Tip of the Week - Breathing

Become aware of your breathing.

Controlling stress is important for health and peak performance. The autonomic nervous system (ANS) helps us maintain the status quo (or not) without us necessarily being aware. Like yin and yang between the ANS has 2 sides - the sympathetic nervous system (SNS), which is active with arousal, and the parasympathetic nervous system (PNS), which is active in rest.

So next time your watching TV, working or exercising pay attention to your depth of breathing, pace and inhalation vs. exhalation. If you have too much SNS activity your breaths will be shallow and quick. So slow it down, learn diaphramatic breathing and re-teach yourself this automatic process.

Drop me a line if you need clarification or comments.

The Overhead Squat - knees out

So in our starting stance, feet shoulder width and pointing straight ahead, squat to at least parallel (full ass to grass squats are OK for the knees by the way). If your knees shoot out to the side you may have a restriction in the hips. In particular test your range of motion in internal and external rotation at the hips. Do it prone and supine with hips at 90 degrees. Let me know how it goes.

Losing weight

If you want to drop excess pounds control your insulin levels. What does this mean? Eat a low carbohydrate diet. The more adipose tissue you have, the less carbohydrates you should ingest. This doesn't include vegetables though. Eat lots of those, especially the green ones. Also add in some fish oils. So in summary, as Charles Poliquin said "if it doesn't walk, swim or fly or isn't green don't eat it." You'll also sleep better, which is a big part of controlling your appetite. 

Healing potential

"Humans inherit self-healing potential for biologic survival. However, this potential to self-heal is considerably affected by stress level, medical history, nutrition, and lifestyle, as well as by genetic endowment and age. Each person, therefore, has a different potential for self-healing capacity, and this potential for self-healing is also changing dynamically. It deteriorates in people who abuse their health, and it improves in those who take good care of themselves."

Source: Ma, Y. Biomedical Acupuncture for Sports and Trauma Rehabilitation. p. 50.

Success

I wanted to give a shout out to a client of mine who put in a fantastic effort towards achieving his goals. Over the period of one month he dropped his bodyfat % from 17% to 13%! During this time he also increased his strength considerably. He made changes in his eating habits and put in some hard work in the gym. Hard work pays off!

The Motor System and Pain

"A hyperactive sensory system will have repercussions for the motor system as well as the other output systems. Like the sympathetic nervous system, there are local responses such as spasms and ill-health of collagen. There are also observable changes in patterns of gross movement and posture as people cope. These are often conceptualized as muscle imbalance syndromes. The decreased movement options available and the learned habits of the chronic pain sufferer may lead to deconditioning."

Butler, D (2000). The Sensitive Nervous System.

The overhead squat - knees in

The biomechanics of the body are such that during movement no one part is isolated from another. Different muscles work together around each joint and the movement of one joint has an effect on other joints. Continuing with overhead squat, if during the squat the feet pronate then we may see the knees and hips rotating in. So focusing on the knees dropping in, the hip, feet or knee tissues may be contributing. So what do you do? Check the range of motion of the ankle in dorsiflexion (foot off the gas pedal), hamstrings and adductors. Also check for soft tissue changes in these tissues and the tissues on the side of the hips as well. The muscles on the side of the hips or a small muscle around the knee may be weak. Here's a practical suggestion. Do Peterson Step-ups. Do 2-3 sets x 40-60 seconds/leg. Notice I said time instead of reps. Add resistance as needed.

http://www.jumpusa.com/peterson_step_ups_for_jumpers_knees.html

Multidimensional Nature of Musculoskeletal Problems

Why would I try to say it when someone else can do it better justice. Here's a must read by Dr. Alejandro Elorriaga and Dr. Anthony Lombardi @

http://www.hamiltonbackclinic.com/blog_workshop/2011/03/the-multidimensional-nature-of-musculoskeleltal-problems/

Does acupuncture help with recovery from exercise?

http://aim.bmj.com/content/28/1/28.full

Neurofunctional Acupuncture

An article on neurofunctional acupuncture...

http://www.hospitalnews.com/modules/magazines/mag.asp?ID=3&IID=152&AID=1856

Contemporary Acupuncture Effects Part 4 - Supraspinal

From the spinal cord the the information travels to the brainstem. The signals here trigger the body's natural ability to suppress pain. It does this by stimulating the release of various chemicals throughout the spinal cord.

From the brainstem the acupuncture input travels to the limbic system, hypothalamus and cortex. These effects may have positive outcomes on mood, pain relief, the immune system and autonomic nervous system activity including certain hormones, stress and conditions such as IBS, headaches, etc.

Wine

Hmmmm...what do you think?

http://www.nutritionj.com/content/6/1/27

Asymmetrical weight shift in the squat

I love the squat as an assessment tool. We use the squat everywhere, from the gym to the sitting on the toilet. If you find yourself shifting to one side at the bottom of the squat check for inhibition and soft tissue changes (trigger points) in the muscles of the hips. The hamstrings may also be involved so check range of motion in that group as well. Let me know what you find or if you have questions.

Dorsiflexion

Limited range of motion in dorsiflexion (pull your foot up) may lead to compensation in other planes of movement. A good functional test is the overhead squat. If you find yourself falling forward in the overhead squat check your range of motion at the ankle. Of course there are other reasons why you may be falling forward but it's a start.

Contemporary Acupuncture Effects Part 3 - Segmental Effects

Once a needle is inserted into the body the surrounding nerves trigger signals locally and to the spinal cord. The signals to the spinal cord are a very important part of the acupuncture effect and, for that matter, in understanding dysfunction. Why?

Each region of the body is supplied by nerves that travel to and from segments of the spinal cord. In some ways the spinal cord is like the gatekeeper, Charon, at the Styx river in Greek mythology. It assists in the coming and going of things. This applies to "regulating" incoming sensory information, information related to the locomotor system (movement) and the autonomic system.

So what does this mean? To treat a problem the acupuncture needle may be used to stimulate the spinal segments on the torso directly or in peripheral tissues (arms, legs) that communicate with those segments.

Here is another video that illustrates medical acupuncture from Dr. Lombardi. The initial treatment is an example of a local and peripheral segmental treatment. At the 3:50 mark of the video you will see direct segmental stimulation along with a local treatment.

  http://www.youtube.com/watch?v=9NhTtYx0yDE&feature=player_embedded

Contemporary Acupuncture Effects Part 2 - Local effects

As I mentioned in a prior post, one of the effects of the acupuncture needle is the local effect; that is the area in which the needle is actually inserted. Once the needle is inserted into the skin clients will often feel certain sensations like an ache and redness will appear in the skin around the needle (by using a pain-free insertion technique, as taught @ the McMaster Contemporary Acupuncture program, you will not feel a sharp pain as you might expect). These effects are a result of the local sensory nerves and substances being released. These are important in healing the tissue in the area being stimulated, particularly the increased blood flow to the area as a result of the needle insertion.

The "local" treatment is useful for targeting inflammation in the area, skin conditions, minor injuries and may improve glands in the area. Have a look at the video in the link below. Dr. Anthony Lombardi, a mentor of mine, uses a combination of a local and peripheral segmental treatment in helping his client's shoulder.

http://www.youtube.com/watch?v=wk0eeJDBs3c&feature=player_embedded

Placebo

Great video on the use of placebo...

http://www.youtube.com/watch?v=yfRVCaA5o18&feature=player_embedded

Contemporary Acupuncture Effects Part 1

As I mentioned in a previous post, contemporary medical acupuncture is about stimulating nerves with the use of fine needles to have a goal directed effect on the nervous system. The age old tradition of acupuncture has taken on new meaning in recent years in light of new research on its mechanisms of action. When I talk to people about acupuncture it's usually a response of "I had acupuncture and it worked great!" or "it didn't do anything for me." When people answer in terms of acupuncture working or not working it usually is a reflection of the mechanism of pain relief that is part of the needling response. However the mechanisms of pain relief (or other benefits for that matter) may be influenced by several mechanisms and the effects of the needle take place at several "layers" of the body. To expand on the mechanisms, the needle effects take place at the local, segmental, and supraspinal (extrasegmental and central) levels. I'll review these mechanisms in upcoming posts.

Relative strength training for the upper body

A while back I discussed the difference between absolute and relative strength. I also posted a simple relative strength workout for the lower body. Here's one for the upper body

A1. Push press: 5-1-5-1-5-1; rest 120s then do A2.
A2. Chin-up: 5-1-5-1-5-1; rest 120s then go back to A1.

So you do 5 reps of push press, then 120s, do chin-up for 5 reps, then rest 120s do 1 rep of push pres, rest 120s, etc. Complete until 6 sets of each exercise is complete. I would avoid going for broke on the 1 rep sets. Keep a little in the tank but push hard.

Sensory Processing Disorder

I was just chatting with a colleague of mine about a child with OCD (obessive complusive disorder) and she mentioned that the child seems to over-respond to what should be non-noxious stimuli. In addition to musculoskeletal work I also work in the field of mental health. A particular area of interest for me for the past few years has been what is known as Sensory Processing Disorder or SPD. Dr. Lucy Miller in Denver, CO has devoted her life to increasing awareness of SPD. She is currently trying to get recognition in the next edition of the DSM. If you have a thirst for more information on SPD check out Dr. Miller's website @ http://www.spdfoundation.net/ . Of course you may also send questions my way.

In a future post I will explore my thoughts on the topic further.

Mechanism of Pain

Although most people are interested in the source of pain, equally important is the mechanism of pain. As I mentioned in another post, pain is an output based on one or more different levels of processing. The mechanism will help determine what you can do to help yourself, the prognosis and the most effective form of treatment. For instance, you may have low back pain related to long periods of sitting. It's also worse in the morning and feels better after a period of moving. A possible mechanism is ischemia, which means that frequent periods of movement is indicated for treatment. This will increase perfusion to the tissues thereby minimizing the nocioceptive signal.

Of course this does not mean that functional changes have not occurred (i.e. trophic changes, inhibition, etc) but it does help you understand why you may be experiencing the pain at that given time.

Functional Goals

The underlying similarity in any diagnosis is that it has an impact on everyday activities. This similarity also makes each individual's situation unique to him or her. Whether you're dealing with a musculoskeletal problem or a mental illness think about how your particular problem affects your day to day activities. Then focus on how you would like it to change. Create objective measures. Otherwise you're prone to the subjectivity of the day to day up and downs. The objective measures create a means to see change, which brings meaning to what you do!

Focus on Function

Pain is a complex thing. Most people associate pain with a stimulus...(i.e.) I do "X" and it hurts. Pain may be related to input, processing and/or output (I'll explain these at another time). Dr. Alejandro Elorriaga Claraco, MD, a Sports Medicine Specialist stated that "there are no acute injuries, more likely acute events." Dysfunction accumulates over time until the system can no longer adapt to the demands placed upon it. This means that it's unlikely that pain problems are linked to one event.

So what does this mean? Focus on restoration of function not a reduction in symptoms. This doesn't mean that the symptoms won't go away...quite the opposite in fact...by improving function the problem will go away for good!