Thursday, 16 October 2008
Spend Less, Lose Weight!
Saturday, 11 October 2008
The Interim Workouts
Saturday, 4 October 2008
Interview with a Physiotherapist
Oops. You did it again. You've gone and scrapped that knee - that precious knee. You're sitting at the computer reading this post as you intermittently massage away at the throbbing pain. So the question is, who do you see about this? With all the people out there claiming they can kiss your pains away with pixie dust, who's the best man for this job?
Well for those of you thinking about physiotherapy, this one's for you. During my stint at Totum Life Science, I worked with Mary-Catherine Fraser Saxena, a sharp woman with two of the most adorable kids I've ever seen and a wily husband who moonlights as a chef. In any case, I had the idea to get her voice on Gymnazein, so I shot MC an email and here's what she had to say.
So what's your name and what do you do again?
Mary-Catherine Saxena, and I'm a physiotherapist who works in an out-patient orthopedic setting.
Has physiotherapy been around since the Dark Ages?
Pretty much...it began in earnest after the WWI and WWII, helping soldiers recover from their injuries. Throughout the 1950's and 60's, the universities taught a combined degree of physiotherapy and occupational therapy, and then you chose which vein you wanted to focus on in your practice. Since the late 1960's or so, physiotherapy has been a bachelor degree. More recently, programs are requesting a bachelor degree prior to admission, and then you graduate with a master's degree in physio. In the US, more programs are shifting to a D.P.T. program, from which you come out with a doctorate in physical therapy.
Where were you educated? How long have you been practicing?
I did a four-year bachelor degree at the University of Ottawa, which is the only bilingual program in Canada. I graduated in 1993. In 2005, I completed a master's in Rehabilitation Science from the U of Toronto. I have now been practicing for , gulp, 15 years!
How important would you say physiotherapy is in the larger framework of healthcare? Does it have ties with other healthcare professions/institutions?
The most visible part of the physiotherapy profession for the public at large are those of us working in out-patient clinical settings. However, a large proportion of our profession continues to work in hospitals, in a variety of settings and varying levels of care. You will find physios in tertiary care centers, assisting patients in the ICU with intubation and respiratory challenges. In the neurological injury setting, physios play a large role in the post-stroke and post-spinal injury populations, from immmediate interventions to long-term rehabilitation. As hospitals have downsized their out-patient clinics, therapists working in home care settings are creating an important bridge between the medical community and successful returns to independant living at home.
Physiotherapists work closely with physicians, surgeons, nurses, social workers, occupational therapists and psychologists to complete a patient's healthcare team and successfully return that person to an independant, mobile life. We are the exercise and mobility specialists.
How is it different from what a GP does? A chiropractor? An osteopath?
A medical doctor can order radiological exams, interpret blood test results, prescribe medication and refer on to other specialists. They are not skilled at doing differential diagnoses for musculoskeletal exams. For example, they can diagnose an ankle sprain, but are unlikely to be able to know if the talus is sitting forward in relation to the tibia as a result of the sprain.
A chiropractor can also order radiological exams, however they can not prescribe meds or refer to medical specialists. Chiropractic medicine has it's basis in the subluxation model, and tends to use manipulation as a common approach to many ailments. This, however, is changing...
An osteopath is also skilled in spinal and peripheral manipulation, however they have a deep belief that many ailments are due to changes in the craniosacral rhythm due to fascial and dural restrictions.
Now let's get to the juicy bit. For those of us who have no idea, what sorts of problems do you treat?
At Totum Life Science in downtown Toronto, we see a variety of acute, sub-acute and chronic musculoskeletal injuries.
I would estimate a third of my clients have neck/shoulder issues, another third have knee issues, and the rest is a mix of lumbopelvis, TMJ, ankle, wrist and elbow. Of these, approximately 25% are post-operative, meaning they are recovering ligament repairs, fractures, or arthroscopic surgeries.
Are your treatments based on scientific evidence or do you place a special potato on patients' heads through which you funnel your healing energy?
I am a big believer in evidence-based practice. In fact, my master's thesis was looking at the use of clinical practice guidelines for knee osteoarthritis by physiotherapists in Ontario. However, the dilemma in physio is that the evidence for many of the things that we do isn't there. This is where the concept of 'clinical reasoning' must take over. It's important to take the evidence that is available and incorporate it into your clinical decision making, and where there is no evidence, to use reason your way through why something should or shouldn't work. No potatoes required.
What sorts of problems don't you treat?
Due to the funding structure, I don't treat injured workers or many MVA patients.
On average, how many treatments does it take to see noticeable difference? What does this depend on?
Unfortunately, the answer to this is 'it depends'. The acuity of the injury, a client's history, the degree of the injury, the compliance of the client to follow through on their exercises...I would say a client should note a positive change from their treatment within the first 2 treatments. One of the keys to successful rehab is frequent re-assessment; if the initial approach isn't working, then a re-assessment is required to ensure that nothing was missed on the initial assessment.
What would you say are signs of a great physiotherapist - so we know what to look for?
Brown hair, 5'8"...kidding! Look for someone who takes the time to listen to your history and takes a detailed account of factors contributing to your injury. Be wary of someone who hands you a pre-printed exercise sheet used for all neck/low back patients without modifications for your specific condition. Look for someone who provides 30 minute treatment sessions - this will ensure enough time for re-assessment, hands-on treatment and exercise prescription/modification/demonstration, as applicable.
And finally, would you be kind enough to divulge your training secrets to us - tell us how you keep in such incredible shape?
Haha...My own training? Run 2-3X/week, weight-training 2-3X/ week, lots of core/medicine ball work and a yoga class thrown in when time allows. Eat when you're hungry, avoid meat unless it's organic and of the best quality, and have a little chocolate every day.
And listen to whatever advice Varun gives me :) [I told her to say that]
Thursday, 2 October 2008
The Six Pack: Part II
Wednesday, 1 October 2008
The Six-Pack: Part 1
So how do you train to tone the torso? What exercises do you use? What do you do differently from the rest of the flock to accelerate your progress?
Read on.
The Sit-Up
The traditional sit-up involves lying face up on the floor and drawing the chest up to the knees whilst keeping the feet on the ground (ideally); and on first glimpse this seems a perfectly appropriate exercise to train the rectus abdominis. But low back pain guru, Stuart McGill, put out a book a few years ago that explained the folly of the sit-up. Until this time, it was axiomatic that the sit-up stimulated the abdominals over any other muscle. Instead, it appeared that it was the hip flexors (iliacus and psoas) that seemed to perform the most work to move the subject from initial position to the...sit-upped...position.
But McGill's argument wasn't even this. He said that during the sit-up, the hip flexors actually use the spine as leverage to heave the upper extremity into the upright position. I don't know much, but I know I don't want my spine used like that.
So the bottom line is this - the risk to benefit ratio for the sit-up exercise is high enough to scratch it from your arsenal. It doesn't target the muscles you want to and it actually hurts you at the same time.
In the next article, we'll go over exactly what you need to do and how you need to do it.
An Aside on Diet
For best results, follow healthy eating habits. If you have no idea what that might be, check out this article, or this site. No supplements are required, but a proper whey protein powder is optional.
Saturday, 27 September 2008
Things I Know
Sunday, 21 September 2008
To Kettlebell or Not to Kettlebell?
Thursday, 18 September 2008
Untitled
Tuesday, 16 September 2008
Re:Muscle Wasting
Monday, 15 September 2008
My Gym is Better Than Yours
Sunday, 14 September 2008
Fat Loss: Getting Started
- An appropriate diet
- Consistency
- An initial pre-fat loss phase of muscle building if necessary
- Whole body workouts to maximize caloric expenditure
- Short and subjectively intense workouts to elevate metabolism in the post-workout stage
- Involves a component of high intensity cardiovascular work
- Eat every 2-3 hours
- Eat lean protein with each meal
- Drink nothing above 0 calories
- Consume healthy fats with each meal
- Consume vegetables or fruits with every meal
- Do not consume any carbohydrates from starchy sources (breads/pastas/potatoes/etc) unless you just worked out
- Eat only whole foods
- Sprint 50m (or hop on the treadmill for 2 mins at high intensity)
- Clap push ups (regular push ups are fine as well) - 20s
- 1 leg squats - 30s (match number with other leg)
- Close grip chin ups - 20s
- Standing double leg long jump - 6 reps
Saturday, 13 September 2008
The Basics, Part III: The Bench Press
- develops horizontal pushing ability
- develops triceps and anterior deltoids in addition to pectoral muscle group
- Place yourself so that eyes are underneath the bar
- Spread your feet wide and bring them as far back as you can keeping the heels on the floor; this gives you a stable base from which to work; arching the back is fine, but don't let the bum come off the bench
- Hold the bar slightly wider than shoulder width apart (be careful not to go too wide as it puts too much strain on your shoulder capsule at the bottom of the movement)
- Retract your shoulder blades (think about pinching a penny between your shoulder blades)
- Never let your shoulder blades relax from this position
- Lift the bar off the pins and begin by pulling, not lowering the bar to your chest (imagining a pulling motion activates the back muscles to a greater extent, which stabilizes your shoulder joint)
- When the bar reaches your chest, without bouncing it, push yourself away from the bar to raise back to the starting position
Oh my Threatened Masculinity!
Friday, 12 September 2008
What's in Your Fridge?
My Bike Trip
An Aside on Muscle Wasting
Thursday, 11 September 2008
The 2 Hannington Place Workout
The Basics, Part II: The Deadlift
- a compound exercise like the front squat
- activates the posterior chain of muscles (hamstrings, glutes, and spinal erectors)
- because of the location of the weight being movied, the subsequent stress on the spine to maintain a neutral position forces the 'core' to work..very hard
- develops joint coordination and overall strength
- excellent for 'toning' the low back, glutes, and hamstrings
- begin with a narrow stance - toes pointed forwards
- hold the bar using a pronated grip with elbows locked out throughout the motion
- at no point should you try and shrug the bar up - this is not an exercise for your shoulders
- keep the chest high (inflate the lungs) and tummy sucked in
- lower the bar along your legs (never break contact with your skin) and keep the weight in your heels throughout
- once the bar has been lowered to the knees, bend the knees and continue lowering till the weight plates touch the group lightly
- reverse the motion by thrusting the hips 'through' and forward
- squeeze the glutes at the top and try to get your head to touch the ceiling
Wednesday, 10 September 2008
The Basics, Part I: The Front Squat
- it's a compound exercise meaning it moves multiple joints and activates several large muscle groups in the body
- it's a functional exercise - there is good transfer between this exercise in a gym setting and actions in real life settings (e.g. picking up a box on moving day or jumping for a header during a football game)
- an excellent choice for building the quadriceps (muscles in the front of the thigh), glutes, and hamstrings (muscles at the back of the thigh)
- develops torso stability as well - the muscles of the upper body must stabilize the spine before the weight can be lifted safely)
- in the standing position, raise the arms in front of the body (like a zombie) with the fingertips on par with the nose
- assume a slightly wider-than-shoulder-width stance with toes pointed slightly outwards
- 'puff' up the chest by filling the lungs with air; suck the stomach in (pretend you're trying to fit into the world's tightest pair of jeans); keep the shoulders relaxed - do not hunch up
- keeping this upper body position, focus on pulling your hips into the ground
- IMPORTANT: minimize the forward movement of the shins; to help you with this, have someone hold a stick across your legs (4-5 inches away) just beneath the knees; touching the stick is fine, as long as you're not pushing it away
- lower yourself until your legs are parallel to the ground or as far as you can keeping your spine neutral (i.e. no bending of the spine)
- to return to the initial position, visualize trying to get your head to touch the ceiling; as you ascend, push the hips through and squeeze the glutes (imagine trying to hold a penny between your glutes!)