I often talk about the importance of having a strong core. Not only does core strength improve workout performance, it also significantly reduces the risk of back, shoulder, and neck pain and many other injuries. These exercises are known as “McGills Big Three,” and are designed to increase muscular endurance around the spine. They are low impact exercises that can be done anywhere you can find a comfortable floor to lay on. Dr. Stuart McGill is a professor at the University of Waterloo in Canada where he focuses on spine research. He has also written several books about the spine and back pain disorders.
The McGill Curl Up: This exercise strengthens your abs without adding a lot of compressive forces on your lumbar and thoracic spine, which is a concern when doing standard sit-ups and crunches.
Step One: Lie on your back with your hands under your low back, just beneath your sacrum.
Step Two: Bend one knee so your foot is flat on the floor. Keep the other leg straight on the ground.
Step Tree: Slightly tuck your chin so that the back of your head is pressed against the floor.
Step Four: Slowly curl up your shoulders lifting from the center of your breast bone until your shoulder blade are off the floor. Do not jut your head forward as you curl. Hold for 5-8 seconds.
Step Five: Slowly return to the starting position and repeat. Complete half the repetitions with one knee bent and the other half with the other knee bent.
The Bird Dog: This exercise challenges core strength as well as core balance and glute strength.
Step One: Start on the floor on your hands and knees in a tabletop position. Your hands should directly underneath your shoulders and your knees should be directly underneath your hips. Make sure your back is in a neutral position.
Step Two: Raise your right arm in front of you while at the same time raising your left leg straight back. Raise your arm and leg until they are in line with the torso.
Step Three: Slowly lower your arm and leg and repeat on the opposite side. Complete 4-8 repetitions on each side.
Note: Make sure to keep your chest and hips square to the floor and to not let your hips or shoulders rotate out.
The Side Bridge: This exercise helps to strengthen the muscle on the side of your torso along with your shoulders.
Step One: Lie on your side with your elbow underneath your shoulder and your knees either bent to 90 degrees or with your legs straight and your feet stacked. Performing this exercise on your knees is easier and a great place to start as you build your strength.
Step Two: Push the floor away from you with your elbow to lift the shoulder up. Lift your hips off the ground maintaining a straight line from your head to your knees/feet.
Step Three: Hold for 30 seconds, then repeat on the other side. As you increase strength, increase the amount of time you hold the plank.
Summer is a wonderful time of the year when we have ample opportunity to spend more time outside. Although it feels good to soak in the sun, it is important to take precautions to account for the higher temperatures and additional hours of sun exposure. Here are few tips to help you keep safe and healthy while enjoying your favorite outdoor summertime activities.
1. Drink plenty of water.
We all know how important it is to drink enough water throughout the day and many of us work hard to get the requisite 64 ounces. However, when exercising in the summer, especially when exercising outside, you need to be drinking more water to account for the higher heat and inevitable water loss from more sweat. Since our muscles are composed of about 70% water pre-hydrating before any outside activities can decrease the risk of cramps, fatigue, and heat stroke. In general, you should consume 15 to 20 ounces of water one to two hours before exercise. During exercise you should focus on sipping small amounts of water whenever you get a chance. Once you are finished with your workout, make sure to follow up with an additional 15 to 20 ounces in the hour afterwards. Then continue to drink water throughout the day.
2. Protect your skin from the sun.
Sunburns are one of the most common summer injuries. They are not only painful, but increase your risk of skin cancer. You should wear sunscreen every day, but it is especially important if you are going to be outside for an extended period of time. Find a sunscreen with a high SPF and apply it to all exposed skin at least 15 minutes before heading out. Don’t forget to wear a visor or hat to shade your face!
3. Eat plenty of fruits and vegetables.
Fruits and vegetables are the perfect snack pre- or post-workout. They have high water content and will help you replace all the water-soluble vitamins you sweat out. They also are a much healthier choice than sports drinks to replenish your energy levels after all your hard work.
4. Listen to your body for sings of heat stroke.
One of the most dangerous side effects of too much sun is heat stroke. If you, or anyone around you, are experiencing any of the following symptoms, call 911 and seek out help immediately as these are signs of heat stroke: shortness of breath, nausea, dizziness, blurry vision, red, hot and dry skin. When being active in the summer heat, it is crucial that you pay attention to how you feel and adjust your exercise duration or intensity accordingly. It is very possible that you will tire more quickly than you do in cooler temperatures. Listen to your body and give it the rest and recovery it needs.
5. Try to avoid the heat of the day.
Do your best to fit in exercise either in the early morning or evening hours when the temperatures are cooler and the sun is less direct. If the only time you have to exercise is during your lunch break then try to stay in the shade or workout in an indoor facility.
Happy New Year! It’s that time of year again. The time of year where we stop to reflect and identify the areas we would like to improve over the next 12 months and convince ourselves that this is the year we will finally get it together. In January we make good on our promises to eat more vegetables, go to the gym, and save half our paycheck, only to find ourselves in March sitting on the couch, binge watching Netflix, while eating that premium ice cream that costs $8.99 a pint (hey, at least it’s organic and gluten-free, right?).
Sound familiar? You’re not alone. Only about 8% of those who make New Year’s resolutions actually reach them. This is not to say that setting resolutions or goals is a useless activity. On the contrary, people who explicitly make resolutions are 10 times more likely to reach their goals than individuals who skip the whole resolution business altogether. Unfortunately, the way we typically approach resolution setting often sets us up for failure before we even begin. But don’t worry! A few small changes to how you tackle your resolutions can help ensure you are among that successful 8% come December 31st, 2017.
Focus on the how, not the what. When setting goals we tend to devote plenty of time deciding on what we want to achieve and spend little time thinking about how we will achieve it. Reaching a goal takes concentrated effort. Not thinking about how you plan on reaching that goal is like heading on a cross-country road trip that’s supposed to end in Miami without a map (or your Google Maps app). You will probably see some interesting sites, but instead of southern Florida you may end up in Wildwood, Minnesota, which I’m sure is beautiful but requires a vastly different wardrobe that you didn’t pack. Are you going to lose weight by joining a running club or cutting out your nightly cookie? Does saving money mean making coffee at home instead of going to Starbucks every morning or eating out less often? By thinking of the actions you need to take to reach your goals, you are more likely to take steps that will move you in the direction you wish to go instead of just moving you around.
Set mini-goals. New Year’s resolutions tend to be large, somewhat ambiguous goals that will take an extended period of time to achieve. Focusing on an endpoint that is far away in both time and effort can make us feel overwhelmed. It also gives us the false assumption that we have plenty of time to do the necessary work so can put off starting until a later date. Setting smaller weekly goals can help us stay motivated and make sure we keep ourselves on track. Establish one day as your goal-setting day. On that day, think about the upcoming week and decide what you will achieve to move yourself closer to your resolution. Write those goals down somewhere you will see them every day so you don’t lose sight of the target.
Get S.M.A.R.T. about goal setting. When setting goals it’s important to make them SMART. And no, I don’t mean smart as in it’s a wise decision to contribute to your retirement account every month (although that is an intelligent thing to do). S.M.A.R.T. stands for Specific, Measurable, Achievable, Realistic, and Time-bound. Let’s explore these components one at a time:
Set Yourself Up for Success. We humans have notoriously terrible willpower. So stop telling yourself you just need to have more self-control. Instead, create environments and situations that set you up for success. Don’t keep junk food in your house. Set up an automatic deposit into your savings or IRA account. One creative woman even told me she drops her house keys off at the gym in the morning to ensure she makes it there after work. A little extreme? Maybe. Completely genius? Absolutely! Find ways to manipulate your environment so that acting on your goals requires as little dependence on that unreliable self-control as possible.
Happy 2017! Here’s to your most successful year yet.
Jamie Cassutt-Sanchez, MPH, CHES
Shoulder injury or pain is one of the most common complaints I hear from my patients. Whether caused by direct trauma, overuse, or poor posture, shoulder pain is a very frustrating ailment to deal with. This is because any movement involving your hands or elbows is initiated by the shoulder. In this blog we will discuss the anatomy of the shoulder, why shoulder ailments are so common, and some strategies to prevent and address these issues.
Anatomy is Fun
So let’s talk some basic anatomy. While often referred to as the shoulder joint, the shoulder is more of a complex as it is a complicated structure made up by not one, but four different joints that all must work in synergy in order to achieve pain free motion. It only has one true connection to the rest of the skeleton via the sternoclavicular joint, which attaches to the sternum via the collar bone. The other joints making up the shoulder complex are the glenohumeral joint (what most think of when describing the shoulder), the acromialclavicular joint (which is the bony prominence on the top of the shoulder), and the scapulothoracic joint (made up of the scapula sitting over the thoracic rib cage). These three joints are not directly connected to the rest of the skeleton, but instead are held in place by ligaments and muscles. This allows for a very large range of motion in our arms and shoulders, permitting us to reach high above our heads or far behind our backs. The shoulder in fact has the widest range of motion of any joint in the body! However, this wide range of motion also means the joint is far more unstable than any other in the body, increasing the risk of injury.
Now a little bit about the muscles. There are seventeen muscles that attach to the shoulder to pull, stabilize and push the shoulder in various directions. The larger muscles are designed to take on the majority of large movements, while the smaller muscles primarily act as stabilizers. In a perfect world, these muscles would work together to help us achieve optimal performance in our daily tasks. However, as we are all shown time and time again, things rarely operate as they should.
Why Does My Shoulder Hurt?
If you fall or get hit in the shoulder, then the cause is pretty apparent. But most patients I see who are experiencing shoulder pain have no idea what caused it. This is because the problem is not usually a single event, but rather builds over time as a result of everyday living. Modern life, with all of its sitting, typing, and texting, encourages us to slouch our upper back and round our shoulders forward. Our body eventually learns this position and remains in it even when not sitting or playing with our many tech toys. Unfortunately, this rounded posture is not ideal for many of the motions we want to perform with our arms. The muscles and fascia adapt to this new posture, leading to a dysfunctional movement pattern that eventually causes imbalance and pain.
For example, try to raise your arm above your head while you are slouching with your shoulders rounded forward. See how high you can raise your arm without swaying your back. Do not push your arm past it’s natural stopping point! How high could you raise it? Next, stand up straight with your eyes forward, chest up, and shoulders slightly back. Raise your arm again. Notice a difference? You should be able to now raise your arm straight above your head without any pain, popping, or clicking or motion from the rest of your body. Unfortunately, most of us tend to perform this and similar motions with improper mechanics, causing nerve, blood vessel, and muscular compression. In case you haven’t guessed yet, this is the perfect recipe for disaster.
Alleviating and Preventing Shoulder Pain
There are a number of injuries that can occur at the shoulder, ranging from minor to severe. Below are some suggestions for addressing and preventing shoulder pain and injury. However, if you are experiencing chronic pain or extreme pain, it is important to seek out professional care as soon as possible to ensure proper diagnosis and treatment.
Stretching can help reduce pain and prevent further injury. It is important to incorporate stretches into your daily routine as well as prior to and after strenuous exercise. It is important to warm up before stretching by doing at least five minutes of light movement. When stretching, move slowly into the stretch until you meet a slight resistance and stop there. If you feel any burning or shearing pain, you are stretching too far and need to back off a little bit. Hold each stretch for one to two minutes. As your muscles relax, you may find that you can naturally move deeper into the stretch, but never push past your personal edge. Below are a few great stretches to open up and relax the shoulders.
If stretching alone is not working, then you may need to couple it with foam rolling. When performed correctly, foam rolling can be a great tool to loosen muscle tissue. When foam rolling it is important to roll over tender areas slowly. Once a tender spot has been identified, stay on that spot for 30 seconds to one minute. As with stretching, it is important to warm up the body with light movement before foam rolling. Here are a couple ways to foam roll the shoulder complex.
If you are experiencing shoulder pain that continues after a few weeks of self-care or gets worse, make an appointment with your doctor. Chiropractic care combined with Active Release Technique (A.R.T.) is an excellent treatment for many shoulder issues. Seeking treatment sooner than later can help decrease the risk of severe shoulder conditions.
If you have any questions about injuries to the shoulder or any other part of your body, feel free to reach out to me at email@example.com.
These delicious bites of pumpkin, spice and everything nice are the perfect grab-and-go breakfast or afternoon treat. These muffins are gluten free, lightly sweetened with raw honey, and filled with amazing nutrients, compliments of everyone's favorite fall squash. Pumpkin is full of vitamin A, beta-carotene, potassium, carotenoids, and fiber, making it great for your eyes, skin, and overall immunity. Hope you enjoy these as much as we do!
Healthy Pumpkin Spice Muffins
1 cup blanched almond flour
1/2 cup coconut flour
1 teaspoon baking soda
1/4 teaspoon salt
1 Tablespoon Pumpkin Pie Spice, plus more for sprinkling on top*
3 large eggs, at room temperature
3/4 cup pumpkin puree
3 Tablespoons melted coconut oil
1 teaspoon vanilla extract
1/4 cup honey
*If you do not have Pumpkin Pie Spice, you can combine 1.5 teaspoons cinnamon, 1/2 teaspoon ginger, 1/2 teaspoon nutmeg, and 1/2 teaspoon clove.
Preheat oven to 350.
Grease or line a 12-cup muffin tray
In a large bowl, combine the almond flour, coconut flour, baking soda, salt, and Pumpkin Pie Spice. Mix together.
In a medium bowl, combine the eggs, pumpkin puree, coconut oil, honey, and vanilla extract. Beat until just combined.
Add the wet ingredients to the dry and stir to combine. The batter will be quite thick.
Fill each muffin cup about 3/4 full. Sprinkle some extra Pumpkin Pie Spice on top of each muffin.
Bake for 20-25 minutes, or until a toothpick inserted in the middle of a muffin comes out clean.
Enjoy! Store extra muffins in an air tight container in the refrigerator for up to one week.
Recipe adapted from Gluten-Free Homemaker
What is Fascia
We are well aware of bones, muscles, tendons, ligaments, nerves, blood vessels, and organs, but what provides support, division, and functional unity for these structures is a type of tissue known as fascia. Fascia is a connective tissue composed mostly of water, proteins and carbohydrates that envelops every muscle, nerve, blood vessels, and organ in our body. It weaves throughout our muscles from head to toe in a web-like pattern keeping them bundled together and organized in various sheaths and enabling them to smoothly glide past one another during contraction. You can think of fascia as saran wrap around every structure in the body. We all know how annoying saran wrap can be when it binds to itself, twisting and clinging as we spend minutes trying to pull it apart. Fascia is similar in the way that it can stick to itself or to muscle tissue. When this happens it can restrict our movements. Even more frustrating is that when fascia becomes bound to surrounding structures it can cause compression in our muscles, nerves, blood vessels, or bones, which can then lead to pain.
Why is Fascia Important?
Not only does fascia support important bodily structures, but it also connects series of movements into fluid movement patterns we perform on a daily basis. In order to reach for an object above your head or bend down to tie your shoes, your fascia has to be free from restrictions and flexible enough to move with your muscles as they expand and contract. While muscle tissue is more elastic and behaves similar to a rubber band, fascia is more plastic. Because of this it takes several minutes for fascia to take a new shape and hold. However, once your fascia has taken a new shape it will not quickly return to its previous shape. A common example of this is what happens to all of us when we sit. After sitting for an extended period of time, the fascia located down your back into your hamstrings, calves, and feet will re-shape itself into a shortened position, causing tightness from you back all the way down to your feet. As you transition from sitting to standing, you may notice that it is difficult to spring up from your chair as you once did when you were 6-years old. Believe it or not this is not due to old age, but it is related to the health and integrity of your fascia. As kids we freely explored the world around us by running, climbing, jumping, and playing on the ground for hours. As we have grown up and as technology has advanced, we have transitioned form exploring the world with our bodies to exploring the world through a computer screen in one position.
Fascia is also one of the bodies largest sensory organs in that it is highly innervated with sensory nerve endings. This is why tightness or a kink in your fascia can mimic nerve pain, such as numbness, tingling, or sharp pain.
Keep Your Fascia Healthy
Here are a few tips to help keep your fascia healthy so you can live pain free!
Drink Plenty of Water
Fascia is composed of about 70 percent of water. It is therefore very important to stay hydrated in order to keep your fascia lubricated and mobile. Think of the difference between a piece of beef jerky and a filet mignon. The beef jerky represents your tissue when it is dehydrated, very tough immobile. The filet represents your tissue when your body is properly hydrated, flexible, soft, and spongy. The recommend daily water intake for men is 13 cups (3 liters) and for women 9 cups (2.2 liters).
Foam rolling is a great way to keep you loose and speed up recovery after your workouts. When foam rolling, be gentle and move slowly. When you find a tender spot, slowly roll over it for three to five minutes. If you feel any sharp shooting pain, pulsing, or throbbing you are most likely on a nerve or blood vessel. Just move the foam roller slightly to the left or right and continue.
Stretching your fascia on a daily basis is a great way to help you reduce pain and stay mobile. Similar to foam rolling, you want to be gentle when stretching. Before you start, make sure to warm your body up for five to ten minutes by doing general movements, such as walking or jogging. Stretching can be very intense when you first start out, so start slowly and with multiple short bouts. For example, start by holding a stretch for 20 to 30 seconds and then recovering for 10 to 20 seconds. Repeat this pattern three to five times. Slowly start increasing the amount of time you hold each stretch until you can maintain the position for three to five minutes. With every stretch, make sure you only go to your edge and do not push your body too far. You will be able to move deeper into a stretch as your muscles and fascia become more limber over time.
Move More Sit Less
Movement is one of the best ways to prevent tightness and chronic pain. It only takes about 20 minutes of sitting before degenerative changes in the spine begin to take place. Combat this by getting up and moving more often. This can be as simple as standing up for a couple of minutes to stretch, talking a quick walk around the office, or jogging in place. The point is to just move. Our bodies were designed for movement. If they were designed to sit then our feet would be located on our butts, but that’s not the case.
Get Regular Treatment
If you are experiencing chronic pain that is not responding to any of the above, then seek treatment from an individual that specializes in soft tissue therapy. A combination of frequent movement, regular treatment, and a healthy lifestyle can help keep your fascia young and flexible. Remember, you’re only as old as your fascia!
Chew, Ming PT, The Permanent Pain Cure.
Lucas, Julia, Understanding Your Fascia. http://www.runnersworld.com/injury-treatment/understanding-your-fascia