Being More than ‘Nice.’

Story time: one of the first transformative experiences that I had in college was in a history class titled Creating Contemporary America.

Dr. Pollock was not a woman to mince words, and so when WASP behavior, the creation of the American suburb, ticky tacky houses, and ‘nice work’ became the topic of conversation, she didn’t hold back. “What is the POINT of ‘making nice?’ why have pointless conversations about the weather or peewee sports to be likable?” Is never having a ruffled interaction worth a 100 non memorable conversations? What about 1000? A lifetime?

I realized it wasn’t. I have to assume that I only get one life, one chance to EXPERIENCE. I don’t want to spend it biting my tongue, telling half truths to lubricate interactions or feigning interest or sweetness. If someone doesn’t regard me in a positive light, why should I care? Why be ‘nice’?? Why allow your defining characteristic be a lack of interesting experience? I can think of fewer things more distasteful than for this to be my descriptor. ” For fucks sake, BE SOMETHING, anything else.” I told myself. I did not/do not want to be a glass half full, rose tinted glasses person, because this person is in denial. They live in a pleasant Matrix and for this they have my disdain.

To be clear, being KIND is not the same as being nice. Sometimes people need an unpleasant but beneficial reality check. To avoid it, is Nice. To tackle it for their benefit or others is kind. To fight for things that are right is kind, but it is not nice and is often unpleasant. Sometimes ‘nice’ masquerades as kind or kind may be mistaken for nice. The difference is in quality.

‘Nice’ is vanilla. It’s sweet without intensity. The remaining taste in your mouth after a ‘nice’ interaction is as much about what you don’t experience (challenge, intensity, excitement, anger, passion) as what you do.

Be brave.

See things as they are.

Have more depth than superficial pleasantness.

Be more interesting than everyone’s cup of tea.

Be more challenging than likeable.

Be more than nice.

For many reasons this thought has been working its way through my brain. Too many times biting my tongue in the hospital setting? One too many times hearing “but they’re soo nice” as an excuse?

Maybe it’s being passed over for the easier/more palatable option too many times that has effected this post. Regardless, I will continue to be more than just nice.

-NM

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Grief for the Normal

As a person who has long prided oneself on not being normal I have to admit; I really miss it.

I miss being able to just get in my car and go to the store without anxiety.

I miss seeing friends whenever our schedules coincided.

I miss packed restaurants, bars and music venues.

I miss normal….

Ive been thinking about why everything and everyone seems so shitty this year, and I had a thought the other day that I can’t shake. I believe we are grieving. People are shitty when they are grieving and we Americans are, at best, entitled in normal times.

The order and nuances for the stages of grief can be argued by those more scholarly than myself; however, I do tend to see around me Anger, Sadness, Denial, Bargaining, Depression, and sometimes… Acceptance. I’m not sure if I’m ready to enter that last one but it seems that 2020 is trying to teach it to me anyway.

Since I had this realization a few days ago I have been trying to keep grief in mind when I interact with others. This is not only the understanding that I have grief and it affects how I interpret things, but that others do too. Their world’s have also been upended and they too miss their normal. Perhaps they are in denial that their normal is gone. Either way: understanding and sadness, or possibly just cognitive dissonance. I don’t feel that any of us are ok. Our new ‘normal’ requires changes, understanding and flexibility.

We may be tempted to ask “why me?” “Why should I be the understanding one?” Or even just “why did this have to happen to us, now?”

The best answer I have, and it is not perfect, comes in the form of a quote.

Frodo: “I wish none of this had happened.”

Gandalf: “So do all who live to see such times, but that is not for them to decide. All we have to decide is what to do with the time that is given to us.”

Why your knee pain isn’t getting better.

Have knee pain but didn’t suffer some kind of injury?  You’ve probably tried the standard interventions Rest, Ice, Elevation, Compression, maybe even a brace or KT tape.  Airrosti anyone?  Chances are, this hasn’t done anything for your problem, the pain keeps coming back, or any time you try to go without the brace/kt tape the pain comes right back.

Right behind back and neck pain the most common area I seem to treat in the clinic is the Knee.  The above is how the story usually seems to go.  The aggravating factors?…Squats & Stairs.  So why isn’t your knee pain getting better or why does it always come back?  Because you’ve been treating the symptoms rather than the cause.  We can’t just ice the knee without asking WHY is it inflamed to begin with?  What caused the damage?

The answer: Poor Movement Patterns. 

When your tires are wearing weird on your car do you just replace the tires or do you check the alignment?

Why?  – Inward Rotation of the Knee
This can happen either because of hip weakness, foot weakness, or both.

from: https://goo.gl/images/cALrnH

1. Weak Hips
   • It is very common for people (even frequent gym goers) to have weakness in the hips, specifically the muscles that rotate the leg outward. When these muscles are weak the thigh will rotate inwards as the hip flexes, causing the knee to ‘turn in’ or move inward in relation to the foot and hip.  If these muscles are very weak, this will happen when a person is standing on a single leg.
     

     From: netter atlas of human anatomy

2. Weak Feet
   • If a person has weak foot muscles their arch will collapse when put under increased strain.  If the foot collapses, the knee will again move in relative to the foot and hip.
     

     From: Netter atlas of human anatomy

• Summary: The knee is the joint caught in the middle of two very problematic areas and when there is dysfunction, its often the knee that takes the brunt of it.

So the question is, when traditional methods fail what do you do?

1. Form Check – Try squatting in front of a mirror or film yourself performing a body weight squat. Does it look like the picture on the left?  If so we’re talking about a movement impairment problem.

http://www.aphysio.com.au/runners-knee/

2.  Strengthen

• Hips – 
  • Clam Shell

    Position: Laying on side, knees bent, feet together
    Heels, shoulders and hips aligned
    Tilt body slightly forward (pointing navel toward the floor)

    Action: Squeeze through your glutes (buttocks)
    Keep your heels together and lift top knee up.
    Hold 5 seconds, slowly lower to starting position. (In this photo I have a resistance band around my knees, this is a simple way to increase the challenge but is not necessary to benefit from this exercise)

    Form: Do not arch your back.
    Do not allow hips to rock back & forth.
    –You may want to perform with a wall or other straight surface behind you
    Keep glutes contracted the entire time.

    To increase the difficulty you can add a resistance band around the knees or hold for a longer period of time.

    

  • Glute Bridge

    Laying on back, knees bent about 100 deg,feet on floor & close to the buttocks. Squeezing your glutes and ab muscles, push through heels & raise hips off the floor until hips and knees are in a line. (if you feel your back working, don’t lift your hips quite as high)

    Hold position 2 seconds

    Slowly lower hips back towards the ground and repeat. (you can add difficulty by placing band around knees.)
    Feet – 

• Foot Muscle Energy Technique 
  • Sitting upright, curl toes passively, using hand.
  • Remove assistance of hand and continue holding toe curl with muscles in foot.
  • Hold for 10 seconds.

       Toe curl and point

• Sitting upright, leg extended out in front of you. Curl your toes around a small towel (dish cloth), you may need to bunch up the towel a little.
• Keeping toes curled/holding towel with toes, extend your foot as if pushing a gas pedal. Try not to drop towel. Hold for 1 second and return to starting position.

from: HEP2go public

Towel Curls

• While seated, place a towel on a smooth floor under the arch of the foot (heel is in contact with the floor). Curl your toes in pulling the towel back towards you.
• Be sure to keep your heel in contact with the floor the entire time.
• Place a small weight or bag of rice on the towel to increase difficulty

3.  Stretch

hep2go public

Standing calf stretch

• Start by standing in front of a wall about an arms reach away, feet about hip width apart.  Step one leg back about 3-4 feet, keeping the leg straight.  Point the toe of back foot slightly in, plant the back heel.
• Lean forward towards the wall as you allow your front knee to bend until a gentle stretch is felt along the back of your leg.
• Hold for 1 min each side, repeat 2x.

– Credit to: www.enhancephysiotherapy.net

Lunge Stretch: Start in a lunge position, with the hip you are stretching as the back leg. Move your hips and torso as far forward as you can and make sure your back knee doesn’t slide forwards. Keep your torso upright and chest forwards. You can add more of a stretch by incorporating an anterior pelvic tilt – by tucking your buttocks underneath you and moving your pelvic bone towards you.

TFL Stretch – kneeling

• Kneeling position, extend leg closer to the wall back and to the outside of the outer leg.
• Bend front knee and lean hip that is being stretched into wall.

The backfixer.com

5. Support

• If your feet are an involved component I highly recommend addressing your shoe-ware.  Unstable/soft shoes allow the arch to collapse if these are the shoes you wear when you lift, this compounds the problem.  Try buying a pair of “stability” shoes and using a pronation orthodic insert to help correct this.

The above interventions should get you on your way to correcting the ACTUAL problem rather than just treating the symptoms.  Fair warning: This is NOT a quick fix. Its not a magic pill.   It takes weeks for your body to build real strength and it takes many repetitions of doing something properly to make it habit.  The question is, is it worth it?  If the old methods aren’t working, isn’t it time to try something else?

Dr. Mims  PT, DPT.

 

 

 

Lead by example

Many of our health habits we get from how we are raised and what we saw adults do. You can choose to be an example of what to do, or what not to do.

Make a healthy choice today.

Max Strength – ‘How To’ and Sample Week

Ever heard people discuss their “phase” or “stage” of training and wonder what the heck they were talking about?  Like a lot of fitness buzzwords, people like to throw these terms around without much explanation as to the what/how/why.  If you are fuzzy on the purpose of training phases in general, please check out my most recent article on what the phases are, and how to transition through them.

As I discussed previously, progressing through phases of training can provide a structured way to change up your routine and continually challenge yourself, provided it is done with planning and care.  I myself use my own modification of the NASM’s phases for my personal and my client’s programs.  One of my favorite phases to work in is the one I just started last week called Max Strength, and what that entails is what I would like to discuss today.

Why: The purpose of Max Strength training is fairly self-explanatory with the goal being to increase the maximum amount you can lift in a single repetition or very short period of time (__<6 reps).  You do this by performing a relatively LOW number of repetitions, at a high intensity, for a high number of sets.   This increases the density of your ‘fast twitch’ or explosive muscle fibers by placing short time/high resistance strain on the body.

What:  Exactly what do I do to place this kind of strain on the body? The breakdown of structure is as follows.

	Sets	Reps	Timing (Ecc/Iso/Con)	Intensity % of 1RM
Week 1	4-5	6	1/0/1	85%
Week 2	5	6	1/0/1	85-90%
Week 3	5-6	4-6	1/0/1	90%
Week 4	6	4	1/0/1	90-95%
Week 5 *	6-7	3-4	1/0/1	90-95%
Week 6 *	7	1-3	1/0/1	95-100%

*Optional

How: What does this look like in a day to day? Now that you have a basic idea of what Max Strength Training involves, here is a sample using my personal workouts from last week.  If you were interested you could take this week as an example and repeat it across your entire phase, changing reps/sets/ and weight as needed.

Week 1 – Day 1: Legs

	Super-set 1
	Set 1	Set 2	Set 3	Set 4	Set 5
Reverse Lunge	6/95#	6/95#	6/95#	6/95#	6/95#
Single Leg Calf Raise on decline	10/+20#	10/+20	10/+20	10/+20	10/+20
	Super-set 2
Stiff Legged Deadlift	6/125#	6/135#	6/135#	6/135#	6/135#
Back elevated Glute Bridge, with band	10/BW	10/BW	10/BW	10/BW	10/BW
	Final – Stand Alone
Sumo DL	6/155#	6/175#	6/155#	6/155#	6/155#

 

Week 1 – Day 2: Vertical Push/Pull (Lats, Shoulders, Legs)

	Circuit 1
	Set 1	Set 2	Set 3	Set 4	Set 5
Wide Grip Lat Pull down	6/105#	6/105#	6/105#	6/105#	6/105#
Shoulder Fly/abduction	6/12.5#	6/12.5#	6/12.5#	6/12.5#	6/12.5#
Functional Squat (to 90 deg, band below knees)	10/ BW	10/ BW	10/ BW	10/ BW	10/ BW
	Circuit 2
Neutral Grip Lat Pull down	8/105#	6/110#	6/110#	6/110#	6/110#
Barbell Shoulder Press	8/50# *no 60# available	8/50#	8/50#	8/50#	8/50#
Single Leg RDL	10/BW	10/BW	10/BW	10/BW	10/BW
	Circuit 3
Underhand Grip Lat Pull down	7/105#	6/110#	6/110#	6/110#	6/110#
Post Delt cable pull back	6/40#	6/40#	6/40#	6/40#	6/40#
Monsterwalks, heavy resistance band	8/BW	8/BW	8/BW	8/BW	8/BW

 

Week 1 – Day 3: Horizontal Push-Pull (Chest, Back, and Legs)

	Circuit 1
	Set 1	Set 2	Set 3	Set 4	Set 5
Dumbbell Chest Fly	5/2×30#	6/2×25#	6/2×25#	6/2×25#	6/2×25#
Single Arm Dumbbell Row (lawn mowers)	6/50#	6/50#	6/50#	6/50#	6/50#
Back elevated Glute Bridge with band around knees	10/ BW	10/ BW	10/ BW	10/ BW	10/ BW
Jump Rope	30 sec	30 sec	30 sec	30 sec	30 sec
	Circuit 2
Machine Chest Press (neutral)	6/80#	6/80#	6/80#	6/80#	6/80#
Machine Wide Row	6/2×50#	6/2×55#	6/2×55#	6/2×55#	6/2×55#
Monster Walks with heavy band	8 each direction	8 each direction	8 each direction	8 each direction	8 each direction

 

Week 1 – Day 4: Legs

	Super-set 1
	Set 1	Set 2	Set 3	Set 4	Set 5
Hex Deadlift	6/155#	6/165#	6/175#	6/185#	6/190#
SL calf raise, on decline	12/BW	12/BW	12/BW	12/BW	12/BW
	Super-set 2
Leg press	6/315#	7/340#	7/350#	6/360#	6/360#
Single leg RDL	8/ BW	8/ BW	8/ BW	8/ BW	8/ BW
	Super-set 3
Sumo Dead-lift	6/155#	6/155#	6/155#	6/155#	6/155#
Jump Rope	30 sec	30 sec	30 sec	30 sec	30 sec
	Super-set 4
Hip Thrust with Barbell	6/135#	6/155#	6/155#	6/155#	6/155#
Low Ab-roll	8/bw	8/bw	8/bw	8/bw	8/bw

 

* Here is a short video I took of myself doing HEX dead-lift that night.

 

 

Week 1 – Day 5: Vertical Push-Pull (Lats, Shoulders, Legs)

	Circuit 1
	Set 1	Set 2	Set 3	Set 4	Set 5
Underhand Grip Lat Pull down	6/120#	6/120#	6/120#	6/120#	6/120#
Barbell Shoulder Press	5/60#	5/60#	5/60#	5/60#	5/60#
Functional Squat, band around knees	10/BW + heavy Band	10/BW + heavy Band	10/BW + heavy Band	10/BW + heavy Band	10/BW + heavy Band
	Circuit 2
Neutral Grip Lat Pull down	6/120#	6/125#	6/125#	6/125#	6/125#
Dumbbell Shoulder Fly	6/2×15#	6/2×15#	6/2×15#	6/2×15#	6/2×15#
Single Leg RDL	8/BW	8/BW	8/BW	8/BW	8/BW
	Circuit 3
Wide-grip Lat Pull Down	6/105#	6/105#	6/105#	6/105#	6/105#
Posterior Delt Cable Pull back	6/35#	6/35#	6/35#	6/35#	6/35#
Back elevated, glute bridge. Band around knees	12/BW	12/BW	12/BW	12/BW	12/BW

 

Week 1 – Day 6: BEACH!!! (Arms, Abs, Calf)

	Circuit 1
	Set 1	Set 2	Set 3	Set 4	Set 5
Cable Tricep Extension, forearm pronation (bar handle)	8/30#	8/35#	8/40#	7/42.5#	7/42.5#
Dumbbell Hammer Curl	7/2×20	7/2×20	7/2×20	7/2×20	7/2×20
V-up core	12/BW	12/BW	12/BW	12/BW	12/BW
	Circuit 2
Standing, single arm Tri extension, (neutral forearm)	8/15#	8/15#	8/15#	8/15#	8/15#
Preacher Curl with bar	6/40#	6/40#	6/40#	6/40#	6/40#
Single Leg Calf Raise on decline	12/BW	12/BW	12/BW	12/BW	12/BW
Leg Raise	10/BW	10/BW	10/BW	10/BW	10/BW
	Circuit 3
Classic Crunch	30 sec	30 sec	30 sec
Oblique Crunch Left	30 sec	30 sec	30 sec
Oblique Crunch Right	30 sec	30 sec	30 sec
Bicycle	30 sec	30 sec	30 sec
Clam 3	20/bw	20/bw	20/bw
Band resisted Glute Bridge	20/bw	20/bw	20/bw

 

Keep in Mind that these are my personal workouts, and thus what you can do in the gym may be much more, or less.  Go based on how you feel, but always try to challenge yourself.

I hope this was helpful.  Please leave any feedback in the comments below.

Best,

Nicole Mims.  PT, DPT.

Break out of the Rat Race

Wellness: healthy body + clear mind

Midnight Wonderings

Laying in bed contemplating, mind wandering through wonderings.

A risky tangle, underbrush in which to stray…lost. Losing the forest in the trees. Or is it the other way around? Do I miss the picture in the details of memories or are the memories lost with the foreknowledge of their ending.

And I wonder if any thoughts like this plague your mind. Do you sleep soundly?

And I wonder if you care enough to wonder, even for a moment.

I wonder why I didn’t compare. And why I couldn’t. And why I give a fuck.

…And I know I’ll never know, and it wouldn’t matter if I did.

But still I lay here, and I wonder.

Holiday truth bombs

I’ve always loved Teddy Roosevelt quotes. This one rings true, especially today.

Keep going, soon goals will be accomplishments

Credit to https://me.popsugar.com/fitness/photo-gallery/43830242/image/43830233/Motivational-Workout-Quotes-Memes