Back Clinic Physical Rehabilitation Team. Physical medicine and rehabilitation, which is also known as physiatry or rehabilitation medicine. Its goals are to enhance, restore functional ability and quality of life to those with physical impairments or disabilities affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles, and tendons. A physician that has completed training is referred to as a physiatrist.
Unlike other medical specialties that focus on a medical cure, the goals of the physiatrist are to maximize the patient’s independence in activities of daily living and improve quality of life. Rehabilitation can help with many body functions. Physiatrists are experts in creating a comprehensive, patient-centered treatment plan. Physiatrists are integral members of the team. They utilize modern, as well as, tried and true treatments to bring optimal function and quality of life to their patients. And patients can range from infants to octogenarians. For answers to any questions you may have please call Dr. Jimenez at 915-850-0900
Patellofemoral pain is an extremely common and disabling condition that affects both men and women of all ages. Functionally it limits everyday movements and activities such as squats, lunging, walking up stairs and hills. It has been suggested and research concludes that dysfunction between the Vastus Medialis Oblique (VMO) and the Vastus Lateralis is one of the common predisposing factors that precedes patellofemoral pain.
The anatomical structure of the patella and the groove in the femur (trochlear groove) dictate that if the patella does not sit within the groove perfectly, then the hard edge of the lateral femoral condyle will contact the undersurface of the patella and create a pressure area that begins to wear down the cartilage structure of the patella and femur. Dysfunction of the VMO creates the situation whereby the patella is not able to be centralised in the groove and thus rides up on the lateral femoral condyle.
Physiotherapists, Chiropractors and exercise professionals have for decades been utilising VMO exercises in the treatment of patellofemoral pain.
Some of these exercises have been validated as effective VMO exercises and others have not.This month the focus of this research review is on VMO activity in rehabilitation exercises and also the validation that VMO dysfunction is associated with patellofemoral pain. The first study from Stanford University in California (Pal et al 2011) studied the relationship between VM activation delay and patellar tracking measures in different groups of knee pain patients. They hoped to find that measures of patellar tracking, patellar tilt and bisect offset correlate with VM activation delay in patellofemoral pain patients labelled as lateral maltrackers.
They selected 40 subjects who had suffered for more than 3 months with patellofemoral pain.
They had to have had pain on at least 2 of the following provoking movements � stairs, kneeling, squatting, prolonged sitting and isometric quadriceps contraction. They also selected 15 active, painfree control subjects. The subjects were initially studied in a motion analysis laboratory whilst walking and jogging. From this they collected data on ground reaction force and also the EMG data of the quadriceps was measured during leg swing phase before heel strike. Heel strike was the start of the measurement period and they continued to collect EMG data between the VM and VL during stance phase.
The researchers then measured the EMG signals from the VM and VL in all 55 subjects whilst performing isometric quadriceps contractions to generate �normal� data on each individuals maximum VM and VL activation. The isometric contraction was performed with the subject seated and the knee flexed to 80 degrees and they contracted against the resistance of the examiner. Magnetic resonance images of the subject�s knee in standing with the knee flexed to 5 degrees was also undertaken. From this they could evaluate the relative position of the patella in relation to the femur. They looked at the patella
The research papers
1. Pal et al (2011) Patellar maltracking correlates with vastus medialis
activation delay in patellofemoral pain patients. American Journal of Sports
Medicine. 39(3). 590-598.
2. Sousa A and Macedo R (2010) Effect of the contraction of medial rotators of the
tibia on the electromyographic activity of vastus medialis and vastus lateralis.
Journal of Electromyography and Kinesiology. 20: 967-972.
3. Irish et al (2010) The effect of closed kinetic chain exercises and open kinetic
chain exercise on the muscle activity of vastus medialis oblique and vastus
lateralis. Journal of Strength and Conditoning Research. 24(5): 1256-1262.
bisect offset value (which is how far lateral the patella sits relative to the midline of the femur) as well as patella tilt angle which is a measure of the lateral rotation of the patella in relation to the femur. From this data they statistically compared the VL/VM activation during walking and running between 5 groups; pain free controls, all patellofemoral pain patients, patellofemoral pain patients classified as normal trackers, patellofemoral pain patients who were maltrackers either with the patella tilt or the patella bisect offset and those with both tilt and offset. What they discovered was that subjects with both patella tilt and bisect offset as shown on MRI had the greatest and significant differences in VM activation delay. Interestingly, from the 40 subjects with patellofemoral pain, 7 were maltrackers with either a tilt or bisect abnormality whereas 8 had both. The other 25 pain subjects did not show tilt or bisect abnormalities. But when the painfree normal subjects were compared as a group to the pain group, there existed no significant correlation between the groups in VM activation delay in both walking and running. The second study from Portugal (Sousa and Macedo 2010)
approached VM/VL activation in a novel way. They compared maximum quadriceps contraction and the VM/VL ratio between normal quadriceps contraction and quadriceps contraction with resisted tibial medial rotation. The hypothesis was that activation of the medial tibia rotators would increase the VM/VL ratio favourably to recruit the VM over the VL. They selected 24 normal healthy females to participate in the study, all of whom had no injury to the knee, were not athletes and had a Q angle of 14-17 degrees. They had the subjects perform 4 series of contractions with 3 repetitions of each � a total of 12 maximum contractions held for 5 seconds with a 2 min rest. They randomised the sequence of contractions to avoid the fatigue effect. The 4 series were, isometric quadriceps contraction, isometric with forced medial tibial rotation with the tibia internally rotated, neutral rotation and externally rotated.
They found that significant differences existed between VM/VL ration with no tibial rotation and with forced activation of tibial rotators. It did not matter if the leg was medially rotated, neutral or externally rotated, contraction of the medial tibial rotators preferentially recruited VM over VL during isometric quadriceps contraction. The final study from Plymouth in the United Kingdom assessed the VM/VL activation in 3 commonly used rehabilitation exercises – leg extension, squat with resisted adduction and lunge. They selected 22 healthy asymptomatic subjects (11 men and 11 women) to perform the series of exercises. They initially collected normalised data for maximum EMG activity by
performing repeat maximal isometric quadriceps contractions at 45 degrees of knee flexion. This was done over three trials. They then had the subjects perform 3 trials of the following exercises; 1. Knee extension � seated and contracting the thigh with the knee from 90 degrees to full extension. 2. Double leg squat with isometric hip adduction. With the back flat against a wall and a pillow between the knees, the subject squatted to 45 degrees with constant pressure against the pillow. 3. Lunge exercise. Standing in a stride stance position the knee was flexed to 45 degrees followed by a return to full extension.
What they found was that the squat with the pillow and the lunge produced a greater VM/VL ratio than knee extension. There was no difference between the squat and the lunge with VM/ VL ratio, but the squat showed greater VM activation than the lunge. Furthermore, the leg extension showed greater VL than VM activation. The lunge
exercise showed the best idealised ratio of 1.1 with the VM/VL. Swimmers who covered more than 35 km in training were 4 times more likely to have tendinopathy than those who swam less.
Need to know Is any of it really new?
The first study from Stanford University is the first study to look at standing MRI images of patella position and have this correlated with EMG data for VM activation
delay during walking and running. Previous studies had looked at supine MRI of the patella with the leg relaxed. The patella engages the trochlear groove at 30 degrees knee bend so patients suffering from patellofemoral pain tend to notice their pain once the patella engages into the groove.
By investigating the patella position in standing, it would more approximate what the patella does in weightbearing activities such as walking.
The UK study is one of the first to have studied the VM/VL ratio in a lunge position. Considering that this is a commonly used rehabilitation exercise, it adds to the evidence of the effectiveness of this exercise as a useful rehabilitation exercise for patellofemoral pain.
Does it challenge the consensus? The Australian EMG study does challenge previous research that If anything, the Standford University study demonstrates that evidence for patella maltracking and patellofemoral pain is in fact quite unrelated. Many of the subjects who suffered patellofemoral pain had normal patella tracking on MRI imaging.
Any clinical implications? Absolutely. If patellofemoral pain and patella maltracking and VM onset is only loosely correlated, then perhaps many of the causes of patellofemoral pain are unrelated to poorly functioning VM and patella maltracking. Perhaps reasons as simple as tight overall quadriceps which may increase the compression force between the patella and femur in knee flexion may be a simpler explanation. The study from Portugal adds another dimension to VMO rehabilitation. By actively internally rotating the tibia (even isometrically) the VM increases its activity. The suggestion is that the VMO also acts as a tibial internal rotator due to its position on the medial patella. However, they measured the activity at 90 degrees knee flexion, a position not suitable for painful knees and post-operative knees. The UK study adds further credibility to the understanding that closed kinetic chain exercises are more favourable for knee rehabilitation than open kinetic chain exercises. Possibly the lunge is a better exercise for gaining preferential 1.1 ratio of activation but the squat with the isometric hip adduction may be better if the goal is to selectively activate the VM.
Any loose ends? Unfortunately for the Stanford University study, the MRI images of the patella were only taken at 5 degrees knee flexion and not 30 degrees. It would be interesting to view the patella position at greater angles of knee bend whilst standing. Furthermore, it cannot be concluded that what a patella to femur relationship looks like in standing is the same as what happens in walking/running. Due the impact of gait on the limb, perhaps the patella maltracking may be more pronounced due to the influence of the supporting soft tissues such as VL, ITB and also hip joint position. Furthermore, the Stanford University study did not differentiate from the EMG data if the activity was from the Vastus Medialis Obliquus (VMO) or the entire VM. Perhaps with more defined EMG analysis of the VMO � which has been shown to be a significant patella stabilizer � the correlation between VM delay and knee pain may have been more pronounced. It would be interesting if the Portuguese study also looked at their study with the knee flexed to 60 and 30 degrees knee flexion.
Perhaps the knee angle plays a large part on selective activation of the VM when the tibial rotators are activated. Furthermore, they did not specify how much force was placed on the tibia to be resisted for the medial rotation. This may also have a bearing in the clinical setting. Similar to the Portuguese study, the UK study only looked at the effect of the exercises on normal subjects. Would the results have been different in patients with patellofemoral pain?
There is a growing awareness in the U.S. for childbearing women to seek help in adjusting to their post-baby body. This is not to be confused with the celebrity magazine headlines of �How I Got My Body Back.� The goal is not to return to the same jeans you wore before or to fad diet and slim down to your former self.
Women who bear children can feel the history in their bodies. A cataclysmic journey has taken place: conceiving, carrying, and delivering a human into the world. It is a beautiful experience to be revered and should not leave the woman with any upset about the glory of what she has been able to do. Yet the entire year of making this happen � the three trimesters plus the so-called �fourth trimester� of infancy � does affect the body, sometimes in a way that bewilders or hinders us.
“This is not to be confused with the celebrity magazine headlines of ‘How I Got My Body Back.’ The goal is not to return to the same jeans you wore before or to fad diet and slim down to your former self.” ��Laura Lash
Perhaps because of the nationwide growing practices of yoga and mindfulness, or because Western medicine is opening up to the mind-body connection and the influences of Eastern medicine, we now have women asking for more support in the physical recovery of their bodies after childbearing, not seeking to return to the body they had, but to learn how to improve functionality of their body as it is now. In this article we will hear from a physical therapist, a yoga/Pilates instructor and a bodyworker to learn about common issues and how they can be addressed.
Issues
Nature allows for a graceful advance throughout pregnancy. Week to week with the growth of the baby, a woman�s body has the opportunity to adjust to carrying increased weight. We make modifications in how we sit, carry things, even in the way we get in and out of the car. Sleeping positions are limited and rest can be fitful. After nine-plus months of this accommodation there is the birthing event. The experience varies from person to person but as one of my yoga teachers � cracking a joke about the �will-this-ever-end� mentality � said: �All the babies come out!� And the babies do come out, all with their own unique birth stories. Regardless of the way in which a baby is birthed, it is a huge undertaking for the female body. The mother will then begin to heal herself, at the same time providing nourishment to her newborn, by breast or bottle. The first three months of a child�s life are a precious time for the mother�s mind, body, and emotions. And it can be a challenge to see clearly what the mother�s needs are when the newborn needs constant care. Admittedly, some women require medical attention in their postpartum recovery. More commonly, women are simply trying to get by in the sleepless, incubated state that is new motherhood.
Sheri Baemmert, E-RYT 200, RYT 500, RCYT, RPYT, teacher of Pilates, yoga and Thai yoga bodywork, elaborates on her experience with childbirth: �After I became pregnant with my son, I started to really understand what women experience.� As the teacher in class, Sheri�s demonstrations became different.
�Our bodies are amazing, and after my first home birth I realized preparing for birth is like training for the most intense workout you will ever have. � ��Sheri Baemmert, E-RYT 200, RYT 500, RCYT, RPYT, teacher of Pilates, yoga and Thai yoga bodywork
“As I got bigger and bigger and had to push myself off the floor instead of just hopping up, I understood what books can’t teach … After having a second child, I realized things don�t bounce back the same why they can after the first child. Again, knowledge can come from books, but wisdom comes from experience.�
There are common issues that arise for the postpartum mother. And as previously mentioned, there is a heightened awareness now that women are allowed, even encouraged, to seek help in improving the function of their core/abdominal muscles, pelvic floor (the muscular base of the abdomen supporting the bladder, intestines, and uterus) or any other body area that has been affected, and is perhaps dysfunctioning, after the pregnancy and birth experience.
Stephanie Powell, P.T., a physical therapist with Mayo Clinic Health System, has been working with women on these issues for 11 years, nine of them as a specialist working with the pelvic floor: �I just always encourage women to let their providers know any concerns they have postpartum, even if symptoms �are not a big deal.� Most common postpartum conditions include urinary incontinence (leaking urine), prolapse (when some internal structures such as the rectum, uterus, or bladder can sit lower in the pelvic floor), and reports of back pain (can be low back, mid back, neck, or all three).�
Approaches
At Prajna, a studio in Eau Claire, Sheri offers cues from her yoga and Pilates background to assist women in strengthening their pelvic floors and finding deep core strength. This work is done on Pilates-specific equipment and on a yoga mat with props. She attracts a wide range of clientele: �Basically anyone ready to commit to rebalancing their body. This includes finding subtle strength. We need to be both strong and flexible. We need to be balanced. We need to undo the consequences of our work style, lifestyle, play style. I offer my clients a full body, breath, mind approach to well-being. Some clients spend the first hour learning how to breath again. Others spend time �finding their true deep core.� � Sheri is incredibly understanding about the needs of new moms and is delighted when moms bring their babies along for sessions. She makes sessions physically and logistically accommodating so mothers feels it�s possible to repeatedly attend.
Christopher Hayden, LABT, CAR, a licensed bodyworker, will offer Visceral Manipulation (VM) and other modalities at Tuning Tree, a collective of therapists offering services in a new location on South Barstow Street, beginning in May. In his training with VM, he is �learning how to apply gentle hands-on techniques to the internal organs. This is aimed at improving their function, but can also help your body move and feel better.� In addition to postpartum work, VM can aid in digestive health, relaxation, and better movement throughout the body. �I�m excited to bring this work to clients to not only improve functioning, but also embodied self-awareness that really makes a long-term difference,� Christopher says. �I�m pairing up with Sandra Helpsmeet at the Yoga Center of Eau Claire to incorporate yoga techniques and visualizations with hands-on techniques in workshops and individual sessions.�
If you are most comfortable in a clinic setting, physical therapy may help you understand the shifts you�ve experienced and how to work with your postpartum body.
Timing
While caring for an infant, it can be hard to get a true sense of what your needs are. There is very little alone time to contemplate and focus on yourself, compounded by having very little time to take action on what your needs may be. It often gets to a point of fatigue or breakdown before women can recognize that something needs to change for them. By highlighting what is available to women, we can encourage them to seek help earlier on in the first few months of motherhood so they feel supported and can soldier on.
�Early intervention is key for treatment success, so letting women know that we are here and can help them is vital.� ��Stephanie Powell, P.T., a physical therapist with Mayo Clinic Health System
That said, treatment is possible at any time. Taking into consideration which approach to care may be best for you, you can work on rehabilitation of the body months or years after childbearing.
Stephanie elaborates on the commitment needed: �Timeline can be variable, dependent on severity of symptoms as well as other medical factors. While all therapists have their own approach, generally starting with once-weekly visits to establish tolerance to treatment, changes in symptoms, and assisting with challenges that may affect success. In terms of treating incontinence, we may see patients every two to three weeks to give them time to work on a home program.�
As wonderful as it is to seek and receive professional help, what simple things can you do to make things easier on yourself? Stephanie has more great suggestions: �Can you keep a few pillows near the area you normally feed baby, to keep your arms propped and avoid hunching the upper back? Are you keeping up with your water intake, and taking bathroom breaks regularly to try avoiding urinary tract infections or constipation? It is easy to forget the little things in the postpartum phase.�
Chronic low back pain can be a challenge to treat, but new research suggests that massage therapy may provide some relief.
“Current medical guidelines actually recommend massage therapy prior to the use of opioid medications for lower back pain,” explained William Elder, the study’s principle investigator. “Yet even with those guidelines, physicians and nurse practitioners are not recommending massage therapy,” said Elder. He’s with the University of Kentucky’s departments of family and community medicine and clinical services.
Low back pain is a common problem, and for most people, it’s short-lived. But for about 15 percent of people with low back pain, the problem becomes chronic and lasts more than three months, the study authors said. There aren’t a lot of effective treatment options for chronic back pain, and physicians often prescribe opioid painkillers such as OxyContin or Percocet to ease the pain. But those drugs come with a risk of addiction.
Other possible treatments include exercise, steroid injections, behavior changes, chiropractic, acupuncture and surgery, according to the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases.
Massage for Back Pain
The new study sought to simulate real-world back pain and treatment. Researchers asked physicians to recommend massage for people with chronic back pain. Just over 100 study volunteers were then paired with an approved, experienced massage therapist in their area who assessed the problem and created a treatment plan. The study participants received 10 treatments, which they set up directly with their therapist.
More than half of the participants had less pain after 12 weeks and many continued to report reduced pain after three months.
The research also showed that massage therapy worked better with patients aged 50 years and older, although younger people benefited, too.
“These results are exciting because it shows that most doctors can refer their patients for massage as a treatment. It’s applicable to the real world,” said Elder. “Some medical providers have taken interest in massage, but most don’t know which type would be helpful. We learned that just referring the patient to a massage therapist and letting them work to select the therapy is effective,” he added.
Dr. Anders Cohen, the neurosurgery division chief at The Brooklyn Hospital Center in New York City, recommends massage therapy to his patients as part of what he calls a comprehensive treatment plan.
“Massage is great way to break up adhesions and is great for soft tissue,” Cohen said. “If the back pain is a soft tissue issue, such as muscles and ligaments, it works great. Plus, there is the bonus of therapeutic touch.”
Reasons for Varying Back Pain Care
Patients in the study received the massage therapy free of charge. But, cost could also explain why some physicians recommend opioids instead. Cohen noted that massage prices vary, and may not be covered under some insurance plans. Study co-author Niki Munk is a licensed massage therapist who’s with the Indiana University School of Health and Rehabilitation Sciences. She said the researchers saw that massage needs to occur regularly when someone begins treatment to reduce the pain.
Munk added that more research is needed on the ideal pain maintenance schedule. But the study authors think that once a level of comfort has been achieved, people can continue to manage their back pain through regular massage therapy on a schedule that fits their needs, such as once a month or every other month.
Munk also noted that selecting the right therapist is important.
“Look for a masseuse that you can establish a therapeutic relationship with over time,” she recommended. “Chronic low back pain is a complex issue that can’t be cured from just a one-hour massage. Find a therapeutic massage clinic and ask questions about the therapist, such as their initial training and continuing education. Also, make sure that the therapist sets up a treatment plan that will work for you,” Munk said.
The study was published online recently in the journal Pain Medicine.
SOURCES: William Elder Jr., Ph.D., professor, family and community medicine and clinical services, University of Kentucky, Lexington; Niki Munk, Ph.D., L.M.T., assistant professor, health sciences, Indiana University School of Health and Rehabilitation Sciences, Indianapolis; Anders Cohen, M.D., division chief, neurosurgery, The Brooklyn Hospital Center, New York City; March 14, 2017, Pain Medicine, online
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Additional Topics: Whole Body Wellness
Maintaining overall health and wellness through a balanced nutrition, regular physical activity and proper sleep is essential for your whole body�s well-being. While these are some of the most important contributing factors for staying healthy, seeking care and preventing injuries or the development of conditions through natural alternatives can also guarantee overall health and wellness. Chiropractic care is a safe and effective treatment option utilized by many individuals to ensure whole body wellness.
Doctor of Chiropractic, Dr. Alexander Jimenez and PUSH as Rx Owner/Exercise Physiologist Daniel Alvarado discuss calisthenics or (gymnastic exercises to achieve bodily fitness and grace of movement.)
You�re not far off when thinking of calisthenics, in case you possess a mental picture of the military performing jumping jacks to cadence. The truth is , though, that calisthenics exercises are rooted much deeper in history, dating back all the way to ancient Greece. (More on that later.)
As it pertains to your own personal history, you likely first experienced work outs that were calisthenics in elementary school physical education class in the type of sit-ups, push ups, jumping jacks and other bodyweight exercises. Calisthenics, when performed actually help individuals serves at the same time as an aerobic type of exercise and gain muscle. Talk�about a timesaver.
Talking of that, with individuals�s time-crunched schedules, fitness plans seem to be largely focused on the best way to get the benefits of exercise in the least quantity of time. (That�s appropriate, one-minute workouts really are a thing.) Packing plenty of exercise, including plenty of bodyweight training, into a brief amount of time, is becoming fairly popular, as with PUSH-as-Rx �, CrossFit and programs like P90X�.
What I’d like to stress is that, as previously mentioned, this kind of workout is nothing new, although these workouts all attribute calisthenics to some amount. Actually, the American College of Sports Medicine reports that workplace wellness plans included calisthenics into worker breaks as far back as the 1960s. The purpose? To develop employees� mental and physical fitness. Sadly, the majority of our corporate structure today does not allow for extended time off in the centre of the day or week.
What Exactly Are Calisthenics Workouts?
Simply put, the calisthenics definition is utilizing your bodyweight and gravity to do exercises (some of which are quite extreme) using good form. What�s wonderful is the fact that it could include various actions such as for instance gymnastics and does not require a gym membership, Pilates squats, lunges for great legs, crunches, walking, just to name a number of calisthenics work out thoughts and jumping.
A common term for calisthenics today is bodyweight training. Irrespective of what you call it, this sort of training could possibly be the core of an exercise plan or utilized in conjunction with other training programs, including cardio workouts, HIIT workouts (including my Burst training), marathon or triathlon training, weight training or all sorts of other exercise. Mixing it up is a great strategy to ensure that you happen to be working your muscles all and provides a more healthy approach to fitness.
Varieties Of Calisthenics Work Outs
There are lots of types of calisthenics work outs; push-ups and pull ups are most common. Pushups are one of my personal favorite calisthenics exercises due to the fact that they build strength in numerous regions of the body and can be done everywhere. Without lifting one weight it’s possible for you to attain great muscle growth.
Performing push-ups, for example, strengthens the muscles in your chest, shoulders and triceps while also strengthening your core. You could add variety by doing push ups or including a clap between each one. Among my favorites is the spiderman pushup, which works the obliques by bringing the knee up towards the arm as you lower into the push up.
Pull-ups are excellent for working your back and biceps. The most famous design is with the palms facing forwards; however, the chin up, palms facing towards you, is a great challenge, too. While you can do these using a pull-up bar in the gym, you can also perform them having a sturdy tree branch or find a bar in a nearby park. There are several options readily available for installation in doorways of your home, too.
A different type of calisthenics workout is the abdominal work out. For many, having a six-pack is the supreme target. While having a six pack may be wonderful, it�s about losing stomach fat for an overall more healthy body extremely more.
There are various ab exercises which you can do to contract the muscles and work towards strengthening them. The push ups mentioned previously can help do this if you focus on contracting the muscles while performing the push-up. There are lots of exercises that are amazing for the stomach area stomach exercises, like the board, and hip lifts � all of which joined with integrated into your routine or may be achieved with your body weight, making these kinds of exercises great for a calisthenics work out on their very own.
Cardio is excellent because it supplies an opportunity to burn off calories, for burning fat. Running and cycling are great cardio workouts, but you can select exercises that could easily be incorporated right into a daily routine wherever you’re, for example high jumps or conventional jumping jacks.
Jumping jacks are great because they get the heart pumping � not only offering fat-burning benefits, but keeps the heart healthy. The entire body motion combined with bound provides an excellent total cardio to the body. If you’re unable to bound at this time or demand to work up to it, you can do a low impact variation by stretching one leg at time as the arms go overhead in the traditional jumping jack sort.
Most bootcamp workouts provide calisthenics-specific exercises and may be found at your local health club or you can do one in your family room. Blast training may be ideal for this which is just another kind of calisthenics workout.
I have a burst training workout for beginners right on my website. The majority of the Burstfit workouts offer astounding strength advantages from muscle toning to cardio and also a mix of the two and don’t use any gear. They are also helpful for the beginner and also the advanced supplying adjustments for several exercises.
6 Top Benefits Of A Calisthenics Workout
1. You Can Do Calisthenics Anywhere
This type of training may be performed anywhere because calisthenics could be done using just your bodyweight. Just what a beautiful thing. (Read between the lines: No explanations!) You can do an entire routine in the privacy of your home, in the fitness center or in a closeby park. I done short work outs in the airport.
There are numerous ways to execute calisthenics exercises at different levels. By way of example, a push up can be performed on the knees for newcomers. Over time, you can work as much as the toes and eventually add in side knee tucks or claps. The choices are many and will build muscle and stamina.
2. Calisthenics Can Help Provide Improved�Coordination
The Journal of Sports Rehabilitation published a study investigating how calisthenics and Pilates impact a person�s coordination. The participants comprised healthy females ages 25 to 50. The results indicated that calisthenic exercises were more likely to improve coordination after 3 and 6 months of training compared to Pilates. Pilates is amazing, but you may gain more from calisthenics, when you�re looking to increase coordination -kind exercises.
3. You Gain All-Over Muscle Tone
Calisthenics offers the capability to build amazing muscle tone and also you can pretty much take it as far as you want. Ever notice how some men in the gym appear to own a little back and legs, although arms, enormous chest and shoulders? This could happen when using special weights which are targeting particular muscles; nonetheless, using your own bodyweight can permit you to focus on total body tone and specific muscle tissues in once.
Typically, when lifting your personal body weight, it demands focus and involvement of many more muscles to ensure proper form. That means that all of those muscles are getting work which will lead to a more evenly distributed physique.
4. Provides�Support For Fitness Goals�& Other Sports
Calisthenics-type exercises really are a safe option since it puts less strain on the muscles and joints of the body. It really is recognized as a �natural� type of training because you might be utilizing your own bodyweight to do the exercises. That is not an injury-free guarantee, but with suitable form and gradual increase in strength, it could undoubtedly give a safer alternative for a fruitful workout.
Calisthenics work outs are perfect for adding strength without adding bulk. This really is often needed to be efficient at other sports along with helping prevent harm. To be able to be more efficient at running while minimizing the risk of harm endurance runners commonly must reinforce the hips. A study analyzed athletes by increasing their strength training but decreasing their total volume of training. The group that raised their strength training resulted in improved performance through improved muscle growth.
Another study found that results enhanced by enhancing endurance as a result of improved neuromuscular efficiency. This occurs when the nervous system uses while stabilizing the body in all three planes of motion, the right muscles reduce or to produce force.
The National Academy of Sports Medicine shares that resistance training, in this situation utilizing your own body weight, can improve running economy a significant component for endurance athletes such as for instance Ironman sportsmen and ultra trail runners, without additional mass.
5. It�s Perfect For Beginners�To Advanced
Calisthenics is perfect for anyone starting a physical fitness plan or someone who’s improved, but wants a more shredded physique. A beginner can begin a good application that can supply amazing gains, particularly if consistent; yet, make sure to choose a program which offers adjustments so that you could have alternatives which are right for you personally and at your degree, by starting slow. Starting at a too-advanced degree gets you at an increased risk of harm.
In terms of frequency, I’d propose 3 to 4 days per week to begin. Over time, you are able to work time periods that are longer and more exercises into your training schedule. An advanced exerciser can cultivate amazing overall body tone, muscle growth and strength by performing more extreme editions of calisthenics.
By way of example, if strength is a focus, an advanced exerciser could work towards performing one-handed push-ups. This will make an extraordinary quantity of muscle and strength development in the entire body for the reason that it requires extra focus and numerous muscles groups to conduct this exercise nicely.
6. It�s An Option Even If�You�ve Got Health Problems
Calisthenics isn�t merely for people that are already in shape. Check with your physician to find if it�s right for you if you�re living with chronic disease. But in 2016, Turkish researchers published a study revealing that calisthenics is as safe and effective as even cycling for people living with chronic obstructive pulmonary disease (COPD).
Full-Body Calisthenics Workout
Consider a calisthenics workout a couple of times a week, in case you are looking to get excellent muscle tone. Create a routine that you can commit to doing in the event you would like to get results and remain consistent. Listed here is a great work out that you can try.
History Of Calisthenics
Calisthenics ‘s been around for a very long�time originating from the ancient Greek words k�los, which means �beauty, � and sth�nos, meaning �strength.� It’s understood to be �qualities of inertia� and using body weight to help grow the physique.
It may have already been named after the Greek historian, Callisthenes, who was tutored by Alexander the Great. Gymnastics and physical education programs were developed in the 19th century, in particular due to the Battle of the Systems, an attempt to learn the most effective type of exercise crossing to the 1920s in the 1830s.
Afterwards, calisthenics became connected with crowd-attracting road workouts, much like choreographed performances by well-trained individuals. These routines would occur in parks, in a contest style, particularly where there are resort areas with taverns, attracting on crowds with their amazing ability to hang their bodies using a lot as well as their developed muscles of practice. These competitions regularly had judges creating even more authenticity to the craft of calisthenic fitness.
Even today, The World Calisthenics Organization (WCO) based in Los Angeles, California, has a well known competition chain called Battle of the Pubs, adding to the the increasing popularity of worldwide competitions.
Calisthenics Precautions
Like all new exercises programs, please seek advice from your physician before performing these exercises. Begin slowly and work your way into more sophisticated moves with time. If anything causes injury or unusual discomfort, or if you are feeling dizzy or dehydrated, cease immediately and consult a physician.
Closing Thoughts On Calisthenics
Calisthenics is a fantastic method to start your fitness journey (or to dive deeper to the trail you�re already on). What�s great is it is possible to take it with you wherever you go, even when traveling. You may also get the children to join you. Consider preparing a laptop of workouts you prefer available today or take a look at a few of the truly amazing work out apps. Make fitness a priority in your lifetime and results will follow, particularly when combined using a wholesome eating plan.
Patients who go straight home from the hospital following hip or knee replacement surgery recover as well as, or better than, those who first go to a rehabilitation center, new research indicates.
And that includes those who live alone without family or friends, one of three studies shows.
“We can say with confidence that recovering independently at home does not put patients at increased risk for complications or hardship, and the vast majority of patients were satisfied,” said that study’s co-author, Dr. William Hozack. He is an orthopaedic surgery professor with the Rothman Institute at the Thomas Jefferson University Medical School in Philadelphia.
Hozack noted that while in the past it was “not uncommon for patients to enter a rehabilitation facility in order to receive additional physical therapy,” most patients today do not end up going to a secondary facility. In fact, roughly 90 percent of Hozack’s joint replacement patients are discharged directly home following surgery, he said. “Considerable evidence has now shown that most patients do just as well at home,” he noted.
Hozack and his colleagues are scheduled to present their findings in San Diego at a meeting of the American Academy of Orthopaedic Surgeons (AAOS).
Home Recovery Following Surgery
Two other studies being presented at the meeting also found that recovering at home may be the better option.
One study found that patients who are discharged directly home following a total knee replacement face a lower risk for complications and hospital readmission than those who first go to an inpatient rehab facility. The study was led by Dr. Alexander McLawhorn, an orthopaedic hip and knee surgeon at the Hospital for Special Surgery in New York City.
McLawhorn was also part of a second Hospital for Special Surgery study, led by Michael Fu. That study found that hip replacement patients admitted to an inpatient facility rather than being sent home faced a higher risk for respiratory, wound and urinary complications, and a higher risk for hospital readmission and death.
Dr. Claudette Lajam is chief orthopaedic safety officer with NYU Langone Orthopaedics in New York City. She was not involved with the studies, but agrees that home recovery is the best option for most patients.
“The home setting is the single best way to get people back into their routines as quickly as possible after surgery,” she said. “In some cases, this cannot be done,” Lajam acknowledged. “Some patients live in settings that are inaccessible, [such as] a 5th-floor walk-up apartment where the patient would need to go downstairs to let the visiting nurse and therapist in the door.” For some patients, anxiety about the recovery process could also pose a challenge, she added. But “being in an institutional setting after surgery only reinforces the idea that the patient is ‘sick,’ ” Lajam added. “We have learned that this type of thinking slows down recovery. We want our total joint patients to start using their new joints as quickly as possible, and staying in bed at a nursing facility is not the way to do this.”
Hozack and his colleagues set out to see whether patients who live alone fare as well as those who live with others. All 769 patients enrolled in the study by Hozack’s team went home following either a total hip replacement or a total knee replacement. Of those, 138 lived alone (about 18 percent). Once home, all were assessed on multiple levels, including functionality (ability to move); pain levels; hospital readmissions; emergency department visits; unscheduled doctor visits; dependency on assisted-walking devices; and time before returning to work or being able to drive again.
Hozack’s team observed no differences by any measure. And while those who lived with others indicated relatively higher satisfaction levels at the two-week mark, by the three-month point there was no appreciable difference between the two groups.
“We feel that giving patients back their independence early on is the best way to promote a safe and effective recovery,” said Hozack. His team concluded that single-household patients who go straight home can expect to fare as well as those who have live-in support.
A recent Mayo Clinic study calculated that between 2000 and 2010, the number of Americans who underwent hip replacement surgery more than doubled, rising from just under 140,000 to more than 310,000 per year.
Meanwhile, AAOS figures indicate that in 2010 more than 650,000 knee replacement procedures were performed, with about 90 percent involving total knee replacement. AAOS estimates from 2014 show that 4.7 million Americans now live with an artificial knee and 2.5 million have an artificial hip.
Findings presented at meetings should be viewed as preliminary until published in a peer-reviewed journal.
SOURCES: William J. Hozack, M.D., professor of orthopaedic surgery, Rothman Institute, Thomas Jefferson University Medical School, Philadelphia; Claudette Lajam, M.D. assistant professor and chief orthopedic safety officer, NYU Langone Orthopedics, New York City; March 14-18, 2017 presentations, American Academy of Orthopaedic Surgeons meeting, San Diego
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Additional Topics: What is Chiropractic?
Chiropractic care is a safe and effective, alternative treatment option utilized to diagnose, treat and prevent a variety of injuries and conditions associated with the musculoskeletal and nervous system. A chiropractor, or doctor of chiropractic, commonly uses spinal adjustments or manual manipulations to help correct the spine and it’s surrounding structures, improving and maintaining the patient’s strength, mobility and flexibility.
Chronic low back pain can be a challenge to treat, but new research suggests that massage therapy may provide some relief.
“Current medical guidelines actually recommend massage therapy prior to the use of opioid medications for lower back pain,” explained William Elder, the study’s principle investigator.
“Yet even with those guidelines, physicians and nurse practitioners are not recommending massage therapy,” said Elder. He’s with the University of Kentucky’s departments of family and community medicine and clinical services.
Low back pain is a common problem, and for most people, it’s short-lived. But for about 15 percent of people with low back pain, the problem becomes chronic and lasts more than three months, the study authors said.
There aren’t a lot of effective treatment options for chronic back pain, and physicians often prescribe opioid painkillers such as OxyContin or Percocet to ease the pain. But those drugs come with a risk of addiction.
Other possible treatments include exercise, steroid injections, behavior changes, chiropractic, acupuncture and surgery, according to the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases.
The new study sought to simulate real-world back pain and treatment. Researchers asked physicians to recommend massage for people with chronic back pain.
Just over 100 study volunteers were then paired with an approved, experienced massage therapist in their area who assessed the problem and created a treatment plan. The study participants received 10 treatments, which they set up directly with their therapist.
More than half of the participants had less pain after 12 weeks and many continued to report reduced pain after three months.
The research also showed that massage therapy worked better with patients aged 50 years and older, although younger people benefited, too.
“These results are exciting because it shows that most doctors can refer their patients for massage as a treatment. It’s applicable to the real world,” said Elder.
“Some medical providers have taken interest in massage, but most don’t know which type would be helpful. We learned that just referring the patient to a massage therapist and letting them work to select the therapy is effective,” he added.
Dr. Anders Cohen, the neurosurgery division chief at The Brooklyn Hospital Center in New York City, recommends massage therapy to his patients as part of what he calls a comprehensive treatment plan.
“Massage is great way to break up adhesions and is great for soft tissue,” Cohen said. “If the back pain is a soft tissue issue, such as muscles and ligaments, it works great. Plus, there is the bonus of therapeutic touch.”
Patients in the study received the massage therapy free of charge. But, cost could also explain why some physicians recommend opioids instead. Cohen noted that massage prices vary, and may not be covered under some insurance plans.
Study co-author Niki Munk is a licensed massage therapist who’s with the Indiana University School of Health and Rehabilitation Sciences. She said the researchers saw that massage needs to occur regularly when someone begins treatment to reduce the pain.
Munk added that more research is needed on the ideal pain maintenance schedule. But the study authors think that once a level of comfort has been achieved, people can continue to manage their back pain through regular massage therapy on a schedule that fits their needs, such as once a month or every other month.
Munk also noted that selecting the right therapist is important.
“Look for a masseuse that you can establish a therapeutic relationship with over time,” she recommended.
“Chronic low back pain is a complex issue that can’t be cured from just a one-hour massage. Find a therapeutic massage clinic and ask questions about the therapist, such as their initial training and continuing education. Also, make sure that the therapist sets up a treatment plan that will work for you,” Munk said.
The study was published online recently in the journal Pain Medicine.
El Paso, TX. Chiropractor Dr. Alex Jimenez examines good health and wellness.
Most individuals will experience neck or back pain at some time in their own own lives. Neck pain and back are among the leading causes of disability worldwide, along with the number of cases is increasing. Some factors behind this are increased usage of cellular devices bad position, and unhealthy lifestyle choices.
Though it’s not necessarily possible to stop neck and back pain, you will find steps individuals can take to help decrease the chance it is going to occur.
Why good posture?
One of the most important approaches to ensure your spine stays healthy would be to keep good posture. A healthy back has three natural curves� an external curve at the upper back an inward curve at the neck, and an inward curve at the low back. Proper bearing helps maintain these curves that are natural and puts minimal pressure in your joints. Defective bearing does the opposite. It may stress or pull muscles, causing pain and musculoskeletal imbalances in the back, neck, and extremities. Some typical postural blunders rounding your shoulders are positioning your face too much forward, and slouching so you lose the normal curve in the lower back.
Cellular Devices &�Neck Pain
The increasing use of cellular devices can bring about inferior spine health, influencing our posture and body mechanics in ways that are unhealthy. Kenneth K. Hansraj, MD, the Chief of Spine Surgery at New York Spine Surgery and Rehabilitation Medicine, created a computer model of the cervical spine that demonstrated how use of mobile devices directly contributes to neck pull. In an article published in Surgical Technology International, Dr. Hansraj, MD, revealed that neck pull increases as the forward angle of the head increases, as it does when you look down at your cell phone or tablet. As you lean your head, you round another aspect of poor position, your shoulders. All this surplus strain creates additional wear and tear on the structures of the neck, upper spine and back, and can result in spinal degeneration that could need surgery.
Body Mechanics &�Prevention Tips
Good posture and placement is particularly important when you’re bending over, squatting, and when you are lifting things. When lifting boxes or alternative things you should avoid twisting your body. But it also is crucial to keep good posture while standing and sitting. It really is a lot more crucial that you develop a good ergonomic working arrangement to safeguard your spine with people spending increasing quantities of time at work,. Over time, poor sitting posture and workplace ergonomics can damage spinal structures and contribute to persistent or persistent back and neck pain.
Sleep Time
One other place people spend a sizable percentage of the time is in bed. That makes it vital to truly have a mattress that enables you to have a supporting and restful slumber. The identical natural spinal alignment you have is maintained by a mattress that is good when standing and will help prevent back pain.
Eat Well &�Exercise Frequently
The diet and exercise choices you make might assist you to protect your back. Exercise can help prevent back pain and neck pain by strengthening the muscles supporting your vertebrae. Strength training, flexibility training, and aerobic exercise are part of a healthy exercise routine, and every type of exercise contributes to spinal health. Great nutrition also is crucial to helping us reach our optimum well-being and feel our best. A nutritious diet along with exercise also assist you to keep a healthier weight, that is just another approach to simply help make sure your back is not overstrained.
Smoking, Your Brain, Chronic Back Pain & Bone Health
Another lifestyle alternative that’s damaging to spine health is cigarette smoking. Researchers from Northwestern University conducted a study demonstrating that smokers are three times more likely than nonsmokers to develop chronic back pain. �Smoking affects the brain,� according to scientist Bogdan Petre, who headed the study, which was published on the internet in the journal Human Brain Mapping. �We found that it appears to make people less resilient to an episode of pain and changes the way the brain responds to back pain.�
Smoking also reduces bone density, which increases the risk for osteoporosis along with other degenerative spine conditions, and it can reduce the success of spinal fusion. People who are facing fusion or any back surgery should make every endeavor to avoid smoking. The associated dangers will reduce and raise the probability of an effective spinal fusion surgery.
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