Crying Kids and Painful Knees

I am sure that many of you know I have a few kids. If anyone has ever had kids you know there are going to be about 354 crying episodes per day that make you want to lock them in a closet until they turn 40. Wait...I'm the only one? Yeah right. While crying kids can make you want to do some crazy things they are also sort of fun to laugh at...

This is my oldest daughter and as you can tell she is pretty upset about her painful knee. I can't exactly remember what it was that she did but it sure seems like it hurt! Whenever I see my kids cry you know what the first thing I think of is? Nope, I don't think about helping them. I think about how awesome it would be to have a VMO like this dude...

I guess it might be a good idea to explain why on earth I think about having super awesome legs while my kids are crying. Well here it goes. See that muscle right above the knee? That muscle is called the vastus medialis, sometimes referred to as the VMO which stands for vastus medialis oblique referring to the oblique or diagonal direction of the fibers that are just to the inside of the knee. If you look really carefully you can see that it sort of looks like a gigantic tear drop, right?

This muscle plays an important role in a client that comes to me with sore and painful knees. The VMO, along with the other three muscles in quadriceps, is responsible for extending the knee while walking, running, squatting, lunging, etc. It has a unique function in that right before the knee locks into position it  keeps the patella inline with what is called the trochlear groove. It does this so that there is minimal amount of friction between the patella and the femur. When this muscle is dysfunctional there is an excessive amount of friction which causes pain and can eventually lead to arthritis. Here is what happens when there is a weak VMO and lack of knee stability...

Notice how this dude's right knee is just buckling inward like crazy? Part of this can be attributed to weakness in the muscles the surround the knee. You may even notice this happening to you. Here is an experiment. Stand in front of a mirror. Now place your hands on your hips and raise your left leg just off the ground. Next, begin to slowly squat down and watch what happens to your knee. Notice how it buckles inward? You may even lose your balance pretty quickly and have to hop around in order to stabilize yourself. Don't worry, this is actually pretty common. Here are a couple of things that you can do to strengthen the area around your knee.

1) Terminal Knee Extensions

This is a great exercise to focus specifically on that last little bit of extension, the part right before the knee locks into place. Get an elastic band and anchor it down then wrap the other end around the back your knee. From here you will slightly bend your knee, then straighten it out, and squeeze tightly. Try to keep most of  your bodyweight on the working leg. Perform this exercise for 3 sets of 20 controlled repetitions...

2) Tube Walking

This is a great exercise because it will help improve stability at the knee via the hip area. Along with a weak VMO there is usually some weakness in the glutes. The glutes, primarily the gluteus medius, help to keep the knee from buckling inward by rotating the femur outward. Be sure to keep your feet facing straight ahead and not rotate outward. If you allow that to happen you are working your hip flexors more than the glutes! Here is an example of tube walking. I have my clients do this for about 20 steps to the left then 20 steps to the right for up to 3 sets...

3) Single Leg Squat Touchdown

The single leg squat touchdown is similar to the movement I had you try out to see if your knee moved inward. Now we are going to use it as an exercise. Stand on one leg with the other slightly elevated off the ground. The goal is to squat down and touch the floor. This can be pretty challenging so if you are not able to go all the way to the ground then just go half way. Maybe try touching your knee or the middle of your shin then progress to the floor as you get stronger. While doing this be sure to keep your knee over your second toe. This will ensure that your knee is aligned properly with the rest of your body. I would start with a couple sets of 10-15 reps on each side...

Doing these three exercise on a daily basis will start to improve your knee strength and stability. While these are fantastic exercises they are merely suggestions to help with a limited joint condition. Knee pain can stem from all sorts of crazy things. The best thing to do is find someone you trust that has the knowledge and ability to assess the joint and develop a safe and effective program to help you specifically!

Thanks for reading and have a great day!

Danny

3 Things I Learned Over the Weekend...

Over the weekend I had the opportunity to attend a course that focused primarily on living a holistic lifestyle. I would like to take a few minutes and tell about some of the things I learned from this course. This course opened my eyes at how injured the fitness and health industry truly is. There is a lot of misunderstanding out there about health and this past weekend was an eye opener to say the least!

So here we go!

1) Anything Can Affect Anything

I have always been a pretty logical thinker especially when I became more and more interested in medical exercise. My thought process was just like many others. If I have a client that comes to me with back pain then the logical thing to do is to assess the back to determine what is going on. Unfortunately most back pain cases have no structural dysfunctions that cause the pain. Because there wasn't anything structural I usually focused their program simply on stabilizing the midsection, working on some flexibility and strength issues that are known to help with low back pain and so forth. For some people it seemed to help. Their back pain would go away and all was well. However, some of my clients would still complain that their low back hurts regardless of what we would do. I needed to change my approach but I didn't exactly know how.

After this weekend I learned about some alternative methods that can reduce low back pain. For instance, I learned that stressful relationships at home, personal safety, and security can all influence the low back and lower extremities causing pain and discomfort. Those same things can also affect the adrenal glands which can lead to fatigue causing an abnormally high level of stress hormones. I learned that an effective way of reducing discomfort can come simply from identifying certain stressors, learning how to manage them, and then becoming aware of situations that cause stress. By looking at the whole picture I learned that management of low back pain isn't remedied only through exercises.

2) Different Types of Exercises Have Different Effects on Hormones

Ok so that sounds pretty obvious but let me elaborate. Your central nervous system can be divided into two different parts. The sympathetic nervous system and the parasympathetic nervous system (I already knew this before the class by the way...) Depending on what types of exercises you do will influence one system or the other. The sympathetic branch is responsible for releasing stress hormones such as adrenaline and cortisol. This is the part of the nervous system that prepares the body for the "fight or flight response". The parasympathetic branch is responsible for digestion, immune function, growth and repair process and has a calming effect, the exact opposite effect of the sympathetic branch.

You might be thinking "well that's cool but so far you haven't told me how that affects exercise!' Well here it goes. If you are a person that is typically stressed out or high strung then your body is dominated by the sympathetic branch. This means that stress hormones are constantly elevated meaning that your body is in a constant state of breaking down. If you are trying to get stronger or lose weight then this is not a state that you want to continually be in! Working different muscle groups can actually stimulate the different branches of the nervous system. Try this out...lay down on the floor or couch or bed or what ever and simply focus on breathing. While you are doing this be sure to take deep diaphragmatic breaths meaning that you are allowing your belly to expand while breathing in and relax while breathing out. Breathing through the nose would be best. By doing this you are forcing the diaphragm to do all the work. Do this for about 3-5 minutes. The diaphragm is affected by the parasympathetic branch meaning that it has a relaxing effect. If you find yourself stressed out (in a sympathetic state) then this exercise will actually cause you to relax by suppressing the sympathetic branch.

On the opposite end of the spectrum. Larger muscle groups are influenced by the sympathetic branch. Consider this...If you are walking down the street and something scares the hell out of you what typically happens? First of all your body goes into an immediate "fight or flight response" which is the action of what? The sympathetic branch! The other thing you might notice is that your major muscle groups, such as quads, hamstrings, chest, and shoulders get really tense in preparation to fight or fly. All that being said, if you feel like you are tired and need to wake up then exercising major muscle groups will stimulate the sympathetic branch and you will notice things such as an increased heart rate, increased respiratory rate, increased muscle activation and even increased adrenaline. Sounds awful familiar to what happens during the flight or fight response right? Full body exercises such as squats, deadlifts, bench presses, and sprinting are good exercises to stimulate the sympathetic branch.

Now that we know what types of exercises stimulate the different branches of the nervous system we know what exercises will be beneficial. If you are are completely stressed out then we want to stimulate the parasympathetic branch to relax you and if you are too relaxed and want to get all crazy then stimulate the sympathetic branch! Awesome huh?

3) Calories Don't Actually Matter



The body is pretty good at letting us know what it needs. If it needs more calories then we get hungry, if it doesn't need more calories we get full. If we are craving carbs then we probably need what? That's right, more carbs. Same thing goes for protein. Everyones metabolism is slightly different and they will require different macronutrient ratios. Once you have figured that out and are eating the right foods then the body will notify you when it needs to be fed. If you restrict calories your body will release cortisol which is a stress hormone which stores fat which isn't good which will make you upset which will cause more stress and send you into a downward spiral of weight gaining bliss. Nothing good comes from counting calories. Just figure out what your body needs (I know how by the way, but you have to comment on my blog!)!

So there you have it, a few things that I learned over the weekend that showed me that the health and fitness industry is pretty messed up. I hope that you have learned something as well and if you have any questions then I will do my best to answer them!

Thanks for reading!

Danny

Who's the Best Trainer?

A common question that is asked in a fitness center by new and regular members is "who's the best trainer?" It is a legitimate question that should be addressed. Those who are trying to get into shape realize that a trainer generally costs a little money and they want the best. The only problem with that is the best trainer is a completely relative term. There is a best for me, best for you, and a best for whoever. I want to take a few minutes and offer some guidance in picking a fitness professional that is best for YOU!

1) CERTIFICATIONS

There are literally hundreds of certifications for personal trainers. Some are good, some are bad, and most are ridiculous. For instance, I know of a certification that has the course material and the test available to read and take at the same time. You can actually have the test and the material open in different windows and the test even follows the material question by question. Once you have copied all the answers over you can choose to be "regular" personal trainer or even a "master" personal trainer. It just depends on how much money you want to pay. That one fits in the "ridiculous" category. These trainers usually train their clients the way they themselves have worked out in the past.

There are some certifications out there that have some pretty decent course material and require the prospective fitness "professional" to take an exam once they have studied for however long. The problem is that the test is taken in the comfort of their own home and there is no one monitoring the exam to be sure that you are not just skimming through the book and looking up the answers. While they may have read the book here and there they have no idea how to apply the information and worse they don't even understand what is actually being asked. This type of trainer, like the one above, will typically train their clients the same way they train themselves. Doesn't seem so personal does it? These could be categorized as the "bad" ones.

Now we get into the "good" category of fitness training certifications. A good certification generally has a third party national accreditation that basically says this exam truly tests the competence of the candidate. The course has outstanding material that not only teaches principles of training but also teaches the application of training. For instance, a lot of the training certification materials that I have read talk to some extent about static stretching. A "ridiculous" course tells the trainer that static stretching is good. A "bad" one will say that static stretching is good and it should be held for thirty seconds or more. A good course will say that static stretching is good under certain circumstances and it needs be held for 30 seconds or more because it stimulates a certain mechanoreceptor that allows that muscle to relax. Then it will go on and say what to do after that and give you some progressions, and regressions and all that jazz. The testing for the "good" certifications in usually done in a proctored setting where there is zero chance of using the materials to help you pass the exam. If the candidate has studied and knows that material they will have pass the test.

Here are some examples of "good" fitness training certifications. They are NCCA accredited and are widely known throughout the world.

-National Academy of Sports Medicine
-American College of Sports Medicine
-National Strength and Conditioning Association

Here are a couple that aren't NCCA accredited but sill some of the best programs:

-CHEK Institute
-Poliquin International Certification Program
-American Academy of Health Fitness and Rehabilitation Specialists

Note - There are several other "good" programs out there; these are just some of the ones that came to me at the moment. It is always good to research the credentials of the professional you potentially will be working with.

2) EXPERIENCE

Experience is a huge part of picking a fitness professional that is best for you. Picking someone with a lot of experience is important because that means that they have worked with people from all walks of life.

An inexperienced trainer is one that will train their clients the way that they train themselves. This is not so much a bad thing but it just means that they are very limited in what they can do. If they are training for a contest or show they will probably train you the same way regardless of your goals.

A trainer with some experience knows that there are more ways than one to train a client but maybe they haven't been around long enough to see what types of programs work and what doesn't work. I find that they have an open mind and are willing to try new things. They are aware that most of the people they come into contact with are not going to have the same goals and will therefor train their client based around his/her personal goals. This is the direction that we want to be going toward.

Now we get to trainers that have lots of experience. I would say that these trainers have been constantly training for 5+ years and have worked with all types of people. Their client list includes people that are in outstanding shape and those that have just been released from physical therapy because of a total hip replacement surgery or other major condition. This trainer is capable of assessing clients and knowing what is the best approach to reach their goals.

3) PERSONALITY

Ok here is a very important part of picking the best trainer for you. Let's be honest, you can pick the trainer with most experience, the best credentials, the biggest biceps, but if you don't click with them it's not going to be a good fit. On the other hand you might pick the newest trainer, with OK credentials, and  have toothpick arms but has a personality meshes with you completely. They motivate you, keep you accountable, and inspire you. This would clearly be the best fit. I have been with clients that I thought absolutely I was the best trainer for them, but our personalities were just too different. They picked a trainer that fit all the "bad" descriptions but somehow they just connected. That client got great results. Personality is HUGE! Make sure that you and your trainer work well together. It can make all the difference.

Hopefully this gives you some ideas on what to look for if you decide to work with a fitness professional. This is not an all-inclusive list but offers at least some guidelines. All in all I think it ultimately comes down to how well you and your potential trainer get a long with each other. The experience and credentials are maybe like screening tools, if you will. At any rate...have a good week

Daniel Stephens

Injured Fitness?

Hi, thanks for checking out my newly developed blog Injured Fitness.  As a private fitness trainer I talk to several people that have expressed to me that they feel they are unable to exercise because of an injury, or health problem, or some other real or made up reason. I want to show and provide people with information, or at least some insight that it is possible, regardless of most injuries, to exercise safely and get fantastic results. Unfortunately there are a lot of people that, in the past, have had some type of injury such as a knee or shoulder injury that went to physical therapy for a while and did OK but then a few years down the road it re-manifests itself for whatever reason. I want to help people learn how to exercise effectively to overcome that issue and in a lot of cases improve their condition.

Not only do I want to help people that have injuries, or joint replacements, or degenerative conditions, I want to provide fitness information that is effective and nonsense free. Injured Fitness, to me, also means that the fitness industry itself is completely messed up and flooded with useless devices such as the Shake Weight, Body Blade, Ab Rocket and other stuff that is similar. These things are 99% useless and deter people from trying out a fitness program that is actually effective. There are a million different programs people can try and it can get awfully confusing. I just want to help people make wise decisions by guiding them in the right direction.

I hope that you find this information helpful and provide feedback. If there is a topic or something that you would like to know about I would be happy to write about it and hopefully answer some questions you might have. I do have to add that I am in no way a professional writer and will probably have run-on sentences, grammatical errors, and onomonopias (whatever those are) in all the wrong places! Don't hold it against or else I will be forced to offer you a complimentary training session which is code for "I'm gonna make you puke your guts out all over the place and laugh at you hysterically and then blog about it."

So watch it.

In Health,

Danny Stephens, MES

PS. I purposely used a lot of commas this time so that in the future when I don't use them it makes me look better...