Fitness Foundry Blog

Archive

Newer

Tuesday, December 2, 2008

Got Knee Pain? Corrective Exercise Strategy. Pt 1

By Julio A. Salado, NASM & NSCA C.P.T.

My essay is a basic corrective exercise approach to specific knee pain caused by lack of ankle mobility. Most individuals will either have knee discomfort underneath the knee, also known as ‘Jumper’s Knee’ or ‘Runner’s Knee’ e.g. discomfort on the side of the leg/knee. Please recognize the difference between ‘discomfort’ and ‘pain’. As I always tell my clients ‘we do not work through pain’ but discomfort is a red flag. Stop the exercise and learn how to address and prevent the pain.

The discomfort is the precursor to a bad situation becoming worse. Fortunately, attending to the discomfort and applying some exercise science and commonsense we usually can reverse the ailment.

If you have had consistent knee pain then I would suggest seeing a medical professional. Lastly, I highly recommend getting an assessment of your posture, flexibility and muscular strength imbalances by fitness professional. The information will help you become more efficient in your workout and prevent any joint dysfunction. Your goals will be easier to attain because you will recruit more muscles for your workout and not be sideline by injury.

This is part 1 of my ‘Got Knee Pain?’ essay. In this essay, I will discuss the importance of ankle mobility and muscle balance in the calf/shin muscles. Visualize what you do when you get out of bed. The first part of our body to touch the earth is our big toe followed by the other toes, the ball of our feet then heel. If you ever stumped your toe, you will quickly notice the importance of our ankle mobility and how it affected our posture. We will compensate the pain in the toe by changing the way we walk, unconsciously leaning on one side of our body which stresses other muscles and joints.

Most knee pain is the result of sedentary lifestyle (8-10 hours of sitting or inactivity per day), muscle imbalances, poor form while performing exercises and lack of rest (overuse). There are other possible factors such as flat feet, posture, age, type of shoes, past surgeries etc…

Knee discomfort usually springs from a disruption of the ACL or MCL (Anterior Cruciate Ligament- front of knee, Meniscus Cruciate Ligament –both sides of the knee). View the ligaments as the ‘shock absorbers’ of the knee. There are other ligaments in the knee joint but I will only address the most common injuries. The knee is a marvel when you think how much pressure/shock it absorbs from our regular walking to work, walking up stairs, jogging and even abrupt stopping. Without a stable knee, our easiest everyday tasks become a challenge. Did you know that the foot moves in all anatomical planes, unlike the knee, which primarily moves in the sagittal plane (flexion and extension).

Generally, people who sit all day will have tight hamstrings, hip flexors, calf muscles, weak gluteus (buttocks) and underactive inner thigh muscles. Please note, other preventable muscle imbalances and joint dysfunction may arise from overuse or a sedentary lifestyle e.g. low back pain, hip drop/hike, neck pain. FYI, when you have tight muscles, its primary functional movement might be altered. For example, tight hamstrings and tight lower back usually signal a weak gluteus muscle. The weak gluteus (buttocks) muscle function of being an extensor muscle will be dominated by the hamstring and lower back. This will limit your range of hip joint movement and affect the joints above and below: spine, shoulder blades, rotator cuff and also the knee.

The joint below the knee is the ankle. Tight calf muscles, whether from sitting down all day or wearing high heels may alter you ankle mobility. The shin muscles will be unable to perform it primary role because its’ opposing muscle ‘the calf’ is overpowering it via its tightness. Many people get shin splints and plantar fasciitis because of tight calf muscles and weak shin muscles ( posterior tibalis).

It’s important to note that no muscles work independently. Secondly, if you have tight muscles its’ opposing muscles are usually weak and needs to be strengthen. Remember, muscles wrap around our joints. When they are tight our joints range of motion is affected and it travels throughout our posture and human body kinetic chain.

Some symptoms from tight calf muscles and weak shin muscles:

· Jumper’s knee- underneath the knee

· Runner’s knee- muscles on the side of your hip/leg down to you knee. (ITB,TFL)

· Plantar Fasciitis

· Shin Splints

· Achilles Tendonitis

· Low back pain

· Feet externally rotate

Basic assessment tests for hamstring and calf muscle flexibility and extensibility: I highly suggest asking a fitness professional for assistance.

Sit and reach: Sit on the floor with your legs together and straightened. Sit upright, exhale and reach for your toes. Measure the results. How far away were your fingertips from your toes? Note: You can have flexible hamstring muscle with tight calf muscles. This is generally a hamstring flexibility test. If you can touch your toes then go to the tube stretch drill.

Foam Roll: Foam roll (Self Myo Fascia SMR Roll) are everywhere. Most gyms have them but few people use them. I use them for muscle recovery/regeneration and for assessment of muscle tension. Place the foam roll underneath your calf muscles. Lift your body off the floor with your hands so your can have more pressure between the foam roll and calf muscles. Breathe and draw in your navel. Lastly, cross one foot over the other and check for tension. If on a scale of 1-10, 5 being uncomfortable, you score higher than a 5 then you have tight calf muscles. For more information on foam rolling techniques buy 'Maximum Boost Workout© 8 Week Body Sculpting Book'.

Resistance Tube Calf Stretch: This is a sure way to check for tight calf muscles. Obtain a resistance tube or thera band with 15lbs-20lbs of tension (towel can also be used). Sit on the floor and place both handles over the bridge of your foot. NOTE: Make sure to secure it over the bridge of the foot or it can become loose and slap you in the face. After the handles are secure grab the opposite side of the tube with your hands and lay flat on your back. The leg that does NOT have the handles on the foot should be straightened with the knee touching the floor and toes pointing up.

Next slowly lift the leg with the handles over the foot. Bring the leg towards your hip and make sure your leg is straight. Once you reach the maximum flexibility of your hamstrings, point your big toe downwards toward you face. You should feel the calf muscles being stretched. If you feel a stretch behind the knee or in your hamstrings then this may be the cause of your knee discomfort. Hold for 1mintute and 30 seconds, breathe and keep your shoulder, head and lower back on the floor.

There is no silver bullet when it comes to lessening the knee discomfort. If your discomfort persists thenn please see a medical professional.

Suggested corrective exercise drills for tight calf muscles and ankle mobility:

First and foremost: Foam Roll your calf muscles including the sides and shin muscles. Find a tender spot and hold it for 45 seconds. One technique is to place the foam roll underneath your calf muscles. Lift your body off the floor with your hands so your can have more pressure between the foam roll and calf muscles. Breathe and draw in your navel. Lastly, cross one foot over the other and check for tension. If on a scale of 1-10, 5 being uncomfortable, you score higher than a 5 then you have tight calf muscles. For more information on foam rolling techniques buy 'Maximum Boost Workout© 8 Week Body Sculpting Book'.

Tennis Ball Roll: This is similar to foam rolling. While seated place a tennis ball under the bridge of your foot (no shoes/sandals). Roll the ball under the foot while simultaneously gently pressing downward. Once you find a tender spot, hold it for 40 seconds. Repeat as needed.

Tube Stretch: This is a sure way to check for tight calf muscles. Obtain a resistance tube or thera band with 15lbs-20lbs of tension (towel can also be used). Sit on the floor and place both handles over the bridge of your foot. NOTE: Make sure to secure it over the bridge of the foot or it can become loose and slap you in the face. After the handles are secure grab the opposite side of the tube with your hands and lay flat on your back. The leg that does NOT have the handles on the foot should be straightened with the knee touching the floor and toes pointing up.

Stepper or Tri-Stepper: Steppers are a convenient way to stretch your calf muscles. There is now available a Tri-Stepper that allows you to stretch your calf muscles in all anatomical planes (left, right, back, forward). They might have a different name but a fitness professional will understand and be able to assist you.

Shin Muscles Strength Drills: These drills are best when done with a partner but can be done alone. You will need either a resistance tube, band or cable machine. You want to exercise your shin muscle from (3) different angles. It is very important you perform these drills with diligence and go for the full range of motion instead of speed/increased tension.

Sit upright on a bench with one leg resting on top of the bench. Your ankle and foot is slightly off the bench. Note your toe is point up. Place a resistance tube (10lbs-20lbs tension) over the foot. Your partner will pull the handle and foot down and away from you (plantar flexion)…you will dorsi flex or bring your foot back into a 45degree angle. Repeat 12-20 times ..hold for dorsiflexion for 2 seconds. Repeat as needed.
Repeat instructions above…but your will now evert your foot (turn foot outwards). Your partner will gently pull the handle over the foot in the opposite direction. . Repeat 12-20 times ..hold for dorsiflexion for 2 seconds. Repeat as needed.
Repeat instructions from #1 drill…but your will now invert your foot (turn foot inwards). Your partner will gently pull the handle over the foot in the opposite direction. . Repeat 12-20 times ..hold dorsiflexed foot for 2 seconds. Repeat as needed.

Trainer tip: Use only one resistance tube handle for the first couple of sets. Learn the complete range of motion of the drill then increase tension.

Standing calf stretch with rocking (ankle mobility): Stand in front of a wall with a stagger stance. Stretch your arms out and place your hands on the wall- directly in front of shoulders. Back leg is straight (do not lock knee) and leading leg is in a 90 degree bend with both heels on the floor... This drill resembles a calf stretch but you will rock back and forth for 45 seconds. Perform drill on opposite leg. Repeat as needed.

Bosu Ball foot compression (ankle mobility): Great for plantar fasciitis and promoting ankle mobility. Stand on top of a Bosu ball (Dome up and flat piece on the floor). Once on top of the dome learn to balance, stay upright with knees slight bended and navel drawn in. With hands on your hips begin pressing the ball of your feet down on the ball and then shift your weight to your heels. Go back and forth and alternate feet compression. Perform for 45 seconds. Repeat as needed.

After you relaxed your muscles with foam rolling and lengthened them via stretches do the following.

Single Leg Stance with leg abduction on Airex Balance Pad: This drill can be done without a Airex balance pad but I prefer the instability to promote neuromuscular efficiency and inter muscular coordination..Stand on top of a Airex Balance Pad. You are upright with hands on your hips and navel drawn in. Remember to think tall and relax the shoulders. Lift one leg off the floor and to the side for 8-12 repetitions. Keep the toe inward and slowly perform the exercise. Repeat for 3 sets

By the way, consider the following as possible culprits to your knee pain:

· Do you wear high heels on a regular basis?

· Check your footwear for arch support.

· Do you have a workout that promotes joint health and muscle recovery/regeneration? E.g. foam roll, ankle mobility drills

· Are you performing hip dominated exercises to balance out your knee dominant exercises? e.g. single leg deadlifts

These are a few suggestions but there are many other modalities that can assess and alleviate most common knee pain. Integrate a corrective exercise routine into your program and your will be amazed on the positive results. It is time to take your fitness to the next level!

In my next essay, I will discuss how muscles imbalance above the knee leads to knee discomfort and pain. Feel free to contact for pictures and videos of the drills or more information on strength and conditioning training.

Be well and stay ACTIVE!!

Julio A. Salado, NASM & NSCA C.P.T.

Fitness Foundry, designed for healthy living©

Certified Personal Trainer
Assess, Initiate, Motivate

Email: juliosalado@fitnessfoundry.net

http://www.fitnessfoundry.net

11:38 pm est

The 2008 Top 10 Weight Loss Myths

The 2008 Top 10 Weight Loss Myths.

By Julio A. Salado, NASM & NSCA C.P.T.

Consult with your doctor before starting a fitness or weight loss program.

Being a certified personal fitness trainer, I hear misinformation on how to lose weight on a daily basis. There are too many examples to list and a slew of new myths and products always appear each year around New Year’s Day. Usually, they are marketed with half truths about the effectiveness of their programs. None of these programs or products talks about long term weight loss…because they would go out of business.

It’s my responsibility to educate my clients on how to achieve long term weight loss based on exercise science and steer them away from fad diets, misinformation and ineffective products.

The reality is that there is a difference between weight loss and body fat loss. Most of us look at the scale which reflects our total body weight but this does not take into account the total body fat lost. For those on a fad diet without an exercise program the total weight loss number on the scale does not indicate if you have lost muscle. The point is that a loss of muscle mass will decrease your metabolism and affect your body’s ability to have long term weight loss.

Losing weight and keeping it off is 100% possible when we are open minded, willing to apply ourselves to a program based on exercise science and avoid the weight loss myths.

Here are the 2008 top 10 weight loss myths and reasons why they do not work, are not healthy, short term and how they can lead to a cycle of more weight gain.

Currently:

10. Myth: Eating a NO fat diet...Learn to differentiate good fats from bad fats...e.g. no trans fat vs. good polyunsaturated fats found in fish oil. Good fats are a high density energy source, make us feel full longer and are essential for cellular processes. Total low fat diet should be part of a complete weight loss program..
9. Myth: Eating a NO carbohydrate diet... Eating low complex carbohydrates is best e.g. potatoes, veggies vs. simple carbs white flour, sugar drinks. The body main source of energy (including the brain) is carbohydrate not protein.
8. Myth: Working abs for flat tummy... Constantly working on abdominals may lead to an increase in muscle imbalances and affect posture. Exercising major muscles in a total body workout burns more calories...e.g. chest, legs, back, shoulders.
7. Myth: Wearing plastic gear such as shirts or pants to promote weight loss.... I have seen people use garbage bags under their shirt to promote weight loss!!! Your body’s system of cooling thru perspiration will be compromised. Hence, you will lose more water and that will lead to dehydration plus lessen your cardio/endurance potential.
6. Myth: Fasting and working out...The body is a machine...no fuel will eventually lead to the internal breakdown of muscle, organ function, balance, coordination and mental clarity. Fasting sends a signal to brain to save energy and the body’s favorite source of energy to save is FAT.
5. Myth: Depending on a gym or special equipment to lose weight. Believing you have to be at the gym to lose weight is an only excuse not to workout. There are many benefits of having a gym membership however circumstances such as finances or time may prevent us from going to a fitness club. You can workout at home using low cost equipment e.g. resistance band, stability ball, even bodyweight exercises. You can also burn extra calories by taking the stairs not the escalator, walking to the store rather than driving. 20-30 minutes of daily brisk walking is a good start.
4. Myth: Not enough time to begin a program: A weight loss program depends largely on a daily energy expenditure (burning more calories than you consume) and eating a healthy daily diet. Fact: If you have time to eat then you have time to begin a weight loss program. Eliminating or lessening your sugar, mayonnaise, peanut butter, white flour, fried food and high sodium foods will promote weight loss. These foods will trigger a response in your body to save fat and lowering your intake will increase your body’s fat burning efficiency.
3. Myth: High Repetitions vs. Low Repetitions: The repetition frequency should be based on your current level of fitness experience. Beginners should start with reps between 8-12 to focus on technique and muscle conditioning. After a couple of weeks you can increase the weight and decrease the reps to 6-8 repetitions to promote muscle growth and prevent plateauing. Remember, an increase in lean muscle mass will increase your metabolism.
2. Myth: Cardio workouts lasting more than 60 minutes. The laws of diminishing returns can apply to this myth. As your body adapts to the same long cardio workout (a.k.a plateau) from jogging, elliptical, cycling etc… you will lose less body fat per workout, metabolism will not increase and loss of lean muscle mass increases.
1. Myth: Believing your happiness depends on how much you weigh. Working towards a goal of losing weight is challenging but rewarding mentally and physically. Unfortunately, movies, television and media all portray that happiness resides in being a certain body type or weight. On the contrary, a healthy lifestyle, faith, family and friends are what will enhance one’s overall sense of well being.

Here are 5 Fitness Foundry Tips that will promote weight loss without losing muscle:

1. 15-20 minute total body workouts before your cardio: Research shows that an increase in lean muscle will increase your metabolism. A workout that uses more muscle groups will burn more calories then isolating a single muscle. For example: Doing squats while bicep curling dumbbells then shoulder pressing will burn more calories than sitting on a bench and doing bicep curls. For more ideas on total body workouts check out: Maximum Boost Workouts© Free Video clips: Click Here

2. Support: Get a workout buddy. We are less likely to skip workouts if we have a partner. Also, encouragement from your workout buddy may give you the incentive to go the extra mile!

3. Nutrition: Keep your nutrition simple. Avoid foods high in saturated fat, high sugar etc… Your nutrition should be based on current weight, medical history, lifestyle and goals. Also, keeping a weekly or daily nutrition journal will help you develop awareness of the quantity and quality of foods you eat. Here is a great resource on nutrition, weight loss and health www.mypyramid.org

4. Rest and Recovery: Lack of sleep will affect your body’s functional capacity to burn fat. Also, sleep is very important for muscle recovery and overall health.

5. Frequency/Consistency: In a perfect world, we would workout every day. However, this is unrealistic. My suggestion is to plan out your workout a week in advance. At least 25 minutes of physical activity 3-4 days per week is a great start. If we are unable to workout then focus on your nutrition on that day. For example, eat more vegetables and protein and fewer breads and sugary foods.

Each day, you ARE a step closer towards your goal. Long term weight loss results arise from behavior or lifestyle modifications, consistency and enjoyment. It is a myth that LONG TERM weight loss is easy and exclusive to a certain population. You can achieve your goal by resolving each morning to give it 110% effort, being honest about your nutrition and knowing you are worth it. Don’t wait till New Year’s Day to begin…start today!

For more details on personal training click here: Fitness Foundry Goals and Asssement Form