Archives for July 2011

Hate sit ups??? Perfect, stop doing them….

We’ve been doing sit-ups for decades to strengthen the abs and protect the back. While there is truth to the fact that core strength (and endurance) is protective for the low back, the best way to train this is still debated (or at least not widely adopted).  It is not uncommon to see people in many gyms or even elite athletes doing sit ups and leg lifts.  But commonality does not mean it is correct.  Professor Stuart McGill of the University of Waterloo has taken the effort to quantify the load placed on the lumbar spine and disc during many of these common exercises.  It has become very clear that sit-ups, crunches, leg lifts, and many other common ‘abdominal/core’ exercises have unsafe back loads and are likely more harmful and injurious than they are protective.  We need to move beyond the idea of training the abdominals to simply look good at the beach or pool and start doing better core training.

This is discussed in a NY Times article on Core Myths.  Please read the short article.

The obvious question then becomes what exercises should I be doing, if sit ups and crunches aren’t ideal.  McGill has popularized his Big 3 and has research to support their effectiveness in activating the core as well as showing lower spinal loads during the activity.  The Big 3 include:

  1. Side Bridge
  2. Bird Dog
  3. Curl Up

As with all exercise proper form is essential.  Without proper form the exercise is not as effective and more likely harmful.  If you have questions consult a competent health care or exercise professional.  [Looking for one?  Try searching the ISCRS website]  To view these exercises, and another challenging core stability exercise called ‘Stir the Pot’ view this 3 minute video. McGill- Core Values.

Do I need orthotics or special running shoes???

An age old question from so many runners, walkers, athletes, and those who work on their feet.  In hopes of catching the blog up, this along with others, will be old posts that I often find myself discussing with patients and colleagues.

Read NY Times Blog Post below:

http://well.blogs.nytimes.com/2010/07/21/phys-ed-do-certain-types-of-sneakers-prevent-injuries/

While not a definitive study, it appears to have debunked the idea that so many people need ‘motion control’ shoes due to foot problems.  The original idea was that a ‘motion control shoe’ reduces pronation and would subsequently reduce injury in those pronators who wear them.  I suspect that more often pronation is the end-result of another issue  and should not be our main focus.  While in a small number of cases pronation may be solely a foot issue, it is likely that it is the result of a problem farther up the chain (most likely the hip; with delayed onset or weakness of the gluteus medius or lateral rotators).  My estimation is that as we fix pronation with a ‘motion control’ shoe, the compensation for the hip issue is eliminated.  This prevents energy leakage from the system and as energy remains during each step it overloads a different tissue/structure/joint leading to the increased rates of injury noted in the article.  Further study is needed, but we need to be aware of these sacred cows and exercise myths.  Look for future posts on strengthening the foot (foot drills & short foot exercises) as well as hip stability exercises.

Welcome

Welcome to RehabChiropractor.com.  This blog will serve as a site to share and spread health related information, particularly pertaining to manual therapy, functional rehabilitation, and corrective exercise, as well as occasional posts regarding general health and wellness.

It is also a way for me to further explore and challenge my understanding as, “Clear writing requires clear thinking”.  I hope you enjoy and learn along with me.  Please feel free to post your comments.