Is Your Suspension System Responsive?
Pelvic Floor Health is the topic today and this doesn’t just refer to the ability to control urine. There are many pelvic health concerns and discussing them continues to be uncomfortable for many. This is a topic that has been on my mind to discuss for awhile and thankfully my colleague Christina Carrick and I were able to reach out to three Physiotherapists to obtain content for this blog and radio show.
From Christina: “I caught a television commercial the other day which effectively had the message “you are a woman, you are of a certain age, it’s time to start thinking about which absorbent undergarment to choose”. The tone of the commercial struck me, as it suggested urinary incontinence is a normal part of aging and it happens to everyone once they have children, or reach some age. Although incontinence is common, it is by no means normal! Incontinence is a symptom of pelvic floor dysfunction, and should be addressed just as you would any other muscular dysfunction.”
We don’t talk about the pelvic floor nearly as much as we should, which can result in not thinking about it as much as we should. Both men and women can experience pelvic floor issues. With men it presents most commonly after trauma, or prostate pathology, but can be insidious, states Marnie Giblin, Pelvic Floor Re-education Certified Physiotherapist. Many women develop problems with just the aging process, childbirth, and surgeries.
What is the Pelvic Floor?
The Pelvic Floor is a sling of muscles that connects your genital area front to back. They work in concert with your lower back and abdominals. Without getting too specific on the names, picture the location and then turn you attention to the most important aspect: Function. Does your pelvic floor function as it should?
Both men and women suffer from pelvic floor dysfunction and it should be a consideration in those suffering from back pain. I think of the core as a cylinder or box that includes the shoulders, neck, and hips. At the lower end of this core box lies your pelvic floor, and in the middle lies your diaphragm. The importance of proper breathing mechanics makes sense when you think of the diaphragm having a piston action on your pelvic floor with each breath in and out. The diaphragm intersects your whole torso so it is very important in core stabilization and function of the pelvic floor health.
The muscles and connective tissue of the pelvic floor within the pelvis which serve many functions which we will call The 4 ‘S’s:
- Support for the internal organs
- Sphincters – constricting pelvic orifices including the urethra, vagina, and anus
- Sexual function
- Stability, including balance and responsiveness (did someone say CORE?!?).
If you are having problems with any of these functions, it could be time to start thinking about your pelvic floor!
Have you been drawing your belly button into your spine thinking that this could be helping your pelvic floor and core? We had a great coffee shop chat with Cheryl Leia, Certified Pelvic Health Physiotherapist that included some interesting visuals like this little chicken. It demonstrates that drawing that belly button in pushes the pelvic floor south which is not ideal!
What is Pelvic Floor Dysfunction?
Pelvic Floor Dysfunction occurs when the pelvic floor tissues are not functioning well enough to provide the 4 ‘S’s. The tissues might be weak and muscles unable to contract as strong as we would like or with the speed we would like. Or the tissues might be hypertonic – always contracted, and unable to let go. (In order for a muscle to function, it must be able to both contract and relax!) Or it could even be that muscles are not firing in a synchronized fashion.
Symptoms of pelvic floor dysfunction include:
- Urinary or bowel incontinence. This includes leaking during exercises (such as skipping, jumping, heavy lifting) as well as the inability to make it to the bathroom in time.
- A feeling of heaviness or protrusion during lifting. This could be an indication of pelvic organ prolapse – one of the internal organs has protruded or dropped through the pelvic floor’s support.
- Pain during sexual intercourse. Sex should not hurt.
- A difficulty maintaining core posture and transferring forces between limbs.
- Constipation. Even if you are pooping, you might still be constipated. Did you know you can poop around poop?! If your poop looks like deer droppings or toothpaste more often than not, you are probably experiencing constipation.
Side note: How often should bowel movements occur? Three answers for you:
- Former Nurse Sheila: If you don’t go every day or other day we have trouble.
- Physio Siobhan: Every day or so.
- Physio Cheryl: Three times a day to three times a week.
An important note on this topic includes the fact that constipation contributes to pelvic floor issues as well as being one. Start with water and fibre, and daily movement to improve frequency. (And movements!) The state of your gut health is currently a hot topic so I encourage you to look into this if you have chronic constipation issues.
Why is a personal trainer talking about this stuff?
Pelvic floor dysfunction could be hindering your workouts and your progress. Are there exercises you avoid because they cause you to leak or they give you a feeling of heaviness or protrusion? Or perhaps there are exercises which are more difficult than they should be, because the pelvic floor cannot maintain pelvic and core stability. The body is not just a bunch of adjoined compartments, working individually. It works as a whole, complex system, and if one piece is out of whack you can bet that everything else is being affected.
As trainers we fill the training plans with load to achieve other goals such a muscle gain and bone density. Program planning must consider pelvic floor cuing and I am here to state it hasn’t been in my experience. We must change this folks so get comfortable talking about it and incorporate the cues shared here into your training and practice.
What cues should we be using to ensure we train safely and minimize risk?
We have to be careful that the cuing we use with our clients is not causing more issues cautions Cheryl Leia, Certified Pelvic Floor Physiotherapist. We do need to pick up and support the floor prior to an imposed demand. The controversy lies in what that means exactly. The pelvic floor muscles do respond to sets and repetitions with the same principles of adaptation as the rest of the body. It seems to me that intensity of the exercises in the pelvic area are what one should be careful with.
If too many Kegels are being done with the wrong intensity (too much squeeze) or the breathing isn’t right it can make matters worse. Many are at a loss as what to do.
Siobhan O’Connell of Trimetrics Physiotherapy states we are moving away from squeeze words and gives us some updated terminology:
- Draw in a little
- Activate gently
- Engage lightly
- Gently pick up a “blueberry” without crushing it.
For the Men:
- Pull the testicles gently to the body.
- Bring the boys back home.
Can proper breathing help the pelvic floor?
Yes, and in fact learning about the piston action of the diaphragm and pelvic floor can go a long way to helping improve the function and responsiveness of this area.
If you suspect a problem….what can you do?
If you are experiencing any of the above symptoms, you should mention it to your doctor or trainer. Both should suggest a referral to a Pelvic Health Physiotherapist who is qualified to make a thorough examination and assessment with follow-up exercises. The Pelvic Health Physiotherapist and the Trainer can then work together to ensure you are getting the most out of your workouts while strengthening the pelvic floor. Often this will involve special attention to breathing mechanics and postural alignment during exercise.
Poor postural alignment can also lead to shortened and weakened pelvic floor muscles. Standing with the hips tucked under all day can lead to some of the pelvic muscles always being in a shortened, contracted state. When the body then looks for pelvic stability, the muscles can misfire or are unable to fire in a synchronized fashion. With the pelvic floor compromised this way, symptoms such as incontinence can occur. Adjusting posture so that feet, hips, shoulders and head are aligned to the task can help balance out muscular contraction and aid in responsiveness of the pelvic floor.
Marnie Giblin another Pelvic Floor Physitherapist we consulted (Myodetox/Pivotal Physiotherapy) states “Many people with pelvic health concerns stop exercising, but this is more damaging long term. Development of core strength, postural awareness, and control of the diaphragm and pelvic floor muscles are key.”
In the first picture above, notice how tucking the hips under moves them forward of the feet and shoulders. In the second picture, the shoulders and hips stack evenly above the feet.
Just where is your weight going with jumping jacks and skipping? If this is you, try getting your hips over your shoelaces instead of your toes.
What about Kegels?
Kegels are a highly debated topic among health and fitness professionals, with some universally prescribing kegels as the exercise to prevent or treat pelvic floor dysfunction and others saying they are a waste of time or even counter-productive. As usual, the truth probably lies somewhere in between the two extremes.
A Kegel is a pelvic floor contraction – an exercise meant to strengthen the pelvic floor. One common cue for performing a Kegel is to “stop the pee”. Some physiotherapists have found that this cue results in over-gripping, however, so a better cue might be to “imagine picking up a blueberry with your vagina”. If you are a man, a more appropriate cue would be to “bring the boys home”. (See above for more notes on cuing.)
Some experts have pointed out that Kegels might not be the exercise a person needs, however. Biomechanist Katy Bowman points out that Kegels will pull the sacrum inward, and for someone with weak gluteal muscles which cannot balance out the Kegel, this will result in excessive gripping of the pelvic floor and an inability to contract properly. According to Katy, the best way to GET pelvic floor dysfunction would be to do too many Kegels while having weak glutes! Katy instead prescribes exercises which strengthen the glutes and surrounding muscles, and encouraging a more central posture with the bum not tucked under.
If you are doing kegels and not sure if you are doing them correctly, or if you have been doing them but not getting results, consult a Pelvic Floor Physiotherapist. The therapist will be able to do an internal and external examination and get you on the path to a stronger pelvic floor! Some therapists have real time ultrasound so they can see what is really going on (or not) which can be helpful in making the treatment plan.
Written by: Sheila Hamilton and Christina Carrick
Copyright Jan 2019
Thank you to these three Physiotherapists for contributing to the content of this blog:
Certified Pelvic Health Physiotherapists
Trimetrics Physiotherapy: Siobhan O’Connell
Canopy Health: Cheryl Leia
Myodetox/Pivotal Health: Marnie Giblin
From the web:
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Are you a good Chief Operating Officer of you?
As the year draws to a close once again we all should sit back and take an inventory of how 2018 has unfolded. In my business it’s called the year end review. Taking an inventory of the stock on hand and systems in place. Are the systems working? By what measures are we evaluating the business?
If we switch this focus back to personal and pose similar but more probing questions to yourself you can get an idea of how to assess and take stock of your health and well being. Whether you own a business or not you are the COO – Chief Operating Officer – of you. Answer these questions truthfully to tap into whether what you are doing is serving or working for you. Need some things to change? Then let’s also take a new approach to what you can do to effectively make change. Where you start will make more sense when you have a clear idea of where you are at now, and what aspects of change will have the biggest impact on your wellbeing and bringing out the best in yourself.
I brainstormed with colleague Andrea Brennan on this topic a few weeks ago. We both travelled to Atlanta to take a Foundational Strength and Functional Movement Level 2 course. The FMS system is “easy” in a way once you understand that everything is connected. Addressing one movement impairment or imbalance can positively influence many other movement patterns in the body. We threw a high five at each other when applying this principle to overall health and wellness. Could there be an algorithm of correction for health and wellness? We think yes, and evaluating where you are is a great place to start.
Before we get to the meat and potatoes lets review the classic tried, true, and sometimes successful way of setting goals.
Are you setting unrealistic goals?
Old school and classic model of goal setting tells us:
- To put them in writing.
- Make goals specific and measurable
- Give them a timeline
- Make them realistic!
Are you setting too many goals at once?
Have you heard about the Power of Less? Author Leo Babauta emphasizes this point in stating:
The only way you will form long lasting habits is by applying the power of less. Focus on one habit at a time which brings in success rates of 80%. When we get too ambitious and attempt two habits simultaneously, the success rate drops to below 20% for either habit. (-1)
Are your goals really going to serve you?
Are your goals outcome based or behavioral..as there is a big difference. Typically we can set ourselves up for failure by making lofty outcome based goals that do not contain the elements of smaller behaviour changes (think habits) that will bring success.
In another example we are usually pretty good at setting goals for things that we are already good at. I like to go to the gym and so my gym based goals come easily to me. Achieving them can give me a semblance of success but behind the scenes and in my own mind (my biggest demon) lies a number of things that really could be better if I was prepared to address them.
Where are you on the readiness and commitment to change continuum?
On one end we have low commitment and we wish, hope, and would like to change. On the other end is the high commitment folks who really want change and are willing to put effort and commit to the work needed. Either end of this continuum can result in change but it requires you to find a realistic place that works for you to start if you want a chance of success.
How prepared are you to answer these probing questions with truth, heart, and courage so that you can really impact the areas that need to change? Ready to take a look? Peel back the layers of the onion and see what lies underneath the surface? Is there a huge abyss that needs to be filled?
Did you achieve last years goals? If not, why not?
Is what you’re doing working for you?
Are you getting results?
Maybe you are doing good…could it be better? Yes, it can always be better. This is where I suggest you may need another area of focus.
#1 Soul and Spirit
- Have you found what makes you happy?
- Are you accepting of yourself?
- Do you feel you have a purpose in life?
- Are you in the church of nice? With every religion just be nice.
- What motivates you?
- Do you have a circle of support around you? Friends and or family.
- Do you feel you have quality in your relationships?
- Do you feel you are living an authentic life?
- What is eating at you? If you don’t look within, you go without.
#2 Health Measures
- Are you prioritizing your own health?
- Do you do enough self-care? There is huge value in taking care of yourself first.
- Do you get regular medical check-ups?
- Is your weight where you want it to be?
- Do you have regular bowel movements?
- Is your urine a light yellow color and does it have a strong odor?
- Do you get enough sleep? Do you know how much sleep allows you to function at your best?
- Are you drinking enough water? Eating nutritious foods? Fiber?
- How many servings of fruits and vegetables do you eat daily?
- Do you eat enough protein for your aging and fitness goals with each meal?
- Do your good habits outweigh your not so good habits? Alcohol, sugar, emotional, and mindless eating to name a few.
- How many times a week do you eat out or order in?
- Do you do enough meal planning and preparation?
- Do you eat until you are more 80% full on a regular basis?
- Are you getting enough exercise? How many times a week are you active for more than 30 minutes?
- Do you do any strength or resistance training?
- Have you achieved your fitness and or aesthetic goals?
- Are you still suffering from the same aches and pains you did last year?
- Do you have the same postures and bad habits?
Make your Standard Operating Procedure
Based on your answers to the probing questions perhaps you have discovered a key area that could use your focus. Creating an SOP – Standard Operating Procedure will help you to formulate that area with more intention and focus.
While there are so many components to success there are also many to failure. If we look to one thing for the fix it often does not happen because it’s more complicated than that one thing!
Have you been going after the wrong thing?
I’m saying you can’t blame one thing, and I’m also suggesting that you focus on changing one thing at a time.
Focus on one qualitative instead of quantitative! Get yourself going with 90% compliance on one “thing” before adding another “thing” into the operating plan.
Assess, plan, and reassess. What non-negotiable change have you decided to focus on?
You only own your own body so I encourage you to take care of it inside and out. Looking at the graphic you can get a sense of the algorithm.
Make a positive change in one thing and it will change other things!
In her article “Six Steps to Positive Change,“ author Shelley Levitt writes and quotes from psychologist Dr. Susan Whitbourne that our ability for change doesn’t carry a “best before” date. At any age, we can change aspects of ourselves, and most people want to change at least some aspect of their personality. The great news follows that when you start to change your behaviors there is a favorable effect on how you think about yourself. Win-win!
I take the responsibility of coaching very seriously. I believe I can make a difference and hold the opportunities I have been given close to my heart. As I continue to learn I continue to lead. We are living proof that taking care of yourself improves your wellbeing and happiness. Set yourself apart and hold yourself to some new standards in 2019 to bring out the best in yourself.
I’ll be waiting to hear from you! Take care of yourself.
Inform, Instruct, and Inspire @ it’s time! Fitness Results
Written by: Sheila Hamilton and Andrea Brennan copyright Dec 2018
Mark Nepo: More Together Than Alone: Pathways that Bring Us Together
Book and 1 day workshop Vancouver Oct 20, 2018
FMS Level 2, Foundational Strength Course: Lead Instructor Brett Jones
Atlanta : Nov 16 – 18, 2018
Magazine: livehappy: The Science of Happiness Issue 26
P.32 Six Steps to Positive Change by: Shelley Levitt
Precision Nutrition : The Essentials of Sport and Exercise Nutrition
P.254-255, 262-263 (-1)
Conversations with: Andrea Brennan :Lead Kinesiologist at time! Fitness Results
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Meal Planning and Preparation
I think meal planning and preparation is my greatest challenge to long-term nutritional success. In my quest to be a role model and ambassador for fitness results I often put pressure on myself to walk the walk. I’m human and in my experience, the challenges I face are not unique to me. I often come across others that are feeling similar nutritional challenges with themselves, and their families. It’s reassuring to know that all improvements we can make with consistency will result in progress towards the end goal of sound eating in my opinion: To feel healthy and move well in your skin. Listen here to my discussion on this topic with Jon McComb on CKNW 980am.
Nutrition is the answer to your health, body composition, and performance goals. There are many factors that influence our nutrition and some are easier to dial in more consistently than others.
Do you have these daily habits under control?
Water, eating until you are 80% full, eating slowly without distractions, eat protein dense foods with each meal, 8 servings of vegetables and 2 fruits, and healthy fats.
In order to make those happen you have to have food on hand and so that leads me to ask you about Meal Preparation and Planning.
Who’s driving your nutritional bus?
Does the meal planning and preparation belong to one person or member of the household, or are the responsibilities shared? Who is the chief cook and bottle-washer? Do their nutritional goals align with yours? Perhaps some honest conversations have to happen in order to close the gap between what is happening currently and what needs to happen to improve the nutritional habits we are talking about.
Message From Top of the Food Chain – Coach Ewart
I have worked with Dave Ewart at it’s time! Fitness Results for 6 years. I joke when I say he’s at the top of the food chain but the truth in the humor is that he lives at the top end of nutritional health. The staff and I are always in awe of his lunch and dinners plates at the gym. He shares some of his strategies with me here:
The hated meal prep! To facilitate a healthy diet and body composition it is of utmost importance. Why so challenging? It takes time and our days seem to be filled with other important things or are they? If we asked 10 people to list three things that are of utmost importance to you what would they be, well health is going to be on most people’s list. In order to be healthy, eating habits have to be established so meal prep is on the top of that list. When you meal prep you leave out grey areas like what am I going to eat now. Your meals are ready to go leaving out any guesswork.
To be successful at meal prep you first must know what you are going to eat. I do not change what I am consuming much but for people who need variety research your recipes well and then shopping is a necessity. The reason I do not change my food selection a whole bunch is I consider food to be fuel and healthy fuel means a better functioning body. I also am the type of person who does not need a ton of variety so once again if you are they are many good recipes out there. I think side note: sometimes simple healthy food selections go a long way in our busy worlds and yes simple can taste great.
Some people dislike it and some like it. Personally, I like to shop and yes I am one of those people who will read labels and take my time. As you get accustomed to certain foods you are going to consume your time in the grocery store becomes much faster and becomes a fine art. Really the only foods you ever have to read labels on are ones in packages so the fresher the better and that begs to less processed food. I shop twice a week usually and typically with driving time spend 1.5 to 2.5 hours a week food shopping.
Is this feeling like “work”? No this is a healthy habit that must be slowly installed into your lifestyle. When you have a family you and your spouse should share the duties of shopping and cooking, hopefully, everyone in the household is on board with the healthy eating habits and meal prep.
Now that you have done your shopping, cooking for the week let’s see what that looks like. Well in my case I cook on Monday afternoon or evening for my work week, which is Tuesday to Friday. My goal every week is to eat as healthy as I can during workdays and be okay with a bit of weekend eating outside my healthy habits. I do not like cheat days but if it is a birthday or special occasion a piece of cake tastes so good. Cooking typically takes me 2 to 3 hours including cutting or chopping. Yes that means I eat leftovers during my work week you can cook twice a week if you like or you can cook every night you come home but this once a week works efficiently for myself. If you can establish the 80/20 rule which is 80 percent of the time I will eat healthily, and 20 percent of the time I will eat outside my healthy habits you are doing okay. Ask yourself if that what you are doing now? I follow the 90/10 rule but I eat to fuel so read into that as you may.
Dinner or late night
Meal prep for dinner or late night eating really is a hard thing for all or is it? I typically spend including driving time between 11 to 13 hours driving to, at, and driving home from work. So the 4 days of work per week are full day consuming, never mind the countless hours the team spends behind a computer at night or morning. No complaints love my career and teammates. My dinner is my lunch so that is my biggest meal I also bring a salad to work. When I get home around 9 pm I am going to eat again but what? For sure I am eating high protein foods with some complex carbs, those are long days but I am not reaching for crappie food choices. I have healthy meals delivered to my house each week, lots of good food services out there, which is an option to consume or one of my favorites is an egg white wrap with possibly a bit of cream cheese. Having done meal prep on Monday I could just warm up some of that healthy food or consume a salad, my salads are very hearty and taste delicious.
Food prep is a habit and like any habit being consistent is key!
Dave’s Order of things:
- Know what you are going to consume before food shopping
- Food shopping once or twice a week. High-grade protein and vegetables, eating the rainbow, are main foods on my list
- Food prep and cooking pick a day and be consistent each week
I’m driving the bus but….
I’m trying to make things that everyone likes, I’m trying to please…food is love right? I can’t keep up with the likes, dislikes, ethics, and the choices keep changing in my world. Vegan yes, Vegetarian yes, ok only vegetarian…and a little meat.
Entertaining. This has a huge influence of what goes in the body.
Do you have occupational influences that affect your nutrition? Are there unhealthy foods at work? Responsibilities to dine out, and travel?
I put in quotations to emphasize the power that can be put on us through food by our families. “Have a little more, have seconds, have dessert, have another glass of wine.” “I spent so much time making this for you and you won’t eat it.” ” Eat your vegetables or no dessert for you!”
“When my son Mitchell was little I got into a major disagreement with my mother-in-law one day while staying with her about the fact he would only eat the bacon in the spinach salad and not the spinach. She exerted her powers on us by withholding both from him. I was very upset with her for making such a big deal about it and not allowing him a bite of bacon! It was her house, her food prep, and her control. Fast forward 18 years…now he doesn’t eat bacon…only spinach. He’s celebrating 1 year as a vegan. ” ~Sheila
How to Master Meal Planning and Preparation: Adapted from Precision Nutrition’s Guide
Look ahead – Make a menu or two, plan shopping, and cooking time in your calendar
Shop: Decide 1 -2 -3 times a week
Stick to your planned cooking times: batch cook your food groups
Make storage easy and convenient by having lots of glass containers on hand
Making real food with fresh ingredients can be fun. Try cooking your way through a cookbook. At least you know what’s going into your body. We lose that control with processed food and restaurant meals. Use cookbooks as a way to experiment, eat healthier, and reap the rewards for your taste buds.
Remember Weight Loss Should be slow
A review of the “Dieting Principles”, by Dr. Bill Campbell that I discussed in an earlier blog can be found here.
#1 The Rate of Weight Loss Should be Slow
#2 Do not Decrease Dietary Protein When Dieting
#3 Perform Resistance Training During Caloric Restriction
Improving your meal planning and preparation will result in success. You can enjoy all the benefits of great nutrition, lose weight, and achieve long-term results with a few improvements. Tailor or scale the habit to suit your lifestyle and evaluate your changes every few weeks. Remember Dave is dialed in through the week and leaves the weekends less rigid.
Prepare for social situations, travel, and dining out in advance. Open up conversations with your friends, family, and co-workers so you can share with them the importance of improving nutrition for the long term.
We can succeed and make progress towards the end goal of sound eating in my opinion: To feel healthy and move well in your skin.
We’re in it for the long game – Will you join us?
Inform, Instruct, and Inspire @ it’s time! Fitness Results
Written by: Sheila Hamilton and David Ewart
Pictures below: Dave’s Vegetable Prep, and Christina’s Overnight Oat Prep
Christina Carrick: Coach at it’s time! Fitness Results
Conversations with Dave Ewart and the staff at it’s time! Fitness Results
Notes from Precision Nutrition Infographic: How to Master Meal Prep
The Essentials of Sport and Exercise Nutrition – Certification Manual: Dr. John Berardi, Ryan Andrews
Photo Copyright: <a href=”https://www.123rf.com/profile_scyther5″>scyther5 / 123RF Stock Photo</a>
Notes from the NSCA National Conference: Maximizing Body Composition and Metabolism with Exercise and Nutrition: Abbie E Smith Ryan, PhD Associate Professor University of North Carolina
The Science of Weight Loss – Dr. Bill Campbell : NSCA 2018 Conference notes and slides
Let me convince you to SEE the importance of a healthy neck.
As I understand more about the neck and the importance of its good function I believe I can convince you that some more attention, actually daily attention, to the neck is an excellent idea.
Of course one of the main purposes of the neck is to hold the head in position but remember your head holds the brain and many sensory structures such as the eyes and ears. Neck pain disrupts your senses. Forward head posture changes many things regarding our movement as sensory input shapes our motor system. Movement accuracy can be compromised if the sensory input is.
I’ve posted a blog on the neck in both 2016 and 2017, so having Jon McComb request the topic of necks for my next appearance on his radio show got me thinking as to the importance of repeating and explaining the message of the importance of “neck hygiene.”
Over half of us (54%) have experienced neck pain in the last 6 months. (Cote, P et al 2000)
The neck bones are technically called the cervical spine or cervical vertebrae. The C1-C7 references the order of the vertebrae from top to bottom. The movements of the head and neck have a complicated relationship with our body. There is often a strong connection between neck pain and dysfunction, and shoulder pain and dysfunction. Without going too far down this complicated path let me ask you this:
“If you were given a nice car in your teens and told it’s the only car you would ever have, what would you do with it?”
Answer: Take care of it I hope!
Do you think of your neck like this?
What does a healthy neck look and move like?
The movements of flexion, extension, lateral flexion, and rotation of the cervical spine are dependent on many factors that can change within life: environment (posture, sitting, electronics), role models, (parents and siblings), age, injury, personality, sense of self, and stress.
I’ve enjoyed some sessions lately with local Feldenkrais practitioner Janet Willson of Uplift Studio. Janet shares, “Most of us have the capacity as young people to move with ease (use ourselves globally), as one unit rather than a sum of parts. Over time, life (in our western world) acts upon us to increasingly limit our movements. We think of this as aging but a lot of this is unneccessary and can be regained. Her methods have taught me a lot about how my movement today is a reflection of so many factors in my life including stress. Slowing down and spending more time on self care is my big take-away. I feel it’s kinda like this happiness quote: It’s not easy to find happiness (or good movement) in ourselves and it is not possible to find it elsewhere. (Quote from Agnes Repplier)
You have to do the work
Neck pain or not, I think it’s important to realize that your neck needs work. Neglecting this part of your body will make it a lot harder to recover from any injury that you may sustain. My previous blogs are full of some great ideas for neck hygiene – that information has been out there for a few years so what you need to do is available to you.
Neck pain is complicated because….
One of my favorite sayings currently is, “It’s never one thing.” This is very true when talking about the neck (cervical spine) because how it moves is related to so many issues. The condition and movement of the thoracic and lumbar areas of the spine, and the condition and function of all the muscles affecting them play a role.
There are degenerative forces to your neck that can aggravate it or make the injury/pain increase over time. Often its repeated exposure to lower forces, repetitive movements, aging, or static postures over time that lead to problems as the stress tolerance on your neck exceeds its capacity.
So you see it’s not just falls and accidents (high force exposure) that give you neck pain, but if you unfortunately add a sports injury or car accident onto an underlying degenerative neck and you may have yourself a BIG pain or problem in the neck. Dare I mention improper attention to neck posture and neck position when exercising here? This can be a big contributor to your neck issues.
“When looking to the right do we just move our neck or can we optimize our whole self to turn from the ground and feet up?” Who knows what is right or optimal? I suggest we don’t know, and we are not doing it right! ~ Sheila
It’s not just your cervical spine but also the muscles involved to support and stabilize the head that contribute to your neck health. Working to improve neck posture daily is needed to attenuate further changes and to minimize the overuse and overload of the stabilizing muscles.
In my experience many folks want to exercise but reach limitations with movement because their underlying accumulative neck issues have not been worked on and resolved to a point where exercise can be executed safely. An increase on the pain scale, or a headache that may not be directly attributed the exercise program, may in fact be a result of trying to add strength to a body that simply defaults to it’s weakest link during the movement. In an effort to improve fitness we see or feel a setback.
When programming for a client like this we have to modify their program to avoid any movements that would aggravate or flare their imbalance. Although this can be done, it creates a limiting factor in overall fitness results. Committing to the work that has to be done to make progress is where most folks slide. If a person is not prepared to devote the time needed to complete simple effective release and stretching work, no progress is made.
A little Anatomy
The primary neck active stabilizers of the neck that support it in all planes of movement are called the Deep Neck Flexors. (DNF) “The DNF are most active in the ‘chin tuck’ or cranio-cervical flexion, followed by cervical flexion, and cervical rotation. (-2) The activity of the DNF is decreased or delayed in people with neck pain and postural change, such as forward head posture.
“So if the head is in a forward head posture just think about how decreased your peripheral vision has become. This could present many problems when you think about it from a focus, balance, and safety perspective.” ~ Sheila
“The statistics on neck pain would be higher if we tracked low intensity or low disability pain”, states Dr. William J Hanney, Associate Professor at the University of Central Florida. He adds, “Exercise is a powerful tool in the treatment of neck pain.”
Over time the muscles involved around the neck atrophy (go to sleep) and get thick and fatty. This leads to decreased activity of the deep neck flexors, and an increased activity of the superficial neck muscles (accessory muscles). So some muscles get weak, thick and turn off, and others become over active trying to protect you from a catastrophic collapse!
While listening to his presentation last July at the (NSCA) National Strength and Conditioning Association’s National Conference I felt myself smiling inside because he said this: “Research is strong that exercise should be done for improvement and not avoided. Neck pain patients perceive their pain to be debilitating. Education is needed.” This is great news for me to share with everyone.
What to do?
Neck issues can be resolved with a concerted effort get on top of them. Develop a regular or daily routine I’ll call “Neck Hygiene”.
Addressing muscle length restrictions is the first priority. Release the tight areas in the muscles and fascia. This means rolling with a ball, stretching and actually moving your neck through joint (articular) rotations in a pain free range. Second in the order of improvement would be working to obtain some deep local stability of your neck. Getting those deep neck flexors working again. As mentioned above, neck issues often involve shoulder issues so obtaining control of the shoulder blades (axio-scapular) in different planes would be next.
Neck training has the potential to reduce neck pain and decrease the risk of further injury. Seeking professionals to help you is crucial to your success. Don’t settle for a life with a pain in the neck. Enlisting professionals such as physiotherapists, chiropractors, massage therapists, osteopaths, and personal trainers would be money well spent to get your neck to where is should be.
It’s never one thing
Chronic neck pain can really impact one’s life on a lot of levels. Mostly I have talked about the anatomical side of things but know that neck issues can impact you on a psychological and social level as well. Addressing stress levels if applicable (who doesn’t?) is important as they can affect the disorder and potentially affect the recovery.
In a nut shell
Maintain or regain range of motion with release work to the tight muscles. Stabilize your shoulder girdle and work on your strength. There is huge value in improving your neck posture. The computers and aging are not going away – your neck pain can though.
Continue to address your personal stress levels. Appreciate we all struggle in our human experience called life. Strength serves a purpose both inside and out.
Inform, Instruct, and Inspire @ it’s time! Fitness Results.
Written by: Sheila Hamilton. Research from Andrea Brennan Copyright Oct 2018
Sports Injury Prevention and Rehabilitation: David Joyce
Chapter 19 : The Athletic Neck p 246 (-1), 238 (-2),
My notes on neck pain from the NSCA National Conference : Indianapolis July 2018
Exercise Considerations for Individuals with Neck Pain : NSCA National Conference Presentation and slides from: Dr. William J Hanney : Associate Professor University of Central Florida
The Science of the Somatosensory System: Slides from NSCA National Conference Presentation: Dr. Emily Splichal (-3)
Conversations with Janet Willson: http://www.upliftstudio.ca/
Movement System Impairment Syndromes of the Extremities, Cervical, and Thoracis Spine
Shirley Sahrmann and Associates Copyright 2011 Pages: 51-113
(Erik E Swartz,* R. T Floyd,† and Mike Cendoma‡ J Athl Train. 2005 Jul-Sep; 40(3): 155–161. PMCID: PMC1250253PMID: 16284634 Cervical Spine Functional Anatomy and the Biomechanics of Injury Due to Compressive Loading)
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Are you eating enough protein for your health goals?
Here’s an interesting topic to discuss with Jon McComb this week on his radio show. Thankful for the opportunity to share my thoughts on protein in the hope that it will get you thinking about whether you are consuming enough to meet your goals. If you missed it you can listen here to our discussion.
The research on protein was one of the main takeaways I had from attending the National Strength and Conditioning Association’s National Conference this year in Indianapolis. When I speak on these topics I want to make sure I can tell you where I received the information. There was a wealth of information presented this year and I believe it’s because the importance of protein intake is apparent to a broad range of people and their health outcomes.
Deciphering the research isn’t an easy task even for the reseachers! Reading through a study is just one thing. Not becoming one of the legion of armchair reseachers that pretend to know what the research means is important to me. I admit it’s confusing and even some of the presentations this year had conflicting advice. (Ex: Amount of protein recommended per day and amino acid supplements in particular) I suggest there are plenty of good reasons to look at your protein consumption. I met some of the researchers in person and had an opportunity to ask questions which now leads me to sharing this information with you.
“MUSCLES are TORN in the GYM, FED in the KITCHEN, and BUILT in BED.” – Brad Schoenfeld
What are proteins?
Proteins, along with carbohydrates and fats are one of the macronutrients that form the basis of our diet.
Proteins are organic molecules made up of amino acids. These amino acids are joined together by chemical bonds that create three-dimensional structures that are important to our body’s functioning. We generally think of amino acids as the building blocks of muscle, but they are responsible for many other functions in our body. We are constantly using proteins as our cells breakdown and rebuild and when we are lacking protein. Proteins are responsible for many things in our body such as: repairing damaged cells, creating red blood cells, and manufacturing antibodies and hormones.
There are two main categories of amino acids in the body that are classified as essential and non-essential. Essential are those that the body can’t manufacture, and thus we must consume in our diets, and non-essential are those that can be manufactured within our body.
You may have heard of the term complete and non-complete proteins. If a protein is complete it contains all of the essential amino acids required to build and repair protein tissues in the body. Meat, poultry, eggs, dairy, and fish are complete sources of protein because they contain all 9 essential amino acids. Soy, often in the form of tofu or soy milk, is a popular plant-based source of protein since it, like animal-based protein, contains all 9 essential amino acids.
Combining foods that are considered “incomplete” together to obtain a complete amino acid profile is often done, especially with plant based or vegetarian eaters. Combining rice and beans together would be an example of this as the amino acids missing from the beans are found in the rice.
Why do we need Protein?
There are a number of factors to consider when looking at the reasons you need protein and whether you should increase the amounts you are currently eating to meet your goals. Your age, general health, body composition, bone density, medical history, goals, activity level, and level of satisfaction/satiety are all important considerations in determining your needs.
Age: All ages need protein for growth and maintenance of muscle. Age related muscle loss is called Sarcopenia. We will all ultimately lose lean muscle mass with aging that starts in your 40’s. Eating adequate protein and adding resistance training to your routine will stimulate muscle growth and attenuate muscle loss.
General Health: Our bodies need protein and amino acids to produce important molecules in our body like enzymes, hormones, neurotransmitters, and antibodies. Without an adequate protein intake, our bodies can’t function at their best. Protein helps replace worn out cells, transports various substances throughout the body, and aids in growth and repair. We need protein for good immune function.
Body Composition: Having a good amount of lean muscle on your body is so important. A higher composition of muscle will help to decrease your body fat percentage.
Consuming protein can also increase levels of the hormone glucagon, and glucagon can help to control body fat. Glucagon is released when blood sugar levels drop causing the liver to break down stored glycogen for energy. Also, your body uses more energy to digest and assimilate the protein – which raises your resting metabolic rate.
Dr. Bill Campbell’s (University of South Florida) presentation at the NSCA Conference on The Science of Weight Loss highlighted a number of key principles regarding body composition:
Dr. Campbell points out the above principles may be things that you already know, but we now have scientific validation for them. To much of our population weight loss is needed, and thinking of the loss coming from fat is important. Losing muscle as you lose weight is not a good thing so the numbers on the scale can fool you.
Bone Density: Osteopenia and Osteoporosis both mean a loss of bone density; of calcium and protein. “Dietary proteins represent key nutrients for bone health and thereby function in the prevention of osteoporosis.” “Several studies point to a positive effect of high protein intake on bone mineral density, and there is concern that the current dietary protein recommended allowance (RDA), as set at 0.8 g/kg body weight/day, might be too low for the primary and secondary prevention of fragility fractures.” (-1) Having more muscle makes you stronger, which plays a role in preventing frailty and increasing bone density.
History: Taking a look at your history from a health and injury perspective might give you reasons to look at increasing your dietary protein. Do you have any chronic health conditions? Have you recovered well from your injuries? You need adequate nutrition to support your health and recovery.
Goals and activity levels: As individual as this is I can’t emphasize enough that in order to be the best version of ourselves we need to move well and move often. Your performance and aging goals will be better served when you address this aspect of your nutrition.
Satiety: Many folks report feeling more satisfied when on protein rich nutrition plans. Perhaps you have to try it to feel this for yourself, but anecdotally I can tell you there seems to be fewer highs and lows through the day of hunger, and of “blood sugar” lows.
How much protein do you need?
How much protein you need depends on a few factors including knowing how much you are currently eating and whether you are motivated to change that based on an analysis of your goals and needs.
Recommendations can be found that are based on your body weight in pounds or kilograms. Currently in the US the RDA (Recommended Dietary Allowance) is .8mg per kg of body weight. There is currently legislation in place to double that, to 1.6 mg per kg of body weight. On the low end of these numbers you might find yourself within a range that prevents protein deficiency, but is not necessarily optimal.
The optimal recommendation falls within this range: 1.4 – 2.0 g per kg (or around 0.64-0.9 g per lb.) of body mass. Therefore a 150 lb. (68 kg) person would need about 95-135 grams of protein per day.
Dr Campbell’s thoughts from the above principles and lecture – if fat loss is the goal: “During energy restriction protein intake should not go lower than 1.5 grams per kg of body mass (0.7 g per lb. of body mass).”
Athletes, bodybuilders, and those wishing to gain muscle: 1 gram of protein per pound of mass, so 150 grams per day for a 150 lb. individual.
When do we need protein?
The timing of protein is another factor that has been highly researched. Is there a metabolic window that will get you more gains? The “window of opportunity” is not as narrow as often believed. The level of importance with protein timing depends once again on your goals. A general fitness person with weight loss goals that trains non-fasted will likely not need to be concerned with timing. But if you have aggressive body composition goals and your training is more intense, then possibly you should be taking a closer look when you eat and supplement around your training schedule. Intense exercisers whose training sessions last more than 2 hours at a time definitely should consider timing as a very important aspect of their nutrition profile. (Adapted form Brad Schoenfeld’s presentation slide.)
Consuming your protein throughout the day is my advice on optimizing your response. So consider how much protein you are consuming with each meal once you determine your requirements. With each meal: 20-40 grams for females, 30-60 grams for males. It seems prudent to consume a high quality protein both pre and post exercise within about a 4-6 hour window of each depending on the meal size.(-2)
Great words from Precision Nutrition coach Ryan Andrews: “We need a small amount of protein to survive, but we need a lot more to thrive.”
How much protein is in the food you are eating?
Once you gain the knowledge around why you should be aware of your protein intake, it’s time to start looking at food sources to meet your requirements. Add up the grams of protein you are currently eating to see if you are consuming anything close to the recommended amount for your goals.
It’s good to remember that protein can be found in a variety of foods. Look at food labels for the grams per serving and start to keep a tally of your daily intake.
Both plant and animal protein sources have the potential to stimulate muscle protein synthesis. Most animal based protein sources, including dairy, meat, and eggs are more digestible than plant proteins such as soy, wheat, rice, and potato.
Although I’m a big advocate of eating non-processed food I’ll make an exception when my daily requirements can’t be met, and use protein powders. There are many types of powders available these days including whey, hemp, soy, and pea. Finding one that agrees with your taste buds, budget, and digestion is the challenge. Making a small shake or simply mixing a scoop into food (like steel cut oats), or water is a quick method to boost your intake.
General rule of palm for serving size: One palm for women, and two palms for men.
Real food examples: Subject to serving size and brand. I suggest looking at labels to see what you are really eating!
Lean Ground Beef Hamburger: 19 g (100g serving)
One Hard-Boiled Egg, Large: 6 g
Cottage Cheese 2%: 12 g (100 g)
Chinook Salmon: 27 g (100 g serving)
Roasted Chicken Breast: 31 g (100 g serving)
Halibut: 28 g (100 g serving)
Ribeye Steak 24 g (100 g serving)
Ezekiel Bread: 8 grams protein per 2 slice serving
Rice And Beans: 7 grams per 1 cup serving
Hummus And Pita: 7 grams per 1 whole-wheat pita and 2 tablespoons of hummus
Peanut butter sandwich: 15 grams per 2-slice sandwich with 2 tablespoons of peanut butter
one cup cooked pinto beans = 15.4 grams protein
1/2 cup cooked spinach = 3 grams protein
one medium baked potato = 5 grams protein
one cup green peas = 8.5 grams protein
one cup cooked edamame = 18 grams protein
1/4 cup almonds = 6 grams protein
From the article, “12 Complete Vegetarian Proteins You Need To Know About” the contributing authors remind us that:
Every time legumes like beans, lentils, and peanuts are combined with grains like wheat, rice, and corn, a complete protein is born. Peanut butter on whole wheat is an easy snack that, while high in calories, provides a heaping dose of all the essential amino acids and plenty of healthy fats to boot.
Summary and recommendations:
- For basic protein synthesis, you don’t need to consume more than 1.4 to 2.0 g per kg of body weight (around 0.64-0.9 g per lb of body weight) of protein per day. Consider a higher amount based on your goals. Try this amount out and monitor your response to the increase. Are you less hungry for example?
- Consuming higher levels of protein (upwards of 1g per pound of your ideal body weight) may help you feel satisfied after eating as well as maintain a healthy body composition and good immune function.
- Track your protein consumption as a starting point to considering a change.
- You should consume some protein before and after training to ensure adequate recovery. Might as well maximize the muscular adaptations and facilitate repair. Provided you are eating a protein rich meal about 3-4 hours prior to a workout, no need to stress about slamming a protein shake immediately post-training.
Written by: Sheila Hamilton. Copyright September 2018. Contributing content and ideas: Andrea Brennan.
https://jissn.biomedcentral.com/articles/10.1186/1550-2783-10-5 Nutrient timeing revisited: Is there a post exercise anabolic window?
- Alan Albert Aragon
- Brad Jon Schoenfeld
https://www.ncbi.nlm.nih.gov/pubmed/22139564 Protein Intake and bone health (-1)
The Science of Weight Loss – Dr. Bill Campbell : NSCA 2018 Conference notes and slides
David Ewart: PN -Precision Nutrition certified coach at it’s time! Fitness Results. Conversations and emails for content .
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The effect of protein timing on muscle strength and hypertrophy: a meta-analysis
NSCA National Conference Notes: Sheila Hamilton
Brad Schoenfeld Presentation and slides: Protein Needs, Nutrient Timing, and Recovery Considerations. (-2)
Myself and Andrea had the pleasure of attending Dr. Jacob Harden’s Prehab 101 and Movement Optimization course over the past weekend.
This course educates fitness professionals and healthcare practitioners on how to raise the ceiling of our body’s structural capacity to avoid injuries. It also looked at overcoming injury and how it affects our tolerance for movement. Dr. Harden spoke about physical stresses applied to the body and how incremental movement and loading is necessary for adaptation to take place. We had an amazing time learning new exercises for the core, shoulders, hips and everywhere else in between. We are excited to share this with the it’s time clients!
What is Prehab?
Prehab is not injury prevention. It’s impossible to eradicate injuries completely because life it not predictable and some injuries are inevitable (e.g. running into a pothole and rolling an ankle). Instead, Prehab is building up our tissues capacity so that they’re more structurally durable. Over time, you will start to raise the ceiling of your body’s capacity, and as you do your body will be able to handle more and more stresses. The more you build your tissue’s capacity the more activities or weight you will be able to handle without injury. The big takeaway from this course was you must be functional and strong enough for YOUR life. If you want to hike the grouse grind, your knees and ankles must be strong enough to support your body up the 2,830 stairs.
The only way to raise your ceiling is to train! To build resilience in your muscles, ligaments, tendons and bones you need to apply an appropriate amount of physical stress that will trigger adaptation. This stress needs to be enough to stimulate adaptation but not too much that it surpasses your tissues stress capacity, causing injury. But how will you know if it’s enough stress? A good way to know you are triggering adaptation is to train near your stress tolerance level. This is your body’s alarm system, for example that feeling of soreness the next day is your body telling you that you are close to your stress tolerance. If the physical stress is not progressively increased, then you will only maintain your tissues current capacity. Additionally, if the stress applied is less than what you are used to, your tissues will become detrained, meaning they will start to lose strength and function. Your body isn’t going to keep strength and mobility in your joints and tissues if it’s not being used.
The take home message here is that you need to train near your stress tolerance level to trigger adaptation, but not past your stress capacity level where you will get injured. The training must also be consistent to see any adaptation. Ultimately, clients who train three or more times per week will have better results. Those who training more than three times, vary the intensity of each day to stay within their limits, e.g two hard days, two medium days and one easy maintenance day.
Stress is Stress
Everything puts stress on the body. For example, as I sit here and write this I am putting compressive stress on my low back and hips. Most of the time physical stress is unavoidable, from the time you get out of bed in the morning you are placing some amount of stress on the body. However, just because you cannot avoid these stresses it doesn’t mean you can’t manage them. I can manage the time that I spend sitting here or the posture that I am sitting in to minimize the stress on my back.
Stress is stress, the body cannot tell the difference between life stresses (work, family, nutrition, sleep) and exercise/physical stress. You must listen to your body and account for these additional stressors when determining adequate recovery periods. Reduced sleep, work stress, and poor nutrition might leave your workouts feeling harder than normal but this is not a time to push your limits, it’s a time to regenerate! Use this opportunity to work on your technique, patterning, mobility, core, or motor control. On the other hand, if you feel great and have a hard workout where you are pushing your limits your body will need more time to recover. This is the most important time to have good nutrition and sleep habits. If you want to apply stress you must recover from that stress.
Physical stress is a combination of a movement pattern and the amount of load placed on that pattern. For example, the movement pattern could be a squat, and the load would be your bodyweight or however much weight you are carrying. A squat with an inefficient pattern or heavier load both place more stress on the body, versus an efficient pattern and a lighter load.
The energy we use must be appropriate for the task at hand, and use no more energy than necessary. This is called movement efficiency. As effort and load increase, your movement efficiency must increase as well to minimize the risk of injury. An example of this is picking something up from the floor. If I were simply picking up a pen off the ground, I have a wide variety of techniques (movement patterns) that I can use without being too cautious of how I do it (e.g. bending my spine). However, if it was a 300lb deadlift my options to lift without injury are much more limited to a very technical pattern (utilizing breathe and bracing of the spine with a hinge). Furthermore, if you have an injured back, your options for how you lift the pen are limited, you may have to treat it like a heavy deadlift, in order to protect from further injury. An important key here is to not villainize the pattern, it is also the load placed on that pattern that increases the stress placed on the body which can cause injury.
What happens when I get hurt or am recovering from an injury?
After an injury the body’s capacity for physical stress will decrease dramatically. This is when you need to take precautions and slowly build back up to your full strength with progressive loading. Once the pain is gone away we can’t expect our body to be able to handle the same stress that it could right before the injury. Therefore, training within your body’s current capacity is essential for not getting re-injured.
How can I put this into my current exercise routine?
- Use an RPE scale
An RPE scale is defined as your rating of perceived exertion. It’s a way to determine how hard you feel like you are working. For example, on a scale of 1-10, 1 is lying in bed and 10 is running away from a bear. You can use this scale to manage the stress placed on your body. One day you could rate your 10kg TGU as being a 5/10 and another it could feel like 8/10. Listening to your body is key when training near your stress tolerance level to keep your body below its stress capacity to avoid injury or over training.
- Plan your recovery time
Plan recovery time into your schedule based on other stressors that might happen that week. If you have a big project due at work this week, you know you won’t be getting as much sleep and you won’t have time to cook yourself a nutritious lunch for the next day, therefore you should take that into account with your training and recovery time. Recovery is vital for your fitness progress as the body can only make adaptations at rest. Strategies include staggering your workouts in terms of difficulty. Add in a mobility and core day in between your strength workouts for relaxation and stress reduction.
- Heal from injuries then progressively reload
While you are recovering from an injury the first step is to remove aggravating factors. Then you need to modify your activity so it doesn’t include those aggravating factors. Additionally, maintain your fitness levels throughout the rest of your body. Gradually reload the injured tissue so as it heals it becomes stronger, until you get to the point that it is stronger than before you hurt it.
Written by Jessica Pastro and Andrea Brennan, Kinesiologists and Strength Coaches at it’s time! Fitness Results
Content based off of course Prehab 101, by Dr. Jacob Harden
Stay Hydrated This Summer!
As you are well aware, summer is officially here and it’s looking to be a warm one!
One of the ways you can maximize your fun is by staying hydrated. This may sound silly but dehydration can lead to fatigue, headaches, increased body temperature and cramps!
Generally, most of us do not drink enough water to begin with. When you combine this with summer temperatures reaching into the high 20s, and increased sweating, we really start to put pressure on the body. Drinking sufficient levels of water and replacing lost electrolytes* is integral to overall health! And no, beer and wine do not count as hydration!
(*Electrolytes are minerals dissolved in body fluids. This includes sodium, potassium, phosphate, calcium and magnesium. These ions are essential to normal function.)
Why is water so important to our bodies?
Water is what our bodies are made of! We are anywhere from 45-60% water depending on your body type (1). We use water as a means transport, a place where chemical reactions can take place, to filter toxins, it also lubricates joints and provides padding. We simply cannot survive without water!
With exercise and movement, our body temperature rises due to increased metabolic processes. Water is essential for temperature regulation and assisting with cellular activity during physical exercise. If that was not enough motivation, research has proven that drinking more water can help with weight loss! Water makes you feel fuller, and may also increase metabolism (2).
What is dehydration?
Simply put, dehydration occurs when the output of fluids is greater than the input.
How can we get dehydrated?
As well as not drinking enough, we can also increase our demand for fluids by increasing our activity. While we think of exercise or getting sweaty, anything physical such as gardening, walking or just heat exposure can promote dehydration. Certain medications, illness and fever can also leave you in demand of fluids!
Children and the elderly are more at risk dehydration and should be monitored appropriately. Children who play outdoor sports should drink plenty of fluids and be given “shade breaks” to allow their body temperature to decrease.
What are some sign and symptoms of dehydration?
If you are feeling thirsty or your mouth is dry, chances are you may already be dehydrated.
What do I need to look for? Some signs you should pay attention to are:
- Mental fog
- Increased body temperature
- Dry skin
In cases of severe dehydration, vomiting, vision problems, and even loss of consciousness can occur. If you are unsure, one particularly accurate assessment of your fluid levels is checking the colour of your pee! Your urine should ideally be clear to light yellow. As you lose fluids, it becomes more concentrated and changes to dark yellow or brownish colour.
Even as little as losing 1% body weight of fluids can impact on your endurance and strength performance (1). If you are training competitively or even just for fun, even this slight change can affect your ability to reach your goal!
Drinking water before, during and after exercise can help maintain appropriate levels of hydration. Coffees, teas and BCAAs can go towards fluid intake.
How much water should I drink?
Precision Nutrition recommend 11 cups of water for females and 16 cups for males. Although there is no precise guidelines as everyone’s requirements are different based on activity, size, climate etc.
Can I drink too much?
Yes it is possible to drink too much water but the quantities would have to be substantial. Over hydration or hyponatremia can dilute our electrolytes to dangerously low levels. This generally occurs by drinking a vast amount of water in a short amount of time, leaving the kidneys unable to clear the excess fluids.
Tips on avoiding dehydration
Make it a habit!
Most people don’t drink enough water during the day because they simply don’t think about it!
- Set reminders. There are now apps available that will help get you track your water intake and set goals.
- Have a glass of water first thing in the morning to replace fluids lost at night and one before bed.
- Invest in a water bottle that you take with you on the go or have on your desk.
- Take regular water breaks in work and during exercise (in between sets)
Monitor your hydration status!
Check your pee and drink water accordingly.
Make it palatable!
Add some lemon, lime, mint or berries to your water to add some flavour.
Drink plenty of water before physical activities that may leave you sweaty rather than replacing fluids once they’re lost.
Drink more when exercising or sweating
Don’t wait until your thirsty, it may be too late!
- Add 2-4 cups of extra water on days that you exercise
- For every pound of sweat, you should replace with 2 cups of fluids (1)
With extremely strenuous activities or activities lasting +60 mins, water may not be enough to replace lost electrolytes. You may consider a sports drink, gels or dissolvable tablets. If you prefer a healthier option, homemade sports drinks are easier than you think and taste just as good. (https://www.thehealthyhomeeconomist.com/homemade-electrolyte-replacement/)
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The it's time! Miracle Ducklings!
On May 13th, 2018 – Mother’s Day – it’s time! Fitness Results welcomed a generation of mallard ducklings into the world. How and why, you ask, would a small local gym choose to become “mother” to wild ducklings? Read on to find out…
In early April, staff and clients noticed a female duck hanging around the green patch outside the gym doors. Within a few days we were surprised to discover that our duck had made a nest and laid eggs! To choose such a location she must have been a fitness enthusiast like ourselves. Our clients became enamoured with this duck and her eggs, bringing her food and checking on her before their sessions. She became part of the fitness family!
Unfortunately, on the morning of May 8th, tragedy struck. During her routine “duck check”, strength coach Briana Kelly came upon a terrible scene. Our mother duck had met a tragic fate and so had her nest. Upon further investigation, we discovered 4 eggs had survived the ordeal – but what were we to do? Calls to several wildlife help lines told us there was nothing they could do, as no one was able to take our eggs. We didn’t know how long they had been exposed, so the chance of survival was slim! A huge decision had to be made.
Being in the business of health and wellbeing, we decided to try our best to save the ducks. We brought the eggs into the gym and put them in a makeshift nest with a heated blanket for warmth. Admittedly a few of the staff, including owner Sheila Hamilton and Operations Manager Dave Ewart, were feeling doubtful about this endeavour but went along with having the eggs join the weekly staff meeting.
Not knowing a whole lot about fostering duck eggs besides their needing warmth, the it’s time! team took to the internet and other resources to figure out what to do to help these motherless eggs. It turned out looking after eggs was no small task. They required a cosy protective environment at a balmy heat of 37 degrees. They also had to be turned every 5 hours!! Just in case the eggs came in the middle of the night, Briana and trainer Christina Carrick took turns bringing the eggs home.
Initially we were unsure whether the eggs were alive, but we discovered a technique known as “candling” (where you illuminate the egg with a flashlight to see inside). We not only determined that our ducklings were alive and kicking but that the eggs were 23 days old, meaning that they had another week or so before they hatched. We used this process to check on them twice a day.
It wasn’t just the staff at the gym that became invested in saving these poor ducklings but also our clients. Long time it’s time! client and animal lover Joyce was instrumental in researching the best home for our babies. Other clients brought their children in to see the eggs. They became the stars of the gym, distracting everyone from their exercise routines!
Over the next few days, we watched our eggs closely for any signs of hatching. Five days after we found them we noticed cracks on one of the eggs. Putting the egg to your ear you could hear movement and peeping! How exciting! The other eggs followed suit and over the next 36 hours they painstakingly pecked their way out of their eggs.
On Mother’s Day, we welcomed 3 out of the 4 ducklings into the world. Healthy, fluffy, happy ducklings! First was Bill, then came KettleBill and finally BarBill. The final egg took his/her time to hatch and arrived Monday afternoon. We named him DumbBill, because he needed a little extra time than his brothers and sisters – and he liked to keep pushing his head back into the eggshell! With all the Bills happy and healthy it was time to bring them to their new home, although saying goodbye proved harder than we thought. Trainer Andrea Brennan was brought to tears by final farewell.
The it’s time! Bills were received by the Wildlife Rescue Association of BC on Monday May 14th, courtesy of our client Ian, who became the delivery man for our precious cargo. Our ducks were not alone as they arrived with 7 other orphaned ducklings that day. The volunteers there were thrilled to meet our ducklings and commended us on how well they looked. Unfortunately, at this time of year, farms and rescue organizations are inundated with ducklings and other young birds in need of care. The Wildlife Rescue, where our gym ducks will make their new lives, relies on volunteers and donations.
It costs $250 per animal to rescue. We want to give our ducks and others like them the best possible chance to lead long healthy lives, that way they can come back to visit us at the gym!! As a result we are encouraging donations to Wildlife Rescue (https://www.wildliferescue.ca/give/) We will also be selling our new Duck T-shirts that were designed by client Grainne to support this cause! Our goal is to raise $1,000. Please contact firstname.lastname@example.org for further details.
We want to share this story with as many people as possible with the hopes of inspiring people to take care of our wildlife. Do not be afraid to take action because the results can be tremendously rewarding!
Sam Smith of media relations with the Wildlife Rescue Association of B.C. states, “The chicks would not have had a chance without your intervention. They are now in the hands of experts that will ensure they have no imprint from humans before their release.”
Special thanks to Grainne Downey a Vancouver-based Graphic Designer and Illustrator for our T-shirt design.
Follow our hashtag #bestduckingym on Facebook and Instagram to stay up to date with our progress!
Written by: Andrea Brennan with input from the whole nest!
The Functional Value of the Hip Hinge
“Lift with your knees!”
The phrase said time and time again in high school gym class, the physical workplace, or heavy lifting workshops.
“Bend and lift using your knees and you won’t hurt your back!”
But men and women in the workplace DO hurt their backs. Homeowners in the garden hurt their backs. People unloading a full dishwasher in the kitchen hurt their backs. Even when they lift with their knees.
How should we be lifting? Is there a better way?
There is some truth to the idea of lifting with your knees and legs; however, there’s definitely more to it. Biomechanically, our hip and butt muscles, or glutes, are much stronger than the quads. If we can modify our bending or lifting movement to recruit our glutes, we’ll protect our backs, save our spines, and increase our bending and lifting longevity.
Let’s modify the instructions: “Lift with your hips!”
The Hip Hinge
The Hip Hinge is a functional pattern we use with our clients to recruit the glutes for bending and lifting safely. The spine and pelvis remain neutral and safe during this movement, reducing strain on the back muscles. Back muscles are used for stability when the spine is neutral, but should not be relied upon for bending down or straightening up. In these instances, when the back muscles are used instead of the hips, huge compressive forces are placed on the spinal discs, and unhappy compressed discs can lead to incredible pain, numbness, and debilitation.
This is a natural movement we tend to move away from as we age. Check out the three year old picking up his toy box at the top of this page: no one taught him to lift, but we can see a perfect hip hinge!
How do we hinge?
- Stand tall and hold a dowel or broomstick to your back, ensuring it contacts three points: back of the head, mid back, and tailbone. Place your shins against a stool or coffee table to prevent your knees from bending forward.
- Maintaining your three points of contact, send your hips back to create a “hinge” motion. Keep your knees wide. Do not hinge/bend so far you round in the back and lose your contact with the dowel.
- Pause at the bottom of your hinge.
- To stand, push your feet into the floor and contract your glute (butt) muscles until your hips are straight.
- Inhale as you hinge back, exhale as you stand.
The hip hinge is the base needed for many strength movements in the gym, but more importantly, for many functional movements in life. See some examples to follow:
In the gym:
- Kettlebell swing
- Glute bridge
- Single leg RDL
- Unloading the dishwasher
- Lifting the kids
- Reaching for laundry in the washer
- Bending to tie your shoes
- Picking the dog toys up off the floor
- Pulling weeds
- Replacing the bag in the kitchen garbage
Back pain and injuries often seem as if they stem from that “critical moment”. However, that moment you bent down to pick up the pen was just the final straw – it takes months and years of poor movement quality and bad habits to get to a point where the back is that fragile.
Let’s master the hip hinge and significantly reduce the risk of injury in our lives. Back pain isn’t normal. Spread the word in your family and workplace – teach those around you that the knees aren’t made to lift, but the hips are!
If you need help with your movement or existing back pain, reach out to us at it’s time! Fitness Results for guidance and supervision as you perfect your hip hinge.
Written by Briana Kelly, Kinesiologist and Strength Coach at it’s time! Fitness Results
Gifts for your wrists and hands
As wonderful as it is to give to others if you do not give health to yourself first you will not have the ability to give a lot to others.
There are so many levels to having optimum health and fitness and unless we breakdown your specific goals and make a plan we run the risk of simply not taking the right steps to achieve them.
Although with the best of intentions many folks skip right to activities like running, skiing, golfing and tennis because they are so enjoyable. Often, they lack the foundational movement skills that would decrease the risk of injury and improve the quality of the experience on many levels during and after with improved recovery.
Wrists and Hands
Did you know a handshake is a better predictor of premature death than traditional blood-pressure testing? According to a study published in the Lancet, a weak handshake can signal an increased risk of a heart attack or stroke. Further implications of grip strength include protection from old-age disability, better overall strength in other muscle groups, and prediction of mortality, disability, disease complications, and increased length of hospital stay. In order to produce adequate grip strength, you must present good wrist, forearm, hand, and finger health!
Each of the wrists and hands is a complex structure. The wrist joint is comprised of the two forearm bones, 8 carpal (wrist) bones, and the proximal ends of 5 metacarpal (hand) bones. The articulations between these many bones allow for range of motion in 3 planes (flexion/extension, pronation/supination, and lateral flexion/extension), and the joint is stabilized by an intricate system of ligaments. Optimal wrist function allows for load bearing and load suspension as well as full range of motion with control.
One hand contains 5 metacarpal (hand) bones and 14 phalanges (finger bones). These create very fragile joints that are controlled by intrinsic muscles (with the muscle belly in the hand) or extrinsic muscles (with the muscle belly in the forearm with tendons extending into the hand). 3 nerves control the innervation of these hand and wrist muscles. The hand sits at the terminus of the arm – it’s so important that the sole function of the shoulder and arm complex is to control the position of the hand!
The dexterity humans possess in their hands and fingers allows us to complete complex tasks such as pinching between thumbs and fingers, gripping, and isolating single finger movements. This intricate motor control sets us apart from other animals.
Beyond the internal anatomical structures, it’s also important to consider the superficial features of the hands including skin and nails. The skin that covers the back of the hand (dorsal) is very different from the skin that covers the palm. Dorsal skin is thinner and more pliable, attached to the hand loosely through blood vessels. The palmar skin is much thicker and is tightly connected to the underlying fascia to increase stability and gripping ability. The nails located at the end of each finger are intimately connected to the most distal (farthest) phalanges (finger bones). They offer protection for these bones as well as contribute to finger dexterity.
Humans are extremely dependent on hand and wrist function. If you’ve ever lost the ability to fully use one (or both) for a short time, you notice very quickly how many actions are affected! Things as simple as brushing your teeth, stirring a pot on the stove, or getting up from the ground all become more difficult. Take the time to work on your wrist and hand strength and mobility and you will reap the benefits.
Visual Inspection: How do they look?
- Are your hands flat and relaxed when on the floor or wall or do some of the fingers bend?
- Are your nails or the skin on your hands cracked and dry?
- Do your joints in your fingers look swollen or enlarged?
- Is there any discoloration to indicate poor circulation or skin dysfunction?
Movement Inspection: How do they move?
- Can you make a tight fist with all your fingers and thumb?
- Can you touch and pinch your thumb to each of your fingers?
- Can you rotate your wrist in all directions and spread your fingers?
- Can you isolate single finger movements? ie. peace sign or ‘Spock’ sign
Sensory Inspection: How do they feel?
- Any numbness in fingers or thumb?
- Do your fingers feel cold? hot?
- Can you feel smooth, gliding movements with finger flexion and extension?
- Any cracking or popping?
Gifts for Your Wrists and Hands!
#1 Roll with ball
Place a small ball (smooth or spiky) on a table and roll throughout your entire palm. Explore the different digits and areas of your palm. Try rolling the back of the forearm too, on the table or against a wall.
#2 Wrist flexion and extension stretch
Use your opposite hand to stretch your wrist into flexion (towards the palm) and extension (towards the back of the hand). Hold for at least 30 seconds.
#3 Wrist lateral and medial flexion stretch
Use your opposite hand to explore lateral movements, bending the wrist towards the thumb and then the pinky.
#4 Finger stretches
Isolate your fingers from the wrist and explore the range of motion. Stretch all the fingers together in flexion and extension, then isolate each finger.
#5 Elastic band stretch
Place an elastic band around your thumb and all your fingers. Gently pull the band apart to work your hand extensors. This reverses the ‘gripping’ flexion motion.
#6 Grip work
As noted above, grip strength is a strong predictor of overall health. Work on your grip strength by holding a kettlebell or other object at your side, tightly squeezing a ball, or hanging from a bar. Grip is a highly neural-demanding function, and is affected by fatigue and dehydration. Consider testing grip strength and its implications. A grip dynamometer can be used to provide an objective analysis. Some athletes test daily.
#7 Hand and nail care
Massage your fingers and hands together every day with lotion. Keep your nails trimmed and healthy. Take care of any cuts, dry spots, warts or eczema.
#8 Gentle loading into wrists progressing to full weight bearing in plank and/or push up
A healthy wrist joint should allow you to load it with your body weight. Start in an incline position with your hands against the wall or a counter. Progress towards the ground until you can hold an all fours position, and eventually a plank or pushup.
#9 Arm bars
Arm bars are one of the best gifts you can give your wrists and shoulders! An arm bar isometrically loads the shoulder and wrist joints, requiring strength and stability of all the smaller muscles. The kettlebell should rest gently on the back of your wrist, and your wrist position should be straight. Slight movements of the arm are natural but the load should be comfortable to control.
- Roll to your back and press the kettlebell up over your chest with a straight wrist.
- Extend the opposite arm and leg onto the ground.
- Roll away from the arm with the kettlebell, allowing it to rotate until it sits directly above your shoulder. A bent knee can support you on the ground.
- Pack the shoulder away from your ear and let the load sink into your shoulder socket.
- Hold for 6-8 breaths then reverse and repeat on the other side.
#10 Farmer’s Carry
The farmer’s carry relies on grip strength and core stability. Hold equal kettlebells or weights in each hand. Stand tall and go for a slow, controlled walk. Weight should help set your shoulders in a neutral position at your sides and wrists should be straight. Only walk as far as you can control with strong neutral posture and confident grip.
#11 Desk ergonomics
Desk, chair, and keyboard height contribute to wrist function. Make sure your neck and shoulders can remain relaxed (the desk surface is not too high) and that you can provide adequate support for the heels of your hands. Your hands should not rest in too much extension.
Give your wrists and hands some of these gifts this season. You may just live a little longer!
Written by: Briana Kelly and Sheila Hamilton December 2017
Click here to listen to Sheila discuss this topic with Jon McComb on the “Fitness Segment,” which airs live every Thursday at 9:05 am CKNW 980am radio.
Copyright: <a href=’https://www.123rf.com/profile_3dagentur’>3dagentur / 123RF Stock Photo</a>
Dynamic Aging – Katy Bowman Copyright 2017 p. 146,
Easy Strength – Dan John and Pavel copyright 2011 P. 228, 229