Bring on the Beach

I had a good laugh the other day. I was working with one of my regular clients and we were doing a simple upper-body strength-training workout. I made a comment about the fact that we were training the ‘t-shirt muscles’ and he quickly mentioned that ‘beach season’ was coming. Beach season? In January?

My client reminded me that there’s only 6 or 8 weeks until many of us start taking off for tropical vacations in warm sunny climates. These are the kind of vacations where bikinis and board shorts come out of the closet and our bodies see the light of day for the first time in months. I quickly agreed. Beach Season is near enough that we’d better start training for it!

I felt that it might be beneficial to put together a column series featuring exercises that could be done over the next 6-8 weeks to shape up for the sunshine. I believe that 3 good exercises for the lower and for the upper body, and 3 for the core should do the trick. Of course it takes more than a few strength-training exercises if you really want to change your body and feel great when you hit the beach. Eating well and burning enough calories to control your fat stores is another a key component to feeling positive about your fitness.

Following are three effective exercises for improving the shape and function of your lower body, emphasizing the hips and thighs. Always stop if you feel pain, and make sure that you consult your physician before undertaking a new fitness program or making changes to your current routine.

Bench Lunge to Step-Up

This is a great exercise for the entire hip and leg complex. Choose a low, stable bench or step that is below knee height. Start by placing your right foot firmly on the surface, with your left hand and arm in front of your body as if you were running. Bend your left leg and lower your knee down until it’s almost on the floor. Keeping your core engaged, drive upward using your right hip muscles, lifting your left knee up toward your chest as you reach full extension with your right leg. Your arms should switch during the movement, so that your right hand is in front of your body as your left knee reaches the top of its motion. Pause momentarily for control, then bring your left foot back down to it’s starting point, being careful to lower it slowly and touch it lightly on the ground rather than pounding down. Repeat for 12-15 repetitions on each side, completing 2-3 sets in total. The deeper you lower your back knee, the more work your glutes will do.

Single-Leg RDL (Romanian Dead Lift)

This is a spectacular exercise for developing athletic glutes and legs. At the same time, you’ll be conditioning the posterior core system that is so important for effective movement and spinal stability. Start in a strong, neutral stance with a light kettlebell or dumbbell in your right hand. Begin to pivot forward on your left hip as you extend your right leg out behind your body, letting the dumbbell draw your right arm toward the floor. Keep both knees slightly bent and work to keep your lower back in a neutral curve with your pelvis square to the floor. Allowing your shoulders to turn slightly will increase the range of motion of the movement, but be careful not to flex the spine forward as you reach the kettlebell toward the floor. Pause momentarily at the bottom, then use your left hip muscles to pull you back up into an upright position. Lightly touch your toes on the floor and repeat the motion. Try 2-3 sets of 10-12 repetitions on each leg, maintaining strong core stability and controlled movement speeds. Because your balance will be challenged during this exercise, it’s a good idea to try it near a wall or chair that you can use for support if necessary.

Roller Squat

With so many variations of the basic squat and lunge movements, it can be challenging to find enough stimulating options. There’s always a way to keep your muscles guessing. One fun and functional way of doing squats is to stand on a foam roller. I want to stress that this can be very challenging and unstable, so if your balance isn’t great, start with a soft roller that will flatten out a bit, hold onto a wall, or place your roller on a soft surface like an exercise mat. If you’re looking for more of a challenge, a firm roller on a hard surface will really activate your balance receptors and recruit a lot of stabilization muscles in your legs. Performing these squats barefoot is a great way of conditioning the muscles of your feet. Perform 2 -3 sets of 15-20 squats with good core engagement and body control.

-Rob Williams is a kinesiologist, elite personal trainer and posture specialist. He has been practicing for over 20 years and currently owns and operates Williams Health Group, a downtown Vancouver personal training studio and integrated health and human performance clinic. Rob is a sought-after posture and performance coach for celebrities and athletes of all levels, and has recently developed the Sport Posture and Movement Specialist certification program for trainers and coaches. Rob is also an accomplished writer and speaker in the fields of fitness, posture and nutrition. Contact him directly at rob@williamshealthgroup.com.

Shock Your System

This is it. A new year and an excellent opportunity to re-new your determination and re-launch your fitness program. Whether you made it to the holiday season on top of your fitness goals, or determined to pick up the pace in 2013, there’s probably a good argument that can be made for trying something new and changing things up a little bit. You don’t need to do this for the whole year. How about for the month of January?

I’ve found throughout my career that people tend to get comfortable when it comes to their training and exercise plans, sticking to the same program or activities for way too long. The approach that may have worked for the first 6 months probably stopped getting results long ago, and likely they didn’t know how to adapt or evolve for continued success. If you’re thinking that you might benefit from shaking things up a bit with your training plan, I’d like to offer a few suggestions.

Of course there are some constants when it comes to fitness, like the fact that you need to get your heart rate up if you want to burn a lot of calories and improve your cardiovascular capacity, or that you have to overload your muscles if you want to see adaptive changes in size, strength and endurance. Nutrition is also a key component of fitness where there are trusted principles, but you can definitely benefit by trying some new things with your meal planning this year.

I know from experience that change can be a good thing when you’re striving for fitness results, so try something new, mix up your approach, and shock your system a bit. Always remember to consult your doctor before beginning or modifying your training plan, and never skip the warm-up before exercising.

Resistance training

I know some readers will already be training differently, but I’m going to suggest that the majority of exercisers are performing a typical strength-training program, with a list of gym-based exercises that they perform for a specific number of sets and repetitions. This can be a very effective approach to resistance training, but not necessarily if you’ve been taking the same approach for years. Because our bodies are excellent at adapting to any consistent stimulus, it doesn’t take long to start seeing diminishing returns on your exercise investment. As an alternative, why not try a new approach for a month or so, like one or both of the following:

Bodyweight – Train using only bodyweight exercises where you push, pull, press and lift your own body to target different bodyparts non-stop for a total of 20-30 minutes. Use your imagination and change angles, body positions and anything else you can think of. Do each exercise until exhaustion before moving to the next exercise. Keep moving so you’re always working. Perform up to 5 days per week.

Bands – Similar to the bodyweight workout, but using only resistance band exercises to work your muscles in as many angles and directions as possible. Complete 20-30 minutes of constant pushing, pulling and pressing to muscular exhaustion. Perform up to 5 days per week.

Cardiovascular conditioning

Perhaps even more than strength training I find that many people do the same kind of cardio exercise for years, and sometimes even decades. The problem is, once your body becomes accustomed to an activity it will become very efficient, and get less of a conditioning stimulus from it. This may sound like a good thing, but if your goal is overload your system for calorie burn, or cardiovascular improvement, you don’t always want to take the easiest route! Instead, if you’re a runner, try swimming. If you’re a cyclist, try rowing. If you always use the elliptical machine, try skipping for a change-up.

Fuel consumption

Despite the high volume of nutrition information available to the public I still believe that most people eat poorly. Sometimes this is because they don’t know any better, but usually it’s because they have developed bad habits that they have a hard time changing. Why not shake it up and try a serious change? You might just break some deep-seated habits and gain a whole new level of control over your nutrition. Here are a couple of options:

Go green: Take a month and try a vegetarian, vegan or raw diet. You might just find that you feel better, have more energy, or love the food. Of course, this isn’t for everyone, but a month should give you a good idea if it’s right for you, and there’s a good chance you’ll clean up some of your bad eating habits.

Be sugar-free: Do everything you can to limit your sugar intake for a month. This includes white sugar, brown sugar, cane sugar, honey, glucose, fructose, dextrose, invert sugar, syrups, molasses, fruit juice concentrate, and more. You’ll be surprised how much sugar is used in the food you eat.

–Rob Williams is a kinesiologist, elite personal trainer and posture specialist. He has been practicing for over 20 years and currently owns and operates Williams Health Group, a downtown Vancouver personal training studio and integrated health and human performance clinic. Rob is a sought-after posture and performance coach for celebrities and athletes of all levels, and has recently developed the Sport Posture and Movement Specialist certification program for trainers and coaches. Rob is also an accomplished writer and speaker in the fields of fitness, posture and nutrition. Contact him directly at rob@williamshealthgroup.com.

Ski Fit Strength

If you’re looking for serious improvement in your total physical performance on the ski-hills this winter, taking a well-rounded approach to training is essential. I’ve previously discussed flexibility and core stability, and now it’s time to address full body strength and endurance.

There are thousands of different strength exercises, and many of them would be good for any skier or snowboarder. However, when I was considering which exercises would be good to include in this week’s column, I decided I wanted the activities to meet a few key criteria.

Firstly, because of the physical requirements during snow sports, I’ve selected exercises that have a component of instability, which requires balance and core control. I also wanted to include exercises that integrate the upper and lower body. Sometimes it’s the upper body that is dynamic, while the lower is holding steady, and sometimes it’s the other way around. Lastly, I wanted exercises that are standing, or ground-based, to incorporate the strength and endurance of the leg muscles, as this will clearly carry over to performance on the slopes.

The three exercises discussed this week can be performed with very little weight at first, and progressed depending on your tolerance. They require nothing more than a single dumbbell, or some other weighted item, like a jug of water with a handle!

As always, consult your doctor before beginning or modifying your training plan, and always perform a progressive warm-up before exercising. Controlling your posture and alignment is critical at all times.

1-arm DB Squat

Squats are one of the most functional and foundational exercises you can perform for full-body strength and athleticism. There are numerous variations of the basic squat movement. Performing this 1-arm version requires endurance in your spine, upper back and shoulders, as well as your entire core system and legs. Start by standing in front of a mirror, with your feet approximately shoulder width apart, holding a light dumbbell in your right hand. Raise the dumbbell above your shoulder as if you were going to press it overhead. Once in this position, pay very close attention to the alignment of your entire body, including your hips and legs. Slowly hinge your hips back and lower them down into a squat position, doing your best to avoid shifting any part of your body off to the side. Keep your feet flat on the floor as you reach the bottom of the squat, with your knees bent to approximately 90 degrees. Press yourself back up to the top of the squat, stopping just before your knees reach full extension, then repeat. Perform 10 reps with the dumbbell in each hand, and try for three sets.

1-arm DB Row

This challenging upper body exercise will require balance and endurance through your hips and legs as you hold a sustained position on one foot. The rowing movement of the shoulder girdle and arm will improve the strength of the muscles in this area, and help to protect you from injury during falls. Start in a standing position with a dumbbell in your right hand. Pivot forward through the hips and extend your right leg off the floor behind you, with your right arm holding the dumbbell directly below your shoulder. Keeping balance and control by recruiting your core and hip muscles, draw your shoulder blade back and pull your elbow by your side as you row the dumbbell up toward your ribcage. Pause momentarily and then lower the dumbbell to the bottom position before repeating. Perform 3 sets of 10-12 repetitions on each arm, switching legs each time you switch arms.

DB Squat Front Raise

Anyone who skis or boards knows that the legs can really start burning during long runs at the end of the first day on the hill. This exercise builds leg endurance while strengthening the core and spinal stabilizers, and muscles of the arms, shoulders and back. Start in a standing position, holding a dumbbell in both hands between your legs. Squat down and hold this low position, while slowly raising and lowering the dumbbell in front of your body to approximately the height of your head. Keep your weight balanced between the balls and heels of your feet and maintain a good, deep hip position with strong posture. The deeper you squat the more challenging this exercise will be on your legs. You can vary the demand by shifting your weight to one leg as you raise the dumbbell, alternating legs each time you raise it. Try 2-3 sets of 10-15 repetitions with controlled movement speed. Avoid generating swing momentum in the dumbbell.

Ski Fit Core Function

Staying injury free and skiing to the best of your ability requires a strong, stable and flexible body.  With a minimal amount of advance preparation, your body can perform at a higher level, and contribute to more enjoyable days on the ski hill.

In this second part of my pre-season ski conditioning series, I want to discuss core function and how important it is to athletic movement. Improving your core strength and control will give you a solid foundation for explosive athletic movements while on your skis, and help to keep you more stable and balanced.

Skiers must assume an athletic body position to be able to ski efficiently, and to react to irregularities on the hill. Once in this position, it’s critical to engage the appropriate musculature, at times contracting and holding a fixed position, sometimes generating dynamic force and power, or perhaps relaxing and allowing smooth adaptation to movement needs without losing balance or control.

Because skiers use their upper body and their poles during turns, there is a need for integration of the upper body and lower body during conditioning activities. This doesn’t have to be the case for all exercises, but it can’t be ignored. By choosing your training activities carefully you can target the right body parts and systems, offering the greatest return on your training investment.

As always, consult your doctor before beginning or modifying your training plan, and always perform a progressive warm-up before exercising.

Ball Plank

Doing an athletic plank on the ball is a great way to train your core, in a body position that totally relates to skiing and many other sports. Start with your forearms on a ball and your hips, knees and ankles flexed. Your spine should be parallel to the floor with neutral curves. Good core activation will hold you strong in this starting position, which is more than challenging enough for beginning exercisers. To increase the leverage, slowly push the ball 2” forward and back, moving only the arms, without losing any quality in your spinal position or core engagement.  As you get stronger, increase the movement of the ball, and incorporate opening at the shoulders and hips at the same time. Perform 3 sets of 30-60 seconds in a smooth, controlled fashion. For increased instability and greater difficulty, try putting your hands on the ball instead of your forearms. As you get more comfortable, you can also increase the speed of the movements, or add side-to-side action to the ball. Always use your core engagement and neutral spinal alignment as your measure of quality, and stop performing the exercise before you lose control in these areas.

Ball Bridge

Ball bridging uses much of your core and hip musculature. Start in a sitting position on a ball, then roll out until the back of your head and shoulders are resting on the ball and your knees are at 90˚ angles, with your feet hip-width apart. Extend your arms upward, with your palms together and maintain good core activation and spinal alignment. This is the basic starting position, from which there are numerous progressions. Try turning your ribcage, shoulders, arms and head as one stable unit, while keeping your hips as still and level as possible. The ball should roll sideways, underneath your bottom shoulder as you turn. Pause and twist to the other side. Keep your alignment as neutral as possible. Perform 3 sets of 20 repetitions. Another variation is to keep your upper body neutral, and your hips elevated and level as you raise one foot slightly off the floor. Hold for 5 seconds on each side. Starting with your feet close together will make this easier.

Ball Side Flexion

Try this great exercise to target the sides of the torso, which include the lower back and abdominal muscles. Start by laying on your right side over the top of an exercise ball, with your feet braced against the base of a wall and your top leg behind the bottom leg. The ball should be positioned so that it supports your pelvis and lower torso, just below your rib cage. Place your arms across your chest, or for greater difficulty, place your hands at the side of your head as shown in the picture. Maintain good alignment of the body as you lower your body down, stretching over the ball, then raise back up, lifting your left elbow toward the ceiling as you shift your ribcage upward. Try 2-3 sets of 10-12 repetitions on each side, maintaining strong core stability and controlled movement speeds. Be careful to maintain good balance and control of the ball while preventing your body from twisting.

–Rob Williams is a kinesiologist, elite personal trainer and posture specialist. He has been practicing for 16 years and currently operates an exclusive private training studio Mixx Fitness Studio, with a team of 10 trainers, as well as a multi-disciplinary posture facility, Performance Posture Clinic. Rob is an accomplished writer and speaker in the fields of fitness, posture and nutrition, and can be contacted at Williams Health Group.

Ski Fit Flexibility

There are a lot of years that ski season sneaks up on many of our clients. One day they’re playing golf and cycling, and the next they’re racing to Whistler because the ski hills have opened. I decided that I’d do my best to make sure everyone is ready this year!

Skiing well, and staying injury free, requires a strong, stable and flexible body. The last thing you want to happen is to lose your balance in a turn, causing you to injure a joint or tear a muscle during a fall. If you can get at least a few weeks of pre-season preparation in before skiing, hopefully you can increase your enjoyment, and reduce your risk.

I’ve decided to look at pre-season ski conditioning in 3 parts this season. First I will address flexibility in the lower extremities and hips, by sharing a few of my favorite stretches. These are static stretches that you can perform every day, with the intent of increasing and balancing your flexibility before you ever get to the mountain. You should also perform a good dynamic warm-up before each session on the hill, but I’ll address this later.

In week 2 I will discuss core function and movement, which will give you a solid foundation for explosive athletic movements while on your skis, while keeping you stable and balanced. Week 3 will cover a few great, ski-specific strength and conditioning exercises to get your legs and other muscles primed and ready to go.

As always, consult your doctor before beginning or modifying your training plan, and always perform a progressive warm-up before exercising.

Glute Stretch

As the largest muscle in your body, your glutes can be your biggest friend when it comes to powerful athletic movement. However, if they’re too stiff, or not firing properly, they can also be a problem. To connect with your glutes and keep them flexible, try stretching them regularly. This stretch can be done on a bench or table, or on the floor as shown. Start on your hands and knees, crossing your right leg underneath you. Support most of your weight on your hands as you lay the outside of your right lower leg on the floor, with your left leg extended behind you. Begin shifting your weight back into your right hip joint, while keeping your hips square and your spine and head as neutral as possible. Be certain to stop this stretch if you feel any strain in your right knee. If you don’t feel a stretch right away, use your core muscles to twist your left hip toward your right foot, while picking up your tailbone slightly. These small shifts should dial up the intensity of the stretch. Hold for 30-45 seconds on each side.

Seated Hamstring Stretch

Also known as the modified hurdler stretch, this seated hamstring stretch is most appropriate for people with at least an average degree of flexibility. If you’re very inflexible you will likely be more successful performing a standing hamstring stretch on a low step. For this seated stretch, begin by sitting flat on the floor with your right leg extended out in front of your body. Bend your left leg so that the sole of your left foot rests against the inside of your right calf or knee. Sit as tall as you can, trying to extend your spine upward, and pivot forward at the hip joints. You can either reach for your toes with your hand, or hold onto your leg as shown. By pulling the toe of your right foot toward you, you’ll feel a strong stretch in your calf as well. Hold for 30-45 seconds on each side, progressing as you exhale.

Kneeling hip flexor

Whether you’re skiing or snowboarding, one muscle group that gets a lot of work during a day on the slopes is the hip flexors. Because they connect your legs to your pelvis and lower back, these are important muscles to look after so they don’t cause you any problems. To stretch your hip flexors effectively, start by kneeling on your right knee on the floor, with your left foot on the floor in front of you, and both legs bent to 90˚ angles. Keep your core muscles engaged to prevent your pelvis from tilting forward or your abdomen from protruding. Once you’ve found this position, use your abdominal muscles to draw your bellybutton inward and your tailbone under, pressing lightly forward with your pelvis until you feel a stretch in the front of your right hip and thigh. Try to maintain the right angles at your hips and knees, avoiding the tendency to lurch forward with the hips to increase the stretch. Hold for 30-45 seconds on each side. Always pay attention to your posture and body position.

–Rob Williams is a kinesiologist, elite personal trainer and posture specialist. He has been practicing for 16 years and currently operates an exclusive private training studio Mixx Fitness Studio, with a team of 10 trainers, as well as a multi-disciplinary posture facility, Performance Posture Clinic. Rob is an accomplished writer and speaker in the fields of fitness, posture and nutrition, and can be contacted at Williams Health Group.

Common Training Troubles – Elbows

One body part where there are a number of common issues is the elbow joint. Terms like tennis elbow, and golfers elbow, get thrown around regularly when people have pain in their elbows. Other related conditions, like carpal tunnel syndrome, also involve the elbow joint and muscles of the forearm.

One of the problems with elbow injuries is that this area of your body is constantly in use. People with pain in their elbows commonly list simple activities like typing, driving, writing, shaking hands or turning doorknobs as movements that aggravate their condition. When nearly everything you do causes pain, it can be pretty hard to fully rest the injury.

Over the years I’ve had my own share of elbow injuries. These have included troubles at the outer, or lateral, side of the elbow involving my forearm extensor muscles as well as at the inner, or medial, side of the elbow involving my flexor muscles. I’ve had problems develop from repeated overuse like extended fly-fishing trips, and from acute injuries during sports. Sometimes the issues have resolved quickly, while other times they have lasted for extended periods.

If you’ve ever struggled with elbow pain, you know how challenging it can be to live your life and participate in your favorite activities without making the problem worse. However, what I’ve found with many people is that they will just put up with the pain and let it linger for months or years, because it’s not debilitating like an acute lower back or knee problem. Take it from me, it’s better to prevent elbow problems if possible, and if they do arise, get on top of them quickly so they don’t become chronic.

Always remember to perform a progressive warm-up when you exercise, and be sure to get medical approval before starting a new fitness program.

Knowledge – Most problems that arise in the elbow area are easier to diagnose than more complicated body parts, like the lower back. This is because there are less joint articulations and for the most part the muscles are more superficial. For this reason, it really makes sense to get a timely, accurate diagnosis of what is causing the problem so you can start doing the right things to correct it.

Of course there are some conditions that can be tricky to assess but a well-trained and experienced practitioner should be able to give you an accurate diagnosis without too much difficulty. If the joints of the shoulder, elbow and wrist are functioning effectively, you’re likely looking at muscle imbalance as a primary contributor, unless an acute traumatic injury occurred. As an example, if the flexor muscles in your forearm are too tight, the smaller extensor muscles can be working too hard to move your wrist and hand, which can cause strain and pain in the tendons. By knowing exactly which stretches and strengthening exercises to perform, you can be well on the way to eliminating your pain.

Treatment – Treating an elbow issue effectively often takes diligence, especially if it’s a problem that has lingered for a while. The first steps are to ensure the joints are functioning properly, then reduce any inflammation in the joints or tissues. For this, icing and ibuprofen may be in order. Icing small body parts like the lateral epicondyle of the elbow can most easily be done with ice massage. Fill a few small Styrofoam cups with water and freeze them. When you need to ice, just pull out a cup, peel back a small amount of Styrofoam to expose the ice, and gently massage the painful area.

Once you’ve reduced the inflammation, gentle exercises to balance the muscles are probably in order. Because of the tendency to aggravate elbow problems, go gently at first until you build up tolerance. For rehabilitation add specific movements like resisted finger extension to more global movements like wrist rotation, flexion and extension.

Prevention – Avoiding elbow problems is challenging in a day and age where computer and smart phone usage is so prevalent. These products put high demands on certain muscles of the forearms and can cause repetitive stress injuries. Sport-specific injuries are also a potential problem when certain movements are performed over and over.

Your best bet is to maintain optimal strength, flexibility and balance in your body, by focusing on good posture and overall fitness. On top of this, pay attention to the health of the muscles in your forearms by doing regular preventive stretching exercises, like the forearm extensor stretch shown here. Extend your right arm in front of you and place your left thumb under your right wrist. Use your left hand to flex your wrist toward the floor. If you don’t feel a stretch in your forearm, curl your fingers up into your palm.

–Rob Williams is a kinesiologist, elite personal trainer and posture specialist. He has been practicing for 16 years and currently operates an exclusive private training studio Mixx Fitness Studio, with a team of 10 trainers, as well as a multi-disciplinary posture facility, Performance Posture Clinic. Rob is an accomplished writer and speaker in the fields of fitness, posture and nutrition, and can be contacted at Williams Health Group.

Common Training Troubles – Neck

I spent time this week working with two separate clients to help them manage their neck pain and stiffness. Both of these individuals get headache symptoms when their neck gets bad, so they’re very motivated to make improvement.

Sitting atop the rest of the body, your head and neck are subjected to a lot of different loads and forces, depending on how you move and carry yourself. Think about it. Through your vision and balance mechanisms, your head is always trying to right itself and stay level. If your pelvis is unlevel, you have stooped, forward posture, or your overall movement is off-balance and erratic, your head and neck are going to have to compensate.

Additionally, because of our jobs and technology like computers and smart phones, most of us spend time in a position of forward head carriage, which overloads the muscles of the neck and upper back. Any time the head or neck is out of neutral alignment, some muscles are getting an opportunity to shorten and tighten, while others become overstretched, creating muscle imbalance.

It’s usually not very effective to address problems at the extremities without discussing the body’s central stability and power centers of the core and pelvis. I’m going to assume you’ve been reading my earlier columns, and have taken a good look at your overall posture and alignment, while working to develop good neutral spine and pelvic positioning and core function.

When exercising, always remember to perform a progressive warm-up beforehand, and be sure to get medical approval before starting a new fitness program. Because the neck can be particularly sensitive or unstable, I always recommend very slow and careful progression of any movements. Be sure to stop if you feel anything negative, like pain, dizziness or numbness or tingling in your limbs.

Knowledge – More than any other area of the body, it’s important to know exactly what is going on with your neck. Because of the high degree of mobility of the joints in your cervical spine, and the complicated spider-web of muscles and other connective tissue in the area, there is a lot that can happen in this region, and a lot that can go wrong. Without any prior knowledge, I’ve had clients who’ve had X-rays of their spine reveal significant misalignment of the bones in the neck, with advanced degenerative changes, including bone spurs, reduced joint spaces and so on.

In instances like this, I’ve heard the rationale of ‘if it isn’t broken, don’t fix it’, meaning that if the person with the degenerative neck isn’t experiencing pain or discomfort, why change anything. My rationale is always the same. It’s only a matter of time before the stress that has caused the physical changes to the neck results in some kind of serious, acute incident. Why not get a thorough assessment by someone you trust, and begin to change your lifestyle and exercise habits to improve your neck, rather than letting it get worse? This includes focusing on your posture and head position as much as possible.

Treatment – I fully appreciate how fragile you can feel when your neck gets very bad and you’re experiencing sharp pain and headaches. If you’ve already had a thorough diagnosis and are aware of problems with the bones, joints or disks in your cervical spine, it can be very daunting to try to exercise your neck. However, just like any other part of the body, if you don’t use it, your neck will get less and less healthy.

For acute neck issues you may need to ice the injured area, or possibly taking anti-inflammatory medications. I also recommend the help of a good physiotherapist or chiropractor to manage the acute injury. Very gentle flexibility and range of motion activities, can really help to loosen a painful neck. For chronic tension in the muscles, try applying heat, or rolling the muscles on a roller or small ball.

Prevention – One of the best ways to avoid neck problems is to pay close attention to your overall body alignment during your daily activities. For example, I use an excellent ergonomic chair and keyboard when I sit to write my columns, and take frequent micro-breaks to move my body and reset my alignment. When you’re exercising, always use good body position and core function strategies to improve your movement efficiency.

Another key point is to remember to focus on balanced flexibility and strength in your neck. Regularly performing light range of motion movements and stretches should help your mobility, and it’s very easy to perform gentle strengthening exercises in a variety of directions using only the pressure of your hand. Of course you want to be sure that your cervical alignment is healthy and stable before doing any resisted work with your neck, so as to avoid any risk of injury or complications.

–Rob Williams is a kinesiologist, elite personal trainer and posture specialist. He has been practicing for 16 years and currently operates an exclusive private training studio Mixx Fitness Studio, with a team of 10 trainers, as well as a multi-disciplinary posture facility, Performance Posture Clinic. Rob is an accomplished writer and speaker in the fields of fitness, posture and nutrition, and can be contacted at Williams Health Group.

Common training troubles – Ankles

As an ex-soccer and football player, my feet and ankles have taken their fair share of abuse. I’ve had broken toes, sprains, strains and numerous other injuries. Even though the majority of these problems are no longer an issue, I still have difficulty with my ankles, mostly because of impingement in the joint at the front of the ankle.

One of my good clients, Jeff McCord, has also been struggling with ankle problems. After a recent accident, Jeff now gets intermittent pain in the front of his ankle joints. Everything might seem fine, and then he’ll make one wrong move (usually the rear foot when Jeff is lunging) and he’ll get a sharp, stabbing pain at the front of the joint. Other favorite activities like water skiing are next to impossible because of the anterior shear forces that jam his ankle joints and cause pain.

For Jeff, regular stretching, strengthening and maintenance of the alignment of the bones in the ankle and throughout his body are important to improving the function of this joint. Fortunately he gets help with this from some great practitioners. Without this management, muscle imbalance in the lower legs would increase the likelihood of this issue becoming a more chronic, painful condition.

Problems at the ankles and feet frequently arise in people who’ve had recurring ankle sprains, or other injuries that weren’t rehabilitated properly. Like any other joint in the body, trauma and immobility will compromise function and increase the chances of re-injury. By bringing awareness to the importance of diagnosis, treatment and prevention, hopefully I can help many people to manage ankle injuries, and stop even more people from ever experiencing one.

When exercising, always remember to perform a progressive warm-up beforehand, and be sure to get medical approval before starting a new fitness program.

Knowledge – Anyone can have ankle issues, and there are many conditions that could be involved. Because of the number of bones in the foot, as well as the need for the ankle joint to move freely in many directions, while under the load of your body, it’s possible to create serious injuries from small missteps or faulty movements. Most of us have ‘rolled’ an ankle at some point in our lives. Most of the time there is no real injury, but serious damage can happen in a split second.

If you have suffered an ankle injury, or struggle through life with ankle pain or immobility, it’s definitely worth getting an accurate diagnosis of which structures are involves. With my own ankles, the hyper-mobility in the joints can allow either ankle to become misaligned when doing something as simple as jogging across the street. I know what happens, what causes it, and what can be done about it. If I ignore the problem it can last for days or weeks and cause me constant discomfort. Usually a single joint manipulation by my chiropractor corrects the problem and I don’t have any further troubles.

Treatment – Ankle issues can be more common than you might expect. And you may not know it, but many people actually end up having ankle replacement surgery if the problem is bad enough. Assuming you’re not a candidate for surgery, there are numerous approaches to management and rehabilitation that can be very effective and help you get back on your feet in no time.

Depending on the exact cause of your ankle pain, you may have a slightly different treatment approach, but it’s an excellent idea to start with reducing the inflammation. This is usually done by icing the injured area, and possibly taking anti-inflammatory medications. Sometimes the help of a good physiotherapist or chiropractor is necessary to manage the acute injury, followed by flexibility and range of motion activities, as well as balance, proprioception and strength exercises. Fortunately there are advanced products like the Ankle Foot MaXimizer (AFX) to help properly strengthen all of the smaller muscles around the area.

Prevention – I used to have more trouble with my ankles and feet, but this has been reduced since I started to really pay attention to my alignment when standing and walking, and my overall foot function. I regularly strengthen the smaller intrinsic muscles in this area, and perform as many barefoot activities as possible. Sometimes these are as simple as doing one-legged toe raises. If you’re going to try this, diligent attention to your ankle and foot alignment is essential.

Another key point is to remember to focus on balance in your training. When I get carried away with too much calf training and not enough training for the muscles in the front of my lower leg, I know I’m always at increased risk for my ankles to act up. Keeping all of the muscles in the lower leg flexible and strong goes a long way. It’s also important to pay attention to your footwear to make sure that old, worn out shoes aren’t promoting poor alignment.

Common training troubles – Hips

I’ve been moving around the body a bit when discussing common trouble areas, first starting at the lower back, then addressing the shoulders and knees, and arriving this week at the hips. Each week I’m getting a growing number of emails from readers looking for help and guidance with their own specific issues.

Some of the people who have emailed, and a number of my current clients, have hip troubles. The issues range in severity, but all should be properly managed. Because the hip joint is so large and central to the body, it supports a lot of weight and takes much of the load during walking, running, and sports. When one or both hip joints become dysfunctional for any reason, movement patterns are often interrupted and other serious issues develop.

My good friend Bobby Lenarduzzi was referred to me almost 5 years ago because of hip pain. After a world-class soccer career that ended two decades ago, Bobby hadn’t done much regular exercise aside from jogging.

When he was diagnosed with a congenital joint condition, Bobby trained hard to get in good shape in order to delay surgery as long as possible, and improve his post-operative outcome. After a necessary hip replacement surgery he has again worked very hard on his rehab. Bobby is now very fit and athletic and credits his training for this success. He’s also seen a positive change in his overall outlook and motivation despite his hip condition.

Because his other hip is showing signs of similar issues, Bobby knows he must maintain his strength, flexibility and overall athleticism. With one artificial hip, and another that will likely need to be replaced in the future, Bobby is getting in better shape every day.

When working your hips, always remember to perform a progressive warm-up beforehand, and get medical approval before beginning a new fitness program.

Knowledge – Hips can be tricky. Although this is a relatively simple joint in terms of it’s anatomy, the function of the joint can be influenced by many factors, and there are numerous things that can go wrong. There are also congenital conditions that can cause the hip joint to be less stable than ideal, which often results in early degenerative changes. No matter how it starts, if you’re dealing with hip trouble, be sure to get a thorough assessment by a trusted practitioner. Once you’ve determined the cause, an effective management strategy can be put in place for your hips.

One reliable indicator of hip function, and the health of the hip joints, is the available range of motion during rotation. A healthy hip joint will have a decent amount of rotation, both inward and outward. This is often assessed in a position of hip flexion, with the subject lying on their back. Total range of motion of 70-80˚ or more is ideal. Usually there is more rotation outward than inward, and the movement should be relatively smooth and pain-free. If there is restricted mobility in any/all of the four directions, or pinching pain in the joint during movement, there can be an increased risk of joint issues.

Treatment – Whether you’ve had a new diagnosis of hip problems, or you’ve been struggling with painful joint degeneration for years, I believe that improved flexibility and strength can reduce pain and dysfunction. When you couple this with better body position, core function and movement quality during all activities, you can’t help but be successful in improving your overall comfort and mobility.

Start by taking the time to stretch all of the muscles around your hips, legs and pelvis. Simply balancing this muscle tension can reduce the compressive forces at the joint and reduce inflammation. Then, find ways to perform the most basic strengthening exercises, as long as they fatigue your muscles but don’t cause joint pain. Even little 3” squatting movements can strengthen and stabilize your body and help your joints. Focus on core stability, balance and symmetrical body position as much as possible to limit any tendency to compensate for a weaker hip.

Prevention – I feel the best way to address the topic of prevention is to look at what we’re doing with Bobby to delay further degeneration of his ‘good’ hip. I know Bobby won’t mind me revealing that he isn’t the most flexible guy around. Today we spend a good portion of our training sessions focusing on mobility in his hip joints. As we continue seeing progress in his flexibility and joint mobility, we also work on his posture, functional strength and athletic movement quality.

We carefully manage the rest of Bobby’s body with regular chiropractic care for his structural health, and Active Release Technique^tm for his soft tissues. This doesn’t mean that everyone with hip pain needs a team of trained practitioners working on them weekly, but it emphasizes the importance of diligent care of your body for optimal function.

Common training troubles – Knees

After my last columns on the problem areas of the lower back and shoulder, I couldn’t decide what should be number three on my list of common training troubles. One of my clients helped me to decide that knees should get the nod.

A year ago Wayne Deans’ right knee was swollen, painful and debilitating. After an MRI his doctor told him he had no cartilage left on the joint surfaces, and he needed joint replacement surgery. I’m going to share how he’s been able to avoid surgery so far, and at 66 years old, is currently very active and 100% pain-free.

The knee is a relatively simple hinge joint, but it does have its share of problems. Because of the amount of stress we impose on our knees through weight-bearing activities like running, cycling, golf and skiing, the internal structures of the joint can become damaged and worn. This leads to painful, progressive conditions like arthritis. In Wayne’s case, years of high-level competition in hockey, squash and triathlons had taken their toll.

In addition to wear and tear, acute knee injuries are common. Torn cartilage or ruptured ligaments can happen to anyone, at almost any time, and will often need surgical repair. I’ve had a major knee reconstructive surgery myself, as a result of a soccer injury. It was performed 25 years ago by Dr. Brian Day, and because I saw the top surgeon and was diligent about my rehabilitation, the knee has been 100% functional since.

In the case of Wayne, myself, and dozens of other clients, the most important aspect of managing knee injuries is to minimize the stress to the joints through proper body position and movement strategies, while optimizing strength and flexibility in the legs.

Always remember to perform a progressive warm-up before training or sports, and get medical approval before beginning a new fitness program.

Knowledge – It’s pretty hard to address a complicated, painful joint condition without knowing exactly what is causing the problem. A good practitioner can often accurately diagnose a knee condition through a detailed history and careful assessments, however appropriate imaging like X-ray or MRI is sometimes necessary. Once you’ve determined the cause, an effective management strategy can be put in place.

When I first injured my own knee, the sports medical practitioners in my hometown put me through almost 6 months of passive treatment, like ultrasound, etc. Every time I would try to play sports I would re-injure the knee and it would swell up like a balloon. Finally I came to Vancouver to see Dr. Day and in 2 minutes he told me that my ligament was ruptured and I would need surgical repair. All the therapy in the world wouldn’t have made a difference. The right diagnosis was essential.

 

Treatment – Just like the other areas that I’ve discussed, if you do have a knee problem, whether acute or chronic, try to get an assessment and treatment by a qualified practitioner that you trust. Once you’ve learned the cause of your issue, I’m going to bet that a good portion of your treatment plan will include strengthening the muscles that support the knee joint, and stretching the muscles that surround it.

Even in a condition like Wayne’s, where the joint is seriously worn and the bone-on-bone contact is causing pain and inflammation, a simplified approach of improved strength and flexibility can yield great results. Where he used to have a 6-8” deficiency in the flexion of his right knee, Wayne has worked hard to achieve full range of motion, getting his heel to his buttocks. We’ve also re-programmed how he stands and moves to properly utilize his muscles and joints. Through a combination of better body position, core function and movement quality, Wayne now uses the correct muscles, which keep his knees healthy rather than harming them.

Prevention – What can you do if you’ve never had a serious knee issue, and want to avoid them? As far as I’m concerned maintaining strong, flexible legs should give you the best chance of living your life with healthy knees. Of equal importance is making sure you move your body in a way that doesn’t cause wear and tear. I’ll use Wayne as an example again. As part of my assessment I determined that every time Wayne transferred his weight onto his right leg, his glute and hip musculature was less active than it should be. This allowed his pelvis to slide too far outward, rather than staying in line with his body, and put too much weight forward onto the ball of his foot. This shift of the pelvis off-loaded his strong, stable hip joint and transferred excessive load and rotational stress to the knee joint. Every step was aggravating his knee. Changing this pattern has been a big part of his success.