This is a question that we get in our office quite a bit because we’re big proponents of exercise. Activity is a key component of your health. We want to keep people moving. Often, pain and other issues will prevent patients from moving. But movement is the goal. Activity is good.
How Much Exercise is Enough?
Of course, it’s individual specific. It’s patient specific. What are you dealing with? What are your goals? What do you want to achieve? Any time you start an exercise program, you’re changing something.
If you have a low back problem or a hip problem or a shoulder problem, you’re exercise program should be supervised by a physician. We definitely don’t want to aggravate or re-injure an existing condition. Even if you don’t have those types of problems it’s important to visit with someone, even a certified athletic trainer to get a plan.
In our office, exercise sometimes means just a simple mobility versus stability model.
OK. What is not moving? What is weak? And a lot times, we’ll have tied hamstrings, tied hip flexors, tied lower backs. We might want to increase some of the motion in those areas whether it’s joint or muscle or tissue or whatever it may be. And then figure out whether the the client is a little weak and recommend the proper stabilization program.
Is Cardio Exercise Enough?
Barring any serious heart problems you’ve had in the past, cardio is almost always a very safe option. Something that I like to talk a to lot of my patients about is changing your “planes” or changing your vectors and what that means is to mix it up. Get on the treadmill, maybe walk or run for a few minutes. Then, get on an exercise bike for a few minutes. Then, get on a stair master and work there for a few minutes. And then, if you have access to a rowing machine, do that. What you’re doing when I say changing planes or vectors, is that you’re getting in different positions that your body is going to respond different to and at the same time, you’re getting a pretty good cardio workout as well.
What About Specific Exercises Like Squats or Pushups?
Functional training is a buzzword right now. We talk to a lot of our patients about training movement, not muscle. It’s kind of a new concept and what that means is, we want to make sure people are moving correctly whether if it’s in a squatting pattern or flexion pattern, because a lot times, these patients or these clients can’t even perform a simple movement pattern correctly. So, before we add any load or recommend any resistance, we want to make sure that they can perform the pattern correctly. And that goes back to addressing any mobility issues or limitations or weakness. So, it’s really important that we determine what those issues are and then start to train the movement and not so much the muscle. The muscle’s going to get stronger anyway but training that movement is what we want to do and it’s also going to really help prevent injury as well.
Often, we’ll start in unloaded positions and unloaded means we’re going to have you lying down or down on the ground and once you can do some of these things, we might progress you to like a quad position or a kneeling position. Then ultimately, we’ll get you to standing loaded position. A lot of times we see folks in the gym going straight to the squat bar and they add a bunch of weight and they’re trying to squat and it’s just a recipe for disaster. They’re going to hurt themselves because they can’t even perform a simple squatting pattern. So, we just want to start them like we all come into the world, on our bellies. And then we, obviously, start rolling over and we crawl, then we get up a knee and then we stand. We kind of want to train people like that. Get them down on the ground first, once they get past that, we get them into some more difficult positions. I talk a lot about squats and a lot of these new fitness programs and so forth, there are a lot of simple things that we can achieve without risking injury. We have all heard about getting on our forearms and toes. That’s a really good core exercise that can wakeup some of those deep spinal stabilizers.
What About Pain in Exercise?
If exercise is causing pain…STOP. If it hurts, you’re done. It’s as simple as that. When we put together a specific exercise program for a patient, we tell them, “If it bothers you at all, you’re done.” We want to figure out how we can modify that activity or that specific exercise to get them to achieve a similar outcome without risking injury or hurting themselves.
This goes back to the philosophy of “Train the movement, don’t train the muscle.” You should see someone who can determine where you’re limited, whether it’s a flexibility or mobility or a strength or stability issue. And then, once you make those determinations, you can train that body part appropriately, starting from the unloaded position.
I always take it back to the early days of human development. As babies, we start on the ground, then in quad position, then on all fours, up on a knee and then ultimately standing. We need to change the way that we’re thinking and train our bodies like that as well.
And lastly, if it hurts, stop right now.
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