Tag Archives: therapy

Movement Tip: Get More Out Of Your Hip Flexor Stretch

Tight hip flexors are common these days.  Here’s how to get more out of your hip flexor stretching.

We’re going to use a PNF (proprioceptive neuromuscular facilitation) technique, also known as MET (muscle energy technique).  Some benefits of using this over a passive stretch are:

  • Getting a deeper stretch
  • Building a neuromuscular connection
  • Creating mobility, not just flexibility
  • Longer lasting effect

How does this work?  By using a submaximal contraction of the same muscle we are stretching followed by the stretch itself, we can take advantage of a response called autogenic inhibition.  Without getting into the fancy terminology, this basically creates a relaxion response that allows us to sink a little deeper into the stretch.  By contracting the muscle in the lengthened position we’re creating neural pathways that let the brain and body know we can use this muscle in this lengthened state.  Knowing we can use the muscle begins to create a new range of motion that you can build control with.  Control of your flexibility is mobility.  This gives you a longer lasting effect.

Sleep Well with S.E.L.F. Correction

Rest and recovery are often undervalued components when it comes to fitness and achieving performance goals.  Many people feel that they need to do more in order to achieve more, which may be true if you’re currently not doing much, but if you’re already grinding away, then doing more is often not the answer.  Quality restoration is crucial to optimize performance and so I’d like to share some of the highlights and strategies that I found valuable from Eoin Lacey’s presentation on Sleep at the 2018 SWIS Symposium interlaced with some of my own findings on the topic.

Your body rests in cycles as you sleep and there are 4 stages within a sleep cycle.  There used to be 5 stages, but recently stages 3 and 4 have been lumped together as researchers have stated that there were no physiological changes between the two stages to necessitate having two different stages.   Each cycle can last from 90 to 120 minutes in length.

Stage 1 – Is usually the shortest stage lasting from 5-15 minutes where your eyes are closed, but you can still be easily awakened.

Stage 2 – Is a little longer in length than stage 1, but your body temperature and heart rate starts to drop along with a reduction in muscle tone as your body prepares for deep sleep.

Stage 3 – Is usually the longest stage where you are in a deep sleep.  In this stage physical restoration such as tissue repairs occur along with strengthening of the immune system.  If you were to be awakened during this stage, you would feel a little disoriented and groggy.

Stage 4 (REM Sleep) – REM stands for” rapid eye movement” and happens around the 90-minute mark of the sleep cycle.  In the first cycle it usually lasts about 10 minutes but increases with each successive cycle of uninterrupted sleep.  During your final sleep cycle REM sleep may last up to 1 hour.  The REM stage is where you may experience intense dreams as your brain is the most active during this phase of sleep causing the rapid eye movements.  Heart rate and breathing quickens along with an increase in oxygen consumption by the brain.  This stage is thought to be the most restorative stage for our brain and central nervous system.  While some may use alcohol to aid in falling asleep, it interferes with the body’s ability to achieve REM sleep and will reduce your overall REM sleep.

Ideally, we would like to get between 3-5 uninterrupted sleep cycles each night.  That’s about the popular 7-9 hours we’re accustom to hearing, but 1-2 hours should be a deep REM sleep.  According to studies, most people get about 60% of the sleep they need for optimal functioning.  Most of us are going through our daily activities only having a 60% recharge!  Most of us don’t like leaving for work in the morning with a cellphone that’s only got 60% of a recharge, yet we do this with our body and mind regularly.  If you consider that studies revealed that people who suffer from sleep apnea are 3 times more likely to develop diabetes and 23 times more likely to have a heart attack, that drives home the importance of getting proper restorative sleep.

So how can we improve our sleep at night?  There’s an array of tips out there for what is known as Sleep Hygiene that we’re familiar with such as sleeping in complete darkness, set a cooler temperature, avoid caffeine 6 hours before bedtime, reduce blue light exposure, etc.  While many of these tips have been shown to help, they are usually part of a wind down routine performed close to bedtime.  But it’s what you do upon waking in the morning and your habits throughout the day that have a greater impact on how you sleep at night.

S.E.L.F. Correction is an approach that might be of greater value, especially if these habits are stacked with good Sleep Hygiene.  Before I break down the S.E.L.F. acronym, I’m going to quickly explain the hormone cortisol because it is mentioned a few times throughout the S.E.L.F. Correction approach.

Cortisol is a steroid hormone produced in the adrenal glands and released into your bloodstream.  It helps with many of the body’s functions including the control of blood sugar levels, metabolism regulation, blood pressure, helps reduce inflammation and assist with memory formulation.  It is a crucial hormone for wellbeing.  It has a bad rap as it is well known as being the “stress” hormone.  There’s a lot of articles about lowering your cortisol levels, but we absolutely need cortisol for proper balance.  The problem comes when we secrete too much cortisol too often and have sustained high levels.  Sustained stress is one of the top culprits for that happening, which causes the release of too much cortisol as our body tries to combat the stress.  Cortisol is trying to help us, it’s not the bad guy.  We want to lower stress to properly balance our cortisol secretion.  That generally means a lifestyle shift that involves less stress.  Proper sleep habits and S.E.L.F. Correction can help with this by boosting cortisol when it’s supposed to be high and having it taper throughout the day.

Here’s what S.E.L.F. stands for:

Social stimulation – within your first hour of waking, interact with someone or people.  Whether it be your partner, children, possibly even some emails if you can’t be face to face with a real person.  Social stimulus boosts cortisol levels which is what you want in the morning to feel awake.  As the day goes on cortisol levels should taper down as adenosine (sleep drive) levels rise toward the evening.

Exercise – get moving sooner than later upon waking.  There is a post exercise spike in cortisol levels which will contribute to that wakefulness, not to mention increased circulation and the array of other health benefits exercise has to offer.

Light – natural light is preferred, but light first thing in the morning will help shut down melatonin and boost cortisol levels to wake your body up keeping your circadian clock on a healthy sleep/wake cycle.  It’s recommended to get at least 1000 lux of light in the eyes for about 20 minutes upon waking.  (This does not mean stare at the sun.  Please do not do that.  You will go blind.)  1000 lux is comparable to an overcast day.

Food – What you eat and when you eat it throughout the day will affect cortisol levels and mood.  Food creates stimulation in your body so eating breakfast and consuming the majority of what you will eat throughout the day earlier on will help make winding down at the end of the day easier.  Foods such as legumes, lean meats, fish, eggs, nuts, leafy greens and colorful vegetables, whole grains, dairy, lower sugar level fruits such as berries, and healthy fats are good options for breakfast and early day meals to help boost morning cortisol.  Starchy carbs boost adenosine and serotonin levels and actually help you wind down, which is one of the reasons why you feel nice and lethargic after eating meals with a high carbohydrate content.  I can sum this up as saying eat balanced meals comprised of real food, don’t get crazy with extremes.

I hope that you have found this information useful!

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.

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.

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.

Movement Tip: The Bird Dog

In my last post I went over the McGill Curl-Up as a movement to assist in core stability to help prevent low back pain.  I mentioned that it is the first movement in Stuart McGill’s Big 3 movements.  The movements should be performed in the order of the Curl-Up, Bird Dog and Side Plank.  I’ve previously posted a demonstration of the side plank, and thought that I should probably finish off the series so that you have a full reference.  So today I will outline the Bird Dog.

The Bird Dog involves the extensor muscles in your posterior chain (back line) and can be performed with legs only or arms only as a regression.  Another option for regression is to begin with lifting your hand and knee only slightly at first and making sure that you are able to maintain your balance and stability.  From there you can slowly begin to extend in small increments over time until you are able to perform the full movement.

Taking your time with these exercises and focusing on the execution makes all the difference.  It’s the small nuances that separate okay results from great results.  These movements in particular are meant to be very controlled and deliberate.  Just flying through them using momentum and zero thought which is unfortunately how I generally see these performed, will not yield any benefit.  Please take your time and have patience.

This movement begins in the quadruped position with hands placed under shoulders, knees under hips and spine in neutral position.  Your hips and shoulders should be square with one another maintaining this throughout the entire movement avoiding torsion.

Engage your core similar to how we did with the McGill Curl-Up by thinking of cinching a corset tight around your waist, holding in your pee and poop, and bracing as if you will be punched in the stomach. There should be a slight draw in of your navel and you should still be able to breathe with this engagement.  Maintaining the slight draw in of the navel will be more challenging in this position as gravity is pulling down on your insides and your torso isn’t resting on the floor.  Your TVA will need to work a little harder.

Slowly raise opposite leg and hand and extend them thinking of placing them into position.  Think of length through your torso and reaching to touch the wall of the room you’re in with your extended hand, and the opposite wall with your extended leg as opposed to raising up toward the ceiling.  In fully extended position, leg and arm should be aligned with your torso, spine still in neutral position from head to tailbone and shoulders and hips still square.

Hold extended position for specified length of time before slowly returning to start position and repeating with opposite arm and leg.

Avoid excessive arching through your lower back and any twisting through your torso or lateral hip sway.

The video below outlines the full Bird Dog movement, but feel free to modify as necessary.  Thanks!

Recommended Variables to Start:
2-3 sets with 60 seconds rest in between, 6-10 alternating reps, 5-10 second isometric holds each rep.

Movement Tip: The McGill Curl-Up

When it comes to the topic of low back disorders, Stuart McGill is considered the top authority. His research and methods have assisted countless people. He’s authored many books such as Low Back Disorders and Back Mechanic that go into detail regarding many low back issues and how to treat or avoid them.

Low back pain is one of the most common conditions that I see, and in many cases the lack of spinal stability is due to weakness through the core region.  An easy fix is to incorporate some basic movements into your daily routine, to keep your core active and strong. Stuart McGill has a series of movements often referred to as The Big 3 that include the Curl-Up, Bird Dog and Side Plank. In today’s post I’m going to outline the Curl-Up. This movement focuses on the anterior (front) abdominals and Transversus Abdominis (TVA).  It is generally the first movement performed (after performing your Cat-Camel to warm-up to reduce spinal viscosity) of the series.

I’ll usually see this movement being performed with too much trunk flexion.  The rectus abdominis (6-pack) is the primary muscle used for trunk flexion and because this movement involves some flexion through this area, it’s easy to dominate with it.  However, the TVA is the deep muscle that provides the most spinal stability and it wraps around the torso creating a cylindrical like compression when engaged.  This is the muscle that we would like to be the most involved with this movement.  To trigger this engagement we need to focus on the compression with only some flexion.  To do this, try imagining a corset cinching tight around your waist.  Your TVA muscle is essentially a built in corset.  There will be a slight draw in of your navel (belly button) toward your spine, and then a small amount of flexion is added in the form of the curl-up to maximize the contraction.  So the curl-up isn’t the primary goal, it’s maximizing the contraction of the TVA which requires more cinching and some flexion.  When you add the curl-up portion of the movement, if you notice your stomach bulge out, so your navel is no longer slightly drawn in, you’ve lost that cinching engagement and are now primarily using your rectus abdominis.  If this happens, regroup and start over.  You may need to start out just working on the cinch without even adding any flexion, or if you can manage some flexion, you may need to start with some assistance from your elbows adding some support on the ground.

Below are the instructions and notes to perform this movement. Please watch the video for the full description. Enjoy!

  • Lie on your back on the floor with one leg bent about 90 degrees so that knee points up to ceiling and place hands under the arch of your low back with palms down so that finger tips touch one another.  If placing your hands in this position is uncomfortable, you may use a rolled towel as a bolster.
  • Engage core by thinking of cinching a corset tight around your waist, holding in your pee and poop, and bracing as if you will be punched in the stomach. There should be a slight draw in of your navel and you should still be able to breathe with this engagement.
  • Slowly raise your torso off the ground just enough that shoulder blades are hovering, maintaining a fairly neutral spine from head to tail bone with only slight flexion.  Think of being long and cinching around waist as opposed to crunching.  Hold position for specified time.
  • Slowly return to start position and repeat.  Switch bent leg each rep or set.

**Note: Only raise torso as far as you can control your core and stability.  If you begin to crunch and your low back arches excessively (loses contact with your hands), or you notice your stomach pushing out instead of slightly drawing in, back off a little until you can control the movement throughout.  You may need to assist with a little pressure into the floor from your elbows until core becomes strong enough to support without.

Recommended Variables to Start:
2-3 sets with 60 seconds rest in between, 3-5 reps, 5-10 second isometric holds at the top of each rep.

This video/article is intended to assist those who have consulted with their health practitioner regarding their specific condition and received this exercise as a prescription. Please consult your health practitioner before performing any exercise on your own.

Movement Tip: The Dumbbell One-Arm Row

The Dumbbell One-Arm Row a staple movement for back workouts.  It’s one of the most common movements that I see when walking through a gym, and one of the most poorly performed.  Hopefully this post helps clean up some of the typical compensations that seem to occur with this exercise.

The dumbbell row is a go to exercise due to its simplicity.  But there’s a lot going on, and it’s not as easy as it looks.  To perform this movement correctly, there’s a ton of stability and core coordination that needs to take place.  I tend to see most people just focus on moving the weight, and completely forget about having a solid base.  The video below explains some of the important things to keep in mind throughout the entire movement to maximize its effectiveness and keep you safe.

Here are the key points to keep in mind while performing this movement.  Watch the video below for a full explanation and demonstration.

  • Think of keeping spine long and neutral from top of the head to tail bone
  • Fill up mid-back maintaining a supportive protraction of the shoulder blades
  • Keep space between the shoulders and ears
  • Shoulders and hips should be square with one another, don’t twist
  • Core should be engaged throughout the movement
  • Keep supporting foot flat
  • Initiate movement with a scapular retraction
  • Drive elbow up toward ceiling and pull toward your hip

Suggested Variables to Start:

2-3 sets with 60-90 seconds rest in between, 10-12 reps each side.  Take 1 second to pull up, pause for one second, slowly return to start position taking 3-4 seconds.

Movement Tip: A Proper Side Plank

The side plank is an often prescribed exercise intended to help build core strength focusing on the oblique abdominal muscles.  It’s an exercise that I find many people brush off as relatively easy.  They feel that to really get those oblique muscles they should be torquing and twisting their torsos.  If we’re being honest, a medicine ball twist certainly looks like more fun that just hanging out in a static hold.  So, I can appreciate the allure.

I always feel that simple is often better, and if you think a side plank is too easy, then you are not doing it properly.  I don’t think that anyone would argue that gymnasts have some of the strongest mid sections around, and as a former gymnast I can tell you that before we ever started twisting, we spent a lot of time in basic static holds.  Another consideration is that if you’ve already got some sort of low back discomfort and you’ve been told to “strengthen your core,” picking twisting movements that require you to already have a strong core are not going to help you, and you’ll probably end up hurting even more.

The side plank is a fail-safe exercise to build a strong mid-section.  If done right, it is highly effective and difficult at nearly any level.  It’s a rare occasion that I see it performed properly, so I hope that this article will help you with nailing down a proper side plank.

To execute this exercise, lie on your side on the floor and prop your torso up by using the floor side arm and placing the elbow stacked under your shoulder with forearm flat on the ground.
Align your body so that head, shoulders, hips and ankles are all square and stacked with one another.

Raise hips off the ground creating a straight line from the top of the head through to your feet with a neutral spine as if a steel rod were passing through you.

Core should be engaged by thinking of cinching a corset tight around your waist, holding in a poo and pee, and bracing as if you will be punched in the stomach. You should still be able to breathe with this engagement.  Hold for specified time.

Think driving elbow and forearm through the ground to give shoulder space and proper support. Shoulder blade should be braced against rib cage throughout movement.

Your body should have a slight tilt forward so that your shoulder blade follows the curvature of your rib cage and is in optimal position for support.  The slight tilt will also put emphasis on the obliques.  If stacked perfectly perpendicular to the ground, the load distribution begins to be shared with other lateral support muscles such as the quadratus lumborum (QL).  This might be okay if that’s your goal, but I have found that most people are fine in this position, but as soon as the slight tilt is implemented, they start to collapse.

Slowly return to start position and repeat.

The most common error I see with this exercise is a twist through the torso where the shoulders are usually tilting forward and the hips are rolled back.  This will give you the illusion that you can hold the position for a long time as instead of using your muscles, you are counter balancing the load.  Shoulders and hips should remain square with one another.  Avoid twisting and rolling back of hips.  I find that balancing on the side of your mid-foot with your heel slightly floating off the ground helps keep you conscious of this.

See the video below for instructions.

Suggested Variables to Start:

2-3 sets with 45-60 seconds rest in between, 3-5 reps each side of 5-10 second isometric holds.