Strengthening the Glutes

Each month Rehab United Physical Therapy and Sports Performance Center will highlight a different topic for our RU Fit? blog. We will post training tips on our Facebook Page each week and summarize them at the end of each month. This August, we discussed "the glutes" and created handouts and a video for proper strengthening of the legs to help rehabilitate from prevent common injuries such as low-back and knee pain.  Read below for more!

Strengthening the Glutes To Prevent Low-Back and Knee Pain
The glutes (a number of muscles in the hip area, including the gluteus maximus, gluteus minimum and gluteus medius) are an extremely important muscle group. When functioning properly, the glutes assist almost every movement in life, aid in rehabilitation of other joints (such as the knees) and can also prevent injuries, like low-back pain.

Exercise Example - Sit-to-Stand Progression: Squats are a widely-accepted glute-strengthening exercise; however, after an injury some patients may lack the coordination, strength, or balance to complete a standard squat. The “sit to stand” is a great fundamental exercise to safely build lower-body strength.

• Sit-to-Stand Progression - Video
• Sit-to-Stand Progression - Handout (see below)

Exercise Example - Balance Reach. Balance is equally important as strength – the balance reach (and its variations) is an excellent exercise to build balance and strength.

• Balance Reach - Handout (see below)

Exercise Example - Piriformis Stretch. Hip flexibility (i.e. joint mobility) is equal, if not more important, than strength and balance.  The piriformis stretch, named after the piriformis (Latin for "pear-shaped") muscle located in the backside of the hips, stretches many of the glute muscles when performed with rotation (reaching left and right).

• Piriformis Stretch - Handout (see below)

Rehab United Physical Therapy

www.RehabUnited.com

Nutrient-Dense Foods

Each month Rehab United Physical Therapy and Sports Performance Center will highlight a different topic for our RU Fit? blog.  We will post training tips on our Facebook Page each week and summarize them at the end of each month.  For July, we discussed nutrition, specifically nutrient-dense foods and drinks.  Read below for more!

Nutrient density refers to the amount of quality nutrients a food or beverage has for its volume.  Nutrient-dense foods have high amounts of vitamins, minerals and fiber with relatively few calories.  Examples include non-starchy vegetables, fruits, lean meats, and fat-free dairy.  Focus on nutrient-dense foods if weight loss is your goal.

Calorie-dense foods, on the other hand, have high amounts of calories for their volume.  Fried foods are an example of calorie-dense foods as they contain calories from the food itself (such as potatoes) plus the extra calories from the oil (and potentially the breading, which acts like a sponge for the oil).  Other examples include candy bars, regular soda, fruit juice, chips, cheese, most salad dressings and smoothies.  If weight gain is your goal, focus on calorie-dense foods that are also nutrient dense (nuts, seeds, dried fruits, nut butters, avocado, whole grains).

A few suggestions to increase the nutrient density of your meals and snacks:

Cut the Calories, keep the taste!
Breakfast: Use half whole eggs, half egg whites; Lunch: Have meat OR cheese on your sandwich; Dinner: Mix half of your pasta with cooked vegetables.

Sweeten drinks & snacks yourself:
1-2 teaspoons of sugar or honey in your tea will provide significantly less Calories than a bottled tea or soda. Likewise, a few teaspoons of honey, agave nectar or berries in plain yogurt will be less calories than "fruit on the bottom" yogurt and healthier than artificially-sweetened products.

Veggie taco shell:
Try butter leaf lettuce leaves instead of taco shells or tortillas to save around 100 Calories per taco!

Justin Robinson, MA,RD,CSSD,CSCS,FAFS
Registered Dietitian

Ground-Up Stretching

Each month Rehab United Physical Therapy and Sports Performance Center will highlight a different topic for our RU Fit? blog.  We will post training tips on our Facebook Page each week and summarize them at the end of each month.  For June, we covered how to use a "ground up" approach for stretching.  Read below for more!


We refer to the body as a chain - i.e. muscles, tendons, ligaments, bones and other connective tissue are a series of links from our big toe to our forehead.  How each link moves is highly dependent on other links - both those close in proximity and those at the opposite end of the chain (thus, tight calves can contribute to low back pain, shoulder pain, and headaches).


Based on this, a recommended approach to stretching involves starting at the ground and working your way up the chain (stretch the calves, then the hamstrings, then hips, etc).  We have included three handouts for the calves, hamstrings and hips.  Enjoy!

San Diego - Birthplace of Triathlon

In addition to its amazing year-round weather, beautiful scenery, and countless outdoor activities, San Diego can also boast that it is the birthplace of triathlon!

On September 25, 1974, The San Diego Track Club, led by Jack Johnstone and Don Shanahan, hosted the first-ever triathlon on Fiesta Island in San Diego, CA. The “Mission Bay Triathlon” consisted of over 5 miles of running, 5 miles of cycling and 600 yards of swimming in a run-bike-swim-run format (compared to the standard swim-bike-run format of today).  The San Diego Track club hosted such events on summer evenings, which originally served merely as an unconventional break from the grind of marathon training.

An athlete named John Collins, a U.S. Naval Officer who raced in the first Mission Bay Triathlon, further played a crucial role in the development of the sport.  Collins took the triathlon concept to Oahu, Hawaii years later to combine three endurance events – the Waikiki Rough Water Swim, Around Oahu Bike Ride, and Honolulu Marathon.  He claimed that anyone who finished could truly call himself an “Iron Man”.

Evolution: Forty-six athletes competed in the first triathlon in 1974 . . . 12 competed the first Ironman® in 1978 . . . the first woman finished Ironman® one year later . . . Sydney, Australia hosted the first Olympic Triathlon race in 2000 . . . today hundreds of thousands of athletes compete annually in triathlons around the world.  The Ironman® triathlon in Kona, Hawaii, is arguable the most recognizable triathlon; however, the Olympic (aka International) distance of 1.5 km swim, 40 km bike and 10 km, is the sport’s most popular and the format used at the ITU Triathlon World Championship, Pan American and Olympic Games.

Coming Home: On May 12th, 2012 San Diego will host an ITU World Triathlon Series race.  The elite race will serve as the final qualifier to determine the 2012 U.S. Olympic men's and women's triathlon squad.  One-hundred and forty of the world's fastest triathletes (70 elite men and 70 elite women) will compete in the draft-legal, Olympic-distance race in Mission Bay (Bonita Cove – a few thousand meters from where the sport was pioneered 38 years ago).

In conjunction with the elite race, age-group athletes will participate in Olympic and sprint distance races in the same venue (albeit a non-draft legal race on a different course).

Schedule of Events:

Friday, May 11th:

-2:00pm – Elite Women’s Race

Saturday, May 12th:

-6:30am – Age Group Olympic Distance and Relay Races

-9:30am – Age Group Sprint Distance Race

-2:30pm – Elite Men’s Race

ITU World Triathlon San Diego Promo Video: http://bit.ly/I4RVAL

More Info: http://sandiego.triathlon.org/

Volunteer Opportunities (be part of history): http://sandiego.triathlon.org/volunteer/

Ch-ch-ch-chia!

It's no longer a secret that Chia seeds (yes, the same ones from your Homer Simpson Chia pet) have multiple health benefits.

Chia seeds are actually a more concentrated source of ω-3's (omega-3) fatty acids than flax seed.  Chia seeds can be ground and used similar to flax seed (added to smoothies, cereal, yogurt, etc.) or soaked in water or fruit juice to make chia fresca (mix with an 8:1 liquid:chia ratio). These soaked seeds are gelatinous in texture and can be used as a substitute for butter or cream cheese in recipes and a nutrient-dense additive to salad dressings, sauces, jams, cereals, dips, puddings, soups, or smoothies.  It will not affect flavor and will absolutely increase the nutritional value.

Look for Chia seeds in the bulk section of health foods stores (next to the teas and/or spices).

Justin Robinson, MA,RD,CSSD,FAFS,CSCS
Registered Sports Dietitian
Director of Strength & Conditioning - RU Sports Performance Center
www.RehabUnited.com

Ditch Your Crunches!

At Rehab United Physical Therapy and Sports Performance Center, we utilize a functional training philosophy based on the science of human movement.  In short, that means whether you visit our facility for injury rehabilitation, injury prevention, or sports performance training we train the body the way it was intended to move.  The therapists and coaches at RU train movement patterns, not just individual muscles.

When it comes to core training, traditional exercises often come to mind: crunches, bicycles, planks, among a few others.  Jene Shaw, Senior Editor at Triathlete Magazine, summarizes how RU tweaks traditional exercises to make them more functional and effective for rehab, training, or conditioning.

Download a copy of "Ditch Your Crunches"

Training The Pelvic Floor

Jena Walther, MS, CSCS

While there is no shortage in media discussion about the core, we seldom discuss the importance of its neighbor, the pelvic floor. The pelvic floor is a group of muscles that line the bottom of the pelvic (hip) bone; they serve as structural support for lower abdominal organs, such as the bladder, bowel, and uterus (in women).

In function, a weakening of these muscles can cause incontinence, pelvic organ prolapse (dropping of the lower abdominal organs), as well as child delivery complications. Additionally, a weak pelvic floor can lead to hip instability, causing a person to feel unbalanced and more likely to sustain injury during normal daily activity, or during sport.

Kegel exercises are a typical prescription for strengthening the muscles of the pelvic floor; however, these exercises do not relate to how we truly function. Kegels are what we call “concentric,” or muscle shortening exercises, whereas movements we perform every day are both eccentric and concentric (muscle lengthening and shortening). Thus, it makes more sense to strengthen the pelvic floor by engaging those muscles in ways that mimic how our bodies actually move:

a) Dynamically (shortening and lengthening)
b) In multiple planes (3-Dimensional)
c) Involving multiple joints at once (e.g. ankles, knees, hips, torso)

Please follow the link below to view some of the exercises we recommend for strengthening the muscles of the pelvic floor: http://bit.ly/ABdWwv

The Real Happy Meal

As a Registered Dietitian, people often ask my opinion of current diet trends and fads - Paleo, gluten-free, vegetarian, vegan, low-fat, low-carb . . . they all seem to work (at least temporarily), so which is the best?  My opinion - none of them or all of them.  The type of diet plan you choose is less important than the principles of healthy eating - To elaborate, I am posting an article written by Dr. James Rouse, founder of mix-1 All Natural Protein Shakes, originally written for a Denver magazine.  I love what he has to say and I believe he speaks the truth about diets!

Justin Robinson, MA,RD,CSSD,CSCS,FAFS 


The Real Happy Meal
Dr. James Rouse
www.mix1life.com

This is your time to transcend and thrive! The right diet and lifestyle can be a blueprint to build over-the-top, fired-up metabolism, cellular vibrancy, mental and emotional clarity and inspiration. Diet comes from the Greek word diaita, which means, way of life. It is nearly impossible to sustain and thrive with a healthy diet alone; that is, in the absence of a healthy way of living. A healthy diet is integrally connected to a healthy outlook, positive daily rituals and experiences of movement, service, community, intimacy, friendship creativity and purpose. When your world is intentionally full with these practices your diet (almost magically) tends to be full of nourishment and satisfaction. When your life is more 'sweet,' you tend to crave less sugar. If you want to make good on your healthy eating intentions this year and beyond consider stocking your day and life with these synergistic forms of nourishment while you stock your fridge and pantry: deep friendships, unbridled play, purposeful work and service, spiritual connection and community (no additives, no preservatives and nothing artificial).

I consider myself an evolving omnivore that is a lifelong student of nutrition. I love good tasting, healthy, and nutritious food! In the last 20 years I have tried and experimented with macrobiotics, veganism, vegetarianism, pescatarianism and today I really know what works for me. I now put energy and intention on eating more locally and sustainably; doing my best to eat clean and consciously. There is no 'one size fits all' way to eat. We are blessed with biochemical individuality . To a certain extent you need to be somewhat of an adventurer and investigator to discover what feeds you best. Keeping a food journal along with how you feel physically and emotionally can certainly help you discover which foods really work for you and which ones make you a little crazy, cranky or just plain uncomfortable.

The Mediterranean diet is a great place to start and the diet I personally embrace and clinically encourage. This diet emphasizes non-inflammatory foods including wild caught fish, nuts, legumes, olive oil, colorful vegetables, whole grains, local fruits, and to a lesser extent, humanely raised and harvested poultry, pork and beef; oh, and wine ( love it). Choosing a Mediterranean style of eating is supported by the scientific literature. Evidence shows that a Mediterranean diet may help lower the risk for heart disease, type 2 diabetes, Alzheimer's disease and certain cancers. Naturally rich in fiber, antioxidants, and healthy fats, going Mediterranean should cover most all of your New Year's healthy diet intentions. Calorie–wise, it's all about portions, no matter what type of diet regime you follow. A recent study published in the New England Journal of Medicine showed that the Mediterranean diet was more effective for weight loss than a low fat diet. Hopefully you're feeling hungry for great vitality and well-being and are inspired to make this year the beginning of a sustainable journey towards the ever-evolving you.

To thrive each and every day you have an opportunity to put these empowering practices to work for you:

• Feed your head first, your body second, and your emotions last. Whole-food nutrition naturally creates a chemical expression of confidence, balance and optimism. When your mind is fed well by eating real food, healthy food, and not skipping meals or snacks, your whole being is in a state of greater hormonal happiness. Strive to eat a whole food meal and/or balanced snack approximately every 3 hours throughout the day.
• Become a morning person and eat your breakfast! Breakfast eaters are the healthiest people around. They have lower rates of heart disease and obesity along with greater levels of productivity, energy and positivity.
• Add nutritious foods rather than delete the not so nutritious choices. Your body chemistry will "adjust" and begin to want healthy foods over the junk. For example, instead of snacking on a giant bag of potato chips, consider crunching on some celery topped with almond butter or peanut butter.
• Water your happiness. Our bodies are more than 75% water. Dehydration makes us more tired and hungry and as a result we often crave sugar and caffeine when instead we should be having a glass of water.
• Sweat your prayers daily with mindful movement and exercise. Dance, play, jump or hoola hoop; it's all good for your mind and body, memory and emotions. Exercise lowers stress, lifts positivity and raises every role you play in life, be it parent, spouse, friend, lover.
• Be grateful. Keep a gratitude journal and be healthier. Research suggests that this practice, combined with healthy eating and exercise, keeps us happier and healthier.

As your quest for optimal fitness continues, you may be romanced by a myriad of sexy and non-sustainable diets that promise results in mere days. Our egos and 'lesser selves' love the idea of a quick fix detox or radical interventions to heal bellies and butts gone bad. To realize your greatest mission and life expression get clear about what you are truly hungry for; peace and fulfillment, conviction with purpose and creative connection. These experiences will feed you greater than any one food or diet. Nourish and support your life with a clean, whole and sustainable eating and living plan. Trust that you are ready to take your body and your life from average to amazing. Balance is the path and the journey is most delicious.

Interview with Lesley Paterson

We had a chance to ask current Xterra World Champion - Lesley Paterson - how her Rehab United (RU) stretching and strength program has improved her performance  . . .

-Stretching is critical to my performance as it has helped maximize my efficiency, strength and power.  It has also been integral in in jury prevention. This largely has to do with maintaining range of motion - as when you're training as hard and as long as I am, muscles get overused and seize up; with that comes restricted range of motion which means that compensation patterns occur.  As soon as you start compensating by using tendons, ligaments and muscles not meant for that job, you lose efficiency and increase your chances for injury.

-Strength training in the off season is my golden ticket to speed maintenance during the season.  Triathlon is all about efficiency and strength, so by working specific exercises for each sport that enhance those, my chances of maintaining speed/power output across long periods of time goes up dramatically.  Not only that, by doing dynamic, functional strength work like we do at RU, I'm strengthening up all of the supporting tissues that often get injured when you start laying on the intensity.

Les - Congrats on an extremely successful 2011 race season and good luck in 2012!

Lesley Paterson with Rehab United CEO and Performance Coach, Bryan Hill.

Periodization/Progression - Strength Training

Resistance training is a vital compliment to any endurance sport training program (triathlon, swimming, cycling, and/or running).  "Resistance training" is the blanket term for what most people refer to as weight training or strength training and includes working out with any form of resistance including body weight, free weights (dumbbells, barbells), machines and/or rubber tubing/bands with the intent to increase muscular strength, hypertrophy (size), power or endurance.  A well-designed resistance training program can:

• Increase lean body mass
• Increase muscular strength and endurance
• Increase running efficiency & economy
• Increase bone density
• Increase joint strength (stronger tendons/ligaments)
• Decrease injury risk
• Improve ability to recovery from difficult workouts.

Just like a triathlon or marathon training program – progressive resistance training must include planned periods of rest and active recovery.  Consider this . . . if you gradually increase your mileage or pace each week, does your body also have the capacity to increase resistance training volume and intensity?  If you are an elite athlete, the answer may be “yes” - however, if you are a recreational runner, the answer is likely “no.”  This means you must plan to incorporate low-intensity or low-volume workouts over the duration of your training program.  We refer to this planning as "periodization," which is essentially planning ahead and adding variety to your workouts to decrease injury and increase performance.

The charts below represent a long-term (annual) and a relatively short-term (19-week marathon) resistance training program.  Both include three primary phases: General Conditioning, Strength/Power and Muscular Endurance. The repetitions, sets, amount of weight, total number of exercises and speed of movement will vary during these phases.  Early in the off-season, it is beneficial to spend about 80% of your time (strength training-wise) focusing on general conditioning to prepare the body for the eventual increase in physical demands.  As a race or event approaches, strength, power and endurance become more important, thus, you may spend equal amounts of time on each.  In all phases, perform primarily multi-joint movements (pushing, pulling, squatting, lunging) and limit single-joint exercises (curls, crunches), which are not sport-specific.

Overall, these charts look similar; however, the marathon training program is a snippet of the annual program (somewhere between pre-season and in-season).  Even though you may be in a "strength/power" phase based on your annual training plan, it is appropriate to vary the volume and intensity week by week (this is referred to as non-linear periodization).

Now is always a great time to build your strength base. As a compliment to your swimming, biking, or running, resistance training can increase your joint, bone, and muscular strength and prepare you for longer runs and harder workouts.  Most importantly, planning ahead to incorporate active rest & recovery can save you an injury and make training and racing seem easier.

Visit our website for details on our training and conditioning programs: www.RehabUnited.com.

Justin Robinson, MA,RD,CSSD,CSCS,FAFS
Director of Sports Performance

Raceday Preparation for Runners

Recover: Training for any event can drain the mind, body and spirit.  The weeks and days prior to raceday are meant for tapering, not cramming; you can not get in shape in one or two weeks, but you can get hurt.  You have likely spent the last 12-18 weeks in “perma-soreness,” so you deserve to run with fresh legs on raceday!  Proper recovery includes decreased duration and intensity of exercise, one or two extra days of rest, increased mobility exercises and increased hydration.  All of this (as apposes to a week of complete rest) will allow the healing and refreshing needed to make raceday enjoyable.

Prepare: Make a checklist before packing your raceday bag – include even the obvious items such as shoes, socks, race bib and timing chip/strap.  Raceday is already hectic enough: finding parking (or riding a shuttle that takes forever), checking in your bag (which can be a half mile from the start), waiting in line for the port-o-potty (maybe even twice), wading your way through the crowd to your starting corral . . . after all of this, you have very little energy to focus on anything else.  Do all you can in advance to limit raceday anxiety.

Fuel: With a wake-up call sometime around 4:30, travel to the race, and the aforementioned “hectic” events on raceday, it is easy to neglect proper fueling.  The only “perfect” raceday breakfast is the one your body is used to consuming.  Eat a larger meal (300-500 Calories) about two hours before the start of the race and then a “jumpstart” snack 15-30 minutes before the start (50-100 Calories, mostly carbohydrate).  It is okay to have some caffeine on raceday – but once again, make sure you know how your body responds.

Hydrate: Similarly to fueling, it is easy to start your race under-hydrated.  Between breakfast and your warm-up, drink at least 20 ounces of fluid (a standard water bottle).  Between your warm-up and the start of your race, drink at least another 12 ounces (half of another water bottle).  Since your body needs a combination of water, carbohydrate and electrolytes – have a sports drink OR water along with carbs and sodium.  The body can load (store) muscles with both energy and water – so your fueling and hydration program begins days before your race, not in the morning.

Warm-up: The #1 way to prevent injury is a proper warm-up – the #1 task people skip on raceday is the warm-up (a few stretches while waiting for the port-o-potty do not count).  As with your nutrition and hydration, you should complete a warm-up routine you have done before.  The ideal warm-up includes exercises that: increase heart rate, increase muscle temperature, take your joints through a greater-than-normal range of motion and involve dynamic movements (as running is dynamic, not static).  Equally important, the warm-up preps the mind for the upcoming 3.1 to 26.2 miles.  Always finish your warm-up with a smile, applause, and/or high-5’s – your friends can use the encouragement as much as you!

Mantra: Never try anything new on raceday!

Make SMART Goals

Happy New Year everyone!

Health, fitness, and nutrition articles this time of year consist almost entirely of “Resolution” themes . . . “Make this YOUR Year to Lose Weight” . . . “5 Keys to Keeping your New Year Resolutions” . . . “Make your Dreams a Reality . . . “ and so on.

Truth be told – I do not make New Year’s resolutions.  I despise them, in fact, for two reasons: 1) Life gets in the way and people rarely keep them past February, and 2) I believe if you want to change something in your life, do it right now – don’t wait for a new year or even a new week.

As a health professional, though, I obviously want people to set and accomplish goals to improve their mind, body, and spirits.  So rather than helping everyone with their New Year’s resolutions per se, I will do my best to help you achieve any health-related goal, whether you decide to plan it on January 1^st or any day of the year.

People often set lofty, general goals such as “I want to lose weight” but do little to break that goal down to determine the very specific steps necessary to achieve it.  “I want to lose X pounds” is a great long-term goal, but SMART goals provide direction and basis for measurements along the way.  I can not take credit for coming up with this acronym, but I utilize it with my clients and encourage others to do the same.  For every long-term goal (what you would like to achieve in the next 1-6 months) you set, create 2-3 SMART goals.

S – Specific

M – Measurable

A – Attainable

R – Reasonable

T – Timed

Example #1 (Using SMART goals to measure potential success):

• Long-term goal: “I want to lose 50 pounds by July.”
• Analysis – 50 pounds in 6 months equals 8.3 pounds per month, which equals an average of just over 2 pounds per week. 
• SMART Goal: I will lose 2 pounds by the end of next Sunday.
• This goal is specific, measurable, reasonable, and timed, but is it attainable?  Two pounds per week, every week for 6 months equates to A LOT of work (creating a calorie deficit of roughly 1,000 kcal per day).  Whether or not this goal is attainable, is up to you and your trainer/coach.

Example #2 (Using SMART goals to determine specific steps):

• Long-term goal: “I want to lose 50 pounds by July.”
• Analysis – You know that skipping breakfast is a barrier to your weight-loss success since it causes you to over eat at night.
• SMART Goal: I will eat breakfast every day next week.
• This goal is specific, measurable, and timed, but not very reasonable and, thus will only be attainable for a short period of time (likely 1-2 weeks).  “Shoot for the stars” on your long-term goals, but “aim low” for your SMART goals!  The key is to maintain these SMART goals each week and build on them as you approach your long-term goals.
• Better SMART Goal: I will eat breakfast at least 3 out of the next 7 days.  (A month from now, change it to 4 out of 7 days).

Each time you create a SMART goal, you should read it (since you need to write it down) and confidently say, “I can do that”.  Challenge yourself – do not write down anything too easy (something you have done a hundred times prior) or anything too hard (unreasonable or unattainable).  Assess your goals 1-2 times per month and reevaluate as necessary.

Good luck with your resolutions – and be SMART about your goal setting and decision making.

Justin Robinson, MA,RD,CSSD,CSCS,FAFS

Director of Sports Performance - RU Sports Performance Center

www.RehabUnited.com