If you are one of the millions of people who suffer with neck pain, YOU ARE NOT ALONE! Do you spend hours hunched over your laptop? Are you constantly staring down at your phone? Is your stress level out of control? Do you lack self-care in the form of exercise and nutrition?
Whether we realize it or not, humans and trees have an organic connection with each other. We exhale the carbon dioxide that trees absorb. Trees emit the oxygen that humans need to live. Many cultures – both ancient and modern – have recognized this interdependency. Nearly every pre-industrial people group has had traditions, ceremonies, and medical practices tied to trees.
Diaphragmatic breathing is a technique that involves engaging the diaphragm muscle while breathing, allowing for more efficient oxygen exchange in the body. This type of breathing can be beneficial for cardiovascular exercise performance, as it helps to increase the amount of oxygen that that is taken in with each breath. By doing so, diaphragmatic breathing can improve aerobic capacity, endurance, energy levels during exercise, as well as reduced feelings of fatigue and improve lung function.
One study conducted in 2016 found that diaphragmatic breathing improved exercise performance in trained male cyclists. The study participants perform a maximal cycling test, during which they practiced diaphragmatic breathing. The results show that the cyclists who used diaphragmatic breathing had a significant improvement in their VO2 Max (the maximum amount of oxygen used during exercise), and power output compared to those who did not use diaphragmatic breathing. Another study conducted in 2015 found that diaphragmatic breathing improved respiratory muscle function and reduce breathing effort during exercise in both trained and untrained individuals. Diaphragmatic breathing can also help to reduce stress and anxiety, which can have a positive impact on exercise performance. Stress and anxiety can lead to increased heart rate, shallow breathing, and decreased oxygen uptake, which can negatively impact exercise performance. By practicing diaphragmatic breathing, individuals can reduce stress, anxiety levels and improve their ability to handle the psychological demands of exercise.
In addition to its benefits for exercise performance, diaphragmatic breathing can also have other health benefits. It has been shown to reduce blood pressure, improve lung function, and enhance overall relaxation and well-being. For individuals with respiratory conditions such as asthma, COPD, or bronchitis, diaphragmatic breathing can be a helpful technique for managing symptoms and improving respiratory function.
It is important to note that diaphragmatic breathing should not be relied upon as a sole method for improving cardiovascular exercise performance. It is best used in combination with other techniques, such as proper warm up and cool down, a balanced intense exercise program, adequate nutrition, rest, and recovery. In addition, it is important to consult with a healthcare professional before incorporating diaphragmatic breathing into any exercise routine, especially if an individual has any pre-existing health conditions.
In conclusion, diaphragmatic breathing can be a useful technique for improving cardiovascular exercise performance. By increasing oxygen uptake, reducing stress, anxiety, and improving lung function, diaphragmatic breathing can help individuals to perform better during exercise and enhance overall health and well-being. However, it should be used in combination with other techniques and under the guidance of a health care professional for maximum benefit.
Reprinted with permission from author.
Mike Rickett MS, CSCS*D, CSPS*D, RCPT*E is a nationally recognized health and fitness trainer of the trainers, fitness motivator, author, certifier, educator, and the 2017 NSCA Personal Trainer of the Year. He has been a fitness trainer for more than 35 years. With Cheri Lamperes, he co-directs BetterHealthBreathing.com, a conscious breathing educational program focusing on the diaphragmatic technique to enhance overall wellness. In addition, he also directs the personal training site ApplicationInMotion.com.
Musculoskeletal injuries from trauma, repeated activities, or overused joints or muscles are very common — in fact, almost every one of us will get injured at some point in our lives. Most of the time, it will reoccur and become more serious when left unattended or untreated. When repeated injuries happen, it is very likely not due to a one-off fluke.
So why do we constantly get hurt at a specific joint or muscle? And why does the pain seem to travel elsewhere after?
The human body is complex and designed to move in countless movement patterns. When we move, kinetic energy travels from our feet to our neck and head. This concept is called the Human Body Kinetic Chain Movement. Our skeletal system consists of various joints linked in a chain, each with specific purpose and function.
When our joint is not functioning as it is intended to, our body will adopt a dysfunctional movement, which can lead to acute pain in our joints or muscles. If not corrected, chronic pain can happen. A sedentary lifestyle, past injuries, poor posture and misalignment, stress, health conditions, diseases, and other factors can lead to the development of dysfunctional movement.
Here’s an example of a common dysfunctional movement at the lower proximity. If your ankle (which is supposed to be mobile) is stiff, your body will seek mobility at the knee which is supposed to act as a stable hinge. A painful knee typically develops as a result. In another scenario, if you spend extended periods of time sitting and experience restricted mobility at your hips, your body may compensate by seeking mobility at your knee or lumbar spine. This reversal of joint roles can lead to injury or pain in the affected joint or muscle.
Continuing to compensate for the long term can cause a cascading effect such as muscle imbalances, poor neuromuscular function and muscle atrophy or hypertonicity.
One of the common mistakes we make is to only address the symptom (pain) with the use of NSAIDs, massage, chiropractic therapy and other non-invasive or invasive treatments, rather than addressing the underlying cause of the problem.
Another widespread misunderstanding is the idea that simply strengthening the muscle at a joint can solve the problem, without considering its kinetic chain relationship. For example, strengthening the quadriceps to alleviate knee pain, without taking into account the mobility of the ankles and hips or the stability of the lumbopelvic area.
That’s why it’s crucial to have a comprehensive understanding of how our bodies are designed to move, and to identify any weak links in our body’s kinetic chain to ensure optimal recovery through appropriate rehabilitation measures, and not view the problem in isolation.
Typically, it is advisable to conduct an assessment initially to pinpoint the root of the problem. However, when a patient presents to my clinic in pain, they often exhibit compensatory movement patterns that can yield false positives/negatives results. For this reason, my approach is to first identify the type of pain or injury they are experiencing and address their pain as a priority. To reduce their pain levels, I utilize methods such as soft tissue manipulation and other therapies that are appropriate for their condition.
Soft tissue manipulation and manual therapy, such as massage has been proven to:
It is best to engage a practitioner who is trained or skilled in this field, or perform self myofascial massage by using a foam roller or trigger point massage ball under guidance.
Once the pain has been adequately managed, I will proceed with a thorough assessment to identify any potential weak links in the person’s kinetic chain. After that, they will begin an active treatment program that includes targeted stretches, mobility drills, and muscle reactivation exercises through a set of neuromuscular exercises. The rehabilitation program also emphasizes teaching the person to disassociate their movements and joints through specific exercise drills, which re-trains their brain to use their muscles and joints as it is supposed to. As soon as they are able to correct their dysfunctional movement, it is highly recommended to strengthen the entire structure based on function, rather than relying solely on brute strength.
Understanding the concept of our body’s biomechanics and how kinetic chain work can help you better manage or even resolve musculoskeletal injuries holistically, and not just detaching the problem to a specific joint or muscle.
Do take note that different types of musculoskeletal injuries may require different forms of therapy or approach. It is extremely important to seek a professional’s help to determine the appropriate care for your musculoskeletal pain or injury.
Ke Wynn Lee is an author and an international award-winning corrective exercise specialist currently owns and operates a private Medical Fitness Center in Penang. Apart from coaching, he also conducts workshops and actively contributes articles related to corrective exercise, fitness & health to online media and local magazines.
References
Field, T. (2014). Massage therapy research review. Complementary Therapies in Clinical Practice.
Moyer, C. A., Rounds, J., & Hannum, J. W. (2004). A meta-analysis of massage therapy research. Psychological Bulletin.
Crane, J. D., Ogborn, D. I., Cupido, C., Melov, S., Hubbard, A., Bourgeois, J. M., & Tarnopolsky, M. A. (2012). Massage therapy attenuates inflammatory signaling after exercise-induced muscle damage. Science Translational Medicine.
American Council of Exercise (ACE)
National Academy of Sports Medicine (NASM)
Walking is our freedom to GO anywhere, anytime, automatically, to get somewhere ‘on our own’ without fear or assistance.
It is the antithesis to the slipper shuffle and a key player in fall resistance, that is, staying UP. A shorter, wider stride, stiffer ankles and feet, and a hunched posture are not a function of aging per se. We CAN be spry, walk tall, with spring in our step, well into our 80’s and 90’s.
One of the most common questions I encounter, especially with prospective new clients, is how exactly does exercise improve mental health? Exercise actually affects mental health in several ways.
Many athletes fantasize about losing weight (“Wouldn’t it be nice to lose a few pounds…”). But some athletes have to lose weight in order to meet a specific division for their sport. Athletes such as boxers might have to make weight for a day only once or twice a year, but others such as wrestlers are wisest to keep their weight low for a season. And then there are figure skaters, dancers, and gymnasts who live in long-term “food jail” to maintain a sleek physique for months on end because they get judged on aesthetics. This article will not focus on the problems with long-term under-eating, but rather offer help for athletes who have to/want to lose weight for the short-term.
Weight classes exist to supposedly even the playing field so, for example, a wrestler or a rower competes against someone who is about the same physical size. A problem with weight-class sports is too many athletes target a minimal weight that is unlikely their best performance weight and focus on a number on a scale instead of ability to compete well. They often resort to last-minute restrictive dieting and dehydrating to make weight. Inadequate recovery between weigh-ins and the event can contribute to early bonking, poor performance, and disappointments. One champion collegiate wrestler shared his winning advice, “I ate well, competed at my natural weight, and clobbered my starving opponents. Easy!” The same goes for athletes in running sports, who believe lighter equates to faster. Not always the case. There’s a lot to be said for running well-fueled at your natural weight.
Obviously, they are not supposed to wait until the last few days before an event to lose weight by abstaining from food and water, over-exercising, and abusing their bodies. The better path is to start chipping away at weight loss weeks in advance. If you have to lose 10 pounds, give yourself at least 5 to 10 weeks to do so, if not more.
Ideally, athletes should first have their body fat accurately measured to determine if they even have fat to lose. Females should not drop below 12% body fat, males no less than 5%. Some athletes will need to lose muscle to be able to reach their weight goal.
What’s the best way to lose weight? Push yourself away from the dinner table before you eat your fill! Plain and simple, you have to eat less than your body requires. Easier said than done. Hence, these tips might be helpful.
• Knock off only 300-500 calories/day from your typical daily intake. Do NOT chop your food intake in half or eat as little as possible! As an athlete, you need fuel to train.
• Fuel by day; diet by night. Plan to lose weight when you are sleeping—not when you are trying to train hard.
• Surround your workout with food, so that you fuel-up and refuel.
• Do NOT cut out all carbohydrates. Athletes need grains, veggies, and fruits to optimize their muscle glycogen stores. A very low-carb diet results in depleted glycogen, “dead legs,” and inability to train hard.
• Enjoy carb-protein combinations: carbs to fuel muscles; protein to build and repair muscles. Protein is also satiating and can help curb hunger.
• When it’s crunch-time, to lose the last few pounds, some athletes target about 1.5 g carb, 1 g protein, and 0.5 g fat per pound of body weight (3 g carb, 2 g pro, 1 g fat/kg). This means a 150-lb (68 kg) athlete would target about 200 g carb, 135 g pro, and 70 g fat (~1,950-2,000 calories/day).
• Athletes who have to lose muscle mass to hit their weight target should cut back on their protein intake.
• Divide the calories into 4 food buckets and eat a meal at least every 4 hours. (The clock starts ticking when you get up in the morning). An athlete who trains from 6:30 to 7:30 a.m. could divide breakfast into 100-200 calories pre-workout at 6:00ish, then 400 calories post-workout at 8:00; eat early lunch (500 cal.) at 11:00ish; later lunch (400-500 cal.) at 3:00ish, and dinner at 6:00-7:00ish (500 cal.). The rest of the night, chew gum, drink herbal tea, go to bed early? (If you are ravenous, please eat a bit more.)
• If you don’t have fat to lose, plan in last-minute water-weight loss of 2% to 3% body weight. For a 150-lb athlete, that’s 3 to 4.5 pounds. Ways to reduce water-weight include depleting muscle glycogen with a low-carb diet (3 grams of water are stored with one gram of muscle glycogen), restricting fiber (to reduce gut contents), sweating, and restricting fluids.
After weighing in, some weight-class athletes have only 1 to 2 hours to refuel and rehydrate before they compete; others have 12+ hours if they weigh-in the night before. To rapidly refuel, they should consume carbs they know they can tolerate well—and be sensible so they don’t vomit during the event. Enjoy (well-tolerated) salty foods like soup, pretzels, and crackers.
• A large bolus of fluid gets absorbed faster than smaller amounts, so dehydrated athletes want to drink 20 to 30 ounces of fluid followed by repeated sips. Salty broth and lowfat chocolate milk retain water in the body better than sports drinks and plain water. Co-ingestion of some protein can help with glycogen restoration (Turkey sandwich? Chocolate milk?)
While the standard advice for weight-class athletes to just lose the weight and keep it off makes sense intellectually, it is the opposite of what the body wants to do physiologically. After having been underfed, hungry athletes experience a very strong drive to eat, if not over-eat, and regain all the lost weight. This happens with most dieters, athletic or not.
The urge to devour food after having made weight is physiological, and not simply due to lack of will-power. Here’s the analogy: If you hold your breath for too long, you will uncontrollably gasp for air. If you rigorously restrict calories for too long, you will uncontrollably grab for food and easily binge-eat. No wonder eating disorders blossom in weight-focused sports!
Any way you look at it, losing weight when you really are not over-fat in the first place is not much fun. Yes, it creates a bond with other athletes doing the same thing—misery loves company—and is embedded into the culture of weight-focused sports. Ideally, it’s time to change that culture to focus more on health (both short and long term) and injury reduction. How about establishing height classes instead of weight classes? Or at least offer better access to sports dietitians to help with the weight-reduction process?
Nancy Clark MS RD CSSD counsels both fitness exercisers and competitive athletes in the Boston-area (Newton; 617-795-1875). Her best-selling Nancy Clark’s Sports Nutrition Guidebook is a popular resource, as is her online workshop. Visit www.NancyClarkRD.com for info.
References
Langan-Evans C. at al. 2021. Nutritional considerations for female athletes in weight category sports. European Journal of Sports Science
Burke, L, et al. 2021. ACSM Consensus Statement on Weight Loss in Weight-Category Sports. Current Sports Medicine Reports
Pelvic floor dysfunction, or PFD, is a broad term used to describe several physical conditions that occur mainly as a result from pregnancy and childbirth. As a pre and postnatal fitness specialist for over 20 years, almost every one of my clients has had some form of PFD. What does this mean and why is it relevant to women’s fitness? I will further define PFD in detail and explain how it changes the way we as exercise professionals program design for this clientele.
First, let’s look at the pelvic floor muscles. The pelvic floor looks like a sling or hammock that forms the floor of the bony pelvis and it serves several important functions in our bodies. The internal layer or “pelvic diaphragm” work with the external muscles of the pelvic floor to support our internal organs, stabilize our bodies, allow for sexual function, urinary and bowel movements and assist in contracting and pushing in the birthing process. These muscles are prone to trauma from the various functions they perform. The stress of the growing uterus in the body during pregnancy coupled with the changing gravity, posture and production of the hormone Relaxin all contribute to weakening the pelvic floor muscles.
Second, consider the whole Neuromuscular Core system. Pelvic floor muscles connect to the Transverse Abdominus (TVA) and they work together in harmony essentially hold the body upright. It is almost impossible to engage one without the other. Tightness in the hips combined with weak pelvic floor muscles creates PFD.
Diastasis Recti, Symphosis Pubis Dysfunction (SPD), Urinary and or fecal incontinence, pelvic pain, chronic lower back pain, Piraformis syndrome, sciatic pain, pelvic organ prolapse are all conditions under the pelvic floor dysfunction umbrella. Below these conditions are listed and defined in more detail.
Diastasis Recti: This is a separation of the right and left side of the Rectus Adbdominus in the Linea Alba connective tissue more than 2 cm in width
Pubic Symposis Disorder: A separation of the pubic bones, which often occurs during birth but sometimes during the third trimester.
Urinary incontinence: Uncontrollable leakage from bladder.
Fecal incontinence: Uncontrollable leakage of fecal matter from colon. Usually as a result from severe tearing during birth.
Pelvic pain: This type of pain can be during sex or when performing a movement that is irritating or uncomfortable, many possible underlying issues.
Chronic lower back pain: Unexplainable chronic lower back pain
Sciatica: Pain that radiates from lower back down one leg along the sciatic nerve as a result of compression of the sciatic nerve
Piraformis syndrome: Also a result of an inflamed sciatic nerve but more localized
Pelvic organ prolaps: When organs of the pelvis fall as a result of weak pelvic floor muscles.
These conditions can be limiting for many women and go untreated because they are embarrassed or told that they are normal “experiences” after giving birth. Until recently, very few fitness programs existed to help women strengthen pelvic floor muscles. It is my opinion that every pregnant woman and new mother should be automatically screened for PFD and treated right away. If women do not learn proper strengthening exercises of pelvic floor muscles they can potentially live in discomfort for years. The sooner preventative care is offered the better the quality of life for these women.
As mentioned earlier, many of these conditions are preventable and remedied through a combination of functional strength with corrective, posture-based range of motion exercises. When a woman becomes pregnant there is an immediate increase in pressure to the pelvic floor muscles. The body begins to produce relaxin which affects the joints throughout the body, especially the pelvis as it prepares to accommodate the growing uterus and eventually for birth. If treatment begins to help women continue strengthening the muscles surrounding the hips immediately, the pressure on the pelvic floor muscles will be reduced.
It was common practice until recently that women were advised to learn and perform Kegel Contractions. We understand more now as movement therapists that Kegel contractions are very hard to teach, very isolated, and in most cases, when examined internally by a women’s healthcare PT, women are not performing them correctly. A more effective approach to strengthening the pelvic floor muscles is to treat the entire hip complex as “one”– or a “global approach” — as described in applied functional science.
So, how do fitness professionals help create beneficial, safe and effective exercise programming for pregnant clients and new mothers that hone in on the core and pelvic floor? We must start by helping our clients improve their posture first and foremost, then work on proper breathing techniques and lastly incorporate larger exercises that do not isolate, but recruit many muscles from the hip complex and surrounding muscles groups. By incorporating all three planes of motion instead of working primarily in the sagittal plane (forward and backward) when performing even the most basic of exercises (i.e., the squat), you must change the movement by foot placement, arm placement, direction, tempo, range of motion etc. The variety in actions creates good stress to the pelvic floor and core muscles. Additionally, increasing the adduction and abduction action simultaneously while performing various exercises will help activate and recruit pelvic floor muscles subconsciously. Anatomically speaking, everything is connected in the body. Understanding that big global movements of the upper body and lower body together affect the position and strengthen of pelvic floor and core muscles is essential. The body is most efficient at strengthening the small muscles when big muscle groups are stimulated in combination. Throughout my years, I have seen much success with clients that incorporated these types of movements into their workout regimen and were safe and conscientious not to perform exercises that added bad stress to the external abdominal muscle group or impact exercises.
Each woman is different on how quickly it takes her to recover from PFD. The most important rule of thumb is to be reassuring and provide support and remember the time line is different for everyone depending on severity of PFD, the fitness level of the client, if the client is breast feeding and prior injuries that could prolong healing time.
Danielle Spangler, C.PT, has been a fitness professional for over 20 years. Danielle is the creator of “Coremom” (Corrective Obstetrical Related Exercises) for purposes of creating a pre and postnatal small group-training program in a variety of fitness facilities. Danielle’s goal is to train other qualified fitness professionals and group exercise instructors on teaching pre and postnatal small group exercise classes using her method. Visit her website, daniellespangler.com
I want you to think differently about exercise. We have to understand that exercise is not only about body builders and gyms. Being strong leads to a better quality of life. Training for fitness gives us the ability to manage