12 Days of Rehab: Day 3 - The Plus from Quadruped

5 Basic Nutrition Tips for the Athlete

Dr. MaryAnne’s

Top 5 Basic Nutrition Tips for the Athlete

1. Excessive carbohydrate loading can lead to extra fat.

Carb-loading.  Fuel.  Electrolytes. These are commonly heard terms among the athletic community, and have to do with carbohydrates.  A carbohydrate is broken down into the simplest form of sugar for energy.  The muscles of the body rely on those sugars for energy during activity.  Glycogen is the first, quicker source of energy for the muscles, followed by fat.  When the body can't use sugar immediately, glycogen stores are filled first before fat, which is more of a long-term storage option.  So, what about when you aren’t active? If not currently active, when simple sugar is ingested, it has a greater potential to be stored as fat.

WHAT DO YOU NEED?  Complex carbohydrates.  Carbohydrates that come from natural sources such as fruits, vegetables and some kinds of unrefined grains offer fiber, which slows down the breakdown of the carbs and allows the body to more efficiently use it for energy.

ADVICE:  Carb-load before, not after!   Make sure to eat some sort of complex carbohydrate about 60-90 minutes before activity to help boost that energy your muscles need.  Need quick energy right before?  Simple sugars such as those found in some fruits and naturally sweetened sports drinks. (And as soon as you find one of those, let me know!)  After? See number 3.

2.  Fats can be good for you! You just need the right kind. (Omega 3s!)

Fats have been portrayed as “bad for overall health” for a long time.  Unfortunately, there are a few fats that are essential to the proper functioning of the circulatory system and general health that have been thrown by the wayside along with the bad.  Females also need a healthy and sufficient fat intake to maintain hormonal balance.

WHAT DO YOU NEED?  Omega 3 Fatty Acids.

ADVICE:  Supplement your diet with fish oils, snack on nuts between meals, and use almond milk as a substitute for regular milk.  Remember that there is always a possibility of too much of a good thing, so moderation is important in all food groups, but particularly fats.

3.  Protein is the most important nutrient for athletes, and chances are, you aren’t getting enough!

When we strengthen a muscle, it is first broken down, and then rebuilt stronger than before.  This process requires all the building blocks necessary to make a muscle.  Mainly? Protein.  An athlete or someone that trains needs more protein than someone the same age and size who is not active on a daily basis.  That post-workout hunger that is often felt is commonly treated with a large dose of carbohydrates (pasta, grains, etc.).  That leads to the protein needs of an athlete to not be met.

WHAT DO YOU NEED?  Lean protein, and often.  This includes turkey, chicken, and fish.  Red meat is also a great source of protein, but dependent on quality and cut may carry large amounts of saturated fats.  Having a variety of protein sources is key.

ADVICE:  If there is a large amount of time between the end of a workout and your next meal, eat a protein rich snack, such as almond butter or a protein shake.

4.  Hydrate, Hydrate, Hydrate!

Our body is mainly composed of water, and when an active body continually needs to replenish itself, adequate water intake plays a large role.  The ability of the body to function is highly dependent on water intake, and young athletes are commonly dehydrated.  Not only do they not take in enough water to function daily, but being active leads to loss of fluids in the form of perspiration, which can lead to further dehydration.

WHAT DO YOU NEED? Drink half your body weight in ounces per day, and extra for any activity.

ADVICE:  Buy a reusable water bottle (BPA free!) that carries at least 750mL of water.  Carry it with you during the day so you are reminded to hydrate and refill it often.

5.  Make sure you are getting your vitamins and minerals!

As your body develops throughout exercise, you need the proper building blocks so that your body replenishes itself properly.  Commonly deficient vitamins and minerals (especially for young female athletes) include (but aren’t limited to): calcium, B vitamins, Vitamin D, and iron.  Making sure that your diet includes ways to get those vitamins is extremely important as you develop and train.

WHAT DO YOU NEED? Balanced nutritional habits that include all vitamins and minerals.

ADVICE:  Take a multivitamin along with your meals each day.  This will help ensure that adequate nutritional building blocks are supporting your health.

           

These are just a few things to keep in mind as you work towards your body’s highest potential.  If you ever have any questions about what type of nutritional adaptations you need to make, never hesitate to ask!  You can email me, find us on Facebook, or check the blog.  Let’s improve your performance!

 

"Torch a quad, save a back"... NO.

After reading an article in the Orange County Register the other day, I was inspired to write this blog post.  Usually I have no idea what to write about... But after reading the article I could not resist.  Event though I play neutral on our Facebook page, I always have my opinion on what we post or ask questions about.  This article that was in the paper had a title called "Torch a quad, save a back". 

 As soon as I read the title I immediately thought to myself, "Oh man, lets see what this personal trainer out of a $4/month all machine workout facility has to say about low backs."  As I continued to read I found myself starting to shake my head from side to side faster and faster until I realized that I looked like a model off of a L'Oreal shampoo commercial.  So if you washed away everything the guy says about the exercise and mainly not listen to what he says the reasoning of how the exercise helps low backs, I absolutely have NO problem with having the ability to perform what the guy calls the 'campfire squat'.  Having the ability to drop down into a below parallel squat is HUGE.  And it is not too important if you are in lumbar flexion (unless you have a history of lumbar disc issues then I recommend staying away from lumbar flexion all together) because it is not a loaded squat.  I am absolutely not saying lumbar flexion is ok if it isn't loaded because we know the results of Pr. McGill's work, but Gray Cook talks about this movement in his lectures and says the most important aspect of the 'campfire squat' is that it is NOT loaded.  BUT, he (the trainer) mentions nothing on how the pattern is important... What he really wants the reader to take home is how important it is to destroy the quads and this will help your low back pain. 

Good thing we do not live in a quad dominant society (no sarcasm here I promise!)... Because everyone in America needs to build their quads to save their low backs from pain when they do their daily activities.  Don't worry about their lack of lumbar stability or their hamstrings driving hip extension due to inhibited glutes (often from quad/hip flexor tightness).  Don't worry about their poor thoracic spine, hip, and ankle mobility because that doesn't matter... Never mind the stability we need in the knee and mid-foot... And who needs that great toe extension?  We need to "Torch a Quad" to help people out.  Com'on Man!  The sad thing is the only thing people are going to get out of this article is to build the $&!* out of their quads...  Sad. 

  The amount of research that is out about low back pain and how it is related to having poor gluteal firing is overwhelming.  And every single time I find poor glutes, I find tight/dominant quads.  Just ask someone with back pain and poor glutes to drop down into half kneeling, they will hate you because their down leg quad is going to be stretching like crazy and they might not even be at 0 degrees hip extension yet.  

This was my reaction the first time I breezed through the article.  Then I read it a second time. 

After reading it in more detail a second time,  I picked out a few things that frustrated me even more... One, he is a chiropractor.  Two, the article was directed to the sedentary person who is almost always quad dominant.  As I read I can see the strides we are starting to make as a profession in the rehab/exercise field are being held back by articles like this.  I can see PT's and Strength Coaches reading this and thinking, "WOW... Not surprising, its written by a chiropractor".  And I wouldn't blame them!  The lack of current exercise knowledge in this profession is scary.  The number of DC's (and exercise professionals)  who have never heard of  Pr. Stuart McGill, Gray Cook, Mike Boyle etc. is dumbfounding.  It is time to open our eyes and minds to what Dr. Craig Liebenson is attempting to show us.  We need to pull everything together and "Bridge the Gap" between performance and rehab.  There is more to it than getting a good burn in the quads. 

Educate yourself on movement first, and then worry about sets and reps later.  And lastly, educate yourself on the real causes of symptoms and do not prescribe exercises because they will give you a sweet burn. 

Screening Movement Quality...How Can it Help?

 Summer is pretty much here, except for Sunday nights on HBO when "winter is coming".  That means the gyms are packed and it means that "Joe the desk worker" realizes he only has two months to "get shredded".  So to do this he has to start hitting the gym at least once a day (if not twice)... More then likely this is going to consist of some sort of super sets of bi's and tri's (cause we all know that having jacked biceps is what really matters) or burning out on the pec deck between your leg press sets of 7000 lbs.  But that is neither here nor there, even though Joe's choice of exercises are poor, he probably doesn't know better.  Plus I bet he is signed up at a gym that is LOADED with fancy machines that isolate muscle groups, I always say that those gyms would be awesome if they would melt all the machines and turn them into kettlebells.

The word on exercises being "functional" or not is starting to get out and more people (not quite enough) are stepping away from the old muscle isolation/"pump" philosophy and stepping into the realm of training movement patterns instead.  The issue with jumping into training in any capacity is what if the way you move is faulty?  My question is did Joe have a qualitative movement appraisal done before he started to try and get in shape? Probably not...

I use the Functional Movement Screen (FMS) in my office for a pre-participation screen to see if someone has any underlying issues that could potentially cause injury if they are starting a program that builds capacity.  Gray Cook says it perfectly, "Move well, before you move often".  Nail on the head!  It doesn't matter if you build a beautiful mansion, if it is built on a crappy and unstable foundation it is going to collapse.  Same applies to your body.  If you have any movement asymmetries between left and right, eventually it's going to catch up to you.  It doesn't matter if you are a high school athlete, CrossFit athlete, runner, or you're just looking to drop some weight and get healthy... GET SCREENED!!!
Do you want to be the best at what you do? GET SCREENED!!!
Do you want to improve your performance? GET SCREENED!!! 

The FMS is so spot-on as an evaluation of movement quality.  It consists of 7 movements and a score (0-3) that is determined on the quality and symmetry of each movement of the individual.   We need to spread the word about movement screening.  It is an everyday occurrence that active individuals walk into my office with new pains that started with a new workout regimen.  These people tell me, "I exercise 5 days a week, I don't know why I have pain"... My question to them is, "Did your trainer perform a movement screen on you before you started the program?"  I have not heard a "Yes" so far... Would they be in my office if they would have been screened? Maybe, Maybe not...  Having a good score (14-21) with no asymmetries on the FMS is not insurance that you won't get hurt with your activity, but it does tell you that you have a less chance of sustaining an injury than the person who scores below a 14 and has asymmetries (below a 14 with asymmetries = 50% chance of getting injured and missing 3 weeks or more of activity). I don't know about you, but if someone would have told me in high school (especially my Dad!) that if I perform 7 tests and my total score would tell me if I was at risk for an injury AND point out my weaknesses to help reduce that risk, there is NO question I would have taken advantage of this!

Just because you do not have pain, doesn't mean there isn't an underlying problem. Pain is the last to show and the first to go! Do you think when someone has a heart attack that there was an instantaneous increase of inflammation causing a giant clog in an artery? NO! It was years of poor dieting, not enough exercise, and high inflammation that caused the eventual infarction of an artery. 

Its the same with musculoskeletal pain... Chronic faulty movements will eventually cause the body to breakdown to a state of non-optimal function and eventually cause pain. With pain, the quality of life decreases drastically. And I don't know anyone who voluntarily wants their quality of life to be poor... So how do you keep yourself from developing chronic faulty movement patterns??? 

 GET SCREENED!!!

Cody Dimak, DC, CPT, FMS Movement Expert

Free Weights vs. Machines

Free weights vs. Machines

with Dr. MaryAnne

With all of the gyms out there, from CrossFit to Curves, and exercise options from at-home videos to kettlebell training classes, its hard these days to define what is the best workout and what is recommended across the board as far as fitness and health goes.  I’ve gotten many questions about this, and its difficult as a healthcare provider to identify what is best for each individual without knowing their physical and medical history, but if I had to give one answer it would this: 

The best workout is one that is a combination of the following components:

1.     Safe.

2.     Effective.

3.     Makes you feel good.

4.     Gives you a better physical advantage when you leave than you had when you went in.  

We are going to be doing a series of comparison blogs that give you benefits and disadvantages of different training styles.  The goal of these articles are to provide information so that people can make educated decisions about their workouts and to give insight and ideas to those designing their own fitness plans.

The first comparison I’d like to focus on is the question of whether to use free weights or machines at the gym.  To a typical person heading into their local 24-Hour workout facility, the multitude of options can be overwhelming and people tend to stay within their comfort zone when they choose what to use, especially because there are other people around.  (God forbid I don’t know how to use this new machine, the meatheads in the corner are watching!)  So let’s get out of the comfort zone and start making some real progress with your workouts!

 

So here’s my thought on machines:  Use sparingly, if even at all.  Let’s think about this for a second.  When, in daily life, do you sit on a seat and specifically require the deltoids to press weight directly above your head in a linear direction as is seen with the shoulder press?  Or, when do you sit at a chair and need to extend your legs straight out in front of you with weight as seen with the leg extension machine? (I am not even going to start with the conversation about how those exercises wreck absolute havoc on the joints involved!)  The answer is never.  So, not only are they not safe for the joints involved, but they aren’t effective and don’t give you any physical advantage.  So why do them?  Machines were designed to isolate different muscle groups so that, by doing repetitions on the machines, you can specifically tone and build those muscles.  Sounds great for someone who is about to compete in a bodybuilding competition, but unless you need to differentiate in public your four different quad muscles, this doesn’t pose any physical advantage.  For the regular person, they will reap many more benefits from introducing a more functional workout into their regimen. 

So, how can you introduce more functional movement into your workouts?  Well, first of all it’s going to require a paradigm shift in the way some look at “weights.”  It’s time to stop looking at the multitude of machines in the center of the gym and look to the periphery, where there (likely) are stacks of free weights that can range from dumbbells to weighted bars, to medicine balls and kettlebells.  For most, it will take learning how to use them and incorporate them into your sets.  First though, let’s address the why.  Properly utilizing free weights gives the amazing opportunity to add balance to the equation, which will require activation of the core.  The core is not something to just work for 15 minutes at the end of your workout.  It’s essential for ALL MOVEMENT!  And the core is not designed to create motion as you would think by how people tend to “workout their abs.” (Another example of wrecking havoc on your joints…for another blog!)  It’s designed to stop motion and control and stabilize the trunk of the body during movement.  Any time you can adapt an exercise to include the core, it will exponentially progress your function. 

What do I mean by adapt to include the core?  Well think about how you can make the moves you plan to do more functional and applicable to your life.  Instead of doing bench-style presses with dumbbells on a bench, do them on a physioball.  Instead of doing rows while you are relaxed on an incline, do bent over rows with the lumbar spine neutral (aka not flexed forward) and core active.  Want a full body workout?  Take a kettlebell lesson or class from an RKC or StrongFirst-trained kettlebell instructor, and incorporate those movements into your workouts.  You can also use an unstable surface such as a foam pad or even as challenging as a BOSU ball.  All of these will allow for you to get more out of your workouts, but here’s the kicker: to be safe, you MUST have proper form.  This isn’t about how many you can do or how long you can go.  If you don’t have the proper movement, you won’t get the benefit of any exercise.  The lumbar spine MUST be neutral and not be flexed while engaging the core otherwise you are setting yourself up for disc failure as well as propagating dysfunctional movement patterns.  And above all, if there is a questionable movement in your exercise regimen or one that causes you pain….don’t do it.  Take responsibility for your body and your health, and find a qualified health care professional to evaluate potential injury risk and to help you achieve your physical goals safely.

Questions? Email me at drma@maxperformchiro.com or find us on Facebook by clicking here!

Q&A with Dr. D: Why are stabilizing muscles important?

Last month I was asked to answer a few questions for a outdoor activities magazine on the East Coast, and I thought that my response would make a great first blog post as it could be very beneficial for anyone, not just people who run and hike.  

"Why are stabilizing muscles important?" 

 

First, lets name the muscles that I would consider "Primary" Stabilizers: Internal and External Obliques, Quadratus Lumborum, Rectus Abdominis, the Erector Spinae group (the low back extensors), Transverse Abdominis,  Multifidus, and the most important of them all the Diaphragm. There are other muscles that I would consider to be part of the "Core", but for the sake of the article we will focus on these. The reason diaphragmatic (belly) breathing is so important is that during activity (or even everyday task) if an individual is not using their diaphragm to breath, and they are using the secondary muscles to breath, they are truly not maximizing their lung capacity which will decrease their performance. Also, if an individual is using the secondary muscles to breath, and are what we call "Apical Breathers", dysfunction tends to arise in the neck and shoulder regions. A proper breath would have the belly button go out and down with an expansion of the lower torso in 360 degrees. 

Now someone may ask, how do I strengthen the muscle you just named, Doc? My answer would be you DO NOT want to strengthen them first! The key is to create ENDURANCE in the muscle BEFORE strength! This could not be more beneficial to the population that are avid hikers especially when talking about the low back extensor group. Having the ability to hold your upright posture for long grueling walks or hikes is very important in avoiding injury. A great exercise for this is called the Bird-Dog (YouTube: McGill Bird-Dog for example). This may look like a wimpy exercise at first, but once the movement is correct it creates a high contraction of the muscles that are aimed and it keeps a low load on the other tissues of the low back to help decrease injury. An exercise I would stay away from is the Roman Chair exercise. This should only be done with VERY high level athletes and the research shows that the compression it places on the spine is more injurious than beneficial.
 

The Quadratus Lumborum is very important for carrying heavy loads. A great way to train this muscle is with the side plank. The key is to create endurance, so holding for time is important. DO NOT drop your pelvis to the floor and raise up during this exercise, this is a static exercise. A more advanced way of training this muscle is doing an asymmetric farmer’s walk or performing a suitcase carry. You have to make sure you do not have any issues with a disc herniation or other spinal injuries before performing this exercise with weight. 

Moving on to the remaining muscles of the core (Internal and External Obliques, Rectus Abdominis, Transverse Abdominis). These muscles are made to STOP motion and TRANSMIT force NOT create it!!! Training these muscles while putting the spine through a range of motion is really a poor training practice. I know this goes against most peoples thinking on abdominal and core training but the research shows that your typical exercises,  full curl-ups, sit-ups, Russian twist, leg lifts, etc., put an unreal amount of unnecessary load on the spine and its tissues more specifically the lumbar disc. When the spine is flexed forward repeatedly or twisted repeatedly the lumbar disc will be damaged. Now if you put the spine through these ranges of motion and add load (weight) the disc will damage even sooner! Instead of the typical core exercises try exercises that have a low pressure on the spine like planks, side planks, stir the pot on a Swiss Ball, and the McGill Curl-up. All of these place less pressure on the spine and there is still a very high contraction of the targeted muscles. There are also more advanced exercises that still have low pressure on the spine and you can contact me for them if you want.

My next point is very important for your readers. If they have been told to "draw in your stomach" (AKA Abdominal Hollowing) before they lift, run, or perform any task DO NOT DO THIS!!!! This decreases performance and spinal stability. This belief that Abdominal Hollowing will help the individual is false and anyone who says otherwise needs a slap on the wrist. All research shows that Abdominal Bracing, 360 degree stiffening of the core (as if you are about to take a punch to the gut), is the most beneficial to a person before they perform a lift (like a heavy pack!). This topic good a lot deeper. Contact me if interested. 

Thanks for reading, and again contact me for more information on stabilizing muscles and how these concepts can apply to your every day life:

Email me: drd@maxperformchiro.com

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