Flexibility Training – Part 1 (why do I care?)

Flexibility Training – what is it and why do I care?

I used to be highly inflexible, the first year of PT school it became somewhat of a joke where classmates would practice special tests on me to see what the “abmormal” result was. However, it was something that I worked on regularly. Now I’m fairly limber, often having clients and patients frustrated at how “easy” i make things look. Flexibility tends to be an underrated aspect of health and wellness as it can contribute to movement impairments and thus injury.

What is flexibility? Flexibility is the combination of soft tissue extensibility and control of the nervous system. This allows muscular control through a full range of motion for a given joint. What the hell does that mean? It means that if you are suppose to have a 180 degree range of motion for a given limb, you can control that limb from 0 to 180 degrees of movement and back.

Why is flexibility training important? – Flexibility training is important, because most people in our society lead sedentary lives. The resulting poor posture and movement patterns increase risk for injury and at the same time decrease the efficacy of workouts. This means that one who is inflexible is not only wasting time while they are working out (let’s be honest, who has time for that?) but also increasing their risk of injury which is of course the opposite goal of health and fitness.

Please stay tuned for a video post on how to determine what you should stretch and how based on your postures.

Best,

Nicole Mims. PT, DPT

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Fitness does not = Wellness

It’s easy to get caught up in trying to lose that last 5 pounds or get that one pose in yoga. Remember that exercise is an investment in your future self.

You’re in it for the long haul!

Best,

Nicole Mims. PT, DPT

Balance Training – Part 2

In the previous post on balance I defined what balance is, why it is important, and what affects it.  I discussed the fact that balance is trainable and that training should be systematic, progressive, and safely challenge “limits of stability.” One challenges limits of stability by performing exercise in an environment which is unstable, but also safe.  I.e. a single leg balance is a great exercise, but don’t perform a single leg balance in a place where you will hit your head if you fall.  It is important to note that as with most exercise, “challenging” is relative to the person in question.  An exercise which may challenge me could be exceptionally easy to someone else.   Difficulty can be added in balance training in several ways.
Duration is one of the more intuitive methods of making an exercise more challenging.  This can be done by adding repetitions or if the workout is timed, by increasing one’s time goals.  I.e. hold for 45 seconds as opposed to 30 seconds.
Instability- Another method is by increasing the demands of the environment in which the exercise is performed.  An example of this would be to perform a single leg balance on an Airex pad as opposed to the flat ground. By making the surface more unstable, the proprioceptive demands of the exercise are increased.

Plane of motion- A third method is to change planes of motion.

There are three planes of motion that we use to communicate exercise. Though we never truly move in only one plane at a time, they are still useful concepts. The three planes are “sagittal,” “frontal,” and “transverse.”

Sagittal motion is front to back. Envision someone climbing a flight of stairs.  The movement of their arms and legs would be in the sagittal plane. Sagittal plane of motion is the one that is most commonly trained at the gym.  Think, bicep curls, tricep extensions, squats, lunges, running.  Because these are very common movements, the body should be more adept at performing them than motions in the other two planes and thus sagittal plane is a good place to start training balance.

The next commonly trained plane is frontal or lateral.  Frontal plane would be out to the sides, or parallel with the front/back sides of the body.  An example of this would be shoulder flys, or side lunges.  Once a reasonable level of stability has been built in the sagittal plane, one can progress by beginning lateral movements. A single leg balance with extension would become a single leg balance with lateral extension.

Finally the least trained plane of motion is the transverse.  This is turning or crossing the body.  This is also, unsurprisingly, the plane of movement that one is most likely to become injured in.  We see this for example in ACL injuries.  When an athlete plants their foot and tries to change direction they are at an increased risk for a knee injury.  An example of a transverse movement would be a cable rotation, or an oblique crunch.  This should be the final plane of motion that one begins training in, as it is the most difficult.  This is also the training that will do the most for injury prevention.
Stay tuned for Balance part-3, as I will hopefully have my recording device and software operating and will be able to show some specific exercises.  Please feel free to leave feedback or ask any questions.

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Balance Training Part I

Lets talk about Balance training-  Part I

 

 

 

 

 

 

 

 

 

What do we mean by Balance?

–       We intuitively understand that balance means maintaining our posture and equilibrium despite our surroundings.  We know that a person with good balance can do things like skateboard, ski and play sports well.  A person with poor balance may trip just walking on an uneven surface.

 

Why do we Care?

–       Balance is a component of all movements and can help in both our athletic pursuits and day to day lives. A functional example can be seen in the elderly.  An older person who falls is at a greater risk for breaking a bone than someone who is younger.  This is important because balance can be trained.  By spending the time and effort to train balance we can become more functional, safer, and better at the things we enjoy.

 

What affects Balance?

–       Balance has a lot to do with the neuromuscular system.  Certainly we have all heard of those with inner ear problems, but for a majority of people balance involves neurologic pathways, muscular balance (length tension relationships), proper joint dynamics, and neuromuscular efficiency.  There is substantial evidence to suggest that sensory feedback to the central nervous system (involved in proprioception and neuromuscular efficiency) is inhibited after injury. This means that those who have been injured are more likely to have problems with balance than those who have not. This decreased efficacy of the central nervous system will lead to poor movement patterns, posture, and likely further injury.

 

How do you Train Balance?

–       Balance like strength training involves constantly challenging oneself.  With strength training you strive to lift more weight or do more reps, with balance training you want to stress “limits of stability,” or the area you can go outside of your base of support without losing control of your center of gravity. This is done by training functional movement patterns in an environment that provides controlled instability and utilizes multiple planes of movement.  This trains the nervous system to activate the right muscles at the right time, and in the right plane of motion.

 

Implementation

–       It is important that a Balance-training program be systematic, methodical, and progressive.  The exercises that should be chosen depend on an individual’s specific abilities and the phase of training they are in.  The next post will involve different stabilization exercises including how and when they should be utilized.

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Flexibility part 4 – what needs to be stretched?

How to tell what needs attention –

Here is a picture of a well aligned body compared to different postural problems.

 

Most of us have at least one of these problems..  As discussed in part 1, this is due to muscles becoming shortened or overly stretched from the positions we keep our bodies in on a day to day.  Movement assessments use knowledge of postural distortion patterns (typical patterns of movement and posture resulting from muscular dysfunction) to determine which areas need to be addressed.  The overhead squat is my favorite movement assessment to conduct. If possible I would recommend that one take advantage of the “free personal training” session which is usually offered at gyms. Of course the goal of this session is to rope you in to personal training, but the information can be very useful. (Bear in mind that I believe in personal training and feel that most everyone can benefit from sessions; however, realistically cost is prohibitive and this is not always an option.)  Another method if you don’t have a gym membership would be to record yourself doing an overhead squat and then review the video.

How to do an overhead squat assessment –

Do not skip ahead!!! It will invalidate the assessment.

Foot position – Stand with feet shoulder width apart, toes pointed straight ahead.

Torso – begin with the torso upright and core tight

Upper body—extend arms overhead, parallel to one another (as if you were holding a beach ball overhead)

 

            The movement – keeping the arms overhead as much as possible squat down to a comfortable level, keeping your weight on your heels.  After reaching a comfortable level, push through the heels and come back up to standing.  If you are recording this squat assessment, you will need several squats recorded from both the front and side. 

If a trainer is watching you (and they are worth their salt) they will record what your postural distortion patterns are and should be able to tell you which areas need to be addressed and how. 

I was going to go into tons of detail, but discovered that this topic has already been aptly covered by someone else.  Please use the following link.

Anterior (front view)

Checkpoint	Movement	Stretching Exercises	Strengthening
Feet	Turn Out	Calf Stretch (Static, SMR) Hamstring Stretch (Static, SMR) TFL stretch (Static, SMR)	Single Leg Balance and Reach
Knees	Move In	Adductor Stretch Hamstring Stretch TFL Stretch Calf Stretch	Lateral Tube Walking Stability ball squat Glute Bridge with Abduction
	Move Out	Piriformis Stretch Hamstring Stretch TFL Stretch	Stability ball squat Glute Bridge with Abduction

 

Lateral (Side View)

Checkpoint	Movement	Stretching Exercises	Strengthening
Lumbo Pelvic Hip Complex	Excessive Forward Lean	Calf Stretch Hip Flexor Stretch Ball Abdominal Stretch	Stability Ball Squat
	Lower Back Arches	Hip Flexor Stretch Lat stretch Erector Spinae Stretch	Stability Ball Squat Glute Bridge Stability Ball Bridge
	Lower Back Rounds	Hamstring Stretch Ball Abdominal Stretch Adductor Magnus Stretch	Floor Cobra Ball Cobra Ball Back Extension
Upper Body	Arms Fall Forwards	Lat Stretch Pectoral Stretch Foam rolling (thoracic spine)	Floor Cobra Ball Cobra Squat to Row
	Forward Head	Scalene Stretch	Tuck Chin and keep head back during all exercises