Doug Kelsey's Blog

Exercise:ology is about the art & science of fitness and human performance. It offers insights, techniques, tools, and tips to get fit and stay fit; physically, mentally, and emotionally from both my experience (now at 28 years) and from what science has to offer.

I will share ideas, provide you with some solutions and hope to encourage you and inspire you to pursue excellence in health and fitness. I know some things but certainly not everything so I welcome your thoughts and ideas. You'll find information on on the " what, why, and how" of exercise, fitness, and health: anatomy, physiology, fat burning, muscle and strength building, speed, power, agility, flexibility, drills I like, drills I don't like, tests to use, motivation, self-growth, and discussions about the latest fads and gadgets. And, lots of other things too.

I'm a human performance coach, writer, teacher, and physical therapist. I am the co-founder of Sports Center - a physical therapy practice in Austin, Texas where we help active people stay active. I also have another blog; you can view it here. If you want to know more about me, click here to go to my online curriculum vitae.

I answer questions here, in the blog, so if you email me, expect it to show up here. The point is to share information. I won't, however, share your personal information unless you give me permission to do so.

I think that's it.

Let's get fit.

DK

Exercise Degree of Difficulty: Side Bridge with Hip Abduction

My wife Elle came home from the gym the other day and described the routine she went through in an exercise class. As she described one of the drills that she had trouble doing, in fact enough that she bailed on the drill, I wondered why an instructor would include this drill in a group setting. Then I realized that the instructor probably hadn't analyzed the degree of difficulty of the drill but had included it because it's a new, hip, current core drill and core drills seem to be really popular.

But degree of difficulty is an important thing to understand when it comes to exercise and there are certain elements of a drill that help you figure out if one is more difficult than another.

So, let's look at the drill Elle was faced with and sort it out.

The drills is a side bridge with hip abduction (photo from womenshealthmag.com):
Why is this drill hard? Well, the first thing is that you have only two points of support - your foot and forearm - over which you have to disperse your entire body weight. Your body acts as a long lever on your shoulder and hip so if you have any weakness in these areas, you'll feel a lot of stress in the joints.

Notice that the head and neck have to be maintained in a neutral position against gravity. But, the muscles that attach to the neck and shoulder - levator scapula and upper trapezius for example - are also working on maintaining the shoulder position. This creates extra load on the neck and for people who have underlying disc or joint disease, the position can create pain in the neck or shoulder.

Finally, the leg moves up and down while you're perched on one foot and a forearm. For most people, hip abduction, done properly, is tough at first because of weakness in the gluteus medius and the rotators of the hip. It's always easier to lift something when the base upon which you lift is stable and secure. In this case, the base is not very secure so the lifting of the leg becomes just that much more difficult.

If you find this drill too difficult, try a forearm plank or a side bridge with knees as the distal contact  point instead of one foot.

For best results from training, match the degree of difficulty of the drill with your capability.

Why the "How" of Exercise Matters

You can go to a gym, sit on a machine and push or pull weight.

It will help you. No question.

It creates a metabolic event in your body, alters hormone production, increases muscle and other soft tissue strength. It might even change the way you look.

But, it doesn't do a lot for your brain.

Your brain is amazingly plastic. The connections in your brain change based on what you do and this happens over your entire life. Exercise that challenges your balance and increases blood flow has been shown to improve the "wiring" in your brain. And, recently, juggling has been shown to do the same thing.

Now, I'm not suggesting you take up juggling but if you're going to take the time to go to a gym or even just to carve out 30 or 45 minutes a day to exercise, then why not perform drills and movements that will help your brain?

For example, you can sit at a chest press machine and push the weight or you could do a push up. In the chest press machine, you're relatively static and stable. The push up involves more muscles, more coordination and if you add one more thing to the push up - stand up - it becomes a cardiovascular challenge as well. You start in a standing position, then move into the push up position, perform a push up, then return to standing and repeat. The movement of your body mass transforms this drill from a muscle training drill to one that includes coordination, balance, and a cardiovascular event.

Or, you could perform a push up using a suspension training device like the TRX. You anchor the TRX to something stable, a door or even outside to a tree limb, and then perform the push up. You can see a sample of this drill here. This movement is much more challenging to your brain because of the instability created by the suspension device.

When you train, train your brain too.

---

"Training induces changes in white-matter architecture."
Jan Scholz, Miriam C Klein, Timothy E J Behrens & Heidi Johansen-Berg.
Nature Neuroscience, Published online ahead of print 11 October 2009.  DOI:10.1038/nn.2412

"Aerobic exercise training increases brain volume in aging humans."                                                    Colcombe SJ, Erickson KI, Scalf PE, Kim JS, Prakash R, McAuley E, Elavsky S, Marquez DX, Hu L, Kramer AF.    J Gerontol A Biol Sci Med Sci. 2006 Nov;61(11):1166-70.

New Device Monitors Sleep, Steps, Calories

Here's a cool new device that tracks calories spent, steps taken, and how soundly you sleep all for about $100. It's called the FitBit.

The downside to devices that calculate your caloric expenditure, like the treadmill or bike at the gym, is that the results tend to overstate the actual amount of calories your burned. The formulas use your body weight to estimate your basal metabolic rate and then return a total calories burned figure. But, you have to subtract the amount of calories that you burn just to be alive (also referred to as Basal Metabolic Rate). The difference is usually around 20%. The Fitbit group claims that their device is very accurate. I haven't seen the proof yet though. 

One of the interesting features of the device is the monitoring of sleep. It does this by detecting motion of your arm. The assumption is that deep sleep renders you motionless and when you sleep fitfully you move around- roll, turn, get up, etc., and the device detects this using the same type of sensor in the Wii system. 

I'm curious how well this thing works and being the early adopter type, may give it a go. If I do, I'll let you know what I think.

5 Reasons Time Magazine Got it Wrong

John Cloud wrote an article for Time Magazine recently, "Why Exercise Won't Make You Thin" in which he wonders why he can't get rid of the "fat gut that hangs over my belt when I sit" even though he has exercised regularly for several years. He concludes that you simply can't lose weight by exercising.

So, Lance Armstrong and Usain Bolt are just lean and muscular by eating the right foods? I doubt it. It seems to me that John and Time missed a few things:

1. Just because you're thin doesn't mean you're fit. Equating your body shape with your degree of fitness is like comparing the size of your wallet to your financial health. It really depends on what's inside. Our society is overly obsessed with "thin" to the extent that some people who are thin are actually over fat. They have little muscle mass.
2. One way to control appetite following exercise is to burn fat during the exercise. Fat contains a lot of energy but it's hard to use it. Your body has to break it down which takes time. To do this, you'll use glycogen and a little fat during the exercise until gradually more and more of your fat stores are mobilized. When you finish exercising and you feel like you want to gnaw off your arm, you probably used up your glycogen stores. So, you eat something which adds back the calories you just spent or at least most of them.
3. All exercise is not the same. "Cardio" is a relatively poor way to mobilize fat unless you exercise for a very long time like Lance or Michael Phelps or Haile Gebrselassie. Most of us don't have that kind of time or motivation. Spending 40 minutes on an elliptical is good for you but has a relatively low caloric demand and very low post-exercise energy consumption compared with high speed intervals done on the same machine. Of course, 40 minutes of high speed intervals will tend to make you swear off elliptical machines for ever. It's very demanding.
4. Not all calories are the same. 100 calories from a Snickers Bar and 100 calories from 2 apples will have drastically different hormonal effects in the body causing a series of reactions that when repeated (not literally of course) can make you fat in a hurry.
5. The fact that you don't lose weight is NOT an excuse to quit exercising. Exercise is good for you even if you don't lose much or any weight. Your heart, lungs, bones, connective tissues all benefit from the activity. You can lower your blood pressure, cholesterol, improve your bone density whether you lose weight or not.

So how does John get rid of his fat gut? Here's a starter list:

1. Find your percentage of body fat and determine the safe level for your age and gender. Recognize that to see your abdominal muscles (which by the way is what you'll need in order to sit down and have no fat hang over your belt), your body fat levels will need to be in the athletic range. Unless this is your day job, be prepared to have some fat over your belt.
2. Eat four to five meals a day of 400-500 calories and make sure each meal is a blend of complex carbohydrates, moderate amount of protein and fat, and fiber. This will help stabilize your blood sugar and keep your muscles well fed while reducing the need for something quick when all of a sudden you feel starved. Eliminate sugar, alcohol, and anything with high fructose corn syrup.
3. Exercise using high speed intervals several days per week for 20-30 minutes. Scientifically proven to mobilize fat.
4. Use intense, short duration resistive exercise that requires many muscles to work at once (like squatting, pushing, pulling, etc.) and vary the routines, intensity, duration frequently. This creates an inefficient exercise program which is what you want. Efficiency in exercise means fewer calories burned.
5. Take 5-7 days off from #4 above every 4-6 weeks. Spend your time on flexibility, Yoga, steady-state aerobics (like cycling, walking, jogging).
6. Expect to lose between 1-2 pounds of fat per month on average. This is when most people give up. It's too hard, takes too long, etc. But, it's the truth. When you lose fat at this pace, you can create the lifestyle changes you need to keep it off. Otherwise, you'll backslide.

Unfortunately, most people don't know anything about the above so they buy the line that exercise is a waste of time in helping you lose fat and then they short change themselves over the long-term by not exercising at all.

How to Increase Upper Back Mobility

The unwitting victim of the sedentary lifestyle is the upper back: the region from the shoulder blades to the base of the neck. Sitting, looking ahead or even worse, down, at a computer screen hours on end, your upper back must resist the load of a teetering bowling ball on your shoulders. Over the years, you'll lose mobility, notice more neck and back pain, and look years beyond your age.

By the time you notice the rounded shoulders and drooping head, you won't be able to correct it by just trying to "stand tall". You'll have to regain the motion first then use the motion you gained.

Some clinician / trainers like to use things like tennis balls, or foam rollers as a wedge to increase the extension in the spine. I don't go there first. The reason is that your spine won't appreciate the sudden increase in load created by, again, a bowling ball dropped over the end of a foam roller. Sometimes it works but I suggest a subtler approach.

Try these:

1. Get on the floor on your hands and knees. Place on hand out in front of you (as in the image). Rock back on your heels slowly and match the pace of your movement to the pace of your breathing. Alternate rocking straight back with rocking to one side or the other. Do this five times and then repeat on the other side; or
2. Get a medium to large Swiss Ball (also known as an exercise ball, stability ball, physio-ball). Get on the floor on your knees and place your forearms on the ball. Slowly sit back onto your heels while maintaining contact with the ball on the forearms. You'll feel a stretch in one or more areas: the shoulders, the sides of the trunk, the upper back, or the lower back. Move in and out of the position slowly.
3. Using the same Swiss Ball, now combine drill #1 with Drill #2. You'll have one forearm on the ball and rock back onto your heels. Alternate rocking straight back with rocking to one side. Do this five times, slowly, on each side.

These drills are designed to improve joint motion before you try any static stretching. Many times, your mobility will increase dramatically without stretching. The reason is that the gentle rocking motion and very light movements stimulate certain receptors in the joint and associated fascia that reflexively inhibits muscle tension. In a word, you relax.

The more aggressive approach, also pictured, stretches the spinal joints into extension but fails to provide much relaxation to the related shoulder muscles (latissimus dorsi, rotator cuff).

If you sit a lot, you probably would benefit from one of these drills. And, as your posture improves, you'll look ten years younger. No kidding.

DK

img src: www.epicself.com   www.bicyclekingdom.com

A Key Stretch for Your Shoulder

Most people lack adequate flexibility in the shoulder in one or more of the main shoulder movements but because we rarely have to use all of the motion, we don't miss it. Until we miss it.

Inflexibility in internal rotation is one of those movements. It's an awkward motion that is required for things like throwing or swimming or serving a tennis ball - anything overhead. You should have at least 70-80 degrees of motion (this is measured as in the image with the hand pointing to the ceiling as the starting point of measurement).

Most people have about 45 degrees or just over half of normal motion. This is rarely a problem until you use your arm overhead. Here's why.

The muscles that help control how well your humerus moves, the rotator cuff, anchor on the scapula (shoulder blade) and the humerus. Normal flexibility of internal rotation means that these muscles have normal length. Muscles that have normal length have the best chance at developing tension at the right time during their use (something called the length-tension relationship). As you lift your arm overhead, the rotator cuff muscles must contract at the right time and the right amount to keep the upper part of your humerus from shifting. If the muscles are inflexible, this timing will be off and the humeral head will drift up and squish the tissues that live in the space between the humeral head and the acromion. If you do this enough, you can abrade the rotator cuff and even tear it. A degenerative tear of the rotator cuff usually happens in a person over 60 years of age who decides to, for example, tackle a large painting project at home. She lacks normal motion of internal rotation (and probably has some weakness as well), doesn't know it and begins painting. The sweeping motions of the arm tax the rotator cuff and the combination of inflexibility with weakness allows the cuff to rub on the acromion. After a few days of this, the person realizes her shoulder really hurts and she can't lift her arm. This is when she ends up in her physician's office and usually is diagnosed with a rotator cuff tear.

The best way to know if you lack flexibility is to have a clinician measure it. But, if you can't get in to see someone here's another option.

To check the right shoulder, you'll need a helper and a tool (a carpenter's inclinometer or if you have an iPhone, you can download an inclinometer application).

• Lie on your right side with a pillow under your head.
• Slide your right arm out from under you until the upper arm is at 90 degrees to your body.
• Position your arm so your hand points to the ceiling. This is the starting position. Have your helper place the inclinometer on your forearm and adjust the forearm position until the inclinometer reads "0".
• Your helper should place his or her hand on the front of your shoulder and apply moderate pressure. This is to keep your shoulder from moving and making it seem as if you have more rotation than you actually do.
• Allow your arm to drop toward the floor. When you have reached the stopping point, have your helper record the angle on the inclinometer. If it is less than 70 degrees, have your helper press down lightly until the movement stops. If by pressing down, your arm moves to ~ 70 degrees, all is well.

If your motion was less than 70 degrees with or without help, you should stretch your shoulder. You can use the same position as the test - sometimes referred to as a "sleeper stretch".

To increase the flexibility, I prefer something called an eccentric or resistance stretch. This stretches the muscle while it contracts. Apply a gentle pressure on your arm and, at the same time, lightly resist it. Now, push your arm downward while maintaining the tension in the muscles. Move until you feel tightness or an inability to move any more and hold it for five seconds.  Release the pressure and go again. Do this five times.

This technique will  increase motion in your arm quickly but your muscles have to learn to use the flexibility. So, keep doing the drill for one week. Then, stop for a week and re-test. If you're over the age of 30, I would check your shoulder internal rotation at least once every three months especially if you have a desk or more sedentary job.

DK

image source: www.shoulderdoc.uk.co

You can comment on any post by clicking "COMMENTS" at the end of the article. Share your opinions and ideas!

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Should You Stretch?

When it comes to stretching, most people think of it as something you do to become more flexible; to improve your mobility. But, how do you know if you're inflexible and what exactly is flexibility and mobility?

Usually, you stumble onto your lack of motion. You reach for something high, just out of an easy reach and feel tightness in your shoulder; you bend down to pick something up and notice your lower back doesn't want to flex;you back the car out of the driveway and find it tough to turn your head far enough to really see behind you.

So, naturally, you begin to wonder if you should stretch something, somewhere, to improve your mobility.

Mobility is using your available motion and flexibility is just one mobility characteristic. It is one of the factors the influences how easily and efficiently you move.  A person who demonstrates flexibility has pliable muscles that can be repeatedly stretched, actively or passively, without injury.

However, you can be flexible yet have reduced mobility because you can't use the motion you have. This usually comes from weakness or lack of coordination.

So, you may not be able to reach above your head because you lack strength in certain muscles to fully coordinate the movement. It may feel as if you're tight when actually you're weak. If you start stretching areas that feel tight when they're not, you'll not only waste your time, but you could make the situation worse.

When you combine flexibility with strength and coordination you'll get well controlled, smooth, and even elegant motion. You'll move easily, not feel tight or off balance or struggle to complete the task. And to maintain this mobility, you have to use it regularly. If you don't, your body will adapt and you will lose both flexibility and strength.

You need to stretch when you lack normal, pain-free passive movement of a joint or joints. You need to strengthen when you have normal passive motion but cannot move through that available motion.

Most people need to stretch and strengthen the shoulders, upper back, hamstrings and hip flexors and to a lesser extent the ankle and lower back. The reason is that most people's lives do not require regular use of the entire range of motion of those body regions. Most people sit, work on a computer or at a desk and rarely make full use, for example, of reaching over head or 80 degrees of hamstring flexibility. Then, occasionally, they demand more mobility from their joints than they possess and run the risk of injury.

Remember that most injuries result from a physical demand in excess of physical capacity and that includes mobility.

In my upcoming posts, I'll discuss how to stretch the shoulders, upper back, hamstrings and hip flexors and how to improve your mobility. In the meantime, pay attention to how easily you move and ask your self if you need to work on your mobility.

Three Exercises to Help Your Neck Without Working On Your Neck

My training routine yesterday was tough for me. Not because I was using a lot of weight or sprinting stairs or hopping on and off boxes. It was tough because one of the drills required me to press a relatively light weight (20 lbs) over my head.

Lifting your hands over head is what is called a "coupled" motion. To achieve normal range of movement, the movement occurs in more than one area of the body although to the eye it appears to be coming from your shoulder.

Most sources report normal shoulder flexion motion as 160 degrees. It's not. Shoulder flexion of 160 degrees is composed of 140 degrees of glenohumeral motion and 20 degrees of thoracic spine extension. So, if you're like me with osteoarthritis of the thoracic spine and lack some flexibility in that area, when you try to reach up over your head, you will either move too much in your shoulder or take up the motion elsewhere which most often in the neck or lower back.

So, for example, for me to perform a simple yoga drill like a Warrior I pose, I feel lots of tightness in the thoracic region from a lack of flexibility there and the muscles work really hard to help me move my arms up where they need to be. Because my thoracic motion is limited (about 10 degrees), my muscles work harder and fatigue faster.

When I add a load, like a dumb bell, and press the weight over head, the muscles in my neck contract more than they should. They're just being neighborly. Lending a hand. As my shoulders reach 140 or 150 degrees of motion, my upper trapezius and levator scapula kick in too much in an attempt to pull my humerus up. This is what then creates the extra stress in the neck. I have to focus on form and not look up. If I look up, I'll increase the amount of neck muscle activity even more from an eye-neck reflex. So, I look straight ahead, hold my spine in a neutral posture and pay attention to how hard I'm working in the thoracic and neck areas.

Some people might just skip any movements that require hands overhead but my attitude is that when you start letting go of movements because they're hard to do or even create some short-term pain, you'll lose that ability forever. Before long, you can't do very much at all.

I help my neck without actually doing anything with my neck by using a couple of flexibility and mobility drills:

• Touch downs. I lie on the floor with my legs on a large swiss ball. This position places tension on the latissimus dorsi muscle and keeps the lumbar spine from moving too much.  I position my arms at my side and bend my elbows and allow my arms to fall away from my body. I slowly slide my arms up over my head but keep contact with the floor. My goal is to reach a "touch down" position with my elbows straight, arms near my ear and in contact with the floor. I do this for about five minutes.
• Roll outs on a Swiss Ball. On my knees, I place my forearms on the Swiss Ball. I then lean back onto my heels (this also stabilizes the lumbar spine) and gently move the ball side to side. This is also about a five minute drill.
• Warrior I pose. This is much more difficult because I am unable to passively stabilize the lumbar spine as I did in the touch downs and roll outs. The Warrior I is a lunge position with arms directly overhead. I reduce tension by focusing on my breathing. I also make this drill easier by holding onto an elastic band or tube. I anchor the tube in a door, hold onto it and then step away from the door. The tension in the tube helps me hold my arms up but the tension needs to be light. Otherwise, it will make the drill harder. I usually perform 5 to 10 repetitions holding the pose for five deep breaths. (Image source: www.atouchofyoga.com)

I have other drills I use but these are the easiest for you to perform. I use a piece of equipment I call a LymberGymber. It's a stretch station made by True Fitness, invented by Gary Grey, PT and it's awesome. It's a 3D stretching and mobility tool. More on that later.

DK

Theodoridis, D. and S. Ruston (2002). "The effect of shoulder movements on thoracic spine 3D motion." Clin Biomech (Bristol, Avon) 17(5): 418-21.

Stamina versus Endurance

What's the difference between stamina and endurance and why should you care?

The term "endurance" refers to cardiorespiratory work capacity. How long you can jog, cycle, swim, for example depends largely on cardiorespiratory endurance. You do not need a lot of muscle strength to jog for thirty minutes but you do need an oxygen delivery system that works reasonably well.

Stamina combines strength with endurance. When you have a high degree of stamina, you can sustain physical work over a long period of time. If you have ever had to chop wood or use a pick ax to dig a hole, you quickly find the limits of your stamina.

Some people use the terms interchangeably but your training programs will be different if you want to, for example, run a marathon (requires endurance) versus ski downhill all day (requires stamina).

Most lifestyle demands require some degree of stamina so make sure you're building that into your or your client's routines.

DK

You can comment on any post by clicking "COMMENTS" at the end of the article. Share your opinions and ideas!

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For the latest on MY TRAINING ROUTINES, click here .
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Do you have a copy of my new book, "The Little Book of Sparks"? You can read a sample and order it here.

More Exercise, Not Less, for Back Pain

People sometimes believe that if something hurts, they shouldn't exercise and sometimes, that's true.

But, a recent study* suggests that more exercise is better when it comes to garden variety lower back pain.

A group of 240 people, all with chronic lower back pain, were divided into four groups: 4 days / week exercise, 3 days / week, 2 days / week and no exercise. The researchers tracked pain levels, quality of life and perceived disability for sixteen weeks.

They found that the group that exercised 4 days / week had the greatest reduction in pain and the greatest improvement in quality of life.

The difficulty for most people is trying to figure out if the pain they have is a "bad" pain or not. One way to assess this is to monitor the severity of pain before, during, and after exercise. If the pain level rises consistently, other activities become difficult to perform, or sleep is disturbed by pain, then usually that's a sign that you need alter the drills or re-assess the client.

DK

*University of Alberta (2009, June 3). Exercise More, Not Less, To Ease Aching Back, Study Suggests. ScienceDaily. Retrieved June 9,

You can comment on any post by clicking "COMMENTS" at the end of the article. Share your opinions and ideas!

**

For the latest on MY TRAINING ROUTINES, click here .
**

Do you have a copy of my new book, "The Little Book of Sparks"? You can read a sample and order it here.