Why Flexiblity is Important

The ability to move in a full range of motion is important because we use our bodies the way we were meant to move. We use ALL of a muscle instead of only a part. We use ALL of our muscles instead of a specific few. This is healthy, balanced movement.

Once we start losing flexibility, our tightness snowballs. My grandmother would ask me at least once a day to get something out of the cabinet for her that was right above her head. My grandfather didn’t have the flexibility or strength to perform a squat; he died as he fell going to the bathroom, hitting his head on the sink on the way down.

Flexibility allows movement. Movement allows the body to function. You (and your grand-kids) can be happy because you are able to do everything you want and need to do in life.

How to Make a Human Cell Out of an Apple

Flexible people made themselves flexible. Inflexible people made themselves inflexible. Everything we do has a cause and an effect.

It is easy for us to forget sometimes just how amazing the human body is. We start life as a single cell. We can put all of the most brilliant minds with all of the money and technology in the world and they still wouldn’t be able to turn an apple into a human cell like the human body can. We can observe the world, and adapt to it. We can treat our bodies like garbage, disrespecting it with poison in the form of processed foods, alcohol, and chronic sitting, and still live a mid-range life into our 60’s.

Being as amazing as it is, everything that our body does is an adaptation to the environment we put it in. Every disease or condition is a SMART response from our body.

Arterial plaquing is a condition characterized by the accumulation of fatty plaques and inflammation in our blood vessels. Too much sugar damages our whole body, including the blood vessels. Plaquing is the body’s attempt to patch the holes caused by the presence of too much sugar. Everything has a cause!

Conventional Wisdom – To Stretch or Not to Stretch?

Fitness enthusiasts and healthcare practitioners alike say “if a muscle is tight, stretch it.” This is a very general level of detail. In order to get to the bottom of “tightness,” we need to delve a bit deeper into specificity.

If everything our body does is smart, why is your hamstring “tight?” A muscle can be “tight” for 3 reasons:

1. Actual mechanical stiffness

According to the “use it or lose it principle,” our body will use energy for necessary body processes because we evolved with a limited food supply (unlike American culture today). Using our muscles in large ranges requires energy. Being efficient, if we don’t use our muscles, our body makes our active muscles passive so that they don’t require energy, thus conserving it for other processes. This is the stiffness that occurs.

This mechanical stiffness is the only reason you would want to stretch a “tight” muscle. A “normal” stretch should be experienced in the whole muscle, not a small part of it. So if you are stretching your hamstrings, you should feel the same intensity stretch from your butt to your knee.

2. Adhesion

Muscles, ligaments, tendons, and nerves develop adhesion (a form of scar tissue, that by definition, formed without trauma). Adhesion is like taking a piece of gum and putting it between muscles, ligaments, tendons, or nerves so that it becomes difficult for them to slide past one another when moving. It is another way to make muscles stiffer as to conserve energy. But it also is a result of tissue overload and injury.

Overloaded muscles without the proper healing environment will heal with adhesion because the damage done cannot be optimally repaired. Overload can occur from:

• doing the same exercises day after day (too much bench press)
• holding the same postures such as sitting or typing or playing an instrument
• stretching or shortening a tissue for too long

3. It’s protecting something.

Yes, your hamstring contracts to protect you. Certain tissues of the body are more sensitive than others, especially when already irritated or overloaded. Nerves are particularly sensitive because once damaged, they have limited healing ability.

The sciatic nerve is a nerve the size of your index finger running down from your butt to behind your knee where it splits. Because of our sedentary lifestyle, this nerve is apt to developing adhesion between it and the muscles it runs near due to the pressure (sitting on our butt) and stretch (sitting puts tension on the sciatic nerve). Again, imagine multiple wads of gum stuck between this nerve and the muscles. As you bend forward at the back and hips, you put tension on the sciatic nerve (will often be felt in the calf!). If it is adhered and stuck, it won’t like being pulled. Hence, your body contracts your hamstring so that you don’t put any more tension on the nerve.

The 2nd and 3rd conditions are more common than the 1st. This is evidenced by the number of people who stretch without effect, not becoming any more flexible and staying in pain.

What To Do

1. Prevention is the first step: Move often. Don’t do any activity (ie. sitting) for longer than 30 minutes without stretching and moving that muscle in its full range of motion for a couple of minutes. So do a 2 minute lap to get a drink of water every 30 minutes at your desk job. Move your wrist as far as it will go back and forth for 10 repetitions when taking a break from playing an instrument or typing.

2. Perform exercises in a full range of motion with good form. This tells our body that we need to use the full range of our muscles and maintains our flexibility.

3. If tight, perform dynamic stretching. This is stretching into a lengthened position, holding for 2 seconds, then coming out of the stretch. Perform repetitions of 10 before and after workouts. Also, doing this throughout the day is not a bad idea.

If daily stretching does not get you increased flexibility after a couple of weeks, chances are that you have significant adhesion in that area of your body. Continued stretching of adhered muscles or “protective contractions” may make it feel better temporarily. But stretching nerves for long periods of time is not healthy and can contribute towards significant damage. If chronic pain goes along with that inflexibility, an Active Release Technique (ART) provider can help you with this specific problem.  Active Release Technique is quickly becoming the gold standard in soft tissue treatment.

Stretching and flexibility is an area of fitness and health that is overlooked. While stretching does have a place, it is not the be all-end all to the “tightness” you experience. If it doesn’t help, you weren’t born tight.  Just don’t let your inflexibility progress until you can no longer do the things you love in your life.

Proper Lifting Techniques

You have heard it before. “Bend your knees when you pick that up or you’ll hurt your back.” Well, that’s true, to a degree. The fact is though, simply bending your knees is not enough to prevent low back injury.

The reason chiropractors, physical therapists, and personal trainers alike advise bending your knees is because they do not want you to put stress on your low back. The thought is that bending your knees will shift the stress from the back to the knee, but this is not always true. Don’t get me wrong, you should always bend your knees when lifting, but there are other things that must be done as well.

To understand what you need to do to protect your back, you will first need to understand some basic bio mechanics. I promise to keep it very simple. You have 24 vertebrae sitting directly on top of one another that make up your spine. Your spine rests on top of a bone called the sacrum. The sacrum is positioned directly in between two bones called the pelvic bones. In between each of the 24 vertebrae and where the spine meets the sacrum is a disc which you have probably heard of before. While the vertebrae and the sacrum are bones, the discs are made of cartilage and fluid that is structurally not much different than a jelly doughnut; they are hard on the outside and soft in the middle.

Simply put, those vertebrae work together like a spring when you bend over. Imagine bending a spring back and forth over and over again. While that spring might be very strong at first, over time, it would weaken and eventually break. Most commonly with bending, the injury is to your disc. Imagine squeezing a jelly doughnut on one side, all the jelly would squirt out the other direction. This is a simplified example of a bulging or herniated disc. So how do we prevent this from happening?

The answer is very simple. Your back shouldn’t move. Your vertebrae shouldn’t be asked to bend on one another. Discs should not be squeezed on either side. The best way to prevent this is by bending from the hips and the knees at the same time. In case if you weren’t clear on where your hips are, they are the place where your legs attach to your pelvis. Run your hands down your sides, the first bone they come in contact with is the pelvis, as you continue to move your hands down towards your feet you will feel two large round bones, those are your hips. When lifting large, awkward objects from the floor, it is often advisable to drop to one knee in order to get the object off of the floor. For smaller objects or for objects that are located in an elevated position, bending at the hips and knees is advisable.

The first important point when lifting objects from below your hip height is the most simple. Stand close! I mean really close. You want the object that you are about to lift to be located as close to your legs as is possible. The closer the object is to your legs, the less it stresses your spine. Also, to avoid twisting, make sure whatever you are about to lift is directly in line with your belly button at all times.

Avoiding twisting when you lift...

Next comes the pelvic tilt. I give my patients a visual aide for this movement. You want to visualize yourself breaking a sheet of glass with your butt. Imagine that you are standing directly in front of a glass window, and you want to break it without bending your knees. You will have to thrust your butt backwards which will create a very stable arch in your low back. Once you have shifted your pelvis in this manner, your focus should be to continue to squat while reaching backwards with your butt as if you were hovering over a public toilet. Pairing the pelvic tilt with the squat will enable you to lock your lower back from any movement and thereby protect it from any injury! This will take practice to perfect, which is why I recommend to my patients that they practice the squat without weight daily.

So let’s recap. The first step in lifting an object is to stand close to it and make sure it is right in line with your belly button. The second step is tilt the pelvis forward to lock the low back. The third step is to squat while reaching your butt backwards the whole time as if hovering over a public toilet. If the object is too large or too low to squat down to, drop to a knee before lifting. My last piece of advice in regards to lifting is very easy to remember. If it’s too heavy, get help with it!

Every day people hurt themselves performing activities that should not cause them any pain or discomfort. If your form while performing these activities is perfect, you significantly reduce your likelihood of becoming one of these people. I recommend that you practice this technique a few times without any weight before you attempt to lift any objects in this manner. At first it will feel strange and unnatural. Give it time. You will quickly begin to take notice of how much better your low back is feeling, and you will be able to attribute that improvement directly to your new lifting technique. I wish you the best of success with this lifestyle change on your way to better health.

Forward any questions regarding this article to drsean@islandchiropractic.net

Dr. Sean Pastuch, D.C.

Time is money... or is it more than that?

I always talk about bang for your buck with patients or people I am training. People can grasp that they want to get the most value for the paid dollars or for their time as they can. To be most effective in any one aspect, it only makes sense to focus the most on those aspects that will achieve the most sufficient results. Stephen Covey lists it has one of his 7 habits of Highly Effective People: “Do first things first.” What happens when we don’t do first things first?

What I did not realize was that there was an economic term for “bang for your buck,” which is “opportunity cost.” Opportunity cost is essentially what you have to give up in order to make anyone decision. In my personal life, having a job costs me the opportunities of having free time to read and spend time with friends. In chiropractic, the time I spend playing games costs me opportunities to learn new techniques or adjusting people. No choice is either right or wrong from person to person, but individually, each choice does bring us closer or farther away from our goals in life.

Let’s bring our attention to exercise. The majority of people love using machines in the gym. They either are just comfortable using them or don’t realize the huge opportunity cost they have by giving up functional exercises. This example is easy to understand by examining the bodybuilder. Bodybuilders spend anywhere from 1-2 hrs per workout, 4-7 days per week. Sometimes more, sometimes less. They need to spend this amount of time in the gym because they choose small muscle group exercises over large ones. For example, they choose leg extensions (exercising the quadriceps) over squats. Here is the opportunity cost of choosing leg extensions over squats: the lost opportunity to…

1. exercise the gluteal muscles, hamstrings, leg, and core musculature
2. to obtain that spike in anabolic metabolism with hormone release such as testosterone, GH, etc.
3. increased cardiovascular effort and calories burned resulting in fat loss
4. to teach the body how to move correctly in daily life as to prevent injury
5. to maintain flexibility and range of motion as age increases.

This opportunity cost by giving up squats and isolating muscles is HUGE! This is why bodybuilders spend so much time in the gym. The only opportunity cost I could think of when it comes to choosing squats over leg extensions is the increased hypertrophy that comes with isolation exercise, although an extraordinary amount of time is necessary to do this. Luckily, most bodybuilders are extremely dedicated and are willing to give the time. But for people who are exercising to lose weight and work on overall fitness, it does not make sense. Using myself as an example, a 30 minute workout a few days per week is sufficient for me, and that includes foam rolling and dynamic mobility exercises.

Now, let’s bring the notion of opportunity cost to chiropractic. There are dozens of different ways to treat musculoskeletal conditions as there are dozens of ways to adjust patients. Certain coaches in the profession stand by their comment that technique doesn’t matter when it comes to your success as a chiropractor. This may be true when it comes to teaching patients about vitalism, because this just necessitates belief in the human body. But when it comes to actual mechanical pain, certain treatments are more effective than other ones. For example, lower back pain is obviously very common. Many of us, including myself, have treated just the low back and gotten some relief. The opportunity cost of simply massaging the low back and adjusting it is as follows:

lost opportunity to: 1) educate why they have their low back pain, how to get themselves out of it, and how to prevent it in the future, 2) treat the PRIMARY cause/tissue of the pain generating tissue, which can often be the hip musculature being tight so that load/stress is transferred from the hips to the low back 3) Teach them how to perform dynamic mobility exercises so they can relieve their own inflexibility issues and then strengthen with the proper functional movement.

Personal training and chiropractic treatment are just two examples I’ve chosen to see how opportunity cost plays a role in daily life choices. However, it is helpful to use the scope of opportunity cost in all of the choices I make in order to be sure I water all the plants that need watering, or in other words, spend time in all areas in my life that I value. They include spending time with loved ones, nurturing my chiropractic education, and maybe most importantly, learning and growing as a human being. But writing is important to me as well, so the opportunity goal of this note is small, about 30 minutes of time I’d spend hypnotized by the television.

Everyone needs exercise

*This article is considered a musing. Musings are articles of interest, but not of research quality. Instead, they are designed for entertainment or personal opinion.

My remarks for this most recent pearl of wisdom stemmed from a couple of different incidents molding together. I finally got myself back into a formal strength training program after being on hiatus for about 3 months (ah ah ah…doesn’t mean I wasn’t running around. Remember, exercise is the meaningful execution of preplanned and purposeful physical activity) when I realized I was only about 6 weeks away from my first internship and I needed to get some hypertrophy going if i was going to be of any use to my future patients (first internship is in outpatient neuro rehab – very taxing). So I wandered down to the health club, which is in a fairly affluent area and on my way in, as well as while taking inventory of what this place really had to offer, I saw a decent amount of people who were interested in their health. Lots of people, biking, running, playing basketball, lifting, etc., but knowing these white collar types, a thought instaneously flashed through my head – what does he have need to be that big for? – as I passed by one gentleman. Very prejudicial, I know, but I can’t help it – first impressions were always snap and uncontrollable with me.

After my 30 min jog on the treadmill, I stretched out and made my way to the weight room to again assess what equipment the administration thought was necessary. Outside the weight room and above the water fountain hung pictures and credentialing of all the personal trainers (serendipitously convenient, no? These guys are good). I was happy that everyone had at least a Bachelors degree in something related (although my ears pricked after reading one girl was touted as having experience with physical therapy as a result of an internship she had, but there wasn’t anything after her name to suggest she was actually a P.T.), but under one gentleman’s mini CV he only had written “Fitness is a Lifestyle!” This is true, however….

(smirk) There’s seems to be a lot of howevers with me, I’ve noticed. Some days I wish my life existed in a little more black and white instead of color. I digress. These two anecdotes overlayed something a dear friend said to me once as I was relishing in the new found power I wielded when I was selected to assist with Physical Therapy Program interviews one year: “So, what do you hope to accomplish with that question? What answer are you looking for?” Random, I know, but I do have I point.

As I worked my lower half on the leg press, I got to thinking. In this day and age of cultural norms, trends, fads, and ulterior motives, I tend to appreciate more those who have a functional, logical, and reasonable purpose for what their doing. For me, I have a functional purpose for my training – I need to be able to support, block, push, pull my patients, to perform my daily and non-daily tasks at home, as well as prevent injury when I play. And maybe the white collar folks have their reasons for living at the gym, as some truly do, but to them I ask a potentially pointed question: “To what end?” What purpose does exercising so much serve for you, and please don’t tell me it’s heavily based on self-image and trying to attract members of the opposite sex. While everybody’s got their something, that’s probably one of the worse, least self-satisfying reasons to do anything. ANYTHING. If nothing else, that kind of thinking breeds narcissism that’s insanely hard to get rid of as one ages.

My solution – find a logical, meaningful purpose. If you want to protect your joints and back against age-related changes, perfect. If you want to do a triathalon, wonderful. If you want to improve your recreational rugby game, amen. If you want to be able to take care of yourself when you reach 90 y.o., fantastic. If you’re diabetic or have high blood pressure and want to reduce your dependence on injected insulin or your risk of heart problems down the road, I’m sure medicare will eventually thank you, but I know your family and bank book will do so more readily. Whatever it is, please, have some depth to your resolution. In the end, the main idea is that you’re active in a challenging way that makes your exercising efforts worth all the blood, sweat, tears and time.

As Jimmy Lunceford once suggested, “It ain’t what you do, it’s the way that you do it.” Just something to think about it.

Taken from Katepedia – Original article, a future PT