Category Archives for "muscles"

How to Activate Your Glute Muscles

Properly activating your glutes before starting any exercise is important to ensure safety and optimal performance. Complex lifts such as deadlifts or squats not only require a strong and engaged core, but also activation of your large leg and glute muscles to help generate a desired level of power for the movement. 

The glute muscles consist of the gluteus maximus, gluteus medium, and gluteus minimus. The gluteus maximus is the largest of the three muscles and its primary function is to extend and externally rotate the thigh at the hip joint. The gluteus medius, which spans laterally to the side of the hip and thigh, works to abduct the thigh at the hip joint. Lastly, the smallest muscle in the group is the gluteus minimus works in conjunction with the gluteus medium to abduct the thigh and helps prevent the hips or knees to collapse inwards. Engaging all three muscles will help stabilize the hip, pelvis, and trunk. Try these exercises below to engage your glute muscles:

1) Side Stepping with a Band

Stand with your feet shoulder-width apart and a circle band placed just above your knees. Bend at your knees and hips to maintain a squat position. Then step to one side, driving the leading knee outwards and engaging the glute muscles. Bring the trailing leg back to the starting position. Continue stepping for another 10-15 repetitions before stepping in the other direction, driving the opposite knee outwards. 

2) Clamshells

Lie on your side with your hips at 45° and your knees at 90° with a band above your knees. Keep your feet together at all times as you open your top knee up against the resistance of the band. Slowly bring the top knee back to meet the bottom knee. Repeat for 10 repetitions. Then complete on the other side. 

3) Sidelying Leg Holds


Begin by lying on your left side to strengthen your left Gluteus medius “Butt” muscles. Keep your right hip stacked on top of your left and place your right hand on your right hip. Then bring your right foot on the ground in front of your left knee and bend the left knee to 90 degrees. Bring your left foot up, while maintaining the ninety degree bend in your knee. Hold this for 10 seconds; Do 3 sets of 10 repetitions.

4) Lateral Step-Downs / Runner’s Step-Ups

Stand with one foot on a step box and your hands on your hips. Then bring the other foot down to the side and touch the floor. Engage your glute muscles at all times and repeat for 10 repetitions for 3 sets on each leg. Progress the exercise by beginning in the same starting position with one foot on a step box and the other leg straight out to the side. Then kick back with the side leg to about 45° behind your body. Repeat for 10 repetitions for 3 sets on each leg. The third progression is a step-up. Begin in the same starting position, step down with one foot, then drive the same leg and opposite arm upwards. Repeat for 10 repetitions for 3 sets on each leg.

5) Ball Raises on the Wall


Wrap a resistance band around your inside hip.Lean your inside hip onto the exercise ball against the wall and pull with the band towards the outside hip with your hand. With your inner core engaged and your posture tall flex your inside knee up to your chest. Start by driving your outside hip into the ball to bring the inside hip upwards so it’s level with your other hip. Then release and drop your inside hip back down and repeat. Do 10 repetitions for 3 sets.
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Mobilizing the Thoracic Spine

A tight upper back may be attributed to stiffness in the shoulder, neck, or back muscles surrounding the thoracic spine. Rounded or slump shoulders, having sway in the lower back, or a forward head position due to weak back extensor muscles, short and tight chest muscles, or weak abdominal muscles may result in an individual having poor posture. Poor posture can place tension in the upper back and may result in irritation or pain. Sports, weightlifting, irregular sleeping positions, or car accidents may also cause tightness in the upper neck and back region. Mobilizing and strengthening the muscles surrounding the thoracic spine may relieve an individual of stiffness or pain, while improving an individual’s range of motion and functioning. Remember to have a balanced, upright posture by standing tall, bringing the shoulders down and back, tuck your chin, and keep a neutral spine to work on better posture.

EXERCISES FOR A TIGHT THORACIC SPINE

1) Thoracic Rotations: 

Lie sideways on a mat or on the floor with both arms extended to one side and hands together. Bend the knee of the top leg to form a 90 degree angle. Place a long foam roller underneath the bent knee if you are unable to touch the ground with this top knee. Keeping your lower body in this position, twist your upper back by bringing the top arm over your body to the other side to touch the floor. Repeat 10-12 times, then lie on the other side and complete the same movement.

2) Cat-Cow: 

Begin in a table-top position with your knees hip-width apart and wrists shoulder-width apart on a mat or on the floor. Keep a neutral spine and head position. Move into the “cow” pose by inhaling as you drop your belly down towards the mat as you lift your chin and chest up to gaze toward the ceiling. Then move into the “cat” pose by exhaling as you draw your belly into your spine and round your back toward the ceiling. Repeat 10-15 times.

3) Seated Lateral Flexion: 

Begin seated in a chair with both feet planted on the floor or seated on the floor. Raise one arm up towards the ceiling. With your arm raised above your head, slowly bend to the opposite side. Return to the start position and lower your arm. Then raise the other arm and slowly bend to the opposite side. Repeat 5-10 times on each side.

4) Thoracic Extension with a Foam Roller: 

Place a long foam roller perpendicular to your spine on a mat or on the floor underneath your shoulder blades. Interlace your fingers and place your hands behind your head to support the weight of your head. Slowly push with your feet to roll the foam roller up and down the thoracic region. Maintain a neutral spine and engage your abs.

5) 4-Point Walk-Out: 

This exercise helps to re-train muscle activation in the shoulder blades and mobilizes the muscles surrounding the thoracic spine for a better functional recovery. Place your hands and knees in a four point or table-top position with a neutral spine. Engage the inner core and start by walking one hand out to one side, then back to the centre, and then to the other side, then back to the centre again. Put full equal weight each time you place your hand down. Maintain a neutral spine throughout the exercise. Repeat for 30 seconds for 3 sets.

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5 Strengthening Exercises for Dancers

Overuse injuries are commonly found in dancers due to their intense training regimes. Nearly 60 to 90% of dancers experience an injury or multiple injuries during their careers (Steinberg, Siev-Ner, Peleg, et al., 2013). These injuries include chrondromalacia patella (“runner’s knee”), Achilles tendinopathy, and metatarsal (foot) fractures. Some major causes of injury may be due to anatomic structure, genetics, training regime, improper technique, floor surfaces, age, body mass index, muscle imbalance, nutrition, and menstrual function (Steinberg et al., 2013).

Dance typically includes being on the toes and forefoot in a extreme plantar flexion position, known as “en pointe.” Individuals with poor balance and landing techniques will experience higher ground reaction forces which may subsequently strain the back, knees, and ankles. Incorrect form in many non-professional dancers entail a valgus knee position (knees caved inwards) and hip adduction. Conversely, mature, experienced dancers are able to rely on stronger hip and knee joint muscles to stabilize themselves during landing from jumps. Young dancers also experience lower back pain. Causative factors include high preseason training intensity, history of low back pain, low body weight, scoliosis, and stress fracture in the pars articularis of the spine (Steinberg et al., 2013).

Studies have recommended minimal exposure for young dancers to overload exercises, especially those involving the spine and caution with extensive stretching exercises (Steinberg et al., 2013).

Prevention

Here are a few essential tips to reduce the risk of injury:

  • Wear proper footwear and clothing
  • Drink fluids regularly
  • Do not dance through pain as it will exacerbate the damage
  • Practice correct dance technique 
  • Take adequate breaks during and between dance sessions
  • Ensure proper warm-up and cool-down (approximately 5-10 minutes)
  • Use preventative taping and/or braces if necessary

Strengthening

1) Woodchops – hold a light dumbbell or single cable in the highest pulley position with both hands and bring the weight downwards diagonally to the side of the leg opposite to the starting position. Remember to keep a flat back and tight core through out the motion. Repeat 8 to 12 reps on each side.
2) Lateral Step Downs – stand beside a step or a box, then place one foot on the step. Lift the other leg upwards by bending the knee to 90 degrees. Then bring the foot back down to the ground. Repeat 8 to 12 reps before switching sides. 
3) Core Stability – place your stomach onto a ball and keep the spine in a neutral position. Keep the inner core muscles engaged and reach one arm up in front with the opposite leg extended back. Hold for 3 to 5 seconds before switching sides. Repeat 10 times on each side.
4) Superman Deadlifts – hold a light dumbbell to the same side as the leg that will be extended back on. With a nice tall posture, engage the core and bend forward at the hips while you extend the leg back and reach forward with the opposite arm. Repeat 10 times on each side.
5) Squat Jumps – start with a tall posture, engage the core muscles by drawing the lower ab muscles inward toward the spine. Avoid arching the low back, with arms in a ready position, do a one-legged squat with the body weight equally distributed over the foot. Lower the body downwards by bending at the knees, then jump straight back upwards by engaging your glute and thigh muscles. Repeat 10 to 15 times for 3 sets.

Steinberg, N., Siev-Ner, I., Peleg, S., Dar, G., Masharawi, Y., Zeev, A., & Hershkovitz, I. (2013). Injuries in Female Dancers Aged 8 to 16 Years. Journal of Athletic Training48(1), 118–123. http://doi.org/10.4085/1062-6050-48.1.06
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Which is Better for an Injury: Ice or Heat?

Ever wondered whether to use ice or heat for your sore muscles, your healing fracture, or any injury? Both ice and heat have been commonly used to treat an array of injuries, but when to use either one is critical in preventing further damage and promoting faster recovery.

Acute irritation or inflammation of a muscle, ligament, or tendon is typically treated with ice. The cold application reduces inflammation and numbs the pain, especially when the superficial tissues are red, hot, and swollen. The inflammatory response associated with damage to tissues is a defence mechanism in the human body that lasts for the first several days to protect against infection. The response involves immediate changes to blood flow, increased permeability of blood vessels, and flow of white blood cells to the affected site.

ICE APPLICATION

Ice can be used for gout flare-ups, headaches, sprains, and strains. It is crucial to apply ice to the site of injury during the first 48 hours post-injury to minimize swelling. For soft tissue injuries such as muscle strains or ligament sprains, an ice massage involving elevation of the injured body part above the heart and circular movement of an ice pack around the affected area may promote faster recovery of these acute injuries. Apply for 10 minutes at a time, then take a break from icing for another 10 minutes. Repeat this process 3 to 5 times a day. Remember to wrap the ice pack in a dry cloth or towel.

HEAT APPLICATION

Heat can also be used for headaches, sprains, and strains as well as arthritis or tendinosis. Heat causes blood vessels to dilate which increases blood flow and relaxes tight or stiff muscles and joints. Do not use heat during the initial inflammatory response as this will further aggravate the site of injury. For minor injuries, applying heat for 15 to 20 minutes at a time may be sufficient to relieve tension. However, longer periods of heat application such as 30 minutes to an hour may be required for major chronic injuries. Hot baths, steamed towels, or moist heating packs can be used as different heat options.

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Building a Stronger Core to Prevent Low Back Pain

Up to 80% of individuals will experience some lower back pain at least once in their lifetime. Lower back pain (LBP) results in high costs and places a burden on society. These costs include diagnostic, treatment, and indirect costs associated with work disability. A number of conditions can lead to low back pain such as infections, tumours, fractures or dislocations of the spine. However, lifting heavy loads is generally thought to be a key predictor of LBP. An important element in prevention of LBP is to correctly stabilize the trunk during lifting by pre-activating the abdominal wall muscles. By doing so, the spine will increase in stiffness to reduce the effect of undesired spinal perturbations. Exercises aimed at bracing the abdominal muscles may reduce the risk of LBP.

There are two ways of stabilizing the abdominal muscles: an abdominal hollow or abdominal brace. An abdominal hollow begins by drawing in the lower abdomen (transversus abdominus) while maintaining relaxation of the other surrounding abdominal muscles such as the obliques. At the same time, small muscles of the lower back (close to the spine) such as the multifidus are contracted while the larger back muscles are relaxed. With contraction of the lower abdomen and small back muscles, intra-abdominal pressure is increased and the fascia surrounding the spine increases in tension. Combined, these contribute to provide intersegmental stability.

An abdominal brace is performed by activating all of the abdominal and lower back muscles, rather than specific muscle recruitment. By tensing the entire trunk without drawing the muscles in or pushing them out, global activation of the ab and back muscles may provide increased stability in all directions in various movement patterns.

Both the abdominal hollow and brace can help increase the stiffness of the spine to minimize lower back pain. The use of either one will depend on the desired movement pattern and the goals of the individuals in stabilizing their core. Strengthening the core muscles is also essential in reducing the amount of loading on the lower back muscles. Watch these videos below:

Back Pain, Lower Back Treatment “Building Core Strength”:

Back, Sacro-Iliac-Joint Pain & Dysfunction: Core Stability Foam Roller:

Strengthening Hips, Pelvis and Low Back For Ultimate Frisbee: “Psoas March”:

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How to Recover from Achilles Tendinopathy

The Achilles tendon is the thickest tendon in the human body. It attaches the gastrocnemius and soleus muscles (together known as the triceps surae) as well as the plantaris muscle to the calcaneus bone (heel) of the ankle. These muscles combined allow for plantar flexion at the ankle and flexion of the knee.

Tendinopathy of the Achilles tendon refers to a condition that causes pain, swelling, or stiffness at the tendon connecting the muscles to the bone. Commonly found in athletes such as runners, overuse of the tendon, may result in microtrauma or repeated injuries to the Achilles tendon. Wearing improper footwear, having poor training or exercising techniques, making a sudden change to your training program, or exercising on hard surfaces may also cause minor injuries to this tendon. Pain and stiffness may develop gradually and are typically worse in the morning. Pain is generally worse after exercise, but may potentially arise during training. Overtime, symptoms may be so severe that individuals may be unable to carry out their usual daily activities.

Recovery:

Rehabilitation occurs quickly or over several months depending on the severity of the injury. Although pain may be present, expert clinicians and researchers recommend continuing daily activities within one’s pain tolerance. As complete rest should be avoided as much as possible.

In the early stages of Achilles tendinopathy, a treatment called iontophoresis may be used to reduce soreness and improve function. This treatment involves delivering a medicine (dexamethasone) to the painful area. Ice packs are also effective in reducing swelling. Apply ice pack wrapped in a towel or dry cloth to the affected area for 10 to 30 minutes at a time.

However, researchers have found that Achilles tendinopathy is often successfully treated with strength training guided by a physical therapist. Strength training relies on using one’s body weight with or without additional weight for resistance to load the tendon and associated muscles to strengthen the calf. Do exercises slowly to decrease pain, improve mobility, and return to normal functioning.

Try these exercises below:

1) Heel-raise: Stand with your feet a few inches apart. Raise up on to your tiptoes and lift the heels by using both legs. Then lower yourself down using the affected leg. Perform 3 sets of 15 repetitions twice per day. This exercise can also be performed seated in a chair.

2) Calf stretch: Stand a few steps away from a wall and place your hands at about eye level. Place the leg you want to stretch about a step behind the other leg and bend the knee of the front leg until you feel a stretch in the back leg. Remember to keep your heels planted. Hold this position for 15 to 30 seconds. Repeat 3 to 4 times before switching to the other leg. Repeat twice per day.

3) Towel stretch: Sit with both knees straight on the ground and loop a towel around the affected foot. Gently pull on the towel until a comfortable stretch is felt in the calf. Hold position for 15 to 30 seconds. Repeat 3 to 4 times before switching to the other leg. Repeat two to three times per day.

Check out these videos:

Strengthen the Calf Muscles with 1-Legged Squats:
Roll Out Stiff Calves:

Reference: J Orthop Sports Phys Ther 2018;48(5):427. doi:10.2519/jospt.2018.0506
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5 Effective Exercises for Tennis Elbow

What is Tennis Elbow (Lateral Epicondylitis)?

Tennis elbow is a widely common soft tissue condition characterized by pain and inflammation on the lateral and outer aspect of the elbow. It is typically due to overuse of the extensor carpi radialis brevis tendon through repetitive actions such as improperly playing tennis, operating machinery, typing or other gripping activities. Symptoms may include weakness in the arm, stiffness in the elbow, and difficulty performing common hand actions such as holding an object. While ice packs and braces can assist with pain control in the early stages of tennis elbow, improving one’s fitness is very important in the long-term management and prevention of this elbow condition. Try these five exercises to strengthen the arm:

BALL SQUEEZE (to improve grip strength)

1) Hold a tennis ball (rolled up sock or towel can also be used) in your hand.
2) Squeeze the ball for 5 seconds and then relax the hand for 10 seconds.
3) Repeat 8 – 12 times for 3 sets, then alternate to the other hand and repeat exercise.

WRIST TWISTS (to improve forearm supination)


1) Place your elbow on a table so that your hand and wrist are just off the edge.
2) Hold a very light dumbbell (around 2 lbs) in your hand.
3) Rotate the arm outward and turn the dumbbell up. Then rotate the arm inward so that the dumbbell will point back down.
4) Repeat 15-20 times for 3 sets on each arm.

WRIST FLEXION (to strengthen flexor muscles)

1) Place your elbow on a table so that your hand and wrist are just off the edge.
2) Hold a very light dumbbell (around 2 lbs) in your hand so that the palm is facing up.
3) Flex your wrist by curling the dumbbell towards the body and then back down to starting position.
4) Repeat 8 – 12 times for 3 sets. Alternate to other hand and repeat exercise.

WRIST EXTENSION (to strengthen extensor muscles)

1) Place your elbow on a table so that your hand and wrist are just off the edge.
2) Hold a very light dumbbell (around 2 lbs) in your hand so that the palm is facing down.
3) Let your wrist slowly drop down and then lift your wrist back up to starting position.
4) Repeat 8 – 12 times for 3 sets. Alternate to other hand and repeat exercise.

HAMMER CURLS (to condition your forearm muscles)


1) Stand with your feet shoulder width apart.
2) Hold a light dumbbell (5 to 10 lbs) in a hammer grip position (dumbbell is vertical) in both hands.
3) Keeping the elbows close to the body, flex your forearm upward to 90 degrees, then back down to starting position.
4) Repeat 8 – 12 times for 3 sets. Alternate to other arm and repeat exercise.

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