Free Golf Fitness Class at the Eagle Ranch Fitness Center this Thursday!

Foam Rolling to Improve Tissue Quality

Foam Rolling to Improve Tissue Quality

View more presentations from Mark Pitcher DC, MSc

Train Your Abs and Back the Right Way

Are you sure you are training your abdominals and low back in the correct way? For years fitness professionals have been prescribing  sit-ups  and crunches as the means for building a strong core, but recent research shows that these exercises put unneeded stress on the lumbar spine (low back).  Here are three exercises that spare the low back from unneeded stress and actually activate your abdominals more than a simple sit-up or crunch.

Before beginning these three exercises, one abdominal technique must be explained.  This is called an abdominal brace and it involves activating the abdominal musculature before beginning the exercises listed below.  Without drawing in or pushing out the abdomen, contract or stiffen all of the muscles around the abdomen.  Many describe this motion as what you would do if someone were to punch you in the stomach.  While maintaining the abdominal brace be sure to keep breathing throughout the exercises.

1)      

      1) Curl up- The starting position is laying on your back with your hands placed on the small of your back.  Next, flex one knee to 90 degrees while the other leg stays relaxed on the floor.  While keeping your head, neck and upper back in a neutral position perform an abdominal brace and raise your shoulders off the floor approximately 1-2 inches.  The head and neck should remain elongated in a straight line without poking or tucking the chin.  Hold the position for 5 seconds.

      2) Side Bridge- Start on your side with your legs extended and elbow directly under your shoulder. Place your opposite hand on the opposite shoulder, pulling down on the shoulder for added support.  With legs straight on the floor, place the top leg in front of the bottom leg.  Activate the abdominal brace while keeping the spine in a neutral position and raise the hip off the ground until the entire body is in a straight line.  Hold the position for 5 seconds. 

3)      Bird Dog- Begin in a four point stance on your hands and knees with your hands placed directly under your shoulders and knees directly under the hips. Maintain a neutral spine, perform an abdominal brace and raise the right arm and left leg in a sweeping motion.  Do not raise the arm or leg past horizontal.  Hold the position for 5 seconds and repeat on the other side.

Depending on the level of fitness for the individual performing these exercises they can be performed in a wide variety of sets and repetitions.  A beginner could start performing the exercises once a day for 5-10 repetitions and an advanced person could perform the exercises two to four times a week with multiple sets and reps.  By performing these exercises with proper form and technique you should notice increased abdominal and spinal stability, while also decreasing the strain on your low back commonly associated with the sit-up and crunch exercises. 

Jonathan Weimer DC, MS

TRIGGER POINT DRY NEEDLING

What is trigger point dry needling? Trigger point dry needling or (TDN) is a treatment technique which uses small filament or acupuncture type needles to release tight muscles. The goal is to permanently reduce muscle pain and dysfunction. Physical therapists are now using this technique around the world to effectively treat acute and chronic orthopedic and musculoskeletal conditions. Dry needling uses a small needle for deactivation and desensitization of a myofascial trigger point. This technique should stimulate a healing response at the tissue and reduce the biomechanical stress of the muscle treated. TDN can help patients reduce muscle spasms and combined with other therapies, can eliminate mysofascial pain.

What is myofascial pain syndrome? Myofascial pain syndrome is a disease of the muscle that produces local and referred pain. It is characterized by a motor abnormality (a taut or hard band within the muscle) and a sensory abnormality (tenderness and referred pain). Myofascial pain syndrome is classified as a musculoskeletal pain syndrome that can be acute or chronic, regional or generalized. It can be a primary disorder causing local or regional pain syndromes or a secondary disorder that occurs as a consequence of some other condition. This is a treatable condition which can respond well to manual and injection techniques but requires attention to postural, ergonomic, and structural factors.

What is a trigger point?  The term “trigger point” was coined in 1942 by Dr. Janet Travell to describe a clinical finding with the following characteristics:

• Pain related to a discrete, irritable point in skeletal muscle or fascia not caused by acute local trauma, inflammation, degeneration, neoplasm or infection.
• The painful point can be felt as a tumor or band in the muscle and a twitch response can be elicited on stimulation of the trigger point.
• Palpation of the trigger point reproduces the patient’s complaint of pain and the pain radiates in a distribution typical of the specific muscle having the trigger point.
• The pain cannot be explained by findings on neurological exam.

 Overall, TDN is a treatment that addresses dysfunction of the neuromuscular system. Trigger points develop in the muscle secondary to various stresses (i.e. postural, repetitive motion, psychological, emotional etc.) and are more likely to develop in tissue that has neurological dysfunction. Most dysfunctions are caused by compression, disc dysfunction, facet joint dysfunction, vascular compression, metabolic stress, biomechanical stress, and postural abnormalities. When muscles develop trigger points, they neurologically remain tight causing local compression of vascular, neurological and joint/biomechanical structures hampering the normal function of that tissue. All tissues away from the involved nerve will likely be involved. If you adequately release the muscle, the tissues are then allowed to resume normal function with improved neurological conduction and vascularity.

Lastly, TDN is a treatment that uses acupuncture needles but that is where the similarity to acupuncture ends. Acupuncture tends to be a more superficial treatment that focuses on restoring energy or “Qi” to the body. It is thought there are blockages that can be restored by properly placing needles along energy channels called meridians. TDN directly treats the neuromuscular system affecting muscle tightness, joint mobility and symptoms of pain and irritation. Testing active trigger points with an EMG needle has shown there is increased spontaneous electrical activity causing the nerve muscle connection to trigger the muscle to be tight. This tightness can cause a decrease in joint movement and many times will restrict the joint enough to limit normal functional activities of the whole body. Relatively new research has reported that there are numerous inflammatory and pain producing chemicals at an active trigger point causing pain and dysfunction of the muscle, consequently affecting the local nerves and joints.

TDN has been shown, when causing a twitch response in the acute trigger point and muscle fiber, to decrease or completely reduce that spontaneous electrical activity and eliminate the irritating chemicals in that active trigger point. This release can immediately improve range of motion, decrease pain and improve function. Patients often feel a significant cramping sensation from the twitch response but then feel an immediate improvement of their symptoms.

Finally, utilizing TDN in physical therapy allows the patient a hastened return to strengthening and exercise, which in turn, results in an accelerated return to function and improved maintenance of that dysfunction.

Dave Blanchard MPT
www.vailhealth.com

Avoid Overuse Tendon Injuries:

As the weather heats up, we head outside to test our athletic prowess. We hit the road and trails on bike or foot without questioning that we may have lost some of our endurance since last fall. Tendon issues may arise during repetitive activity without proper training. Tendons attach muscle to bone and “tendonitis” or “tendonosis” is a degenerative, inflamed tendon. With tendon injury, the tendon tissues become disorganized bundles of collagen, rather than in parallel orientation and no longer function properly.  The most commonly injured tendons in the lower extremity are the patellar tendon, Achilles tendon, and the posterior tibial tendon.

The patellar tendon attaches the knee cap to the shin bone and can produce anterior knee pain with overuse. The Achilles tendon attaches the calf muscle to the heel and will cause pain along the tendon or at the heel. The posterior tibial tendon supports the foot arch and attaches the posterior tibial muscle to the bottom of the foot. Injury can weaken the foot arch causing collapse.

The best way to strengthen these areas, to prevent or recover from tendon pathology, is with ECCENTRIC strengthening. Eccentric means lengthening. By strengthening the tendon in a lengthened position the tendon properties are able to re-align in the parallel orientation making the tendon inherently stronger. The eccentric motion of these tendons is the functional position of where the tendons are at highest stress during repetitive motions. Strengthening in this position is most efficient.

Eccentric strengthening for tendon pathology has been proven is various studies to be effective. The protocol that has been used in research is performing 3 sets of 15 repetitions twice a day. The exercise varies based on which tendon you are attempting to load/strengthen in an eccentric position.

Patellar tendon = Perform single leg mini squats on an incline board. The heel should be raised, toe pointing towards the ground; keep the knee aligned over the first two toes. Only squat to 45 degrees of knee bend.

 Achilles tendon = Perform single leg heel raises off a step, focusing on slow controlled lowering motion, getting the heel lower than the step.

 Posterior tibial tendon = Perform seated with a resistance band over the ball of you foot and attached to a stable surface (band perpendicular to the outside of your leg).Resistance should be pulling your foot into an outward position. Pull the band so your foot/ankle turns inward. Again, focus on the slow controlled outward motion or back motion. Also, performing the Achilles exercise will help strengthen the tendon, since it functions in both actions.

 Before you get on your bike or lace up your running shoes to enjoy the spring sunshine, make sure your tendons are ready to handle the load. ECCENTRICALLY strengthen! Happy trails.

Lindsey Fitch is a doctor of physical therapy and running specialist at Vail Integrative Medical Group. She is an Avid competitive runner, most recently winning the Salt Lake City Marathon

Vax-D Decompression Therapy for Low Back Pain

Do you suffer from low back pain? Vail Integrative Medical Group may be able to help. Approximately 5.4 million Americans are disabled annually due to back pain and up to 85% of the U.S. population will have back pain at some time in their life. And did you know that spine surgery is the second leading surgical procedure in America, with the total number in the U.S. approaching 500,000 per year. Lastly, an estimated 93 million workdays are lost each year due to back pain. What, if anything, can be done about this growing epidemic? 

               

Common conservative treatment for low back pain includes chiropractic, physical therapy, massage therapy and acupuncture. Another form of treatment is Vax-D or vertebral axial decompression. What is Vax-D you ask? It is a patented non-surgical therapy proven to be as much as 88% successful at treating chronic low back pain. This pain may be caused by bulging, herniated or degenerative discs leading to sciatica. Even post-surgical patients and those suffering from stenosis (a narrowing of the spinal canal) have reported significant pain relief from Vax-D treatments.

How does Vax-D work? Vax-D lengthens and decompresses the spine, reversing high intradiscal pressures through the application of negative pressure via a patented “slow ramp-up” process. This reversal of pressure creates a vacuum inside the discs, which takes pressure off of pinched nerves and helps to reposition bulging discs and pull extruded disc material back into place. Nutrients, oxygen and fluids are simultaneously drawn into the disc to create a revitalized environment conducive to healing.

Vax-D stimulates the body’s repair mechanism, providing the building blocks needed to actually mend injured and degenerated discs. Vax-D’s process is the only patented treatment clinically proven to decrease disc pressures to the negative levels needed to facilitate healing.

A recently completed 2 ½ year study has demonstrated that Vax-D achieved a remarkable 88% success rate in the 283 chronic back pain patients studied. The patients selected for the study had failed at least two previous non-surgical treatments. The study also used pre and post MRI’s to determine the extent of the damage to the discs and showed actual reduction in disc herniation, rehydration of disc heights and improved lordotic curve after 6 weeks of 30 minute Vax-D treatments as well as their own tailor-made exercise program.

A typical Vax-D treatment regimen consists of approximately 20 sessions (5 days a week for 4 weeks). Some conditions require fewer visits, some require more.  Many patients report relief from their pain and other symptoms during the first few treatments sessions. Most experience dramatic pain relief after completion of their full treatment.

At VIMG, we specialize in treatment of chronic lower back pain and offer a comprehensive approach to treatment. Along with Vax-D, we offer chiropractic, physical therapy, massage therapy and medical neurology. During the month of May, we will be doing a 12 session trial of Vax-D for $900. This is a 50% discount! Give us a call today at (970) 926-4600 and reserve your appointment for Vax-D. Another day with back pain is another day you are not living life to the fullest.

  

Dave Blanchard MPT

Functional training focuses on the fundamentals

From the Vail Daily March 29, 2011

The term functional training, once an obscure idea, has become a buzzword in the fitness industry. However, much like the term “core exercise,” its definition often depends on who you ask. Some people equate doing exercises, like bicep curls or squats, while standing on gym balls with functional fitness. Unless you are a circus bear, these types of exercises are not overly functional or well suited to develop purposeful strength.

Functional training is not about fancy gadgets or gimmicks but about a philosophy of training. It is based on strengthening fundamental movement patterns, which have carryover into everyday activity or athletic endeavors.

It is a common myth that machine exercises are safer than free weights. In reality, exercises performed with more freedom of movement better engage the core musculature. This means the intensity of the exercise is determined by the weakest link. When you strengthen the body, beginning with the weakest link, you reduce the risk of injury. To borrow a quote from physical therapist Gray Cook, “Having strong arms or legs without a stable foundation or core is like shooting a cannon from a canoe.” When the foundational movement improves, all other movements that follow are stronger.

Any workout program can be modified to become more functional. Simply replace seated or supported single plane exercise with more full body multi-planar exercises. Here are three simple effective substitutions to make your workout more functional.

• Trade your seated biceps curl for a chin up, pull up or TRX curl.

• Knee extension, hamstring curls and hip abductor/adductor machines are all isolation exercises. Replace with exercises such as squats, dead lifts, lunges and side lunges. These require more neuromuscular activation, are better for your joints, burn more calories and have excellent carryover to your activities of daily living.

• Again, gadgets are not necessary for functional training but some do offer significant benefit. For example, the TRX suspension trainer exemplifies functional training. Almost every exercise performed on it can be multi-planar, multi-joint with high neuromuscular demand.

Some of the best exercises for your body require proper technique to be performed safely. Movements like squats and dead lifts are exceptional foundational movements but often require some instruction to be performed properly and safely. If you wish to learn more about how to make your workout more functional or to reduce injury and improve performance, we would be happy to help.

Mark Pitcher DC, MSc
markjpitcher.com 

Vail health: Add running to your routine

From the Vail Daily March 14, 2011

March is here; the sun is shinning, the temperature is rising, and it's time to get outside and jump-start your heart rate with a run or jog.
Running is extremely beneficial to both physical and mental wellbeing. It can impact all bodily systems — from reducing your chances of catching the common cold, to lowering your risk of cancer, to strengthening your muscles and bones and reducing your chance of developing osteoporosis. Running is one of the most effective ways to improve the aerobic conditioning of your lungs and heart. As your cardiovascular health is enhanced, your blood pressure is reduced, the elasticity in your arteries increases, and your resting heart rate is lowered. All of which diminish your chance of heart attack and stroke, and improve circulation throughout your body.

Emotional benefits, though harder to prove with statistics, have been reported by runners time and again. The “runner's high” is a physiologic change in your endorphin levels, which lower the effects of depression and reduce stress. Running can literally be a mood changer as well as a life changer. Those who engage in daily exercise are more likely to make healthier food choices throughout the day. And consistent aerobic exercise, combined with a healthy diet, will result in weight loss and improved self-image, as well as reduced symptoms of depression.

But where do you start? Running is one of the easiest and least expensive hobbies/activities. All you need is a pair of shoes. And then it is just you and the road, wherever you are.

On the other hand, if you are a social person, joining a running group or signing up for local races are great ways to stay motivated and ensure you accomplish your goals. The Vail Recreation District offers a trail running series throughout the summer varying in distances from 3 to 14 miles.

A word of caution: Start slow and listen to your body. Build a running base gradually, one mile to one-half mile at a time. Never increase your total mileage by more than 10 to 15 percent per week. Your pace should be comfortable and you should be able to hold a conversation. As your endurance improves try increasing your speed so that the conversation is interrupted with heavy breathing, pushing your cardiovascular system. Lastly, get proper footwear based on your body-type, arch of foot, and type of running you plan on doing (road versus trail).

Typical running shoes are classified into four main categories: motion control shoes for heavier weight runners with flat arches who have a tendency to over-pronate ; stability shoes for medium to light-weight runners who have the tendency to over-pronate and need stiffness built into the arch of the shoe to help support their natural arch; cushion shoes for the medium to light-weight runner with high arches who stays in a neutral to supinated position as they run; and performance shoes for race day for runners who do not require additional arch support -—these shoes are lightweight and are not made for excessive mileage.

Looking for more information? The Vitality Center at Vail Mountain Lodge & Spa is hosting a running clinic in June (more information to come), including a video running analysis to provide participants with feedback on how to improve running efficiency and prevent overuse injuries.

Spring is a great time to add running to your exercise routine. So get outside and celebrate the sunshine and a healthier you.

Lindsey Fitch is a physical therapist and a doctor of physical therapy at Vail Integrative Medicine, located at The Vitality Center at Vail Mountain Lodge & Spa. She specializes in running injury prevention and running analysis.

Kinesiotape Seminar in October

VIMG is hosting a K1, K2 & K3 approved accelerated format seminar on Oct8-10 that will allow attendees to get kinesiotape certified in ONE weekend as opposed to TWO!

Our instructor is Dr. Darren Hancock, one of Kinesiotapes top instructors that has taught kinesiotaping to USA's Olympic Training Centers

You can click on the photos to the right or download the full pdf brochure here.

Hope to see you there.

TRX Suspension Training

I’ve been working out with fitness anywhere’s TRX system lately. I had read about it and heard rave reviews from some of my fellow fitness and sports med professionals. The TRX is a portable suspension exercise system that delivers as easy or intense as exercise session as you want. Because the design uses your own body weight, you can modify the exercises from easy to ridiculously hard…all while dialing in your core musculature. I already do metabolic and strength circuits, but was impressed at metabolic demands and intensity of workout that was available with this system. From my first use of this system I could see some good rehab application. Sure enough, they are launching their sports medicine & rehabilitation stream to their system. Click below to see a quick clip about how the TRX works.

http://markjpitcher.com/wordpress/?p=198

I’ll post some of my own workouts in the next few weeks. If you want to try it out, see how you can use it to enhance workout routine, or want to talk about working this into your rehab program, give me a call. All the best. Dr. Mark

The Running Clinic

Injury Management, Rehabilitation

& Performance Enhancement

with

Lindsey Fitch, DPT
physical therapist, running specialist

Tuesday August 31, 2010 6:00pm
Eagle Ranch Fitness Center

Learn how to:

Improve running form
Increase running efficiency
Decrease Running Injuries
Increase strength and flexibility

Good luck Brian this weekend at the Leadville 100!

5-time Leadville 100 runner, Brian Costilow getting K-taped by Lindsey Fitch, DPT prior to going for number 6!

Good luck Brian!

Long may you run

The Leadville 100, America's highest 100 mile race is this weekend. Dr. Joel, Dave Blanchard, MPT and Andrew Reiff are all smiles before Andy’s Leadville 100 running race. Good luck Andy and long may you run!!

Adam Plummer in Trail Runner

Own own Adam Plummer gets top spot and a great inside spread in Trail Runner magazine this Summer!

On that note, keep an eye out on our blog, facebook and twitter for our Running Clinic in late August. Our new physical therapist and resident running specialist, Lindsey Fitch will be holding a free seminar at our Eagle office and the Eagle Ranch Fitness Center center and show how we do video analysis of your running gate to identify deficits and faulty biomechanics.

Functional Movement Systems

I was in Brighton, CO this past weekend for theFunctional Momvement Systems seminar withBehnad Honarbakhsh.

The background and rational for the Functional Movement Screen and associated corrective exercises are excellent. Despite being the only chiropractor there, the functional movement analysis created by physical therapist Gray Cook fits seamlessly into my problem solving approach to injury and dysfunction. In the few days back at the office since the seminar, I have already started looking at patients differently and changing how I address their problems.

The Functional Movement Screen (FMS) and Selective Functional Movement Analysis (SFMA) uses challenging movements that are meant to exaggerate deficits and asymmetry in the body. If the fundamental movement patterns in the body are altered, then any strength, power or sport specific training may be built upon a shaky foundation which at best will prevent optimal performance, and at worst reinforce imbalances leading to greater chance of injury.

Check out the video here:markjpitcher.com/wordpress/?p=125

Mark

VIMG Welcomes Lindsey Fitch, DPT

A Big Welcome to Lindsey Fitch

We are very pleased to welcome Lindsey Fitch to our team! Lindsey completed her Master and Doctorate Degrees in Physical Therapy from San Francisco State University/University of California, San Francisco. She has worked in the outpatient orthopeadic setting focusing largely on sports injuries. Lindsey has completed specialized training in running analysis and routinely assesses and treats running related imbalances and injuries. Lindsey will be practicing in our Vail and Edwards locations.

Please call 970-926-4600 to schedule an appointment.
Learn more about Lindsey here

Dr. Joel at Larry Fitzgerald's pre-season training camp.

Dr. Joel was invited to provide care for Arizona Cardinals and NFL great, Larry Fitzgerald's star-studded pre training camp in Minneapolis.

In conjunction with long time colleague, Dr. Josh Sandell, Dr. Joel assisted pre and post sports medicine treatment for the NFL veterans and rookies for the week. 8-time consecutive pro bowler and training camp coach, Chris Carter had not put on cleats in 5 years until several treatments with Dr.
Joel and the group which gave him the 'fountain of youth' to show the NFL rookies a thing or two about creating success in the NFL. Michael Irvin also stated he would have played longer in the NFL with the treatments he received over the week.

Dr. Joel worked with several dozen players from various teams as they prepare for their official training camps in a few weeks. Some of them include Dewayne Bowe (Kansas City Chiefs), Eric Decker (Denver Broncos), Matt Spaeth (Pittsburge Steelers), James Laurinaitis (St. Louis Rams), Golden Tate (Seattle Seahawks), John Carlson (Seattle Seahawks), Domineque Byrd (Arizona Cardinals) to name a few.

http://www.bostonherald.com/sports/football/other_nfl/view.bg?articleid=1266
295&srvc=rss

http://espn.go.com/blog/afcwest/post/_/id/14590/legends-try-to-help-bowe-get-his-groove-back

http://sports.espn.go.com/nfl/news/story?id=5359007

One Love, One Blog

To make life easier for patients, contributors and me, I have merged our articles, patient resource and news blogs into one. I hope you find the compiled information more convenient. All the best - Mark

Turkish Get Up

If you have been at the Eagle Ranch Fitness Center, you may have seen me doing these odd looking exercises and wondered what the heck is he doing? I certainly do seem to be breathing hard to just get off the floor a few times.

The Turkish get up (TGU) is an old school, whole body strong man exercise. You know what I am talking about - Big guys with handlebar mustaches wearing leopard print unitards and bending steel with their teeth. You may not have such fashion or fitness goals. That's ok. The Turkish get up also builds core strength and when used in a circuit with short rest periods between exercises, can be part of a great fat and weight loss program.

One of my friends once remarked " I have no idea what muscles its working, but it definitely kicks my butt". The truth is, it works all of your muscles to some extent. Have a look at the exercise below:

• shoulders, lats and chest to hold and stabilize the weight above you.
• abdominals to bring yourself to a seated position.
• triceps and arms to hold your body as you swing your leg through.
• legs as you go from lunge to standing.
• core activation throughout the exercise.

There are a few variations of this exercise typically having to do with balance and how you move your leg behind you. It is most safely done with kettle-bells and dumb-bells. Start with lower weights get the form, rhythm and balance down. As always, it is good to talk to the resident trainer or therapist to help guide you your first time around.

Mark Pitcher DC, MSc

chiropractor, exercise physiologist

Dr. Pitcher works in the Vail, Edwards and Eagle offices. To make an appointment call, 926-4600. If you have questions for Dr. Pitcher, you can email him at drpitcher@vailhealth.com

Eating Healthy Food is a Human Right.

This might seem like an odd rallying call in this day and age. After all, it seems like there is healthy and nutritious food available in every grocery store. However, if you've ever read a book by Michael Pollan, watched "Fresh", "Food, Inc.", or seen Jaime Oliver's Food Revolution on tv, you may be wondering if your food is really healthy beneath the surface. Over the years there have been product recalls ranging from spinach to frozen meat and peanut butter that have shaken our trust in the large agribusiness and food processing companies. Why are we so scared of our food? And what can we do to ensure that we don't have to be?

My grandmother used to tell me that food didn’t have flavor any more. I was 10, and I thought that my grandmother was just old and experiencing what happens when you get old. As I grew up I saw an explosion of processed foods, convenience foods and fast foods that seemed to be huge steps forward until I was out in an organic garden. I plucked a ripe tomato and bit into it; all of the sudden I understood what my grandmother had meant all those years ago. My grandmother was raised on a farm in Mississippi over 90 years ago where they grew a few cash crops to support the family’s finances along with their own vegetables and raised their own livestock. This was a prototypical small family farm that helped provide for the family and the wider community. As the world changed and industrialization started to become the norm these very small farms faded quickly. After World War Two industrialization spread like wildfire, making many farms impossible to sustain.

We live in a world that surrounds us with cheap food. My grandmother spent a full 25% of her income on food. The average modern family only spends 10%. Subsidies of commodity crops and the extensive use of chemical fertilizers, pesticides and herbicides allow us to grow a lot of cheap calories. Add convenience foods full of empty calories and fat to this equation, and you can see how our food culture has changed.

Thankfully we are experiencing a renaissance of food that has more flavor, nutrition and vitality than anything we have seen in decades. As people found organic foods and demanded more, the industry listened and organic products flourished. Even more importantly, we now understand that even organic food has high costs and risks associated with long distance shipping. As a result, we are seeing a resurgence in gardening, community gardens, farmers markets, farm stands and community supported agriculture.

The relocalization of our food system is a vibrant movement that can change the food landscape all over our state and the country. The challenge in the high country is that we have such a short growing season, ranging from 39 days in Summit County to 59 days in western Eagle county and Routt county. Colorado Mountain Communities are blessed to have growing regions on the Front Range and Western Slope that can feed us through their much longer growing season.

Community Supported Agriculture (CSA) is a way to connect you and your family to a local farm. In a CSA program people become members of the farm and purchase a full season of vegetables that are grown for you on the farm. This direct relationship allows you to know who is growing your food and dramatically reduces the miles your food travels to get to you. Unlike grocery store produce, your farmer grows food for you that is allowed to fully ripen in the field so that you can eat food that is full of flavor, nutrition and healthy for you. CSA’s will normally deliver your produce to your town once a week throughout the growing season. Even in the high country it’s easy to eat farm fresh produce.

To learn more about Community Supported Agriculture and how you can eat better this year call 970-328-1200 or 970-846-6233

http://www.grantfarms.com/home.php

VIMG at the Red Kettle Golf Tournament

We were at the Red Kettle Golf Tournament, June 15, supporting the Salvation Army. We were offering complementary consultations to Red Kettle participants, as well as pre-game sports massage and facilitated stretching. Learn more about the Red Kettle here:http://www.salvationarmyvail.org/volopps.asp

PGA Medical Staff Treatments

ESPN article explains PGA Tour medical staff treatments. Dr Joel has been part of the PGA Tour medical staff since 2009. Enjoy!!

http://sports.espn.go.com/golf/news/story?id=5256227

Interview with Stuart McGill

This is a great interview with Dr. Stuart McGill about how his laboratory research propelled him (Albeit reluctantly at first) into clinical evaluation of patients. He talks about his approach and addresses many rehab myths surrounding lower back pain. Its a long, but extremely interesting interview. Click here and have a listen and you'll see why I am a big fan of Dr. McGill's no nonsense scientific approach to evaluating and treating low back pain.

Enjoy,

Mark

Learn more at backfitpro.com

A Balanced Approach to Core Stability

If you have picked up a health, fitness or training magazine recently, you can not avoid reading about the importance of “core stability”. Core stability is touted as paramount to maintaining a healthy back, however the idea of what “core” actually means, what muscles are involved and what exercises are best vary greatly depending on who you talk to. When you think of the core, the abdominal muscles inevitably come to mind. But that is only part of the picture.

Many of today’s popular ideas of spinal stability originate from research out of the Australian physical therapy group back in the 1990s. The research showed that the transverse abdominis (TA), a deep abdominal wall muscle and the multifidus, a series of spinal muscles, thickest across the lowest part of the lumbar spine, had unique behavior when injured. The transverse abdominis was shown to have a feed forward ability, meaning it turned on before other muscles did during a task that required stability. ^1,2. Further it was shown to have altered activity when there was a lower back injury, sometimes turning on late or not at all. The multifidus was shown to decrease in size and have increased fat content after injury local to the site of injury. ³ This deficit did not recover spontaneously, even if the pain went away and it was found specific exercise was needed to rehabilitate the area. ⁴ Therapists began to use very focused rehabilitative exercises to activate the multifidus and deep abdominal musculature.

The research became popularized, spilling over beyond physical therapy and other health disciplines to personal training and popular fitness culture. The rehabilitative concepts, while useful for addressing specific muscular deficits, grew beyond its scope shaping personal training and core conditioning programs. This may have led to an overemphasis of the deep musculature.

Researchers such as world renowned biomechanist Stuart McGill found that exercises used to activate many abdominal exercises particularly those that repetitively flex and extend the back, offer unhealthy loading of the spine and only work very specific muscles. Further he argues that emphasis on deep musculature can actually destabilize the spine (More on this next time). McGill’’s live and biomechanical modeling also showed that there are not necessarily muscles that were more important than others. All the muscles in the trunk are important at different times, with different loads, under different circustances.⁵ Movements in the body are almost never a result of one specific muscle, but a result of coordination of many muscles, or muscle systems. Muscles that are further away from the center of rotation (the spine) offer better mechanical advantage than deeper muscles. McGill’s approach is to take a broader stroke, training the movement, not an individual muscle. He developed exercises to address the trunk musculature more comprehensively, focusing on exercises that create adequate muscular challenge across a number of muscle systems while putting the least compressive load on the back.

These exercises are often distilled down to what is often referred to as the “Big Three”. (See the related article on our blog) These basic exercises are commonly used initially in lumbar spine rehabilitation. These exercises are also becoming popularized beyond clinical practice as well. (See the NY Times video here: http://video.nytimes.com/video/2009/06/17/magazine/1194841000095/core-values.html?scp=1&sq=core%20values&st=cse)

All patients are different and what is appropriate for one person may not be appropriate for another. But generally McGill’s basic spine sparing core exercises can be used across many patient populations. Clinically I typically pull from more than one school of thought. If there problems with joint mechanics or muscle adhesions, they are addressed with manipulative and soft tissue techniques. I may also look to identify overt muscular deficits such as multifidus or transverse abdominis issues. If present, muscular deficits are addressed and some basic motor control exercises are taught. However, I will usually progress quickly to include a broader and more balanced approach using various spine sparing exercises based on McGill’s research and concepts.

In our next newsletter, we will continue exploring spinal stability

References:

1. Cresswell, A.G, Thorstensson A. (1994) “Changes in intraabdominal pressure, trunk muscle activation and force during isokinetic lifting and lower. Eur J Appl Physio Occup Physiol. 68: 315-21

2. Hodges, P. W., Richardson C. A. (1997) “Feedforward contraction of transversus abdominis is not influenced by the direction of arm movement.” Experimental Brain Research 114 (2): 362-370

3. Hides, J.A., Stokes, M.J. et al. (1994) “Evidence of lumbar multifidus wasting ipsilatreal to symptoms in patients with acute/subacute low back pain.” Spine 19(2) 165-72

4. Hides, J.A. , Richardson, C.A. et al. (1996) “Multifidus recovery is not automatic after resolution of acute, first episode low back pain.” Spine 21(23): 2763-9

5. McGill 2. M, (2004) “Linking latest knowledge of injury mechanisms and spine function in the prevention of spine disorders.” J. Electromyogr Kinesiol 14(1):43-7

Mark Pitcher DC, Msc

chiropractor, exercise physiologist