All posts by customfitwellness

Avoiding Knee Pain During Hill Training

We have an annual hill climb challenge at Active Life Condition called the Grind.  It’s about a 2.2km trail that ascends 237m up Blue Mountain in Collingwood, Ontario.  With this challenge seems to come a sudden increase in the amount of hill climb training volume and in the past, this has led to the surfacing of knee aches and pains.  I wanted to highlight an often-overlooked weakness that can contribute to knee pain to help mitigate these issues.

Often the knee itself isn’t the initial problem but becomes the primary concern when other structures in the body aren’t functioning optimally.  Hips and ankles are the two most common areas that directly effect the health of your knee.  When we look at the biomechanics of a hill climb, due to the incline and increased forward angle of the torso, the demand placed through the hips differs from walking or running on a flat surface.  The force that is driven through the ankle and foot also changes dramatically due to these angles and combining this with the uneven ground surface of a trail, the demand for ankle and foot mobility intensifies as well.  Having the stability and awareness to maintain the proper alignment to channel these forces through your body in the safest most efficient manner is crucial, and what we often see is the poor knee having to take up the slack being sandwiched between rigid or unstable hips and ankles.

The glutes get a lot of attention when it comes to hills or stairs, but I find the hip flexors tend to be a little more overlooked.  With an incline they are required to move the thigh higher into a range of motion often not used and generally weaker.  This leaves them prone to quicker fatigue and compensatory patterns occurring to achieve the hip flexion movement.  The videos below lend an explanation as well as an exercise tip to help create strength within this range.  Remember, this is just one of many things that could be occurring, it’s important look at the big picture, and take everything into consideration.  Enjoy!

Movement tip: Isometric Straight Leg Raise Adduction

In the past I’ve mentioned how I’ve felt that the hip adductors seemed to have been a little neglected with the glute focus that’s been so prevalent in the past few years.  I’m happy to see a lot of higher profile “guru’s” starting to bring them back into the fold again due to their importance in core, pelvic and knee stability.

If we look at their functional anatomy we can see that they play a huge role in core and pelvic stability.  In my experience I’ve found that many patients with deep core dysfunction also have dysfunction with their hip adductors or vice versa.  If you follow the deep front net of Thomas Myers Anatomy Trains, this makes sense as you can see how these structures are interwoven with one another.

In my practice I’ve found a lot of people unable to coordinate this sling which leaves them very vulnerable to back strains or more serious injuries.  In working with a soccer team over the winter months (who won a tournament in Italy in the Spring.  So proud of them!), my colleague and I noticed many of them were giving up a lot of power due to this instability.  This movement prep exercise was discovered to try and help them connect and strengthen this line.  I’ve found it to be quite effective with most populations.  It requires the deep core and hip adductors to work together creating that link.  Give it a try!

Isometric Supine Straight Leg Raise Adduction

  • Attach a large O-band to a secure anchor about knee to mid-thigh height.
  • Lie on your back with body parallel to anchor placing feet inline with the anchor point.
  • Position yourself away from the anchor point at a distance that will provide a challenging tension for you.
  • Loop the O-band around the mid-foot portion of your inside leg.
  • With the band under tension, clamp your body into the ground maintaining a neutral spine.
  • Use your hamstrings and glutes of the outside leg to squeeze into the ground and anchor your sacrum and hips keeping them square with shoulders throughout.  Lock down this position.
  • Ensure that rib cage does not rotate or glide laterally out of alignment with hips.  These are common errors.
  • Start movement by raising inside leg up to about 30-45 degree angle and squeeze in toward mid line of body keeping leg straight with knee and toes point up toward ceiling. Hold contraction for specified time.
  • Slowly release but do not let leg drop before repeating next repetition.

Suggested variables: 

2-3 sets, 4-6 reps of 5-10 second holds per side.

Meal prep – you don’t have the time to not do it

Food Prep

Preparation in general is a habit that pays back tenfold.  Meal prep in particular (in my opinion) is one of the best foundation habits you can have.  It’s close to the base of the pyramid in that it supports and affects so much of your daily structure.  There are a plethora of studies that show how proper nutritional balance improves everything from cognition and sleep to performance and body composition and much more.  Basically everything you need to be the best version of you, yet so many resort to the habit of, “Oh, I don’t have time to prepare a proper meal, so I’ll just grab something on the go.”  That’s okay every now and again, but that shouldn’t be the norm.  With all of the positive outcomes that can occur from one simple habit, it should be a priority, which is a nice segue into a few suggestions that might help make it so for you.

 

Make it a priority – because it is!  Do it during the hours that you feel the most productive so that you can get it done and out of the way efficiently so it takes less time and you can put the quality into it that it deserves.

 

Build an arsenal – Thinking of what to cook is an age old dilemma, but slowly building an arsenal of recipes that become easy to prepare, is a key element in being consistent with food prep.  Try learning a new recipe every couple of weeks and before you know it, you’ll have a wide variety of meals to choose from.  This takes a little bit of time in the beginning, but once it’s in place it will always be there for you.

 

Batch Cook – If you don’t like leftovers, get over it.  Batch cooking is one of the most effective methods of meal prep.  Each week I’ll take a couple of hours to prepare a few different meals all at once so that there’s variety and I have them ready to go for the week.  A lot of recipes will use similar base ingredients, such as onions, garlic etc.  So, if you’re chopping those up already for one meal, you might as well chop up what you’ll need for a different dish as well and prep that too.  It saves more time in the long run, plus it frees up intellectual real estate throughout the week when you don’t need to think or worry about what to cook or eat.

 

Have the right tools – Having the right equipment to perform a task makes it far more efficient and a lot more enjoyable.  A few good quality kitchenware items such as a good knife and frying pan can really make a world of difference.  This plays into something that I mentioned in a previous post about creating an environment that is conducive to the habit you want to create.  What items do you find yourself using the most when you’re cooking?  Do you feel miserable when you have to use them?  Get quality items for the tools you use the most that help you the most and you’ll find a much more enjoyable experience.

I hope these tips give you some food for thought!  Enjoy your week.

Structural Balance: Why it’s important

The majority of the injuries that I see with my patients are usually the result of some form of structural imbalance.  What do I mean by this?  Let me try to explain… 

Our bodies are designed in such a way that everything is interwoven and in a pre-tensioned state.  When everything is balanced as it should be, we are able to adapt to and withstand different ranges of internal or external forces.  This is what makes our bodies so resilient.  To give you an idea of how this works, Fascial Stretch Therapy founders Chris and Anne Frederick often use the example of a geodesic dome (think of a dome tent).  When the poles and tent fabric are placed together and under balanced tension, you have a durable attenuating structure.  By themselves, the fabric or poles wouldn’t be able to stand erect with integrity if at all.  The term tensegrity is used to describe this sort of structural phenomenon. 

So, we have bones which act similar to the poles of the tent, and soft tissues such as fascia, muscles, ligaments, etc. that are like the fabric.  If any of the soft tissues are tensioned more or less than they should be, the entire structure will be unbalanced and compromised. 

Of course we can still function, but not optimally and usually at the expense of an area of our body that is compensating for this imbalance.  You can drive a car that’s slightly off alignment for quite some time, but more wear is put on the tires and they will need to be changed much faster than if the car were aligned properly.  Sometimes that extra wear might result in a premature flat.  Often times our joints are like the tires of a misaligned vehicle.  This is why I am so keen on structural balance as it can provide a solution or prevention to many of the ailments we experience.

I hope this simplified video explanation of tensegrity helps!

Simplified tensegrity/structural balance explanation.

Movement Tip: Half-kneeling palloff press

It’s well known how important core stability is, and while static exercises like planks are a great place to start and learn how to feel and engage your core for stability, you’ll need to advance and be able to maintain stability with weight and or force transfer.  I’ve found that most people are good with sagittal plane stability (resisting a forward or back bend), but poor with coronal (side to side) and transverse (rotational) stability.  The latter two are especially important for all populations as something as simple as getting in and out of your car requires the awareness and stability of all planes.

The Palloff Press is an excellent movement choice that incorporates stability work in all planes, with focus on the transverse and coronal while adding some force transfer through the press.  I like starting with the half-kneeling variation to promote the locking in of good pelvic stability, and for people with tight hip flexors and quads, you get to work in a nice open hip position on the knee down side.  I’ll initially use an isometric hold at the top of the extended range to make sure that people are able to feel and adapt appropriately to the force transfer.

This is a fantastic movement to include in your movement prep. or warm-up exercises.

See the video below for a full demonstration and explanation.

Here’s what it looks like:

Anchor a Large O-Band or resistance band to a stable object at about shoulder height when you are kneeling.

Face 90 degrees away from the anchor so that your torso is perpendicular to it. Holding the band with inside hand first and overlapping with the outside, center hands over solar plexus (mid-torso) and move away from the anchor so that there is resistance on the band. (Distance will depend on your current level of comfort and strength.)

Assume a half-kneeling position with inside knee down on the ground inline with hips, shoulders and head. Outside leg should be forward and flexed 90 degrees at hip and knee with foot maintaining full contact on ground.  Ensure pelvis is level and lock it in by contracting glutes, hamstrings and core.

From this position slowly press hands forward straight away from torso fully straightening arms and maintaining shoulder height.

Keep hips and shoulders square with one another and resist the torsion of the band. Hold arms extended position for specified time and then slowly bring hands back toward torso.

Remember to breathe throughout.

Complete full set with weaker side first before switching.

Recommended variables to start with:

2-3 sets, 4-8 reps per side, 3-5 second holds in extended position.

Movement Tip: Half-Kneeling Short Range Hamstring Curl

This is a movement that I picked up from Dr. Spina’s FRC material.  I love it because it addresses the top range (short range) portion of a hamstring curl or knee flexion which is so often neglected.  Most hamstring movements focus on the mid or low range, and the movements that are supposed to include the top range are often performed poorly, leaving it out anyway.  In many cases people don’t even have to flexibility to perform work for this range and that’s the other reason why I like this movement.  It also works on quad flexibility at the same time, in particular the rectus femoris that crosses both the knee and hip joint which is often a restricting muscle for many people.

I like using this as a movement prep/warm-up movement especially on a lower body focused day.  The set-up is key to making this an effective movement and for those that can’t get into this position, the video below offers an alternative set-up.

Cramping or muscle spasms in the hamstrings are common when first attempting this movement.  This is a normal response and will pass once your body and brain adapt to the pattern.

This exercise should be performed slow and controlled throughout.

Start in a half-kneeling rec fem stretch position keeping head, shoulders, hips and planted knee aligned with one another.  Hold the foot of your back leg up as close to your butt as you can manage.

Slowly release your foot while squeezing hamstrings and glutes controlling the negative all the way down to the ground.  Try not to let your foot just sling shot out of your hand.  Slowly curl your leg back up to the top position as far as possible before assisting with hand as little as possible and returning to start.

Suggested variables:

2-3 sets, 3-6 reps/side, slow and controlled throughout. (4-5 seconds to lower, 3-4 seconds to return to start.)

Super shake recipe

Super Shake Recipe – Custom-Fit Wellness

Super shakes, smoothies, whatever ever title you want to give them, are awesome for packing in a lot of nutrients in a simple manner.  The hardest thing is deciding on what you want to put in it.  So, here’s a recipe that I like to use from time to time that’s more veggie dense.  Again, measurements are not my strong suit and should also be adjusted to your particular needs.  These are just averages.  Enjoy!

Ingredients:

  • 1 tbsp. grated ginger root
  • 1-2 tbsp. chia seeds
  • 1-2 tbsp. hemp seeds
  • 20-30g plain protein powder
  • 1-2 cups spinach
  • ½ cup parsley
  • ½ cup beets
  • ½ cup carrots
  • 1 banana
  • 300ml water

Instructions:  Throw it all into a blender and blend until smooth.  You can add ice to give it a nice cool texture.  Protein powder is optional as well.

Energy Balls!

Homemade Energy Balls! – Courtesy of Custom-Fit Wellness

I went a little crazy with this last batch of energy balls!  I’ve made these on a few occasions now, and this experiment basically came about from reading the ingredients on a Lara Bar wrapper one day and thinking, “I could probably just make these at home.”  So here we are.

These bad boys are an awesome source of dense calories.  They’re perfect for endurance activities and I like them as a sweet pick-me-up if my energy level is weaning or I don’t have time to eat a full meal during the day.  They can be a good alternative to that chocolate bar hiding in your desk, but they are still calorie dense, so moderation is key.  You can be downing these like a puppy and liver treats!

Here’s the recipe, but note that these are averages because I don’t ever use a measuring cup (hence the oversized batch in the picture) so you may need a little more or less of some of the ingredients to get the consistency right.  I take no responsibility for how these may turn out if you follow this.  Enjoy!

Serves:  Maybe 15-20?

  • 250g of raw cashews
  • 400g of pitted dates
  • 3-4 tbsp organic natural peanut butter (crunchy)
  • 4-5 scoops plain whey protein
  • 2-3 tbsp organic coconut oil
  • Pinch of sea salt
  • Cocoa powder to roll them in if you like

I use a blender because I don’t have a food processor, but you want to grind up the cashews into a fine meal.  Empty the meal into a large mixing bowl and then put the dates into your blender/food processor, handful at a time to make a sticky paste.  Add the pinch of salt, peanut butter and dates to the mixing bowl with the cashew meal and begin to mix together creating a consistent paste and then slowly add the whey protein.  I save the coconut oil for last because I only add as much as I need to get the batter consistency that’s needed to roll into balls, or pack into a flat pan to make bars.

Highly experimental instructions, hopefully it works out for you!  Maybe one day I’ll actually measure things and repost.

Why do I Keep Straining My Neck?


By Gavin Buehler, RMT

Disclaimer:  Please consult your healthcare provider before engaging in any of the activities or suggestions that are highlighted in this article/video.

During this time of the season the coaches and therapists at Active Life tend to notice a rise in complaints surrounding the neck and shoulder area.  Generally it’s a little more stiffness than usual or mild “tweaks” frequently around the posterolateral (side/back) area of the neck. 

So why the sudden rise in these occurrences during this time of the year?  Our posture seems to change with the colder weather and maybe even from the stresses that may have been incurred over the holidays.  We channel our inner turtle power (everyone knows Raphael was the coolest Ninja Turtle) and manage to suck our heads into our protective shells between our shoulders, usually with our chins poked forward, and with added stress our breathing becomes shallow adding more to strain to some of the neck musculature that assists in breathing.  Spending more time in this type of posture can make the neck and shoulder area more susceptible to these aches and injuries. 

To understand why this is happening we need to take a closer look at the functional anatomy of these muscles, and since there’s a lot of them, I’m going to focus in on a muscle that I’ve found to garner the most complaints, the levator scapula.  This muscle takes a lot of abuse and is one of the most common reasons why I see people on my table.

As you can see in the diagram, the levator scapula originates from the transverse processes of C1-C4 in your neck and attaches to the superior aspect of the medial border on your scapula (shoulder blade).   Looking at the fiber direction and attachment points, we can see that its functions include scapular elevation (lifts shoulder blade up), scapular downward rotation (rotates shoulder blade down) and ipsilateral cervical flexion and rotation (rotates and flexes neck to the same side).  The most prominent action is the downward rotation of the scapula and it’s important to recognize this along with the cervical attachment points due to the impact this can have on overall shoulder movement.  Explanation is provided in the video along with a demonstration of actions.

When we’re in a forward head carriage postural position, this puts tension on the levator scapula pulling the shoulder blade into downward rotation.  This is generally the opposite movement of where we want our shoulder blade to go for the majority of our daily activities seeing as they are performed with our arms in front of our bodies where upward rotation of the scapula is required.  So we have a muscle that’s connected to our neck that’s pulling in the opposite direction we’re trying to go with our arms, inhibiting optimal movement of our shoulder causing compensatory muscle activation and firing patterns.

The postural placement of our head can interfere with the range of motion in our shoulders.  So if our heads are forward and our shoulders a little shrugged up and we go and try to do anything with our arms, such as reaching for a door handle or shoveling, we’re putting added strain on a muscle that’s already in a stretched position making it easy to “tweak.”

Be conscious of your posture and stand tall and proud with your ear in line with your shoulder to minimize your risk of injury and maximize your shoulder movement.

How Poor Posture Creates Tight Calves

By Gavin Buehler, RMT

Disclaimer:  Please consult your healthcare provider before engaging in any of the activities or suggestions that are highlighted in this article/video.

An issue that’s becoming more prevalent in my practice is lack of ankle mobility, particularly with dorsi flexion (foot flexes up toward shin).  I’ll hear comments about how calves always feel tight even though the individual is always stretching them out.  While the calves feel like they have an issue, the problem might stem from somewhere else.   In a case where I hear comments such as above, looking at the body globally and assessing postural alignment can help find the source.

Two fairly common postural patterns that are just about guaranteed to produce limited ankle mobility as well as many other problems that I won’t dig into in this article are “sway back” and “hyper lordosis.”  In both cases a dysfunction through the core triggers compensatory patterns in order for the body to keep balanced.

Sway Back Posture

Sway Back – In the case of the sway back posture the pelvis shifts forward off the plumb line usually presenting with a posterior pelvic tilt and flattening of the lower back.  There are many possible reasons for this that may include weakness in the transversus abdominis (TVA), imbalanced internal and external obliques, glute weakness, poor sequencing etc.  But it’s the lack of support through the core that displaces the weight creating an “S” like posture when viewed from the side.  With the pelvis shifting forward, the upper torso needs to shift back making the head shift forward.  In the lower body knees will usually lock out in hyper extension and due to the angle that the weight is being driven through the tibia, a constant posterior glide at the talocrural joint (ankle) stresses the Achilles tendon.

Hyper Lordosis Posture

Hyper Lordosis – With hyper lordosis a slightly different “S” like pattern forms as the pelvis dumps forward in an anterior tilt which tends to create a flatter upper back and exaggerates the arch in the low back shifting the torso forward off the plumb line.  The weight displacement of the upper body causes the lower body to compensate by pushing the pelvis backward as well as the knees in a lockout position.  As with the “Sway Back” posture, this places the tibia at an unfavorable angle to bear load through the ankle joint.

There are a number of other issues that are also formed with these postures, but since this article is about tight calves, I’m just going to highlight how they are affected.  In both the sway back and hyper lordosis cases, these postures produce a constant stress on the calves through both the knee joint as well as the ankle joint.  The calves are in a lengthened state crossing the knee and working hard to fight hyper extension and stabilize the joint.  Through the ankle, because of the way the weight is being distributed through the tibia (lower leg) and the angle that it is forced to meet the talus (foot bone), they’re again stretched and working hard to combat the posterior glide and stabilize.  The body’s nervous system will perceive these areas as being unstable causing the calf muscles to brace for stability making them tight.  No amount of stretching will remedy this type of tension.  In order for mobility to take place in any joint, there needs to be stability for your nervous system to allow the movement.  

To address the constant tension through the calves, postural improvement is needed first to place the load of the body in an optimal position where the joints are stable.  Improving the function of your core will generate the greatest success in these situations.

In this video I explain the compensatory patterns and offer a simple tool to help improve your posture.