Core Stability

The core is where the most of the body’s power is derived. It provides the foundation for
all movements of the arms and legs. The core must be strong, have dynamic flexibility
and function synergistically in its movements in order to achieve maximum performance.

  • Motion of the human body is not isolated to one muscle or tissue moving in one specific
    direction. Rather, it is a complex event involving agonists and antagonist structures that
    work together to create changes in position and/or location, and to stabilize the body in
    all three directional planes. Regardless of what sport one plays, it is essential to have core strength and trunk stability to maximize performance and prevent injury.

What Makes Up the Core
The foundation of the core is much more than the abdominal muscles. It includes
muscles deep within the torso, from the pelvis up to the neck and shoulders. The core
includes the following structures:

  • Multifidus – deep spinal muscles that run segmentally from the neck (C2) to the
    sacrum. They produce extension and, to a lesser degree, rotation and lateral
    flexion forces that provide stability to joints at individual levels of the spine.
  • Interspinales, Intertransversarii, Rotatores – deep structures that attach
    directly to the spinal column. These are very important for rotatory motion and
    lateral stability.
  • External Obliques – abdominal muscles that attaches at the lower ribs, pelvis,
    and abdominal fascia.
  • Internal Obliques – abdominal muscles that attaches at the lower ribs, rectus
    sheath, pelvis and thoracolumbar fascia.
  • Transversus Abdominis – abdominal muscles that attaches at the lower ribs,
    pelvis and thoracolumbar fascia, and rectus sheath.

These abdominal muscles work together to transmit a compressive force, and act to increase intra-abdominal pressure that stabilizes the lumbar spine. They also work individually to perform trunk rotation, while the internal and external obliques on the same side can work together, or synergistically, to laterally flex the spine.
Rectus abdominis- abdominal muscle that attaches at the fifth through seventh ribs, the lower sternum and the front of the pubic bone. This muscle flexes the spine, compresses the internal organs of the abdomen and transmits forces laterally from the obliques. It is a common fallacy that the upper and lower rectus are isolated differently. Training the rectus can be done with one exercise.
Erector Spinae – help to counterbalance all the forces involved in spinal flexion. They begin as the sacrospinalis tendon that attaches at the sacrum and ilium. This tendon then gives rise to different muscles that run up the spine and obliquely to attach at lateral parts of the vertebrae and the ribs. In the cervical region, these muscles attach at the base of the skull.
Quadratus Lumborum – attaches at the 12th rib and the upper 4 lumbar vertebrae and the pelvis. It stabilizes the lumbar spine in all planes of motion, stabilizes the 12th rib and the attachment of the diaphragm during respiration and laterally flexes the trunk.
Latissimus Dorsi – this is the largest spinal stabilizer. It attaches via the thoracolumbar fascia to the lumbar vertebrae, sacrum and pelvis, and runs upward to the humerus. It assists in lumbar extension and stabilization, and also performs pulling motions through the arms.
Thoracolumbar Fascia – connects the latissimus dorsi, gluteal muscles, internal obliques and transverse abdominis, supplies tensile support to the lumbar spine, and is used for load transfer throughout the lumbar and thoracic regions.
Abdominal Fascia – connects to the obliques and rectus abdominis, and to the pectoralis major. Fascial connections that cross the midline transmit forces to the muscles of the opposite side of the body.

Training the Core
The common myth is that training the core simply involves sit ups and back extensions.
An efficient core routine consists of multiplanar movements – training in all planes of
motion. As the body moves, the center of gravity changes, and forces exerted by, and on,
the body’s tissues are constantly changing. Dynamic stabilization must be included to
increase proprioception and stability in the trunk, as well as in the rest of the body. This
allows the parts of the body to react efficiently to external forces and stresses, such as
gravity, changes in terrain, and carrying loads, as well as the internal forces exerted by
other muscles.

Dynamic stability is best achieved through training in functionally practical positions that mimic activities or movements in one’s particular sport, or in life as a whole. With this in mind, one can conclude that most core training that is done while sitting or lying down and limiting pelvic movement has little functional value. Medicine balls, balance boards and stability balls are great tools for core training and should be integrated into every program. Core exercises should include strengthening, as well as challenges such as standing one-legged and/or two-legged on stable and unstable surfaces, reacting to external forces such as a partner’s light push or the catching and throwing of a medicine ball, and moving the joints of the body through all planes of motion.

The goal of functional core training is to develop in the core a system of efficient
automatic responses to work as a stable base from which to generate optimal force and
motion.

Postural Distortion and Biomechanical Dysfunction
Consider how the chronic shortening of just one muscle, which happens to be a core
muscle, can impede performance and cause imbalances that lead to injuries. The rectus abdominis is a good example of an over worked muscle. As this muscle is overworked, the other core muscles are often ignored. Crunches, leg raises and exercises using abdominal machines all work only in the sagital plane, therefore limiting “benefit”
to muscles that produce hip and trunk flexion. (Note that repetitive trunk flexion places
increased injury-causing stress on the intervertebral discs of the lumbar spine). It is
imperative to train the core in a multi-planar fashion, especially the transverse plane, in
order to create stabilization in the trunk, and in effect more optimal posture, strength and motion in the entire body. The following is a common example of the result of
overworking the rectus abdominis. A tight rectus abdominis, when creating tension, or pull, on its upper and lower attachments, including the anterior pelvis, anterior ribs and inferior sternum, produces a flexion force in the trunk. This has consequences beyond the immediate structures affected.

These consequences include a chain of effects that begin with shortening and tightening
of the pectoral muscles. These muscles will exert an inferior tension on the clavicle,
superior ribs, and the anterior scapula and will assist in internally rotating the humerus.
The force of gravity also contributes to the internal rotation of the glenohumeral, or
shoulder joint, as the trunk flexes forward. Internal rotation of the humerus tensions and lengthens the external rotators of the shoulder which in combination with the tension exerted on the anterior scapula by the pecs, will bring the scapula into protraction, lengthening and weakening the middle and lower trapezius, and rhomboid muscles. (Note that a tight latissimus dorsi can also be a primary contributor to internal rotation of the humerus.) The internally rotated humerus and protracted scapula will place the rotator cuff muscles at a biomechanical disadvantage in dynamically stabilizing the glenohumeral joint. The cuff will not function effectively, increasing the risk of injury. The reaction of the cervical spine is two-fold. The lower segments of the cervical spine follow the forward and downward movement of the trunk, and they themselves flex, causing lengthening and weakening of the deep cervical flexor muscles. (This can also stress the outer layer of the intervertebral discs, which over time, may lead to injury.) Naturally, if the lower cervical spine flexes forward, the head will follow, and if this force is not countered, gravity will cause the head to fall forward. In order to prevent this from happening, tension will develop in the cervical extensors, including the upper trapezius, splenius, semispinalis, spinalis and sub-occipital groups, which attach to the base of the skull. The upper cervical segments including the base of the skull are extended, shortening the sub-occiptal muscles. This extension will allow the skull to remain somewhat level as it rests on the atlas, or the uppermost cervical vertebrae. The over-working of the upper trapezius muscle and lengthening and weakening of the middle and lower trapezius and the rhomboids will also contribute to early elevation of the scapula with shoulder motion. This will worsen the position of the glenohumeral joint and will further stress the rotator cuff. This example has been limited to the rectus abdominis. It is important to understand that single muscles are rarely the isolated culprits in postural distortions and biomechanical dysfunction. (An exception would be an acute specific muscle injury that has not healed correctly and has caused compensatory overloading in other areas.) Because muscles act synergistically and as agonists and antagonists, there is usually more than one contributor. There are also connections between muscles through tough fascial connective tissue, which help to transmit forces between tissues. These cases of dysfunction can be rooted in other parts of the body, as the musculoskeletal system functions as a whole. Not only will these faulty positions and compensatory biomechanics cause an athlete to move inefficiently. Over time they may lead to degenerative processes in the soft tissues and joints that will lead to further injury and impairment.
The neurological system also adapts to these changes, applying muscle memory, as it
controls the musculature. Training this system is essential in developing healthy
neurological pathways and muscle firing patterns. This is achieved through the methods
mentioned above – using medicine balls, balance boards and stability balls and
challenging the neuromuscular system. Any of the muscles mentioned above may be the source of dysfunctional patterns, but it will most likely be a combination of them that will be the cause. It is important to follow the entire kinetic chain when assessing and treating these conditions.
Cycling
Most cyclists focus on their hamstrings, quadriceps and gluteal muscles, and forget about
the importance of core stability. Consider how many hours the cyclist spends bent over in a flexed position on the aerobars, with no rotational or side bending motions. A strong core is needed to counterbalance these forces. With a focus on the core, a cyclist can generate more power and can sustain a higher level of intensity for longer periods. A stronger core also means less stress on the primary muscle movers and a delay in the build up of lactic acid. Even minor changes such as brake position can affect core stability. If the brake handle position is too low, the cyclist is forced to reach too far forward with their forearms. This reaching position forces the cyclist to raise their head forcing the pelvic girdle posterior. This position can cause a restriction in several key
muscles in the core, thus reducing performance. The ideal position for the forearms is to have the elbows bent and the forearms flattened out. In this position, the cyclist head drops into a more comfortable aerodynamic position, and the pelvis tilts forward. In this
position, the cyclist is able to use all the core muscles with improved efficiency.

Running
Now consider how a shortened rectus abdominis affects a tri-athletes performance during running. Although opinions about the ‘ideal running form’ vary greatly, most authorities will agree that the less energy that is expended, the more effective and efficient the running style will be.

When performing a biomechanical analysis, it is very common to see numerous
imbalances of which the athlete is completely unaware. By video taping an athlete during activity the practitioner can show and explain what is happening then correct it.
When analyzing a runner, some of the most common biomechanical faults looked
for are:
• Over-pronation (rolling in as arches collapse) in the feet – this can cause a series
of biomechanical imbalances from the foot up to the cervical spine.
• Excessive hip adduction – due to tight hip adductors and can cause increased load
in the lateral tissues such as the iliotibial band, tensor fascia lata and gluteus
medius.
• Lack of trunk rotation – due to restrictions in trunk rotators or shoulder extensors.

This can cause overload in the hip musculature, spinal joints, and other trunk
rotators.
• Lack of hip extension – caused by tight hip flexors restricting extension, and weak
gluteal muscles. This causes the extensors and rotators of the lumbar spine to
become overloaded in order to compensate for the lack of hip extension.
• Lack of shoulder extension – caused by restrictions in anterior shoulder muscles
or poor trunk rotation.

Educating yourself on how the core works will help to avoid injury, improve your athletic performance and increase training efficiency. Far too often people read the most popular book or take advice from someone who they think knows more than they do.
This cookie cutter approach does not take into account the persons specific needs and
goals. In my opinion anyone who participates in any sport or activity should have a
professional evaluate them for any weaknesses or poor movement patterns. I can’t tell
you how many patients have told me “It just started hurting I never did anything to it”. A
simple evaluation can save you from repetitive stress injuries.
Written by
Dr. Robert Inesta
Charles DeFrancesco
http://www.fitandfunctional.com

References:
1. McGill, S, Ultimate Back Fitness and Performance: Ontario. Wabuno Publishers. 2004.
2. Kendall FP, McCreary EK, Provance PG. Muscles: Testing and Function. 4th ed. Philadelphia: Lippincott Williams
and Wilkins. 1993.
3. Runnersworld.com

Why Does Everything Hurt?

As we get older,  it seems as if we discover a new ache or a pain in our body every day that never bothered us before.  Many of us are plagued by chronic pain and we often do not know how to alleviate it. Part of the issue is that we are constantly doing things during the day which exacerbate our symptoms and we don’t even realize it. Additionally, as we get older, we often forget that our bodies are not quite as resilient; after a week of sedentary behavior, we will hit the gym or play sports full-force on the weekend which lead to us injuring ourselves.

One of the most common complaints is lower back pain. This often results from sitting for too long and from sitting incorrectly. Sometimes lower back pain can be a result of a disc injury or arthritis, but for most of us, it is just the result of not moving enough. First, position your desk so you are sitting with proper posture. It is also important to get up for frequent breaks and to stretch and to move around. Outside the office, lower back pain can be exacerbated while exercising. It is imperative to make sure you are not using your lower back during weight lifting or other exercises. Instead, focus on activating the hips and glutes to protect your lower back during your workouts. Additionally, strengthen your core muscles to stabilize your trunk, which will also decrease the load on your back.

Another common malady is neck pain and stiffness. This can result from sitting improperly, walking incorrectly, driving with your head jutting forward, or from sleeping with you neck turned.  Also, stress and tension play a significant role in neck pain and stiffness as well.  Neck pain can increase outside during exercise as well. Often, while performing exercises, we lead with our chin and put extra pressure and strain on our necks without realizing it. Proper form and activation is key to keep the neck pain free. Meditation, stretching and other stress relief techniques are also helpful for decreasing neck pain.

Other common ailments are knee pain, joint pains, muscle strains, and carpal tunnel syndrome. If symptoms are severe and you do not see improvement, you should visit a doctor to rule out a major injury. Assuming there is no disc issue or major tear, sprain or break, many of these problems are caused by our activities of daily living and improper form during therapeutic and strength exercises. The way we sit, walk, talk on the phone, sleep, and exercise all impact how our body moves and feels. Form during exercise is extremely important. Many clients don’t realize their positioning is off and might be affecting their mobility, flexibility, cardio endurance, and strength.

Most people will feel better by engaging in a routine that includes stretching to improve join mobility. It is helpful to use tools like a foam roller or baseball to alleviate knots and to help stretching. Secondly, weight loss often helps with daily aches and pains. Extra weight can put pressure on the joints and cause pain and discomfort. A healthy diet and cardiovascular exercise can help decrease weight and issues with pain. Lastly, strength training, especially core training, helps decrease muscle pain because the muscles stabilize the joints.

It seems like the answer to feeling better and decreasing pain is to engage in physical activity with proper form. Always make your body a priority! If necessary, meet with a personal trainer to ensure you are performing exercises correctly and to make sure you are utilizing exercises to help with your individual issues.

Keep Your Core Strong

In the world of exercise, the core is a common focus. Often we hear about how important it is to strengthen our core and to improve core stability, but what exactly does this mean? The core is made up of much more than the abdominal muscles. In fact, most of the power in the body is derived from the core.  It is imperative to have core strength and stability in order to prevent injury and to increase performance. Therefore, it is extremely important to understand what the core is and how we can strengthen it effectively.

The core connects the upper body to the lower body and it affects how we move these body parts. It is involved in activities of daily living, such as bending and lifting, sitting properly at a desk, housework, gardening, sports, balance and stability, good posture, and preventing back pain. Weak core muscles can negatively affect your daily functions. With our sedentary lifestyles, most of us have weak cores. We need to continually work at strengthening these muscles.

The core is made up of muscles from the neck and shoulders down to the pelvis. These include the multifidus, interspinales, intertransversarii, rotatores, internal and external obliques, transversus abdonminis, erector spinae, quadratus lumborum, latissimus dorsi, thoracolumbar fascia, and abdominal fascia. Therefore, core training is not as simple as doing sit-ups.  It is important to train all of the core muscles, not just the “abs,” for effective movement. The core transfers force and acts as a stabilizer, which is why it is important to train the core dynamically in all planes of motion rather than in isolation. Therefore, deadlifts, squats, pushups, pikes to pushups, and planks would be much more effective at training the core than sit-ups. These exercises will create more efficient movement and increased strength. Further, the core should be engaged while weight training other body parts in order to develop core strength. It is important to note that many traditional core exercises do not adequately recruit the abs and have been shown to damage the lower back.

Core stability creates efficient movement and proper positioning to prevent injury. For example, if a cyclist reaches too far forward while biking, it changes the position of the hips and pelvis, which affects posture and power. Similarly, while running, tight hips and lack of hip extension can cause the lower back to hurt and affect performance. It is helpful to use a foam roller to decrease inflammation and tension and to prevent restrictive movement before exercising.  Additionally, meeting with a personal trainer to learn the proper form will ensure you are exercising effectively in order to reach all of your fitness goals.

Don’t neglect your core, since it is the foundation for your health and fitness. The stronger the core, the stronger you are and the better you will feel.  A stronger core equals a more solid you!

Please click on this link for some effective core exercises: http://thearenafitness.com/exercise-library/exercise-gallery/images/pdf/exercise_pdfs/3_core.pdf

Why Your Workouts May Not Be Working

Have you been exercising & not seeing the results you’re expecting? Have you developed pain or made an already painful condition worse with exercises that were supposed to help? Have you been told by a trainer or physical therapist that your glutes are not firing or that you have poor balance and you just can’t seem to correct the problem?

These are very common issues that I hear about in my practice which can have multiple causes. The first thing to examine the program itself – what exercises are being done and are they even appropriate for the individual, based on their health history and present condition. I often see people doing exercises that they should definitely not be doing because they are harmful and will cause injury. Unfortunately, I also see many trainers and specialists prescribing these same exercises.

The second thing to examine is form to determine if the exercises are being done properly. A good exercise, if done incorrectly, can also be a bad exercise. Always be meticulous with form. The purpose of exercise should be to improve our health, whether the goal is increasing strength and endurance, rehabilitating tissue, or correcting movement patterns.

The above are very obvious reasons and should always be ruled out first. However, if the exercises are appropriate & being done with correct form but the issue is still present, there may be another less obvious culprit. This hidden hijacker of a good workout results could be fascial tension.

You may have heard of fascia recently, as it getting more attention due to research. Fascia is connective tissue that literally wraps and connects every structure in the body. To visualize this, imagine removing every organ, muscle, and bone. If we were to leave all the fascia intact, we would have a 3D outline of the entire body – a completely continuous web.

Fascia transmits energy and force, in addition to holding everything together. We often think of muscles contracting independently to perform an action. For example, flexing our elbow we attribute to the biceps and brachialis muscles. But in reality, it is much more than that. Tension is created throughout the entire arm and shoulder, into the trunk and down to the hand through fascial connection. Other muscles are also performing at different levels in order to stabilize the arm. So really, everything is working, but at different levels of intensity.

We often think of muscle contraction generating force in the tendons (which attach the muscles to bones) in order to produce a movement. Studies have recently demonstrated that only 70% of the generated force of a muscle contraction is transmitted to the tendons. The other 30% is transmitted outward to the fascia surrounding the muscle by way of attachments along its entire length. Because fascia is completely continuous throughout the body, this force is transmitted to other muscles and structures. This shows that when a muscle acts, it is doing much more than its attributed movement. It is communicating with and working in conjunction with other muscles along a line.

Fascia is also a sensory organ. Another recent discovery is that there there are more sensory nerve endings in the fascia than there are in the muscle. These nerve endings provide information to the brain and spinal cord about position, tension/stretch and pressure – a sense of where we are in space and what is happening to keep us there. Keep in mind that most of this is happening without us even realizing it.

Fascia is made up of different layers that need to slide over each other in order for movement to happen, and in order to have accurate information exchange with the nervous system. If there is restriction of this sliding, usually due to a densification of hyaluronic acid, the substance that lubricates the fascial layers, overall movement can become restricted. Muscle activity can become inhibited due to the lack of efficient communication through the nerve endings that live in the altered fascia.

The densifications causing this altered function can be a result of old trauma/injuries, surgeries, scars or repetitive strain. For example, an old ankle sprain that didn’t heal properly may subtly cause dysfunction either locally in the foot/ankle, or above in the knee, hip, pelvis or even in the shoulder on the opposite side of the body. These densifications may be difficult to detect because they are often found in different areas than where the symptoms manifest. In this case it would be helpful to be evaluated by a professional who understands this process to properly determine the dysfunction and correct it.

Fascial Manipulation is a diagnostic and treatment system developed by the Stecco family in Italy. It sees the body as an interconnected network of points along the fascia that make up different motion planes. The points are centers of coordination for underlying muscles. Interestingly, many of these are also acupuncture points. Densification, or dysfunction, in these points can alter the muscle activity. Fascial Manipulation practitioners find these areas of densification and remove them through a very specific, deep massage technique. When normal sliding is restored to these points, or centers of coordination, very often pain is relieved and muscles function much more effectively with less stress. It is worth noting that Fascial Manipulation has the most scientific research behind it than any other manual soft tissue technique.

Freed movement in the fascial planes leads to normal coordination of muscle activation. This can allow workout results to be more consistent with the targeted actions of exercise and desired goals. If you feel you are not getting the most out of your workout and you know you are doing the proper exercises with good form, consider a fascial evaluation.

Robert Inesta, DC, L.Ac, CCSP

The Importance of Being Flexible

Flexibility is underrated in both the fitness industry and in life, in general. A person’s flexibility refers to the ability of a joint to move through its full range of motion. It is important to attain a full range of motion to perform activities of daily living and to reduce the stress on muscles, which in turn decreases injury rates.

Flexibility is joint-specific, since each joint has a potential range of motion. Static flexibility refers to the range of motion that can be attained while not in motion; dynamic flexibility refers to the range of motion that can be attained during movement. Dynamic flexibility is important to athletes because range of motion is limited by the amount of time it takes for a muscle to lengthen, which affects athletic ability. The more a joint can flex, the better the athlete can improve sport-specific skills.

Greater flexibility of the muscle(s) around the joint translates into better posture, reduced risk of injury, and less muscle tension and soreness. We need to be flexible in order to perform every day activities, from sitting to standing, and from lifting items to turning the body in different directions. Joints become stiffer as people age. When our muscles are sedentary and inflexible, our bodies create poor posture habits and movements that reduce the mobility of joints and compromise body positions. Flexibility helps prevent this loss of mobility.

Stretching helps to reduce soreness after exercise and gradually elongates the muscle through its full range of motion, which improves muscular balance and resting posture. Additionally, stretching promotes muscular relaxation, which increases flexibility in the hamstrings, hip flexors, and quads. This decreases the likelihood of both sporadic and chronic back pain. Stretching also increases blood flow and nutrients to soft tissue, increasing joint synovial fluid, which lubricates the joints and improves greater range of motion and decreased joint pain and degeneration.

Stretching can be part of a workout or a workout all by itself. As a rule of thumb, before a workout, dynamic stretching should be done. Static stretching should be reserved for after a workout. When stretching, always be gentle and never jerk the muscle into position. Instead, smoothly move the muscle into position to safely lengthen the muscle tissue. Mild discomfort is normal during stretching, but there should never be any pain. Pain is an indication that the muscle is being overstretched or has been excessively stretched. Find 5-10 minutes per day to stretch to reduce stress and improve your health. Your body will thank you for it!

Breathe Easy

Breathing is the most basic movement pattern but it is often done incorrectly.  This causes tremendous consequences, in terms of our musculoskeletal health. If we think about how often we breathe, it is easy to see how incorrect patterns can lead to big problems. Faulty breathing patterns and the impact that they have are often overlooked. This is because it is such a subtle and involuntary movement that we typically do not think about it!

It is common to think of breathing only in terms of respiration, which is obviously essential to sustaining life. However, the effects go beyond the basic respiratory function. There has been much research demonstrating a link between breathing pattern disorders and low back pain, neck pain, shoulder imbalances, TMJ pain, poor motor control and posture.

Posture and breathing are directly related. One cannot be addressed without the other. Breathing pattern disorders usually develop as we begin to develop poor postural patterns very early in life. Watching an infant is a great way to see proper breathing, as they have not yet learned to do it the wrong way.

The diaphragm, which is the main muscle responsible for breathing, can be seen as an essential component of the core function. If we think of the trunk as a cylinder or column, with muscles and fascia wrapping around as a belt, the diaphragm acts a lid, while the pelvic floor muscles make up the floor. Often when working the core, we often focus on the abdominal muscles and do not consider the importance of the diaphragm. If breathing is not correct, one cannot have full core stability.

An easy way to assess your breathing is to stand in front of a mirror placing one hand on the upper part of the chest and one hand over the abdomen. Take a deep breath and notice the movement of the hands. If the hand on the chest elevates, this indicates incorrect breathing, or thoracic breathing.

The correct pattern is when inhaling, the abdomen expands, pushing the hand over the abdomen forward, or outward. The hand on the chest should not move much. This is known as diaphragmatic breathing, and properly engages the diaphragm.

Thoracic breathing engages muscles of the chest, upper back and neck as the primary breathing muscles. Over time, these muscles will develop tension from overloading and doing more work than they are designed to do. While these muscles are overworking, the diaphragm is under-working, contributing to core weakness and the long list of consequences that result.

Awareness of breathing pattern disorders through the simple test above is an important step. To begin working on correcting the pattern, try the following. Lay supine (on your back) and prop your legs up on a cushion, or support, so that the hips and knees are both at 90 degree angles. If you cannot do that, simply laying on the back with knees bent will also work. Place one hand on the abdomen and the other on the chest and breathe normally trying pull the breath into the abdomen. With each inhalation, the goal is expand the abdomen lifting the hand. The ribcage will also expand a bit laterally, but should not elevate. Try to stay as relaxed as possible while doing this and don’t worry about taking deep breaths. Breathe easily and normally. Do this for a few minutes three to four times a day.

This will start to groove the movement pattern and reprogram the system. Gradually, you will begin notice when breathing is being done incorrectly and will be able to easily switch to diaphragmatic breathing. It is more difficult to do this while upright, which is why the supine position is the best way to start the training process. It is very important to work on posture simultaneously in order to achieve the best, long lasting results. It is very difficult to breathe correctly with poor posture.

It’s important to keep in mind that this is a process. It will not change overnight. It takes a lot of work and consistency to retrain a system that has been in place for so long. Remember how often you breathe and for how long it has been done incorrectly! Do not get frustrated if you feel like you are getting nowhere. Keep working on it. If you feel you need more help, consider seeking the help of a professional who has experience with this. Many chiropractors, acupuncturists, trainers, physical therapists, massage therapists and other types of body workers can be very helpful.

There are many other health benefits to proper breathing, in addition to musculoskeletal health. One can write volumes on breathing in terms of musculoskeletal, biochemical, respiratory, mental/emotional, endocrine, neurological and spiritual health. Many types of meditation and relaxation exercise focus on the breath. It is synonymous with life. So contribute a few easy minutes a day to your breathing, and ultimately your health. It is a worthy cause.

Proprioception

Proprioception is defined as the body’s ability to sense stimuli with regard to position, motion and equilibrium. It is the sense of the orientation of one’s limbs in space; the ability to know where a body part is without looking at it.  Therefore, the body is able to sense the position of its parts, analyze it, and react with proper movement. Without proprioception, we would have to constantly watch our feet while we were walking.

Balance and proprioception are not the same things. The sense of balance originates from the fluids in the inner ear. Proprioception is provided by proprioceptors, which are sensory receptors. These nerves are located inside the body and transmit information from the muscles, joints, tendons and skin to the central nervous system.

Proprioceptors control balance, coordination and agility, and by training proprioception, we can improve balance, coordination and agility. Balance is a basic skill needed in practically every activity.  The key to efficiency is changing your center of gravity to match your moves. Agility is what allows us to move gracefully without wasting motion.  It allows our joints to move through the full range of motion smoothly and confidently. Proprioception also reduces the risk of injury. For example, ankle sprains are a fairly commonly injury for athletes.  These are often caused by a lack of balance or proprioception.  Even if a runner has strong lower limbs and good endurance and flexibility, slight deviations in the terrain during running require adjustments in balance. If the athlete has not trained the neuromuscular system to react appropriately when running on uneven ground or when they have a misstep, they may be injured.

Just like any other motor activity, proprioceptive ability can be trained. Any new motor skill that involves precise movement of our arms and legs– from baseball to painting to skiing – involves training our proprioceptive sense. And just like any new skill or exercise, it requires a progression during training. Start with simple exercises and make them more complex as the individual improves.

Proprioception can be tested by standing on one leg for 30 seconds with both eyes open and then standing on one leg with both eyes closed. Beginners should start with static balance activities and advance to agility and coordination activities. Balance exercises should start on the floor and progress to unstable surfaces, such as stability trainers or wobble boards. On the stability trainer, you can perform lunges, mini-squats, etc and progress to using a resistance band and then further progress to one leg. Wobble boards are good for static balance training and can be made more difficult by using a weighted ball. Be sure to exercise caution when using unstable surfaces.

After mastering balance, you can move on to more advanced proprioception for agility and coordination. Activities used to improve agility and coordination including pivoting, twisting, jumping and cutting. Progress jumping from two legs to one leg.

It is important to use correct technique when performing proprioceptive exercises. Reduce the intensity or level of activity if you cannot perform the exercise with proper technique. In order to reduce the risk of injury, perform these exercises before you are too fatigued. It is important to consider age and body weight when engaging in proprioceptive exercises. Performed correctly, this type of core stabilization or stability training is an invaluable tool to enhance overall fitness.

All Trainers Are NOT Created Equal

Many people who have personal trainers feel that theirs is the very best.  I have never met anyone who doesn’t rave about his or her trainer, especially if he/she has been working with them for a substantial period of time. Part of the training experience is the camaraderie and trust formed between the trainer and his client, and the majority of people are very loyal.

However, putting friendship and personality aside, only a handful of personal trainers are truly competent and knowledgeable. As a result, many people get injured and sometimes the client doesn’t even realize that their trainer is responsible. Many injuries are repetitive injuries, which are injuries that occur gradually over time due to frequent, repeated, unsafe movements.

The client may not even know that they are being injured! For example, one morning a person can wake up with his knee bothering him and he is unable to walk without pain. He may not remember doing anything the day before to cause the injury; in fact, this injury may have been happening gradually over a period of time. Therefore, a client may be ignorant to what is causing his ailment. Injuries may be caused by improper form, unsafe exercises, or lack of knowledge about anatomy and how the body works. Clients need to be able to evaluation their trainers objectively; you cannot assume that all gyms are hiring qualified, competent trainers.

Intensive training &/or education is not currently required to become a personal trainer. All that is required is a certification that is accredited that the National Commission of Certifying Agencies (NCAA); for example, the National Academy of Sports Medicine (NASM), NFPT (National Federation of Personal Trainers and the Aerobics and Fitness Association of America (AFAA). Most gyms require that their trainers are certified, but NOT all do! Make sure that your trainer is certified and that he attends seminars and takes continuing education courses to stay current.

The body is a complex machine and it is important that a trainer understands proper mechanics to avoid injury, especially if the client has pre-existing conditions. A trainer should perform an initial evaluation and obtain a health history so to target weak areas and avoid aggravating an injury or condition that is already present. The evaluation should include testing flexibility, balance, core strength, muscle strength and endurance, as well as proprioception. Your trainer should be able to explain why he is choosing certain exercises and how they benefit you. He or she should also be knowledgeable in functional training, which is training for daily activities or a specific goal. Additionally, your trainer should be able to use the initial assessment to design a tailor-made workout program for each individual. There is no one-size-fits-all in personal training.

There are many benefits to using a personal trainer rather than working out on your own. Choose wisely, because not all trainers are created equal. Do your due diligence and do your research to ensure you get the results that you want.