercise.

Don’t forget that the training effect increases faster with increased intensity than with increased duration. A long-duration, low-intensity workout will not necessarily result in a high training effect, while a short, high-intensity workout may produce a high value. You need to develop an aerobic base in your fitness clients, but you must progress to intervals if you want real results in both fitness and fat loss. The bottom line is: The higher the intensity, the more calories will be expended. The more energy expended per minute, the more efficient your exercise time will be for fat loss. By the way, Sheldon’s team went on to win the men’s basketball championship.

Reference

  1. Tremblay A, Simoneau JA, Bouchard C. Impact of exercise intensity on body fatness and skeletal muscle metabolism. Metabolism, July1994;43(7):814-8.
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