The Two Lower Body Exercises to Stop Right Now

Injury

Last month I detailed the 1 Upper Body Exercise to Stop Right Now, and now its time to stop the insanity with the legs as well.  This time I am giving you two exercises.  Now, let me preface this with one detail:  If you have ever competed in  bodybuilding or have already paid your entrance fee to compete, then you get a pass.  I understand the need to isolate muscles for a competition.  This list is simply for the person working out to get in shape, get stronger, or just to be healthy.  Alright, let’s get started.

#1:  The Knee Extension Machine

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This is the reason I am giving you two, because this one showed up as an example during my previous post.  This machine is great for my career as a physical therapist, not great for your knees.

Muscles:  Quadriceps

quadriceps

Mechanism:  Works in an open-chain environment, which in this case means you are not bearing weight through the foot.  When you work the quads in open-chain the quad tendon and patellar tendon work as a pulley over your patella (knee cap).  During the knee extension exercise research shows a significant increase in joint reaction force and joint stress.

Advantages:  Hypertrophy?  Not really, research does show increased rectus femoris activity with knee extensions, the squat showed better recruitment of hamstrings, overall quads, glutes, and a better functional carryover with steps.

Disadvantages:  Imagine you are Eazy E crusin’ down the street in your 6-4, then over time your tires, wheels, and axles fall off the car.  Do you hear that screeching, grinding sound?  Yeah, that’s what the back of your kneecap sounds like during the knee extension machine.

You can hear his voice, can't you?

You can hear his voice, can’t you?

Reason to use: Can’t think of a great one.

#2  Seated Calf (soleus) raises

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Muscle:  Mostly Soleus

Soleus

Mechanism:  By bending the knee you reduce the force the gastrocnemius can generate. The gastrocnemius is a two-joint muscle which means it crosses two joint lines:  Knee and Ankle.  The soleus on the other hand crosses only one joint the ankle therefore with the knee eliminated, the soleus is left to take the brunt of the force.

Advantages:  Isolating the soleus can be advantageous for overall calf development.  Research has shown that the soleus contains significantly more slow twitch muscles fibers than the gastrocnemius.  Therefore, with the distance running population, it can be theorized that development of the soleus can help.

Disadvantages:  The isolation, while good for distance runners in theory can also create a significant reduction in ankle dorsiflexion (see picture).

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A reduction of dorsiflexion can create a loss of efficiency with step length and force absorption in walking and running.  Over time this can cause a breakdown in the feet, knees, and hips.  In addition, trigger points in the soleus can mimic Achilles tendonitis pain.

In both cases there are better exercises to do for functional gain, and the increased risk of injury isn’t worth the effort.

Running Away From Pain

Injury

www.posichiro.com

Runners are a special breed, along with cross-fitters they will gut out the toughest of situations to complete their workout.  However, running while in pain can lead to a host of other issues.  It is common for runners to experience discomfort at one time or another especially as mileage is being ramped up.  If not addressed, these aches and pains may lead to chronic, often performance-limiting issues.

What are some of the main issues with running?

  • Knee Pain
    • Often triggered from an imbalance in the glutes.  With increased training or a change in gait the glutes can stop firing efficiently leading to tightness along the outside of the thigh.  This tightness often times is manifested by pain at the outside of the knee joint where an area that has blood vessels and nerves can become compressed leading to the sensation of pain.

Iliotibial Band Syndrome (ITBS), liac crest, Gluteus medius, Tensor fascia latae, Gluteus maximus,Vastus lateralis, Iliotibial band, Tibia tubercle, Patella, Inflammation of the iliotibial band (ITB) causes outer knee pain and possible pain in the hip, MendMeShop TM  ©2011

  •  Foot pain
    • Foot pain is often caused by tightness in the calf muscles with special emphasis on the soleus muscle.  When overly tight, the soleus can restrict proper ankle dorsiflexion leading to improper landing and push-off with stride.
Soleushttp://www.somastruct.com
  •  Back Pain
    • Back pain is caused by excessive tilting of the pelvis forward.  With this tilting the runner will likely overextend the back to stay upright.  This overextension puts a lot of stress on the joints and muscles in the low back.  In addition, this pelvic tilt can limit hip extension which can cause a vicious cycle of back issues and hip pain.

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To treat these symptoms you must address the underlying cause.  If you are unable to complete your workout, or the pain lingers for more than a couple of hours after the activity you should seek a physical therapist with experience treating runners.

In general a few things you can do to prevent these issues include:

1.  Gradual increases in training

2.  Limit activity if sore.  Soreness, although accepted as normal can change mechanics, faulty mechanics can cause chronic issues

3.  Have  a proper warm-up/cool-down routine, don’t just walk 50 feet, do the general 5 second stretches and call it good.  Do some mobility drills and activate the muscles including the glutes, calves, abdominals.  To cool-down, foam roll, stretch.

4.  Don’t sit all day.  One of the things we can all agree on is that sitting after activity can severely limit recovery.  If you have to sit for your job be sure to stand and walk as much as possible.

For more information, or to see a specialist to help with any of these issues visit www.makovickapt.com

The information in this post is for informational purposes only and does not substitute for the advice by a medical professional.

The Upper Body Exercise to Stop Right Now

Injury, Pain, Uncategorized

In the history of weight training there have been numerous examples of exercises that are fantastic: the squat, deadlift, lunge, pull-up, push-up. However, there are also exercises that make any anatomical professional cringe to the point of white-knuckling. Here are some examples:

I mean, really there is no explanation needed.

I mean, really there is no explanation needed.

Isolation:  Yes, from everyone around you who can't stand listening to your knees crack

Isolation: Yes, from everyone around you who can’t stand listening to your knees crack

Just, no.

Just, no.

The exercise I want you to throw away today, forever…no I mean it, FOREVER is the upright row.

The anatomy is simple:  The exercise is designed to target the traps.  However, to get the traps you have to put yourself into the position of shoulder impingement and the repetitive position that can lead to tennis elbow.

 

Yep, that's the one

Yep, that’s the one

elbow

 

With each of these exercises I know the argument:  “It isolates blah, blah, blah muscle.”  Well, the upright row isolates alright, it isolates the supraspinatus rotator cuff tendon right up under the acromion.  The only pump you’ll get from this exercise is a pump of corticosteroid the ortho doc will be giving you, unless surgery is the better option:

 

 

So, please….don’t do this exercise.  Your body will thank you.

What Should He Do?

Injury

Menisectomy vs Meniscal Repair

If you are a Bulls fan or Chicagoan in general the news of Derrick Rose’s recurring meniscal tear has already sent you into the first stage of grieving. So, now what? A lot of medical professionals and former athletes will be on the airwaves today comparing and contrasting injuries, surgical techniques, and prognoses. The main questions will be: 1. Repair vs removal and 2. Will Rose ever be the same?

The meniscus is a C-shaped cartilage that sits on the top of the tibia. Its primary responsibility is to provide a cushion between the femur and tibia. The meniscus is generally injured by a compression and twisting injury. When injured, people can feel pain, lost range of motion, popping, and occasionally locking of the knee.

A meniscal repair is an arthroscopic procedure where the surgeon will suture down the injured tissue to allow it to heal. This type of surgery only occurs if the tear is a clean longitudinal tear on the periphery of the tissue because this area has blood flow to allow healing. A menisectomy, on the other hand, is an arthroscopic procedure where 10% of the meniscus is removed.

Physical Therapy for either procedure includes improving range of motion, controlling swelling, increasing strength, and fixing any movement faults that could have predisposed the injury. In addition, physical therapy has been shown to be just as effective as surgery in patients with meniscal tears. A Functional Movement Screen should be used before returning any client to sports to decrease the chance of re-injury. In regards to if Rose will be doing this again, the injury itself and the general rehabilitation should be easy enough. However, the psychological hurdle will be the most difficult. Rose will need to again be explosive, with great jumping and landing mechanics, without hesitation. This is no simple feat, and as anyone who watched Rose at the first of the year knows, it was a work in progress.