PUMPING IRON: Female Edition

Once you enter a gym and have been there for more than a few minutes any gym member will notice something odd. A type of dividing line that separates where men and women workout. In the cardio section of a gym, I witness a mixture of both men and women working their calories off to increase performance, slim down, or just enjoy themselves. Sadly, similarities end there because once you migrate across the floor....pass the machines....into the darker section of the gym with barbells, dumbbells, plates, and squat racks...women disappear! WHY IS THAT?

As a Gravity Training System (GTS) trainer at Duffy & Bracken Physical Therapy and someone currently studying to become a Strength and Conditioning Professional, I help women learn about their weight lifting capabilities and it's benefits. The aim for most women is to develop a slimmer waist and toner body. Cardiovascular training will surely help lose weight, but what many women don't realize is that adding weight training will compound your weight loss efforts. That is because weight training adds muscle, which the body must maintain by burning calories and thus increasing your base metabolism. So in a sense, just having more muscle will make you a calorie burning machine just by standing around waiting for the train to come.

Ladies, let's have a heart-to-heart for a second. You're missing out on huge benefits that weight training provides that training with a treadmill and elliptical machine only simply does not. If you are looking for health benefits then look no further than that barbell. It is evident that weight training can increase bone health. So to protect those lovely bones there is no better preventive method than starting a weight-training regimen. Lastly, supplementing weight training with a cardiovascular program will better your performance than cardio training alone. Strengthening those bone, muscles, and ligaments will also help to prevent injury during your long runs. "But Jesse..." you might say..."I don't want to become like those bulky women I see on TV with a manly figure. I want to keep my physique and flexibility." Nothing to worry about, this will not happen unless that is your aim. I have never seen anyone 'accidentally' get a bulky figure.

So lets get to the good stuff....the exercise prescription. Firstly....squats, squats, and more squats. They are considered the King of all exercises for a reason. This multi-joint movement requires ankle, knees, and hip flexibility...strengthening all muscles from the abdominals down. Adding weights by holding dumbbells at shoulder height will stimulate the muscles and bones to grow strong. 3 sets of 10 will make sure those are achieved. Just remember to Watch Your Knees! Don't let them move too far over your toes or buckle inwards, to prevent unnecessary strain on your knees. I advise you to have a trained professional watch your form. Duffy & Bracken is a good source of those aforementioned trained professionals, ask us and we will help.

Next the upper body, women's upper body in relative comparison to men's are weaker so we need to get those guns pumped! Another amazing multi-joint exercise is the Military Press. (I like multi-joint exercises...more muscles demanded = more calories burned) In an upright-seated position grab a dumbbell of mild to moderate weight (5lbs is good for starters) and push overhead. This exercise is great in developing muscle and strength primarily in the shoulders and uses your biceps and triceps to help stabilize the weight. Start with a light weight and slowly progress to heavier until desired shoulder size, tone, and strength is achieved. Three sets of 10-15 repetitions is the ideal range for this exercise.

Supplementing these weight exercises into your cardio training will make sure you meet those cardiovascular goals and here at Duffy & Bracken we are all about making you reach your goals. I recommend coming in for a complimentary group Gravity Training Systems (GTS) workout, which will help develop muscle and trim waistlines. The GTS machine uses a combination of inclines and pulleys to safely and effectively workout nearly every muscle. After a few sessions with us you will feel more comfortable trekking into the weight section of your gym to begin reaping the benefits of pumping iron.

Jesse Barriuso, PT Aide & GTS Trainer

ARE YOU ENGAGED?

As one of the Gravity Training System (GTS) instructors at Duffy and Bracken Physical Therapy, one of the first questions I ask a client is whether there is a specific body part they would like to work on. One of the top answers is, "I want a flat tummy! Give me some abs". In response, I remind people abdominals already exist. They just need to be defined.

So how does one do that? First off, doing crunches all day will not work alone. Bulky abs under a layer of fat will be the end result. However, with a combination of aerobic exercises and resistance training, definition will become more evident. In addition, there stands one more element in regards to exercise that is a key component in getting maximum results during a workout; abdominal engagement.

Doubling as a physical therapy aide at the clinic, I find that patients have to learn how to properly engage their core. When the lower abdominals are incorrectly engaged during exercises that require flexion at the hip, it is common to compensate using another set of muscle called the hip flexor. The hip flexor is used to bring the thigh closer to the trunk and is primarily used during exercises such as running and leg lifts to stair climbing. So how do you distinguish between which ones you're using? It's not that you want to isolate the two completely, but you do want to focus on working the abdominals more with certain movements. The only way to do this is practice!

One way to practice is an exercise called transverse abdominis contraction (TAC) with marching. To do this, lie on your back and bend both knees. Keep feet about six inches apart with feet flat on the ground. Naturally, your lower back will have a slight curve away from the floor.

(Transverse Abdominis Contraction shown in the figure where dotted line is shown. Navel is drawn in towards spine and back is flattened)

The first step (TAC) is to engage your lower abs by tensing the muscle. Try drawing your lower abs towards your spine. You should be focusing on the muscles you feel engage when you cough or laugh. Do not hold your breath! This should make your lower back press towards the floor, providing a protective mechanism for your back. The next step is "marching". Slowly, lift one leg at a time bringing the knee towards your trunk, maintaining the 90-degree angle in the knee. Return leg to starting position and switch legs.

If performed correctly your back will stay pressed down and your lower abdominal should be overpowering your hip flexors. If the back begins to arch away from the floor, chances are your hip flexors are overpowering your abs. This can cause stress in the back.

Practicing transverse abdominis contrations can be done anytime. Sitting, standing, and walking are excellent opportunities to practice, as it will improve posture. To learn more about how to better engage your core during everyday activities or exercises, feel free to consult your physical therapist. Remember, the core is like the foundation of a building. The weaker or stronger the foundation, determines how well the building will stand.

Toupelle Goodman, PT Aide & GTS Trainer

Photo References:

Nicholas Institute of Sports Medicine and Athletic Trauma; http://www.nismat.org/ptcor/lbp

Jackie Brand Personal Trainer; http://www.jackiebrand.com/page46.php

Massage Junkies

Before being a physical therapist (PT), I was a licensed massage therapist for 13 years. In that time, I discovered what an amazing tool massage is in relieving pain, lowering stress levels, facilitating length in muscles and, in general, giving back to a person a deep sense of health and human connection....Temporarily.

That is the key-word -- TEMPORARILY. 

Massage can be a powerful ally in PT, but because it is a passive therapy, the person receiving the massage is reliant on someone else's hands and elbows to give them relief. The analogy would be, the massage therapist is the guy with the bucket in a boat trying to unload the boat from taking on water, whereas in physical therapy, the PT, through therapeutic exercise and patient education gives the patient the rudder of the boat and shows the patient how to steer her/himself out of troubled waters.

In other words, the PT empowers patients by giving them knowledge to help themselves so that when they are on their own, they can continue to take care of themselves. That is altruism at its best, which is one of the reasons why as a massage therapist, I wanted to graduate to become a physical therapist. The beauty of this is that the PT and the patient become 'A TEAM' that works together in achieving the patients' goals.

This brings me to you --- our dear patients at Duffy & Bracken and the topic of massage. Duffy and Bracken is a manual clinic, which means that we specialize in hands on techniques. It would be easy to falsely assume that because we are manual PT's, that we perform a lot of massage when we treat you. Manual therapy actually means that the PT, through their hands and eyes, assess and diagnose a patient.

From that assessment, we choose what would most help you, which may or may not include massage. So what this means to you as the patient and team member in your re-hab, is to resist thinking that the massage is the centerpiece of your session. We realize how difficult it is when massage can feel so good, but think long-term. Would you rather have the quick temporary fix, or would you rather invest long-term and actually address the real reason why you came to physical therapy in the first place? (Please answer, "yes" to the latter!)

Also trust your therapist if he or she one day decides not to do massage. Your PT may have decided that massage would actually make your symptoms worse. In general, we do indeed encourage you to seek out a good massage therapist to act as an ally in your rehab. We can always refer you to one if you are unsure of where to look. In fact, we offer massages on Tuesdays and Fridays here at Duffy and Bracken. In the meantime, we ask you to not become a Massage Junkie and sell your PT short of their skills by thinking that all you should be doing at PT is lying down on the table to get the "rub".

John Howard (Johann), DPT, LMT

john@duffyandbracken.com

Just Do It With Duffy & Bracken Physical Therapy

Let's be honest! For some of us exercising is a lot like eating vegetables, you don't necessarily like eating them but you know they're good for you so you eat them anyway. I feel this way about exercise, I don't like doing it but I know it's good for me.

The studies are endless supporting the benefits of physical activity and its impact on our overall health. Exercise is said to help boost your immune system and reduce stress, not to mention the plethora of conditions it helps to reduce your risk of like heart attack, stroke and high blood pressure.

So we know it's good for us, now what?

I find that sometimes the real challenge is making the commitment to include physical activity into our daily routine. With so much going on in our lives exercise can easily get scratched off the do-list. We even know the simple ways to get exercise into our day like taking the stairs instead of the elevator or parking the car far away from the store entrance yet, we still choose to take the easy way out. Some of us get motivated and then stop after a couple of months when we don't visually see our desired results.

At the end of the day all our reasons for being inactive changes nothing; we still need to find a way to get moving. It's for this reason I love the Gravity Training System (GTS) we have here at Duffy & Bracken. It gets rid of our excuses because it provides everything you need in one machine.

Here's how:

1. It's quick - in just 30-40 minutes you can incorporate a full-body workout into your day.

2. You'll feel that it's working - during and after a session you will feel the burn because it heats up all your major muscle groups at your preferred level of resistance. Trust me, you'll have the soreness to prove it.

3. You'll be motivated - our small group classes encourage and challenge you to keep going. The camaraderie of working out with a group goes a long way because your support system is right there in the room with you. 

4. You'll be guided - a GTS trainer instructs each class. Our trainers help you learn how to work out properly and avoid injury. They advise you when adjustments to your form are needed and encourage you to push harder when you're slacking off.

No matter your fitness level we can help! The physical therapists at Duffy & Bracken can create a wellness program customized just for you. Becoming active is great, but far too many people get injured because they simply do not know how to exercise properly or are trained by individuals without the proper knowledge. As the musculoskeletal experts, physical therapists can help you in ways that no other health or exercise professional can.

No more excuses! Call us at 212-402-5430 to schedule a GTS class and get active today!

Kieffer Pearce

PR & Marketing Director

Learn to Move Again With Physical Therapy

I have been a sports and musculoskeletal therapist for over 15 years working with professional tennis and soccer players, marathoners, triathletes etc. But since the birth of my first child last year, I have a renewed interest in motion analysis and rethinking the way in which we adults move.

Babies develop motor patterns and discover how to get around by learning to balance and control the force of gravity. They start with head control, then rolling and gradually progress to walking. Fast forward into adult life and we let gravity control us --- yes as babies we learn to control gravity and therefore move but as adults we let gravity take control --- and when we do we increase our risk for musculoskeletal breakdown.

Musculoskeletal conditions are the number one contributors of health care costs in the USA. It comes at no surprise that low back pain tops the list. We spend hours at our computer desk and we let the computer screen and office set up decide our neck and spine posture --- the result.... chronic neck pain, low back stiffness and postural headaches. We have gotten very good at compensating; walking with our necks, climbing subway stairs with our backs, we can't even roll in bed without crying "ooh aah ouch". All of this is because we aren't aware of how we move. As babies we move with a purpose to learn to use our bodies efficiently. As adults we move to take care of stuff. And this stuff has caused us to tune out.

ALAS! It's not too late to relearn what you have forgotten. You can RE-MEMBER your body again! Your hips and ankles can work in synergy the same way your shoulder girdle can work with your pelvis. Most overuse injuries can be prevented; most strains can be avoided if we can get balance again.

All of the above is preventable - a concept we must embrace - PREVENTION!

Step 1: know there is help and it is affordable without MRI's.

Step 2: get help --- do a Functional Movement Screen to identify the compensation.

Step 3: relearn what is already part of your own developmental muscle memory i.e. learn to control gravity again.

Then hit DELETE to all faulty movement patterns!

Here at Duffy & Bracken Physical Therapy we teach you to move again. We offer Functional Movement Screens daily to identify the areas where you most likely will break down. Plus, we have a studio that offers Gravity Training classes to work on your strength and movement efficiency. Visit our website to learn more about our wellness programswww.duffyandbracken.com.

Renuka Pinto, MPT, PGDR, CSCS, CES

Renuka@duffyandbracken.com

Overcome Your 'Physical Therapy Blues' at Duffy and Bracken!!

Physical Therapy can bring a variety of emotions to an individual's mind. I have worked in Physical Therapy for seven years and have seen people come in for their initial appointments indecisive, anxious, scared and even some delighted believe it or not. Some have been in pain for days, months, and even years so taking that final step and scheduling an appointment to be treated can be a blissful feeling. Working at Duffy and Bracken, I see a change in patients as they go through their treatment. Many are excited to be able to return to the activities they have had to put on hold and to simply be pain free.

At the front desk I speak with many individuals a day with various injuries and set backs, with the variety comes different attitudes. Many are hesitant to begin their therapy because they have doubts they won't improve. An improvement is possible; it just takes time as well as patience and of course the willingness to spend money on those co-pays. Some patients have wanted to put off therapy because of their co-pays or coinsurance. One should keep in mind that you aren't going to be in therapy forever, taking that 4-6 weeks to commit to your therapy will definitely be money worth spending.

I become used to seeing our dedicated patients every week and when they get discharged, it's bittersweet. Sad because I'll no longer see a patient 2 to 3 times a week but happy because they committed to their therapy and got better with the help of the therapists and aides at Duffy & Bracken. As a patient you are not only committing time and money to improving your injury, you are learning new ways to keep your body strong and healthy....Who wouldn't want that?

Something unique about Duffy and Bracken is that several different programs are available for you, outside of traditional physical therapy treatments. There are specialized programs offered that can help any and everyone from an avid runner to a grandmother and at an affordable price. Visit http://www.duffyandbracken.com for more information. You can purchase a performance package where you learn more specifically about your body and ways to improve it. One reason patients do return back to Physical Therapy (and I've heard this multiple times) is because once they are better they quit doing the things they were taught in treatment. Don't let that be your story. Keeping up with your body is very important and therapy as well as our specialized programs can help you now and in the future.

Vonceia Petteway

Administrative Staff

It's All In The Preparation!

On November 4, some 40,000+ runners and I will eagerly await the sound of the gun (read electronic beep) and begin what is arguably one of the world's most famous races. But that, in my opinion, is going to be the easy part. As a physical therapist I have treated numerous runners, and 9 times out of 10 it is the training, not the race itself that lands people on the treatment table. That in mind, when I received confirmation that I had gained entry to the 2012 ING NYC Marathon, my very first marathon, I made a vow to make full use of my physical therapy background and avoid becoming the next victim of the monster that is the dreaded 16-week-training-plan. Since beginning my training in July, I have run over 200 injury-free miles, and learned a lot about running and myself.

Here are the Top 5 Things I've Learned While Training for the Marathon:

Follow the 10% Rule

The 10% Rule implies that you should never increase your duration, frequency, or intensity by more than 10% per week. I've managed to avoid injury while training for the marathon, but I wasn't so lucky while training for a half marathon earlier this year. I increased my long run from 8 miles to 13 miles in the course of a week and wound up missing the next 3 weeks of training with ice on my knee. LESSON LEARNED!

Adopt the 20-Minute Rule

For anyone who's trained for a race you know how difficult it can be to determine if you should push through that annoying feeling at the top of your right knee or turn around and head home. At times like these I've found it helpful to adopt the 20-minute rule. "If you're not sure whether your body is telling you to take a day off or plow ahead, see how you feel after 20 minutes." Go out the door always! If {after 20 minutes} the pain is worse or the same, take a day off; if it's better and you feel nothing, then do the workout. Twenty minutes is long enough to shake off inertia that plagues all of us from time to time, but not so long that it will worsen an impending injury." - Coach and 2:13 marathoner, Brad Hudson.

Build in Rest Days

Simply stated, don't wait for your body to break down to take a day off. Build rest days into your training schedule and avoid an injury that could instead have you resting for weeks.

If It's Not Broken, Don't Fix It

When it comes to gait and the 'correct' running form, everyone has an opinion. While form and technique can be adjusted, worked on, and improved, it's not something you want to suddenly change 8 weeks out from the marathon, nor is it something that needs to be obsessed over if you're running well and injury-free. I could ramble on for days and days about foot strike, gait, and biomechanics- and would be more than happy to do so should any of you reading this have any questions - but the point is, if you're feeling good, keep doing what you're doing; and when in doubt, take shorter steps.

Don't Get (Too) Competitive

While I'm all about healthy competition, a big ego can lead to a big injury. Some people, myself included, find it helpful to use other runners as motivational aides while on those solo runs. However, there is definitely something to be said about starting off slow, running negative splits, and then picking up the pace once you get your legs under you. Try this at your next race and you'll find yourself passing all those hares that went out way too fast. Remember, you don't have to prove anything to anyone.

Stay tuned for my take on the second half of my marathon training, and if all goes according to plan, the marathon itself.

C. Shante Cofield, DPT, CSCS

I'm raising funds for Liberty Science Center in exchange for guaranteed entry into the marathon this year. Please visit my donation page and contribute to this great cause!

http://www.crowdrise.com/libertysciencecenter1/fundraiser/carmencofield