Nurturing Your Inner Athlete
by Courtney Wyckoff Benavides, CPT, CES
I am a strong believer that every single patient I see harbors an “inner athlete.” And whether that inner athlete will help you run your first marathon in record speed or simply allow you to carry two children on your hip while making dinner, the bottom line is that proper strength training is the key to nurturing it. Over the years, I have seen many patients who, with the best of intentions, dive head first and hopeful into the latest strength-training fad, only to then come out six weeks later lacking measurable results and suffering from plenty of new injuries. Unfortunately, it is this sort of experience that makes many patients give up on their health and fitness goals entirely.
That's where I come in. I am passionate about helping patients find ways to nurture their inner athlete that are effective, sustainable, and fun. I believe that no amount of motivation works better for a fitness plan than simply helping someone to feel stronger and to be in less pain on a daily basis. Instead of waking up in the morning saying, “I should do my exercises,” I find that patients start waking up wanting to do them because they know that it helps them get through the day without a nagging spasm in their neck or an exhausting pain in their low back. Furthermore, I have observed that when people finally start to feel stronger and also start to feel less chronic pain, they become more confident in their daily lives. Self-care begets self-care.
This is why my approach to patient fitness routines is about both pain management and effective, yet sustainable strength training. I am not an advocate of intense, boot camp style work outs for this reason. Rather, I am interested in creating programs that patients can do from home and with very little effort. These programs, while customized for each individual patient I see, generally incorporate the following three components: 1) Retraining movement patterns, 2) Core conditioning, and 3) Self-myofascial release.
Retraining Movement Patterns
All of us have ways of moving that are often contraindicative, which means that they hinder us from performing daily routines without causing injury. For example, many of our chronic aches and pains are often linked to movement habits like standing on one leg more often than the other, crossing our legs the same way every time we sit down, holding our phones to our ears the same way, or even breathing into our shoulders instead of our ribs or belly. It is these unconscious and repetitive movements that are most often to blame for much of our physical pain.
The most common contraindicative movement pattern that I see involves what I call an imbalance of the working muscles and the stabilizing muscles. This is a simplistic way of explaining the tendency many of us have to overuse muscles that are meant to do explosive movements and underuse muscles that are meant to support heavy loads for longer periods of time. The trouble with this is that the explosive muscles consist of “fast-twitch fibers” that use anaerobic metabolism to create fuel and, thus, fatigue very quickly. So, when we force our body to use a fast-twitch muscle to stabilize, we will end up with spasms and joint inflammation. But, when we call into action a stabilizing muscle, which consists of slow-twitch fibers that are more efficient at using oxygen to generate more fuel (known as ATP), we can hold a muscle contraction over a longer time before they fatigue.
I see this pattern occur most often in the upper back and shoulders, more specifically the upper trapezius, levator scapula, and latissimus dorsi muscles. The upper traps and the levator scapula are examples of fast-twitch fibers, which means that they are meant to do more explosive, less sustaining types of movements like catching your child's hand as she runs into the street or lifting a glass of water to your mouth. The latissimus dorsi muscle is slow-twitch fiber, which means it is suited for doing something like simply holding your head up on your shoulders throughout the day or carrying your child on your hip. The trouble is that most of us use our upper trapezius and levator scapula to do both the quick, explosive movements and the long, sustaining ones. In this pattern, the latissimus dorsi becomes weak and ineffective, while the upper trapexius and levator scapula become strong and overactive. This inefficient movement pattern is often at the root of the all-too-common spasm that people experience between the shoulder blades and up into the neck.
In the office and through simple at-home exercises, I help patients retrain this movement pattern so that they can strengthen and utilize the latissimus dorsi muscle and, eventually, end their chronic neck and shoulder pain. It is usually a fairly straightforward correction involving isometric exercises, stretching, and behavior modification. For example, I often have patients wear a rubber band around the wrist during the day, which I ask them to gently snap every time they catch themselves with their shoulders up to their ears, a pattern that encourages the underuse of the latissimus dorsi. Overtime and through consistent attention to new ways of moving and holding their posture, most of my patients begin to feel stronger from simply being aware of habitual movements.
Core Conditioning
I am going to keep this section very brief, since the solution to proper core training is fairly easy:
Stop doing crunches to strengthen your core!
Crunches not only compress the discs in your spine, they also do not work the core effectively.
The muscle group that crunches target is called the rectus abdominus, orthe “six-pack” muscle, which is not a muscle group that you need to focus on in terms of overall core function and strength (unless, of course, you are hoping to take pictures in a skimpy speedo!). In fact, it has been shown that if you can do ten crunches without stopping, then your rectus abdominus is strong enough.
The muscle group you want to focus on instead is called the transverse abdominus, which wraps around the waist like a belt. It is also a deep abdominal muscle which connects efficiently to other deep core muscles in the pelvic floor and even in the back (latissimus dorsi). If you are engaging the transverse abdominus, then you are on your way to true core strength. This is where living a life of no back pain and of flat tummies all begins!
To strengthen the transverse abdominus, the best thing to do is to follow your infant's lead: Crawl around the house on all fours for 20 minutes and you will soon appreciate what core strength is all about.
Self-Myofascial Release
Self-myofascial release is an effective way to keep your aches and pains at bay, with little effort and little cost. The technique involves the use of a tool called a “therapeutic foam roller,” which is used to put pressure and tension on something called “fascia,” a layer of skin that goes around our muscles and organs. Some people describe fascia as being like a sweater for your muscles, since it consists of a weave-like protective tissue.
When you put pressure on the fascia by rolling on a foam roller, you are inciting a process called “autogenic inhibition,” which is the body's natural tendency to protect itself from injury. Basically, when the brain senses tension on a muscle, it sends a message to a mechanoreceptor within the muscle called the “Golgi Tendon Organ” to relax the fascia and fiber. This is done so that the body will not suffer a tear or irreparable contusion. Thus, we now use this natural mechanism to our advantage, knowing that we can create change in the tone of a muscle and in the overall function of the body by applying gentle and deliberate pressure on areas that have “knots,” or adhesions.
The truly fascinating thing about fascia is that not only is it a protective tissue, it is a connective one as well. Scientists have shown through the study of cadavers that fascia is connected in meridians throughout the body, which means that the fascia in your calf is connected to the fascia in your neck. For example, I find that many patients who have low back pain and knee pain also have very tight IT bands (which run down the outer thigh from the hip to the knee). It can often be a very painful process to release the fascia in the IT band, but through consistent work on the foam roller, knee pain can be entirely alleviated. In fact, I have worked with many competitive runners with knee replacements who are now able to run marathons by simply keeping self-myofascial release technique in their daily routines.
A Final Word
My only remaining advice concerning how to best nurture your inner athlete is to let your body be your guide ... don't force yourself into a fitness program that makes your body suffer. Simply do what you like to do. I have never seen anyone who pushes themselves reluctantly into an intense program succeed over the long run. The people that do succeed, however, are the ones who commit to doing sustainable, fun, yet challenging exercises every single day. Whether you do that by simply standing on one foot while doing the dishes or by doing 30 push-ups the stability ball ... all that matters is that you stay conscious in your body and try to let it work the way it is intended to work. Your exercise program should never be something that offers false hope, but rather something that reminds your body of its own inherent strength, which then will motivate you to nurture that strength for the rest of your life.