Exercise

General Information:

Everyone has different goals with their exercise programs and this knowledge helps you determine how much time you will need to devote to it. Most people are concerned about trying to maximize their efforts into a limited amount of time in an effort to maintain their health. Time is the hardest commodity to juggle if you are working full time and have a family that needs your attention. However, the importance of a regular exercise program cannot be understated in the context of attaining good health and the prevention of illness.

There is little debate that our bodies need movement and that exercise benefits our blood circulation, lymphatic drainage, helping with blood sugar regulation, lowering stress hormones, raising endorphins, and toxin elimination. Exercise should address three main areas. There should be a strength component, an aerobic component, and a flexibility component. There are some forms of exercises that incorporate all of these at once. Swimming, Pilates, and Yoga come to mind. However if you don’t like any of those activities, playing in a regular pick up Basketball game a few times a week, or a Volleyball league is certainly worthwhile. Most gyms have various Aerobics classes that will combine weights with aerobics to achieve a vigorous workout. If you don’t like the atmosphere of gyms, there are a plethora of workout DVD’s on the market that you can put on in the privacy of your home. It shouldn’t take expensive equipment or too big an area in your home to accomplish your goals. Something else that should not be overlooked is walking. Regular walking especially walks that involve hills can be a great workout. Even better would be walking trails with a backpack. What is most important is to do something you enjoy, and to do it regularly. If you can exercise 3-5 times per week for 45 minutes to an hour each time, you are on your way to becoming more fit and more healthy.

Beginners

In this section I am going to discuss information for those of you who have had little or no experience with exercise.  This would also benefit someone who was athletic years ago, but has been inactive for too long a time.  This information has to do with heart rate elevation.  In an effort to prevent some of you from doing too much too soon, it may be a good idea to purchase a heart rate monitor.  There are several companies that make them.  This would be necessary if you are doing an activity that doesn’t have one built into the machine.  For instance many treadmills, exercise bikes, stairmasters, and cross trainers have pulse detection built into the machines. 

How to use the heart monitor information is fairly simple.  However, if you have been ill for some time or take a variety of medications the formula for determining a safe heart rate will vary.   The basic formula is to take 220 and subtract your age and multiply that number by .7 and .8 to get a range for where your heart rate should be while exercising.  It should be noted that this range should not be attained until a proper warm up occurs over the course of appoximately 10 minutes.  The cool down for 10 minutes should return your pulse to its resting numbers.  In between exercising for 10-20 minutes is a good starting point.  If you have had a number of health issues in the past year, or structural problems, then the formula would need to be adjusted downward to .6 - .7 on the original range.  It is a good idea to discuss this with your doctor before undertaking this program to make sure that you can do this safely and without any problems.

Lower Back Problems

If you are having lower back problems, this can derail your starting an exercise program.  Obviously as a Chiropractor I think a Chiropractic consultation would be a good starting point to understand the complexity for why pain exists.  In my opinion, combining Chiropractic with Applied Kinesiology offers a unique perspective and treatment options while hopefully avoiding the necessity of  resorting to drugs and surgery. 

Recently there has been a lot of talk about strengthening the core stability muscles to help with lower back problems.  Exercises on a stability ball are excellent for accomplishing this.  If you haven’t seen a stability ball they are balls that stand about 3-4 feet off the ground and made of a thick rubber to provide an unstable base on which to do various exercises.  They can be purchased at most Sporting Goods Stores.  They usually come with pictures or a DVD to follow and if done on a regular basis, help build those core muscles in the spine to help stabilize it. 

A recent article Core Power by Dr. Robert Silverman on core exercises appeared that explained this very well.  It talks about Local muscles vs. Global muscles and how they function to keep our backs stable.    The article can be viewed here.

Essentially what Dr. Silverman is saying is that local muscles are those deeper muscles which help keep your spine stabilized, are of the slow twitch fibers.  These muscles are activated at low resistance levels. Local muscles mainly include the Multifidus and the Transverse Abdominal muscles. 

Global muscles are the more superficial muscles which are responsible for controlling your body’s movement and they are of the fast twitch fibers.  They are activated at higher resistance levels.  Global muscles are made up of the Rectus Abdominus, External Oblique, Erectae Spinae, Psoas Major, and Iliocostalis muscles. 

In many cases, lower back pain results when the global muscles take over and dominate the local muscles in jobs that should be done by the local muscles.  When we lose that integrated way in which the local (stability) muscles and global (movement) muscles controls, distributes, absorbs, and transfers forces then the we lose the kinetic chain to function efficiently during dynamic activities.  If we just do sit-ups and back extension exercises we work the global muscles.  However doing this without activating the local muscles first, you run the risk of causing an injury.  If you have pain then there is a good chance these local muscles have been injured and instead of turning on before you initiate a movement they are even slower to turn on and turn on after movement.  This can be corrected by the following four exercises.

1. Abdominal Brace
2. Curl-up
3. Side Bridge
4. Bird Dog

Abdominal Brace:

Reach behind your back and press your thumbs into your lower back extensors while you slightly bend from your hips.

Feel the extensors contract

Then extend to an upright posture to the point where they feel flaccid again.

Without moving, contract abs and feel the extensors contract again. 

This is called a brace.


Curl-up:

Trains the Rectus Abdominus

Starting posture is lying supine (face up) with your hands supporting the lumbar spine. 

Bend one leg.

Do not flatten back to floor.

Head and neck unit locked onto the ribcage. 

Elbows remain on the floor while elevating the head, with shoulders slightly off the floor.

Rotation focused on the mid-thoracic region.

For those with neck discomfort, place tongue on the roof of the mouth.  This helps stabilize the neck muscle patterns.

Intermediate/Advanced Curl-up

Pre-brace abs (only advanced)
Lift elbows (intermediate and advanced)
Push tongue to roof of mouth

Raise head and shoulders slightly

Side Bridge:

Training quadratus lumborum, lateral obliques and transverse abdominus
(Above mentioned muscles are spine stabilizers)

Abdominal bracing at all levels.

Starting position is on one side.

Use down side shoulder and elbow to elevate upper body.

Top leg is in front of the bottom leg.  (heel of top foot to toe of bottom foot)

The free hand caps the opposite shoulder.

Side Bridge Intermediate/Advanced
Upper body same as beginner.
Hip hinges to bring lower body off the floor

Advanced-ability to roll into other positions i.e., front plank

Bird Dog:

Training back extensors (including longissimus, iliocostalis, and multifidi)

Ab brace while on all fours

Raise opposite arm and leg simultaneously.