Tuesday, May 28, 2013

New Favorite Vitamix Green Drink

Seems like everyone is sharing their favorite greens drink recipe lately, so I figured I'd throw my 2 cents in.

Cup of Kale.  I tear the leaves off the stalk and throw the stalk out.  Lots of Vit K in Kale.  Some people worry about the potential for kidney stones from a lot of raw kale.  If your worried about that, substitute spinach.

1/2 a pear.  Sweetens it up

1/2 cucumber.  Silica in this veggie is good for skin/joints.

2" piece of ginger.  Awesome anti inflammatory, anti bacterial, anti viral.  Good stuff.  I like the kick it gives the drink as well.

1/4 of frozen banana.  Sweetens it up.

Teaspoon of cinnamon.  Potentially helps regulate blood sugar.

Scoop of Pure Vanilla Protein powder.  Some protein powders are better then others.  This one is up there.  Not denatured.  GMP.  No fillers or artificial ingredients.  Don't make a green drink and then dump in garbage.  Pay for a good protein powder or skip it.  20 grams of protein.  Whey is an immunity booster.

Scoop of Bulletproof collagen protein.  Great for the joints and ligaments.  I've tried others in the past that didn't taste this well.  I keep saying I'll make my own bone broth, but I procrastinate.  This serves the purpose and is great quality.  There is a lot of thinking out there that one of the increases in tendon/ligament issues in the younger generation is the lack of this in the diet.

Tablespoon of organic cacao powder.  Good magnesium content, high anti oxidant.

1/2 avocado.  Gives it an awesome creamy texture.  Good fats.

1 cup of raw milk.  If you don't have raw milk can substitute cocunut milk or almond milk.

1 cup of filtered water.

Handful of ice cubes.

Tastes great.  My kid loves it too, win and win.

Monday, May 20, 2013

Tuesday, May 14, 2013

Notes on Anterior Core Training

I recently watched Eric Cressey's presentation on the Anterior Core.  I found it very good.  One of those, wow, Internet is amazing kind of moments.  Fork over 15 bucks and get to sit and learn for 45 min from a respected leader in the field.

He opens with one comment I've come to truly appreciate.  If I can learn one thing to take back to my clinic for my patients and athletes and start implementing, it was worth it.  Give me one thing to take away that can have real value in my world.  Not conceptual.  Applicable.  I learned a few.

First, I found a nice tie in with the Postural Restoration information I had went through a few weeks ago.  Eric is very familiar with it, having taken their seminars and was actually one of the ways I first heard about PRI.  So I found a lot of practical information on how to implement the PRI principles much easier.

Get good proximally before distally.  If the core/spine aren't right, the extremities won't be either.  Get to neutral and stay neutral.  Use warm ups to work on getting flexed people into extension and those locked into extension into flexion, thus getting both to neutral.  The workout then becomes what cements the neutral spine.

Many of the modern injuries we see can all be related back to the anterior core.  Sports hernias, femoral impingement and hip labral tears can all be related back to having anterior rotated pelvis.  Excessive tension through muscles like adductor longus and rectus abdominis.  Thoracic outlet can also have roots from a dysfunctional anterior core.

A great test is have the patient supine.  Flex the hip and internally rotate the hip.  This may cause a pinching pain in many people.  Now, have them brace the abs and slightly posterior tilt the pelvis.  Retest flexion and internal rotation.  Often the pain will be gone.  It's not a hip problem, it's an anterior core problem.

He talks about another simple test to decide if your patient/athlete should even be doing overhead work.    Can you raise your arms overhead without letting the ribcage tip up in the front?  Important for all the Crossfit athletes that live overhead.

Everyone is unique.  There are many great exercises, but you may have to coach and cue one person much different then another.  Again, one may be locked in flexion, one may be locked in extension. Don't coach the exercise the same.

Anytime you lift something overhead, you are working the anterior core.  Gain length in the Lats and strength in the obliques and rectus abdominis and you will gain a much more functional anterior core.

Eric goes on to discuss exercise progressions for many different lifts and exercises.  These progressions, how to implement them and why you would, make up the heart of the presentation.  I would highly encourage anyone that works with athletes to give it a watch.  I'm sure you will walk away with one applicable nugget of information you can start to use right away.

Thursday, May 9, 2013

Review of Postural Restoration Institute Respiration Course

A few weekends ago I had the opportunity to take a Postural Restoration Institute (PRI) respiration course.  It was myself and about 7 physical therapists at the University of Michigan Pain clinic.  James Anderson was the PRI teacher.  He knew his stuff inside and out and was a great teacher, engaging and open to questions.  I had several, more on that later.

First, if your thinking on taking one, I would highly recommend it.  I study anatomy a lot and found myself learning and thinking about concepts in a new way.  As this was a respiration course the primary focus was on the diaphragm,  rib mechanics and how they influence the rest of the body.  I feel I gained great insight and better understanding to both of these anatomical concepts.  Surprisingly, none of the information about rib biomechanics are taught very well in chiropractic school.

PRI is built with the premise that the body is actually asymmetrical and that it's the sum of these asymmetrical parts working together in harmony that make us move and function well.  It's because of some of these asymmetries that we create known dysfunctional patterns that are labeled and treated in PRI.  I'm not going to get into their patterns and treatment methods, as that would take quite a lot of time, but basically the left front leg gets tight and is called an Anterior Interior Chain (AIC) which includes the diaphragm, psoas, rec femoris, TFL, vastus lateralis and biceps femoris.  Also, the right  upper arm gets tight, labeled Brachial Chain (BC) including the intercostals, deltoid, pec, Sibsons fascia, SCM, scalene and diaphragm.   Right rib hump on the back and left rib flare on the front is generally seen  (also 90% of scoliosis has this pattern)

The respiratory system is not symmetrical.  Right diaphragm is larger, thicker, has a larger central tendon, has thicker crural attachments to the lumbar spine and because of this creates a right rotated lumbar spine.  It's 1 to 1.5 vertebral levels deeper on the right and has a more dome shape on the right because it drapes over the liver.  Because of this it has better abdominal integration for opposition.  It can push better against the abs essentially.

The unique anatomy allows us to breath easier on the left and harder on the right.  So the right ribs become more locked down and the left ribs become blown out on the front.  We are a culture that is carrying dead air, we don't fully exhale.  All of this leads to dysfunctional patterns.

Some interesting anatomy.  Subclavius is the only scapular retractor on the front of the body.  When it gets tight, it can inhibit the lower trap and serratus anterior, two muscles that get inhibited a lot.  Thus, subclavius is an important muscle for respiration and shoulder function.

The diaphragm when dysfunctional actually becomes a paraspinal extensor.  If you don't use it and breath well, you will have a tight back.  Because of the described anatomy the right ribs become rotated under the scapulae.  This makes the scapula dysfunctional and will create shoulder impingement at times on the right shoulder.

One of the concepts that I have an issue with that was touched on in the seminar was the use of flexed positions in the lumbar spine to create a neutral spine.  They believe most people are locked in extension and to actually create a neutral spine, squats ect, must be done flexed.  Please reread that.  This concept attacks my paradigm.  I can understand the concept that we are both after a neutral spine.  Obviously no one is saying squat with hyper lordosis but to go the opposite and squat with a flexed spine to get to neutral, I'm not buying it yet.  I brought up McGills research and didn't really get much of a response on that, but we agreed we are after neutral.  I actually did a bunch of flexed exercises and to be honest, I had some radicular pain down my right glute and I haven't had any radicular pain in about a year and a half.  N=1 was a failure for me.  But, I don't believe I'm locked in extension.  So flexed spine for me was a flexed spine in my opinion.

The other concept that was touched on briefly was the use of an orthotic.  He pretty much came out and said if your not in a PRI orthotic all the work you are doing to solve dysfunction won't last.  Really?  I don't buy that one at all.  I'm a big believer that feet play a major role in how we move, but not that big....for everyone.  Need by need basis.  He was very down on the minimalist shoe for everyone.  I talked with a buddy doing PRI with himself and a few athletes and was told he has been doing great without the orthotic and is stronger then he has ever been.

Overall, I really enjoyed the PRI seminar. I truly believe I'm a better clinician having attended.  I'm working with diaphragms and having success with improving shoulder mechanics via the diaphragm.  They give a ton of exercises that can be used for your patients as homework.  I plan on attending more of their seminars in the future, so you can say I like their stuff.

Wednesday, May 8, 2013

Building a Circadian Rhythm Template Through Food, Light and Sleep

One of the most interesting chapters in the book "Perfect Health Diet" by Paul Jiminet was the chapter on Circadian Rhythm.  Circadian Rhythm (CR) is the bodies natural tendencies and hormonal fluctuations.  Every cell in your body has an internal clock.  The more we learn about health and fitness the more importance the roll of maintaing a healthy CR becomes.

The body is an incredible adapter.  It can adapt to anything, almost.  You can get it to run faster, jump higher and lift small cars if need be.  You can train it to run across deserts and climb mountains without oxygen.  It can thrive (not just survive) on vary diverse diets, from Inuit protein and fat to some almost pure plant based diets.  One thing we can't adapt to and probably never will, is lack of sleep and sleeping in the day time.

 Sorry 3rd shifters, but that is not normal and you are messing up your CR big time.  There are a lot of health risks involved with this.  Maintaining a healthy sleep schedule, getting sunlight in the right time and eating at the correct period are probably the biggest steps in keeping your CR healthy.

Here are some highlights from the PHD chapter to be used as guidelines for setting up your proper Circadian Rhythm.

Get sunlight on your eyes early in the morning.  Sunlight not only kick starts the CR but also we absorb Vit D more in the morning.  Sunlight has tremendous amount of blue spectrum light.  Great in the morning and day.  (not at night) Cataracts block blue light and this is one reason elderly have messed up CR.

Avoid blue light in the evening.  Just as blue light in the morning is helpful, blue light in the evening is harmful.  It will block the hormone Melatonin from being produced as much.  (almost 50% less)  Melatonin is highly important for health.  There are now filters that can be put on computer screens and ipads ect to block the blue light.

Sleep as much as you can.  There are so many studies about sleep and they all say the same thing, go long enough with limited sleep and you are going to have some health issues.  Some pretty serious.  This is something we as humans have not been able to adapt to.  Sure there are people out there that thrive on "4 hours of sleep" day in and day out, but chance are you are not them.  There are amazing outliers in everything.

This brings us to food.  Food can have a powerful influence on the CR.  Generally speaking, eat during the daylight.  Create an eight hour window to eat.  Stop about 2 hours before you go to bed.  Carbs have a powerful effect as they promote night rhythm and sleep. Carbs influence the hormone leptin, fat does not.

The hormone leptin follows a circadian rhythm.  Low in the morning and rise as the day goes on, peaking at night.  Eating carbs increases leptin levels 4-9 hours post consumption.  So to time carbs influence on leptin and your natural leptin levels, most carbs should be eaten around sunset.  So dinner.  This goes against most of the dietary advice out there.  (so it's probably right....this also has strong agreement with the Warrior Diet by Ori Hofmekler)

A few supplements that may help are Vit D in the morning, Magnesium at night and Melatonin at night.  All will have strong influence on creating optimal CR.  Light physical activity with your initial sun exposure in the morning can also be highly beneficial.

A healthy circadian rhythm is a template to allow you to do the things that are important to you.  If you are looking for a faster 5k, lose 15 pounds of fat, total elite in powerlifting or just have the energy to enjoy your grand kids, setting your Circadian Rhythm is the foundation to the person you are building.