Core: Are You Training It Correctly?

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Core: Are You Training It Correctly?

The Best Core Exercise You Probably Aren't Doing.

What The Core is And How to Train It

There are a lot of good exercises out there to strengthen your core, the problem is not many people are doing these exercises because there is a poor understanding what “core” means, and how the “core” functions in human movement.  So let’s clear up this confusion first.

I typically tell my patients that you have 3 cores; a core for the neck and shoulder complex, a core for the lumbar spine and torso, and a core for the hips and pelvis.  Granted, this is a bit of a misnomer, because all three of these “cores” are continuous with one another through chains of muscles that all work together to perform the same function, which is to create a stable spine for the arms and legs to move about.  So your “core” actually runs throughout the entire torso from hip to shoulders and into the neck, a much larger area than the abs, which most aesthetically focused exercises target.

A secondary purpose of the core is to control rotational forces that result from day to day activities, the main one being walking.  When we walk, as our left foot comes forward, our right hand also comes forward creating rotation in the spine which can be damaging to tissues (discs, cartilage, ligaments) if not properly controlled.  The control of this motion is mainly done by our obliques and paraspinal muscles (tiny muscles that attach directly to the bones of the spine) and must be trained in order to protect us against repetitive use injuries, and therein lies the problem.  You won't be training these muscles by doing frontal plane (think flexion/extension like a crunch of leg lift) exercises typically seen in the gym.

There are two types of exercises that train our core to be more resilient to this rotational force, anti-rotation exercises like the pallof press, and controlled rotation exercises like chop and lift variations.  However, there is one exercise that not only focuses on controlling rotation, but improves shoulder and hip stability, helps create coordination of the core system, improves mobility in the wrist and hips, requires no equipment, and most importantly, it gets you down on the ground so it’s very safe!

This exercise is quadruped crawling.  It sounds much easier than it really is, and in order to perform these exercises correctly, it requires great hip mobility, a strong core, and coordination of the entire system.  It’s a fantastic neurological exercise as well because it requires the teamwork of so many muscles working together.

So how do you perform this exercise correctly?

The most basic rule with crawling is to keep the butt low and keep a neutral spine.  You can start on your hands and knees, or hands and toes, but as you crawl resist the urge to let the butt raise up high like you would in a “bear crawl”.  Move very slow and controlled, moving the opposite hand and foot/knee at the same time so they leave the ground simultaneously and are placed back down simultaneously.  Imagine a ball being placed in the small of your back, and as you move, try to keep the ball from rolling off the low back.  Variations include forward and backward patterns, side to side patterns, box patterns, and transitions from one style to another.

You may need to condition your wrists if you don’t gain enough mobility and strength in the wrists.  You may also need to work on hip and knee mobility so you’re not over stressing those joints.  These are not always quick fixes, but by not addressing these mobility restrictions you will be at a high risk of injury in your daily life anytime you get into an unfamiliar position, such as falling.  When you’ve built up enough resiliency in the wrists, shoulders, knees, and hips, the crawling variations will tie your core together better than any isolation exercise will ever do.

So next time you are looking for a good warm up or cool down core exercise, ditch the sit-ups or these “core” machines, and practice some crawling patterns for 5-10 minutes.  You’ll be surprised at how challenging these exercises can be. 

 

Dr. Scott Dunaway is a Doctor of Chiropractic located in Clarksville Tn and owner of ChiroStrength.  He specializes in treating injuries associated with repetitive overuse habits by combining chiropractic adjustments, Active Release Techniques, and global movement assessment and corrections.  To schedule an appointment call the clinic at 931-321-1414 or submit the new patient form on www.ChiroStrength.com

 

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"I Just Need to Be Cracked Doc."

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"I Just Need to Be Cracked Doc."

Why It Cracks

A discussion as to why this is a dangerous belief

This is a quote that, as a movement snob (admittedly), is like nails on a chalk board when I hear these words.  Allow me to explain why.

The reason for an area of the spine being locked down to the point where you feel the desire to “pop” it, is almost always due to an attempt of the brain to lock down that area to prevent further injury.  Without proper stability, the brain engages large muscles around the aggravated joint or tissue to keep further movement from causing more damage to the area.  Left unresolved for a long enough period of time, the brain encounters a catch 22.  Satisfy the mobility desire by letting down the protective bracing and risk further damage to joints, or keep the area locked down and starve the cartilage in those joints of proper nutrition resulting in degeneration (cartilage “feeds” by being moved through daily full ranges of motion).  Given these choices, the brain opts for the stiff, starvation route because at least the damage occurs at a slower pace.  By ONLY applying a self manipulation or focused chiropractic adjustment, you could be robbing the body of this desired stability.

The true fix is a combination of increasing the mobility of the stiff area while addressing the lack of stability elsewhere.  Sometimes this stability is a strength issue and sometimes it’s a motor control issue.  Meaning, sometimes the stability can be regained by performing simple exercises in a progressive manner, i.e. strengthening.  A motor control issue is resolved by relearning a movement pattern.  A good example of this is teaching someone how to hinge at the hips instead of flexing from the low back and/or knees when picking something up, pushing something, etc.

The only way to figure out what is needed post mobility is being screened by a qualified professional who is trained in peeling the layers of movement away to find that compensation.  Once found and properly addressed, the patient/client can be educated on what needs to be done to fix the lack of stability. Adding progressive routines to challenge this new stability and mobility will engrain a new movement pattern which the brain will use to perform a given task whether that be running, lifting, throwing, etc.

“I just need to be cracked” is a request which, as a knowledgeable professional, would be unethical for me to grant.  Therefore, at the very least, you should always follow us a mobility session with a stability session.  Not doing so will lead to occasion after occasion of temporary relief until eventually enough damage is accumulated, and conservative treatment is no longer the answer.

Lastly a few notes on stability/mobility. 

Strength does not equal stability.  I’ve known many strong guys (over 500lb squat and deadlift) that had stability issues.  Strong muscles just means strong compensations.

For those of you who compete on a regular basis (sport or hobby), stiffness is par for the course.  Although stability fixes are often needed, repetitive activities will eventually over stress tissues even with the best body maintenance habits.  In this case, assistance from a therapist of some sort will be needed from time to time.  However, this will be very infrequent and the damage to the tissues will be much less when a proper approach to manage your issues is taken.

So next time you find yourself cracking your own back, or going to the chiropractor to “just get cracked”, know there is more work to be done if a more complete fix is desired.  Restoring proper movement is a multifaceted approach and requires consistent work and proper habits to achieve, and with this approach, the results are much longer lasting and healthier tissues. 

So the moral of the story? Don’t Just Mend. Transcend!

Dr. Scott Dunaway is a Doctor of Chiropractic practicing in Clarksville Tn and owner of ChiroStrength.  He specializes in treating chronic ailments associated with repetitive overuse habits by combining chiropractic adjustments, Active Release Techniques, and global movement assessment and corrections.  To schedule an appointment call the clinic at 931-321-1414 or submit the new patient form on www.ChiroStrength.com

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Back Pain? Here are 5 Exercises to Avoid

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Back Pain? Here are 5 Exercises to Avoid

Back Pain? Here are 5 Exercises to Avoid

With a proper plan, the gym can be a wonderful place to prevent injury, but can also be the driving source of your pain.  Whether you currently have back pain or have a reoccurring nagging injury, here is a short list of exercises to avoid or alter to promote injury prevention!

Leg Press – True, the leg press can make you feel like the hulk, pushing up more plates than you can count with each thrust.  But the leg press is basically a squat with zero contribution from the core, and I can promise you that your ability to push lots of weight up a 45 degree incline is not your weakness.  The inability of the core to move and control the loads of squat and deadlift variations are where most weaknesses lie, and ignoring this fact will keep your injury potential high.  Swallow the pride and squat, even if it’s half depth bodyweight squats at first.

Over Head Press – Low Back pain often stems from dysfunction in the thoracic spine, such as lack of thoracic extension.  Coupled with lack of proper shoulder range of motion, the military press can easily cause pain and instability in the Lumbar spine.  Your time would be better spent on mobility exercises for the Thoracic spine and stability exercises for the scapulae in this case. When you have adequate mobility start next with single arm presses.

Leg Curl – Best case scenario, assuming you have perfect form and your entire abdomen stays on the bench while you maintain a neutral spine during the exercise.  While you may get some killer hamstrings, you again are creating dysfunction in the system.  There is not a single scenario you’ll find yourself in that will require you to activate only your hamstrings with your quads completely disengaged. Your time would be better spent perfecting the dead lift, squat, or lunge technique with different variations.

Back Extension Machine – Bottom line, your core (including diaphragm, abdomen, low back, and pelvic musculature) is meant to NOT move while controlling more distal loads.  Yes, you need rotation and other ranges of motion from the spine, but the core’s function is to be a rigid platform to swing the arms and leg about.  Therefore, trying to isolate the low back for a weakness is like trying to decide which one tire to change on a car that’s hit a spike strip.  As you train the system as a whole, you will strengthen the weak links.  Think about deadlifts or bent over rows instead (starting light of course!)

Seated Ab Crunch Machine – I’ve contemplated hiring a hit man to eliminate every one of these machines.  If I were a money hungry business man, I would get one for my office and convince my patients to use it.  However, my love for lumbar spines prevents me from following through with this plan.  Please keep this in mind.  Repetitive lumbar flexion and extension is terrible for your low back.  LOADED repetitive lumbar flexion and extension is asking for injury.  LOADED repetitive lumbar flexion and extension WITH rotation is enough to make my back hurt while watching another person perform this.  There are many cons to this excise and I’m at a loss for a pro.

Quality movement and exercise can be treatment for almost all joint and muscle pain.  However, when performed with no guidance and improperly, exercise can be a high risk activity.  Learning which movement and exercises will improve your condition may mean the difference between a long, pain free exercise career or winding up on the surgery table. 

Interested in great Chiropractic and corrective care to recover from a sports injury?  Interested in some group training? Just call for an appointment at 931-321-1414, or go www.ChiroStrength.com and fill out the form under the “become a patient” tab.

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Rolling your IT band is getting you nowhere

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Rolling your IT band is getting you nowhere

Rolling your IT band is getting you nowhere

“Runner’s knee” is a common phrase used around the running community and is often correlated with a sensation of tightness on the outside of the leg and pain on the outside of the knee.  The Iliotibial (IT) band is the commonly accused culprit for this condition, and the most common do-it-yourself approach to fixing this problem is using a foam roller on the painful leg.

Because foam rollers have been shown in the literature, at least initially, to increase range of motion and reduce pain in muscles, it’s a reasonable approach.  However, the IT band is not muscle, it’s what’s called fascia, and it reacts differently.   

The IT band has deep attachments to the femur (the long thigh bone) and is very strong, but not very elastic.  It’s so strong in fact, that you, or any manual therapist, will never be able to “lengthen” this tissue.  However, a therapist can improve tissue movement at the junction between different hip and leg muscles which the IT band crosses, but the ‘shearing force’ required to make improvements can’t be done with the foam roller.  And finally, the IT band is almost always being over stressed already, or over stretched if you will.  You're better off staying away from the actual site of pain aside from maybe ice. 

Foam rolling the muscles around the IT band in the quads, hamstrings, and calf will assist in improving the condition, but it’s an incomplete approach at best. This condition is not typically a knee issue.  It’s a hip, foot, or core issue, so try this instead.

Roll the foot comfortably on a ball to ensure the joints of the foot are getting good movement, and make sure the big toe is sufficiently mobile.  While weight bearing, you should be able to pull your big toe off the ground with ease to about 60 degrees of extension.  You can also simply spend time out of your shoes on a natural surface which will “wake up” the tiny support muscles in the foot. Without a mobile foot, especially in the big toe, you will likely have less activation of the gluteal muscles which help stabilize the hip and therefore, has a huge effect on the knee.

For the hip, you need quality extension and internal rotation.  Most people have very poor hip extension, and when they get into what appears to be hip extension (think of your back leg on push off), they arch in the low back creating a focused area of extension in the small of their back which will lead to joint and muscle pain of the lower spine/SI joints.  Performing a good hip stretch followed by active hip range of motion will provide better joint motion over time.  For a few good stretches for the hip YouTube the following phrases: “Bretzel 2.0” and “tactical frog”.  For an example of active hip motion I’ve posted a video on ChiroStrength’s Instagram page.

Also, staying with the hip and core, you need to have good balance. Runners spend up to 95% of their race on one leg, however, most people don’t train any one legged exercises.  A little more advanced, but fantastic exercise, is the single leg dead lift (with or without weight).  This is a challenging exercise when a focus is put on maintaining a neutral spine and good hip extension on the up leg.  And because we are bipedal creatures (walk on 2 legs), we must train more transverse plane core exercises instead of frontal plane exercises.   That simply means, core exercises need to be focused on controlling or resisting rotational forces, (think Chops, Lifts, or Pallof Presses) instead of frontal plan exercises like planks, sit ups, or leg raises.  A core that can properly handle the rotational force associated with throwing the right leg and left arm out in front of the body, for example, will be better able to support the lumbar spine, pelvis, and hips thereby saving the stress on the knees.

When these areas are ignored in a runner’s routine, you’ll commonly see them land on a knee that cave’s in, which stresses the IT band.  Not because the knee is somehow functioning improperly, but the support system is failing.  Runner’s knee is almost always a mix between stability and mobility problems, so if you want to foam roll the painful leg, follow it up with some quality stability routines or be prepared to deal with this issue for a long time.

Dr. Scott Dunaway is owner and Chiropractor at ChiroStrength Located in Clarksville TN.  This facility combines corrective treatment with group classes in order to educate clients on how to maintain their bodies regardless of what their sport or hobbies are.  Visit www.ChiroStrength.com or call 931-321-1414 to learn more.

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Self Help Guide to Body Maintanence: Introduction

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Self Help Guide to Body Maintanence: Introduction

The E-book "Self Help Guide to Body Maintenance" will be available to members of the clinic as well as those interested in learning more about how ChiroStrength helps the community of Clarksville stay active.  It is a practical guide into learning how to maintain your body and improve your quality of life.

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Why ChiroStrength?

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Why ChiroStrength?

Why ChiroStrength?

Teaching the Right Way, Not the Easy Way

My journey through the Healthcare field has been one of many lessons.  Lessons in communication with patients, lessons in treatment of patients, but most importantly, lessons in understanding where I offer the most value.  After 3 years of shaping my professional career, I’ve come to the following conclusions:

  1. Our current healthcare model is failing.

  2. Not enough people are working to guide patients through the transition of being pain free into engaging exercise with low risk of re-injury.

  3. My calling is to teach.  Not just to make people feel better.

To make my first point, type this phrase into google search:

“World Health Organization – America’s Health statistics compared to other countries”. 

Spoiler alert, we spend the most on health care and have the overall worst rank (11/11) when compared to other developed countries.  Why is this?  In treating life threatening or traumatic injuries, westernized medicine and the advances in technology has made America the place to be for this type of care.  However, as smart and advanced as we’ve become, we have been unable to fully comprehend the complexity of the ecosystem that is our body.  Therefore, lifestyle diseases or disorders such as diabetes, high blood pressure, degenerative joint disease, and other spinal/joint pains, have been grossly mistreated due to our false sense of understanding.  Our current approach is symptom relief, which at best, simply muffles your body’s natural warning system that something needs to change.  By suppressing the symptoms we lure ourselves into thinking all is well and we go on about our business as usual until the next thing breaks down.  We take zero responsibility for the outcome of our lives and place the blame on “bad genes”.  Clearly genetics plays a role in our health, but you don’t have bad knees because they “run in the family.”  And the almost criminal component to all of this, is insurance pays for people to be sedated by the host of symptom suppressing drugs, but not for life changing habits like fitness or nutrition engagement.  This by far was my most frustrating lesson.

If you have received Chiropractic care, massage therapy, or physical therapy, only to have the exact same pain a year, months, or even weeks later, it was because there was no transition from being symptom free into a sustainable movement/exercise routine post treatment. Ever wonder why you always need massages in the same spot, or the same spot in your back keeps “slipping out”?  It is because of this lack of transition!  It is my opinion that the fitness industry, accompanied by chiropractic and physical therapy, makes much better sense at resolving musculoskeletal issues than any other combination.  Why?  Because the true answer to alleviating symptoms in the human body, is developing a solid foundation with which that body can move often (sometimes meaning exercise) without breaking down so easily.  Sadly this required time and lots of effort from both the professional and the patient and is not seen as practical enough to be covered by insurance.  It is a lack of healthy movement that is keeping us sick and in pain.  After all, the #1 reason for the development our brain’s outer cortex (you know, the part that distinguishes us from all other species), is for learning and application of movement.

And lastly, my passion for teaching.  I believe my patients thoroughly appreciate the amount of time I spend, not only with hands on treatment, but educating them about their issues and what THEY can do outside the clinic to accelerate their healing.  Though my experience, and also learning from my mentors in this profession, I believe the best thing I can be for my patients is be their teacher, not their “Doctor” (for the record “doctor” is derived from the Latin verb ‘docer’ which means “to teach”.)  The human body is an amazing vessel which can adapt and withstand huge amounts of insult, and also has an amazing resiliency to bounce back if put in the right conditions.  The most valuable thing I can do is teach a patient what these good conditions are, and how to avoid the bad conditions which result in pain and rapid degeneration.  With this knowledge, my treatment will be much more effective and longer lasting.

With this in mind, I have developed the Chiropractic and Fitness integrated facility; ChiroStrength.  I will use my background in Chiropractic, Active Release Technique, and biomechanics to address and eliminate as much dysfunction/pain in the joints and tissues as possible.  When we have accomplished this, the patient will be guided through programs designed to make them injury resistant by improving the quality of their movement.  My semi-private and group training programs are based on a brilliant quote from movement expert Ido Portal, “If you can not move your body and control it, then what business do you have moving other objects outside of your body.”  These programs are not designed for the purpose of losing weight, gaining muscle, or improving cardiovascular endurance, because all of these can only be accomplished with low risk after improving your movement literacy. To accomplish this, we use a combination of body weight and kettlebell training.  After going through my programs you can either return to your gym of choice with the confidence of being able to sustain your level of fitness with less risk of injury, or continue to be part of the ChiroStrength family and further your injury resistance and fitness goals.  The aesthetic results of fitness will come naturally if you have the ability to move well.  Because once you move well, you can move often, and when you move often you become stronger, regardless of where you’re starting from.   

 

For more information please find ChiroStrength on Facebook, Instagram, Youtube and Twitter.  I hope in the future I can help you in your journey to a pain free, active life!

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