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Wednesday, December 27, 2017

Study Spotlight: Effects of 8 Week Stabilization Exercise Program on Lumbar Multifidus

By: Joel Luedke


Low back pain can be debilitating and very frustrating.  Research has shown in many studies that activity and rehab can have a significant impact on improving outcomes.  That being said, what are the exact mechanisms that these exercise programs work through.  This study takes a look specifically at a couple of levels of multifidi to see how a stabilization program affects them.


What They Did: 
Researchers used an 8 week LSEP to look at how that program would directly effect the size and function of the multifidi muscles that play an important role in helping with general spinal stabilization.  There was 34 patients with non-acute low back pain and 28 healthy controls to compare muscle size and function to.  The researchers used RUSI to measure thickness of the multifidi muscles both at rest and during some movement to track and changes.

What They Found:
The patient group did not produce systematic changes in RUSI measures when compared to the controls even though RUSI impairments were observed at baseline and that patients had significant improvements in pain and disability.  It was also found that the LSEP did not normalized the impairment of muscle activation compared to the controls.

What It All Means:
As with a lot of research the findings can be confusing and also make you think that nothing worked and that makes doing the exercises not worth it but don't let it deter you too much.  While this particular study did not find the exact results they were looking for there were some silver linings.  There were increases in ability to move and decreases in pain even without the corresponding changes in muscle thickness but improvements in these areas are always welcome.

I think the other thing this study shows is that while a 'standardized' back rehab program can be useful and effective there is nothing that is one size fits all.  I think it also shows that these programs can be more effective when administered by a trained professional that can help customize them to your specific needs and also help correct in real time.  This is paramount to find someone you trust that has the knowledge to dig into the root cause and address it.

Don't write off all the programs but make sure to be very aware of how things are coming along and find a rehab specialist to help increase your performance.

Abbreviations:
-Lumbar stabilization exercise program (LSEP)
-Rehabilitative ultrasound imaging (RUSI)

Source: Lariviere, C. The effects of an 8-week stabilization exercise program on lumbar multifidus muscle thickness and activation as measured with ultrasound imaging in patients with low back pain: An exploratory study.

Thursday, December 21, 2017

Friday Food: Raw Apple-Cinnamon & Chia Breakfast Bowl

A tasty change up to everyday breakfast that does a good job of getting you going but not filling you up with a lot of extra 'stuff' that you're not looking for when you start your day off.  Give it a try coming up.

Ingredients:
  • 3 honey crisp apples, peeled and cored, divided
  • 4-5 medjoll dates, pitted
  • 1/2 tsp ground cinnamon
  • pinch nutmeg
  • 2 tbsp chia seed
Toppings:
  • raw walnuts
  • raisins
  • dried cranberries
  • hemp seeds

The Game Plan:
  1. Finely dice one of the honey crisp apples and add to an airtight container
  2. Take two of the honey crisp apples and cute hem into large pieces.  Add the apple pieces to a food processor along with the dates, cinnamon, and nutmeg.  Pulse the mixture several times and then let it process for 2-3 minutes, stopping occasionally to scrape the mixture down the sides.  Pour the apple-date mixture into the container with the diced apple and stir in the chia seed.
  3. Refrigerate for at least 1 hour or overnight.
  4. Divide the apple mixture between two bowl and top with raw walnuts, raisins, cranberries, and hemp seeds.
  5. Serve and enjoy.
  6. Refrigerate leftovers.

Wednesday, December 20, 2017

Study Spotlight: Preventative & Regenerative Foam Rolling on Reducing Fatigue of Muscles

By: Joel Luedke


Foam rolling can have many benefits.  Often we talk about it helping with your movement and mobility to loosen up muscles and help restore more motion to the joints.  In this Study Spotlight we take a look at some other areas that foam rolling can help with, mainly muscle strength and fatigue.


What They Did:
Forty five health adults (men & women) were broken up into three groups.

  1. Foam Roll of the lower limb muscles prior to induction of fatigue
  2. Foam Roll after induction of fatigue
  3. No treatment; control
These participants were put through a neuromuscular exhaustion protocol that was meant to elicit functional agility short-term fatigue.  The measurements they were looking at was max isometric (not moving) voluntary force of the knee extensors (quads).  They also looked at pain perception and reactive strength (RSI).
The foam rolling protocol they used was the following: Muscles focused on were the quad, hamstrings, adductors, calf muscles and the IT band tract.  Each group was treated for 30s each with slow and constant movements at constant pressure between the origin and insertion of the muscle.  A metronome was used to keep consistent pace and a goal of 7 of 10 on a pain scale (mild to moderate discomfort) was used to try and standardize intensity.


What They Found:
When it came to decreasing the loss of strength both the preventative and regenerative foam rolling sessions showed significant results.  Upon further analysis there was a trend toward regenerative foam rolling as the best time to restore strength but this was not statistically significant.

What It All Means:
The researchers do a great job in the discussion and conclusion stating how nothing in this study was perfectly definitive and that more research will be needed in order to know for absolutely certain how foam rolling can affect these things.  That being said the data they did find is interesting.  The use of foam rolling and when to use it can be confusing and depending on your application it can be very helpful and may harmful.  We recommend reading Dr. John Rusin's article, 'Stop Mindlessly Foam Rolling Like a Jackass' for more information.

What this study does tells us is that you should be doing some form of self soft tissue mobilization can be very beneficial for you when it comes to restoring strength and minimizing fatigue as much as possible.  Now whether you do that before or after is up to you but the data seems to be trending in focusing on doing it as a form of regeneration.  This can be useful after workouts and/or competition. The other area this can open up to is potentially using a foam roller at breaks in your competition to potentially help reduce fatigue and enhance performance for the second part of the competition or workout.

Bottom Line: You should probably become friends with a foam roller.


Source: Fleckenstein, J. Preventative and Regenerative Foam Rolling are Equally Effective in Reducing Fatigue-Related Impairments of Muscle Function following Exercise. journal of Sports Science and Medicine (2017) 16, 474-479.

Friday, December 15, 2017

Friday Food: Dark Chocolate Nut Cluster w/ Sea Salt


Something a little more sweet this week as we keep getting closer and closer to the holiday season.  Just because you want to enjoy a snack doesn't mean it has to put you completely off the rails of trying to eat healthy and keep your nutrition moving in the right direction.


Ingredients: 
-20 almonds (around 20 grams)
-20 pecan halves (about 20 grams)
-20 walnut halves (about 20 grams)
-1 package Ghiradelli Dark Chocolate Melting Wafers (or your favorite kind)
-Sea salt

The Game Plan

  1. Place chocolate wafers in a medium, microwave safe bowl.  Melt in 30 second increments, stirring until melted, about 1 1/2 minutes total.
  2. Working quickly, dip a walnut into the melted chocolate with a fork and shake excess off.  Transfer to a piece of wax paper.  Do the same without the pecan, then lay the pecan on top of the walnut.  Repeat with the almond, finishing the cluster.  Repeat with the remaining nuts.
  3. Finish each with a pinch of sea salt, to do this you will want to sprinkle it on top once they are almost dry so it doesn't absorb, but not to dry or it won't stick.

Source: Skinny Taste

Wednesday, December 13, 2017

Study Spotlight: Physical Methods of Lymphatic Drainage on Post Exercise Recovery of MMA Athletes


By: Joel Luedke

To train hard you have to recover hard.  That being said what is the best method to recovery?  That question isn't so easy to answer.  It is very case dependent and really you have to look at the goal you are wishing to accomplish and then find the medium that works best for that desired goal.  You also have to take into account the personal feeling each person has with recovery. 


This study took a look at a couple different recovery techniques and how the affected the forearms off MMA guys.  That may not seem like it applies to you but please read on.

What They Did:
Researchers looked at 80 MMA athletes and split them into four groups.  Three of those groups received some type of physical method of recovery (see below) and one group received a sham treatment as the 'control' group. Researchers looked at blood flow velocity, maximal strength of the forearm muscles, muscle tissue tension, pain threshold, blood lactate concentration and activity of creatine kinase at rest, after muscle fatigue, 20 minutes post, as well as 24 and 48 hour after the intervention.
Researchers used a standard forearm fatiguing test to create forearm fatigue across the 80 athletes (please reference study for full details)
Treatment Groups:

  • Manual lymph drainage of moving the lymph from the forearm back to the core of the body in order to help with elimination.
  • Electro-stimulation with the 'Bodyflow' device using electrodes distributed along the venous and lymph flow.
  • Deep oscillation using a 5cm head (90+/- 10 Hz for 18 minutes and 50+/- Hz for last 2 minutes)

What They Found:
What the researchers found that all of the physical methods of lymphatic drainage, whether using manual, electro-stimulation or deep oscillation there was an improvement in poster exercise regeneration of the forearm muscles of the MMA athletes. Specific effects varied deepening on the exact treatment but all showed improvements in recovery when compared to the control group.

What It All Means:
Not all of us are MMA fighters and not all of our forearms get locked up in our daily lives but at the risk of making assumptions not found in evidence I think what the researchers did find is promising.  It shows that the more active you are when it comes your recover and working to get the muscles to contract in whatever manner that may be can help with many areas of recovery.  

What that doesn't mean is just sitting in a cold tub, putting a bag of ice on or just laying around after a tough workout or competition is enough to get your ready for the next day.  You should get active and get your body to start the process on its own and optimize for the best response.  Take advantage of it.

Resources: Zebrowska, Aleksandra: Effect of Physical Methods of Lymphatic Drainage on Postexercise Recovery of Mixed Martial Arts Athletes.

Sunday, December 10, 2017

Mobility Monday: Recovery Your Anterior


If your quads start locking down it seems to be that everything starts hurting.  Your hips start talking to you, the glutes start getting extremely tight as they are trying to fight back and if you're like me, somehow your feet start hurting (yep its a thing).  It doesn't take much to get everything to loosen up and move again but the hardest part is just getting started.  This is the one you want to start with.


What It Helps:
-Tight Hips
-Tight Quads
-Recovery from a lot of Sitting