The Best Exercise to take away your Neck, Back and Shoulder Pain

This is my favorite exercise to do on my own to keep my low back and shoulders feeling good.  I teach it to a bunch of my patients that are experiencing similar conditions.  It's fantastic for increasing the flexibility in the upper back to relieve stress on the neck, shoulders and low back. They're called:

Can Openers

To perform this:

• Lay in the side-lying position with your top knee bent and in front, with the knee higher than parallel to the hip
• Extend both arms in front of the body with the hands together, even with the shoulders.  
• Rotate the arm, head and eyes to look behind you as far as possible without the knee coming off the ground.  NOTE - keep your eyes fixed on your thumbnail as you reach behind you.
•  SECRET - Press into the ground with the top knee and stationary arm.  This will provide stability and allow for increased flexibility of the upper back without involving the hips or lower back.
• Once you've gone as far as you can go, return to the starting position.  That's one rep.  Perform 6-12 reps on each side.

This is a perfect warm-up before doing other more strenuous exercises.  This will result in decreased stress on the shoulders, neck, and low back.

For any questions or to schedule a personal appointment in Boca Raton please email me at drscotthoar@gmail.com or dial 561.997.8898.  Keep moving!!!!  To check out more visit www.Mobility-4Life.com

Iliotibial Band Syndrome

Notice the iliotibial band is not a muscle

A common complaint that presents in my office is pain on the outside portion of the knee.  Some people refer to this as ITB or Iliotibial band syndrome.  It's very common with runners, crossfitters and fitness enthusiasts of all kinds.

So here's what happens.  Typically you are someone who does a very high amount of repetitive exercise.  Historically this has mostly been present with runners.  However lately I've been seeing it with crossfitters, particularly those who practice a very high volume of olympic lifts with dysfunctional technique.  

One thing that runners and crossfitters have in common is a limited amount of single leg strengthening activities. (Pistols being the only exception regarding crossfit).  When you don't utilize single leg strengthening exercises you tend to have limited abilities to stabilize the hip.

With that lack of stability at the hip, there is increased shear motion at the hip joint.  So in an attempt to control the movement, the Tensor Fascia Lata and Gluteus Medius muscles (smaller hip stabilizers) get overpowered and the stress is carried down through the iliotibial band all the way down to the attachment just below the outside of the knee.  So that attachment has to work hard to try to stabilize the knee AND hip and it just gets overburdened and inflamed and bam! You've got ITB syndrome.

It's really a pretty unique syndrome seeing that the iliotibial band is not a muscle, it's just a dense collection of connective tissue.  That's why people that have tried to massage or stretch the IT band end up frustrated because it doesn't work.

Two things to watch out for with ITB syndrome:

1) When the knee travels excessively toward the mid line of the body during any weight bearing movements.  This includes Olympic lifts, running, jumping, squatting, etc.  In the clinical world we call this a 'Valgus Collapse'.  The example picture is a gross example.  It's very common to see a much more subtle inward 'bounce' of the knee especially while returning to the standing position during something like deep squats or Olympic lifts.



2) Exercise Programming that lacks single leg exercises.  Examples of exercises would be lunges, pistols (single leg squat) single leg deadlifts, single leg jumps, etc.

Single Leg Deadlifts

If you have any questions or are in the Boca Raton area and would like to schedule an appointment please dial 561.997.8898 or email me at drscotthoar@gmail.com.  To check out more visit www.Mobility-4Life.com

How to Reduce the Stress on Your Body (Stability!)

Most people are aware of the concept of stability within their body.  However what I don't think a majority of us really know what stability is, and why you would want it.

Stability minimizes the amount of stress in your body.

Stability is not strength!  

Stability is a sequence of muscle groups firing in your body to maximize efficiency.

When you move your body in an ideal manner, there are segments of muscles that fire.  This is how is looks:

The inner core

1) INNER CORE - first the inner core fires.  This is the transverse abdominis, the multifidii, the pelvic floor as well as the diaphragm.  A bunch of small fancy worded muscles that should fire without you thinking about it.

2) OUTER CORE - the next wave is the outer core, which are the muscles people normally think of when they think of the core like; abs, obliques, lats, etc

3) Extremities/The Rest - The last thing to move should be things like the hips, the glutes, the shoulders, the biceps, etc.  

The problem is that after injuries or poor posture and lots of other reasons....our sequence gets thrown off.  Suddenly we start firing the 2nd or 3rd levels first.  When this happens you lose flexibility, compensate, maximize the stress on your body and open to door the pain and injury whether it's a sudden or gradual injury.  Studies show that people in chronic pain no longer have this sequence in tact.

The Outer Core

To evaluate if your stability is ideal I recommend you get evaluated by a sports medicine professional.  

The point of this article though it to point out that CORE STABILITY IS NOT HOW MANY CRUNCHES YOU CAN DO!  It's not the strength of the muscles around your mid section but rather if you turn the right muscles on at the right time so that you have ideal flexibility and minimize stress on your body.

How do you know if you have inefficient stability?  Can you touch your toes???  You probably don't if you can't.

For any questions or to schedule your own assessment please contact me at drscotthoar@gmail.com.   To check out more visit www.Mobility-4Life.com

Staying in Shape While Injured

Maintaining you physique and fitness levels while injured can be a tricky thing to do.  I always recommend substituting non-painful exercises for the ones you know bother you, or you just don't do so well.

Here's an article to check out regarding how exactly to do that.  http://www.backtothebox.com/how-do-i-fit-my-prehab-or-rehab-into-my-physical-performance-program-4/  

This is a bit 'Crossfit-oriented' but his template can be utilized in any exercise program you choose.  Happy reading!  

If you have any questions please contact me at drscotthoar@gmail.com.  To check out more visit www.Mobility-4Life.com

I'm Getting Too Old To Work Out and I'm Getting Fat

Is this you?  Is the scale in your bathroom creeping up?  Are you a plumper version of your old self?  AND/OR.....do you have injuries/pain which are keeping you from being able to workout the way you used to?

Ok, well....you're not alone.  I promise.  I hear it all the time.  I have a suggestion for you.

Find 10 different movements that you can do pain free.  Here are some suggestions:

Push Ups
Lunges
Squats
Step-Ups
Jumping Jacks
Jumping Rope
Jumping w/o the rope
Box Jumps
Running
Elliptical Machine
Stair Climber
Exercise Bike
Bike
Burpees
Box Dips
Wall Push Ups
Push Up Position Shoulder Taps
Calf Raises
Planks
Sit-Ups
Bird Dogs (cross crawl)
-there's an endless list of exercises that could be included

This is a version of step ups....most people can perform these pain free

-Pick One Each day
-It has to be a pain free exercise

Now do the exercise for 30 seconds, as many repetitions as you can.

Now rest for 30 seconds.

30 seconds on, 30 second off.  Go for 6 minutes.  Work your way up to 10 minutes.  Even 12 minutes.

Get your heart rate up.  Count how many reps you perform in each 30 second segment.  Attempt to match or top that in the next segment.

This is called High Intensity Interval Training.  There are many forms of it, this is just one option.  You can google "High Intensity Interval Training" and come up with thousands of options.

It's the most effective form of burning fat and maintaining muscle available.

Push Up Taps: Tap your hand to the opposite shoulder and switch.

I highly recommend this if your age 10, age 70, or any age in between.  Just don't do it if it hurts, select a simpler exercise.  Don't let pain or injury or age stop you.  Keep moving!

If you have any questions about any of these please email me at drscotthoar@gmail.com.  To schedule a personal appointment in Boca Raton, Fl dial my office at 561.997.8898.  To check out more visit www.Mobility-4Life.com

Healthy Backs during Squats

I'm really trying my best not to become a purely crossfit/weightlifting type blog, but I noticed something yesterday while I was working out that I feel really needs to be touched upon.

During squats, it's very common that people are not able to stay upright with their spine.  Aka, from the deep part of the squat, the first thing to go back up is the butt, and then the spine follows.  This adds a great deal of stress to the lower back and is one of the reasons that a lot of people choose not to squat (even though it's one of the best exercises there is).

the bar is too high and too far forward

 A major contributing factor that I see, regarding people bending over through the spine during squats, is the placement of the bar.  Far too often people place the barbell just below the bony part of the neck (the Cervical-thoracic junction for all you nerds out there).  This is too far forward (think too close to the tip of the nose).  To maintain an erect spine, I recommended holding the bar back further, just above the shoulder blades.  That way the center of mass of your body with the weight is shifted further back, away from the nose.  You'll be able to sit into your heels better, which keeps the stress off of your knees and low back, and onto the glutes and hips where it should be.

the bar is resting just above the shoulder blade

If you have any questions feel free to email me at drscotthoar@gmail.com or dial my office at 561.997.8898.  To check out more visit www.Mobility-4Life.com

Neck Position During Exercise

When I walk into the local weight room one of the most common mistakes I see are people performing exercises without a neutral spine.

This could lead to lower neck/upper back pain

It's all too common that strength coaches and trainers are recommending looking up while performing activities like squats and deadlifts.  They do this in order to keep you from bending forward while lifting, which is bad.  But complete neck extension isn't the answer.

To minimize stress on the spine, you always want to be in neutral.  This is why during most movements you want to bend at the hips, not the low back.  This protects your lower back from injury.  However when one extends the neck tremendously during a movement, they are no longer protecting the neck.

I recommend having a neutral neck during lifting.  This will protect the commonly injured lower neck/upper back from undue stress.

this is the best pic I could find, I'd prefer his eyes looked a little lower

A great coaching tip for this is to have your gym goer keep their eyes fixed at either the floor about 8 feet in front of them, or fixed on the bottom trim of whatever wall is directly in front of them.

Save those necks!

For any questions/concerns or if you'd like to schedule an appointment please contact me at drscotthoar@gmail.com or phone me at 561.997.8898.  To check out more visit www.Mobility-4Life.com

Your Shoulder and Surgery

Hope this isn't too gross for you guys!

 Shoulder surgery is very common these days.  Typically it's repairing a torn rotator cuff or an arthroscope for degeneration.  Typically after you have surgery, your orthopedic doctor recommends you complete a rehab progression with a physical therapist.  I agree with that.  But what happens after that?  (This approach really applies for surgeries throughout the body, not just the shoulder)

After about 5-6 weeks, broken bones have stabilized.  After about 2 months, most soft tissues will have stabilized. (Nerves can take much longer but you're dealing with a neurosurgeon at this point so that's a different conversation).  What do I mean by 'stabilized'?  I mean you should be free to put weight on the area, to start exercising the area and so on.  Normally your physical therapist is in charge of that and will do a fantastic job for you.  My advice?  Go to physical therapy!!!

But now you've done your course of 3-6 weeks of physical therapy.  They're released you from care, but the area just isn't the same.  And you wonder what to do?  The answer?

A soft tissue chiropractor!  I'd highly recommend one that performs Active Release Technique (A.R.T.), Graston Technique, and utilizes corrective exercises and Rehab.  Surgery and other serious injuries leave you with scar tissue, which can be viewed as a rubber band (muscles) that suddenly feels like a piece of leather (scar tissue).  The techniques described above help to restore the scar tissue to it's normally quality.  When the tissue quality normalizes, the alignment of the shoulder (or wherever else in the body) is able to return to normal and you can start using your shoulder again.

In the mean time?  Wall Walking is always great for range of motion at home.  Here's a video with a pretty lengthy description if you have four minutes:

If you have any questions feel free to call my office in Boca Raton, FL at 561.997.8898 or email me directly at drscotthoar@gmail.com.  To check out more visit www.Mobility-4Life.com

The "Rack" Position

The rack position is a way of holding a barbell in the front of their shoulders in a way that minimizes the stress and energy demands on the body.  It looks something like this:

You have to admit that's an awesome 'stache!

The problem is that if you go into your local Crossfit box, you will see a majority of the members in there do not have the ability to adequately get into that position.  How would you know if you're one of them?  Well if during exercises like front squats, clean and jerks, or thrusters and you notice yourself having wrist pain, you might be one of them.  Sometimes also people that get into the rack position notice that the barbell is actually choking their throat, so therefore there isn't enough space to comfortably rest in that position.

What I've noticed is that there are several main reasons for this.

1)  Limited thoracic spine extension - The is the most common one.  Especially if the bar is choking you out when you get in this position.  Your head, neck and upper back can't go back far enough so there's not enough space for the bar.  Extension is the same thing as 'leaning back' with the upper back.



2)  Limited flexibility of the elbow or wrists - Typically you know if you fall into this category.  An old injury that didn't heal well would most likely be to blame.  Be careful though, just because you feel tension at your elbow as you try to get into the rack position does not mean that you have elbow problems.  It could still be a thoracic spine problem, you just feel added stress and stretch at the elbow because of the upper back's inflexibility.

Ulnar Nerve self tension test

3)  A peripheral Nerve Entrapment of the Ulnar nerve at the elbow - The ulnar nerve (the funny bone) get's almost fully tensioned (pulled tight) in the rack position.  It's close to the orthopedic test we have for entrapment of the ulnar nerve.  The orthopedic test looks like this.  You would feel pain on the inside of your elbow.









Now what do you do if you fall into these category?

1) Thoracic Spine foam rolling techniques - I've gone over this several times in posts in the past.  If you don't know what I'm referring to, go back into the archives section on the bottom of this page.  Make sure you rolling out the spine BEFORE the workout as opposed to afterward.  You need that increased flexibility for your workout.

2)  Try stretching your wrists and your elbows.  Either in two ways, static holding (hold for 30 seconds) or in mobilizations (constant motion to ever end range of motion).  Both will be helpful

3) Get yourself checked out by a sports chiropractor or manual therapist.  There are certain techniques to improving flexibility in a joint or muscle that you just can't reproduce at home.  If you are unable to at least improve your rack position with the foam roller or quality coaching I'd recommend you get yourself checked out.

If you are in the Boca Raton area and would like to get yourself checked out, don't hesitate to sign up for your own exam on the right hand side of the page, or by contacting me at drscotthoar@gmail.com.  Happy racking!!! To check out more visit www.Mobility-4Life.com

Shin splints

Shin splints.....every runner has heard of them.  This is a very common condition. It occurs when there is an overuse injury of the muscles of front of the shin.

There are two kinds: one is just to the outside of the shin bone, one is just to the inside.

What causes it? Typically one of 4 things. It's probably an alignment issue of the lower body stemming from an inflexibility in the foot, ankle, knee or hip. Sometimes it's a stability problem of the arch of the  foot as well.  Flexibility in the joints of your lower extremity serve as the shock absorbers to your lower body. When you have muscle or joint restrictions in the foot, ankle, knee or hip you will add more stress to the lower legs.  Shin splints occur because the two possible muscles involved (tibial is anterior or posterior) are the smallest, thinnest muscles of the lower leg aka the weakest link.

How can you tell if you are at risk for this problem? 4 ways. This will be fun to do on your own

Hip flexibility: can you bend over and touch your toes?(without bending your knees)

Knee flexibility: can you easily pull your knee up to make contact with your butt and easily lock out the knee?

 Ankle flexibility: this ones tricky. Kneel on one knee with the front foot about  one fists distance from the wall. Can you lean forward and touch your knee to the wall (just slightly to the outside of the foot) without your heel coming off he ground?

 Toe flexibility: while standing press your toe into the ground and lift your heel up as high as possible. What angle does the foot make in relation to the toe? If its less than 70-90 degrees than you have a problem.

To improve your flexibility you can do joint mobilizations.

Mobilizations that are just like the assessments.  Rock back and forth into the end range of motion with the particular joint that your trying to affect. Don't hold it too long, then you'll be stretching a muscle.  Joint mobilizations are more effective to making the difference than muscle stretching is.

If you already have shin splints I recommend getting an evaluation with your local sports medicine professional. Be careful, if you let the problem go too long it could turn into a stress fracture which is a pain in the neck to get rid of.  Feel free to schedule an appointment in my office in Boca Raton by dialing us at 561.997.8898 or emailing me directly at drscotthoar@gmail.com.  To check out more visit www.Mobility-4Life.com

Foam Rolling

Have you ever used a foam roller?

Using a foam roller is the next best thing one can do short of seeing a manual sports therapist.  It's very common that runner's use foam roller when trying to self-treat iliotibial band syndrome.  However, there are way more uses then that.  In our office we very commonly use foam rolling as a way to increase the flexibility in our patient's upper back, to minimize the stress on the neck, shoulder and low back.

Having said that this past week I was lucky enough to have a pro, Dr. Nicole Trombetto, a trainer/therapist at RAW Fitness in Boca Raton, FL, who is a MELT Method Certified practitioner (a self-care therapy system) to show me some things about the method.  The method utilizes unique foam rollers and roller balls to help to decrease pain and tension within the soft tissues of the body.  I had no idea how much one can utilize foam rollers and roller balls to treat literally the whole body.  She took me through a class that made my feet feel much looser, and my hands feeling much better, which is always a good thing for a manual therapist such as myself.

Here's a great way to use the foam roller to keep neck, shoulder and low back pain away:

If you have any questions on using the foam roller or if you'd like to get help with any of your ailments please dial my office at 561.997.8898 or email me at drscotthoar@gmail.com. To check out more visit www.Mobility-4Life.com

Should You Reconsider Running?

Reasons You Might Want to Reconsider Running:

if you feel like this when running, there's good news!

1.  More likely to get injured - with the repetition of running without much diversion (like other exercise forms) in your movements, you end up highly stressing certain areas of your body.  Remember the old rule 'if you don't use it you lose it"?  Well running only uses a small amount of the available range of motion of the hips, shoulder, knees and ankles.  It is not a complete exercise form and should not be relied upon as the only exercise form that one gets.  I see more pure runners in my sports medicine injury practice than I do crossfitters.

which thigh would you rather have?

2.  Less muscle, more fat - After about 20-30 minutes of exercise your body uses up the available sugars to provide energy for your exercise, afterward you end up using a good portion of your own muscle mass as energy for your exercise.  Have you ever seen someone that isn't fat but they don't have any muscle definition whatsoever?  They might be an endurance athlete that only relies on one exercise form to stay in shape.  Therefore they're not fat, but they don't really look good.

3.  Your body adapts and conserves energy - This is what the body does, it adapts.  That's why we're all still here.  That's why I was born in Buffalo, NY and used to think that type of weather (cold and snowy) was normal and that the south Florida climate I'm in now was crazy.  And now I'm shivering when I'm up there and comfortable down here.  The longer you do any process the more the body will become efficient (meaning burning less calories and lower your metabolism). 

4.  It takes too long - what? It does....You can burn more fat effectively in a 4 minute tabata interval.

Having said all of this, running is not a bad thing.  If you are passionate about running and it leaves you feeling happy and healthy, then by all means you should continue running.  Now if you don't actually enjoy running, what I recommend you do is to try alternate options as far as your healthy and wellness. Options like crossfit, the orange theory, boot camps, High intensity interval training, yoga, pilates, triathlons, etc.  There are so many options out there and I recommend you try them all.  If you don't like running...then don't do it!

 As always feel free to tell me what you'd like me to write about and if you'd like to schedule your own appointment dial my office at 561.997.8898.  To check out more visit www.Mobility-4Life.com

You're doing those Lunges wrong.....

Lunges are one of the greatest exercises going.  They strengthen the hips, glutes, quads, and core.  They can be performed as a a cardio based exercise or with added weight as a strength training exercise.  There are many variation to keep you interested.  Here are a few tips for what mistakes I see when people perform lunges.

Common Lunge Mistakes:

1.  The toe is the first body part to hit the ground.
-this places far too much stress on the knee

2.  You lean forward with your spine
-typically this occurs because of either tight hip flexors or weakness of the quads

3.  Your knees go beyond your toe
-knee killer for sure

4.  Your knee collapses inward
-although this is a bit exaggerated, I'd say 9/10 lunges involve the knees collapsing too far in like this

Advanced Lunge Variations:

1.  Walking lunges
2.  In place lunges

3.  Reverse lunges

4.  Star Lunges
-a fantastic exercise for hip stability (yes that means you runners with IT Band syndrome)

5.  Unipolar weight lunges
-a great way to incorporate core into the lunge

6.  Overhead lunges
-making this a whole body exercise

If you have any pain during lunges or have questions and are in need of a movement assessment, contact my office at 561.997.8898 or email me at drscotthoar@gmail.com.  To check out more visit www.Mobility-4Life.com

Rules for Returning to Activity after an Injury

My last two posts have been regarding my experimentation with the Carb Back loading diet.  I intended to continue the updates but last week I sprained a ligament in my back, leaving me unable to workout in the manner that is appropriate for Carb Back loading.  So I thought I'd take a week off from Carb back loading and instead write today about what I'm currently dealing with: returning to activity.  So many of us get injured and have questions and concerns about how we should approach ramping up our activity levels to pre-injury levels.  So I thought I'd make some general rules to follow.  Trainers, i'd suggesting posting this on your gym wall so your client have some future reference.

Rules to Return to Activity After Injury

Rule #1 - Get yourself checked out by a sports medicine professional.  This is their expertise, you don't want to end up hurting yourself further or again.  This will significantly speed up the process.

Rule #2 - If you feel pain, don't do it.  Don't even do a movement in which you even 'feel' the affected area, without  pain.  I think you know what I'm talking about.  When you exercise in pain, you will automatically compensate.  Why is that a bad thing?  I'll explain later.

Rule #3 - Start with non-weight bearing, non-painful exercises.  This might include rowing, or swimming, or cycling, or elliptical.  Getting some serious blood flow to a recently injured area can do great things as far as speeding up this whole process.

Rule #4 - Next step, body weight exercises.  This could include push ups, or air squats, lunges, pull ups, etc.  Make sure you're doing full range of motion.  Don't move on to the next step until you have full range of motion.

Rule #5 - Don't add weight until you perform the most provocative movement (if it hurts to squat, squatting would be the provocative movement) with just bodyweight, pain-free without any asymmetries of any kind.  Ask your local trainer or a gym friend that you know has a great deal of knowledge of exercise and technique.  Have them evaluate your movement from all angles.

Rule #6 - Work the opposite extremity - If the injury is to your right foot, workout the left foot while you're recovering.  This works for the upper extremity as well.  Studies show that the more this is done, the less atrophy and muscle wasting occur of the injury extremity.

Rule #7 - DON'T COMPENSATE!!!!! - This is the biggest one.  It should be number one.  "I can run if I just step towards the outside of my foot" or "I have to extend one arm before the other".  This is huge.  When you compensate you rapidly start wearing down other parts of your body.  Don't do it.  That's why you want a trainer to make sure that your exercise movement is completely symmetrical.

Rule #8 - Perform other exercise/activity.  This is a great time to do some kind of cross training.  Performing exercises you wouldn't normally perform (as long as they are completely pain and compensation free) is a great way to workout and diversify your program.  I.e. if it hurts to swim, then jog...or if it hurts to do cleans, do snatches.

Rule #9 - Don't wear braces.  Sometimes they are necessary in the short term.  However, braces create stability for joints which is good for acute injuries, however it creates 2 things that we don't want.  #1- dependence on the brace.  Since it's creating stability in that joint, your muscles don't have to stabilize and the stronger you get, the more dependent you will become leaving the door open to future injury.  #2 - Braces limit your flexibility in that joint which, in the long term, will create more compensation in surrounding body parts.

I hope this is helpful.  For anyone wanting to know if they are ready to return to exercise, please call my office at 561.997.8898 or email me at drscotthoar@gmail.com.

To check out more visit www.Mobility-4Life.com

Carb Back Loading, Part II

Ok so one week into the Carb Back Loading Diet.  So far the results look like this:

Lost two pounds, same body fat Percentage (212lbs, 13.9%)

That's really not what I want.  My goals are to gain muscle and decrease body fat percentage.  However, it's far too soon to pull the plug.  Let's recap what's going on here:

Carb-Back Loading Principles
1.  Skip Breakfast
2.  Consume little to no carbs all day
3.  Resistance Training in the Afternoon (preferably 4 or 5pm)
4.  Consume extremely high carb meals immediately after and throughout the evening

Now here's the science behind it....hold on...this may hurt a little bit.  I would not consider this a metabolism based diet, I would consider it a hormone based diet.  Here are the specific hormones at play:

INSULIN - is released upon increased blood sugar levels, it's purpose is to open up the muscle and fat cells so the contents of the blood get stored in the cells.  It's a 'building up' hormone.
CORTISOL - circulates without the presence of blood sugar, it's a 'breaking down' hormone.
GROWTH HORMONE - circulates, among other times, during sleep and while there is no sugar in the blood stream, it's a 'building muscle, burning fat' hormone.

W/o breakfast we prolong the high cortisol levels(hopefully)

Ok, so let's explain the principles/theories:
1. Skip Breakfast - consuming breakfast (with sugar) would kill off the cortisol levels in the blood, thereby inhibiting the breaking down of the fat tissues.  It would break down muscle as well but it's recommended to put about 5 grams of protein powder in your morning coffee to decrease muscle burning.
2. Consume little to no carbs all day - without the presence of sugar in the blood, no insulin is released.  Without insulin, nothing is added to our cells (to make us fat).  Growth hormone is free to circulate all day which leads to burning fat and building muscle.
3.  Resistance Training - Resistance training increases the ability of muscle cells to absorb sugar/fat/protein.  It leaves the muscle cells in state in which they will grow more than the fat cells.
4.  Consume extremely high carb meals in the evening - The higher the sugar in your meals, the more of a insulin release you will have, leading to increased absorption of the nutrients from your food.  Since the muscle cells have been 'pre-treated' to absorb more than the fat cells, the muscle cells grow more.  As well the high carb based meals replenish the 'glycogen' levels which are the muscle secondary energy source which is to be used during exercise.

-That's the diet in a overly simplified quick explanation.

So given that I haven't gained any muscle, and feel a little bit softer than last week I wouldn't say I'm all that happy yet.  Having said that, like I mentioned earlier, it's far too early to judge.  A body can easily gain or lose two pounds for no reason at all and the method in which I'm gauging my body fat % (bioelectrical impedance) isn't exactly 100% accurate all the time.

One thing I've learned is though, that this diet isn't that simple.  You can't just go be a fat kid and consume anything and everything you want in the evenings.  The first few days I was eating Wendy's Frosties, bowls of cereal, chili with crackers, chocolate milk, candy, etc at random times throughout the night.  No rhyme or reason.  This was a mistake.  I'm finding the key is to consume meals with lean protein sources and high sugar contents immediately after workout, than about an hour and a half after another similar sort of meal.  Maybe another smaller carb/protein combination just before bed but that's about it.  This is not random glutenous gorging......I might be guilty of doing the second option the first few days.

I've felt fine though.  No breakfast hasn't been that much of an issue, and I'm a lifelong breakfast eater.  The coffee helps keep the edge off and surprisingly I've been doing very well in my workouts.  I've had two personal records in the last week.

I'll give you another update next Wednesday.  Hopefully by that time my body fat percentage will be lower than it is right now.  To check out this diet you can go to Carb Back Loading.  Like always, feel free to contact me at 561.997.8898 or email me at drscotthoar@gmail.com. To check out more visit www.Mobility-4Life.com

Carb Back Loading

Ok.  Brace yourself.  I'm about to go 360 degrees compared to everything we've ever learned about nutrition.  Don't worry, I haven't lost all my sanity.....I think.  I've started a 'diet' that includes pizza, beer, milkshakes, wings, bleu cheese ,etc.....  It's called the 'Carb Back Loading' diet, and I'm excited.

 Since my days in grad school I've tried to stick to a paleo-ish type diet.  Lean meats, fruits, veggies nuts.....no added sugar, oils, no grains, no flour, etc....  I've tried to eat that way for a long time and I've gotten good results.  I'm thinner than I used to be before grad school and feel like I have a good hold on my nutrition.

BUT....I'm just going to be completely honest.  I wish I had like 10 more pounds of muscle, and 10 less pounds of fat.  AND....I want to be able to eat what I want.  I'm from Buffalo, NY originally...if I don't get some beer, some pizza and some wings in my body every now and then it makes me feel like I'm dying a little bit inside.  I want to be able to eat what I want and have the body I haven't been able to achieve.

Enter Carb Back Loading.  This was designed and described in a book by DH Kiefer, a physicist that grew up a chubby kid and wanted to solve the human puzzle of looking the way you want to.  It's promised to have you gaining muscle and losing fat at levels previously unattained.

Here's the principles:

1) Skip Breakfast - this goes against everything we've ever learned....what happened to starting up the metabolism fire as soon as you wake up?
2) No carbs or sugars before working out, in the afternoon - as opposed to 'eat your fruit and carbs early in the day so you can burn them over the course of the day'
3) Workout without carbs in your system - as opposed to 'added fuel for working out hard' which has always been the case
4) After you workout, consume as much high sugar, high fat, crappy food as you want! - as opposed to ...well no one has ever said that one......
5) Continue eating as much as you want until bedtime - as opposed to fasting for the last few hours before bed because your metabolism is at an all time low.

I'm using my body as a laboratory in experimenting this diet for a few reasons.

1) I've lost all professional objectivity....I really want it to work.   I want to eat whatever I want and still achieve the body composition that I want.....don't judge me.
2) I think it's important to seriously questions everything you think you know from time to time.  This is definitely going in the face of mostly everything I've ever known.

Next week I'm going to post my updates and the explanations to these new principles on losing weight and gaining muscle. (they actually make a lot of sense).  Bottom line, I'm not promising anything and I'm not recommending anyone try this themselves.  Personally, I am trying the carb back loading approach and will fill you in on the details as I go along.

To check out more visit www.Mobility-4Life.com

Deep Squats

Crossfit in general is a very polarizing subject not only in the sports rehab world, but also the fitness world.  I am thankful I was introduced to Crossfit though.  If nothing else, because of the return of the deep squat.  They were definitely not the inventors or originators of the full deep squat, but for the purposes of this post I will be giving them credit for re-introducing it to, if no other, yours truly.   

We spent the 80s, 90s and early 2000s squatting to parallel.  Why?  To protect the knees.  It made sense and we all did it that way for a long time.  Yet we all had knee pain anyway and slowly but surely stopped squatting to parallel. 

this was me before I started squatting to parallel

With Crossfit they always want you to have full range of motion with your movements.  Squatting was no exception.  So you started seeing people squatting again much lower than parallel.  And guess what?  It's so much better.  The more you bend you knees, the more the quads are inhibited and you start actually using your glutes and pelvic floor aka your deep core.  So not only did we stop having to do crunches, but we got a much nicer butt than before.  This is also good for the knees by the way.  With the stress taken off the quads, it's taken off the knees as well.  We are now able to utilize the much stronger hips and glutes when we squat low.

look at me now!

When pregnant patients come into my office and want to make sure that they have a strong and conditioned core not only for late stage pregnancy but also for giving birth, what do you think I have them do?  Deep squatting.  (Yes you read that correctly, I have 3rd trimester soon-to-be mothers sitting in a deep squat in my office).

You can do this exercises your self.  Squat as low as you can.  Make sure your heels are on the ground.  Raise your arms overhead until you start to feel the sensation of not only your deep core turning on, but also of you falling backwards.  Fight it!  You're training your core and pelvic floor.

TWO MAIN POINTS

1.  If you notice that you cannot squat down below parallel without pain or falling down, then something is wrong!  GET CHECKED OUT BY A FUNCTIONAL MOVEMENT SPECIALIST!  You might not be in pain yet, but for certain you're going to have trouble getting off the toilet in a few decades.

2.  For most people when you squat all the way to the floor, a certain amount of Lumbar Spine flexion comes into play.  This is contra-indicated for disc pain patients that get triggered by flexion.  Once again, GET YOURSELF CHECKED OUT by a spinal specialist.  If you don't have one in your area, email me.  I'd be happy to find a good one in your area.

Feel free to contact my office at 561.997.8898 or email me directly at drscotthoar@gmail.com. To check out more visit www.Mobility-4Life.com

Core Strength and Not hurting your back

Today I'd like to write about 'the core' in regards to your body and your movement patterns.  A lot of misinformation exists out there and the point I'd like to make today is why it's necessary to strengthen the core with a neutral spine as opposed to through movements like flexion and extension (aka sit ups and back extensions).

What is the core?

Inner Core Anatomy

The core is the surrounding musculature of your torso.  It's literally all 360 degrees of the torso; your front abs, side abs, and back muscles.  Now I'd like to differentiate between inner core and outer core.  Your inner core consists of mostly smaller deep spinal stabilizers.  The outer core consists of bigger muscles like the obliques, rectus abdominus, the lats, the glutes, etc  The muscles you typically think of as core (except that you don't typically think of it in a 360 degree frame).

When scientists study the core, what they find is that the first muscles to fire during any movement are the inner core muscles, then the outer core muscles, then the extremities.   The inner core creates increased pressure in the abdominal cavity which provides stability to our spine, pelvis,etc.  So the core's effectiveness is really more about timing than strength.  What we see during faulty movement patters, i.e. people in pain, people with very poor flexibility, or people with poor stability, is that the order of muscle firing gets altered.  Instead of creating interabdominal pressure(the purpose of the core) with the inner core, we create it with the outer core and extremities.  That makes the extremities overly tight and not as flexible, resulting in compensations and movements that add too much pressure to your body.

SO CORE STABILITY IS MORE ABOUT TIMING THAN STRENGTH.  WHICH MUSCLES TURNS ON AT THE RIGHT TIME IS WHAT CORE STABILITY IS.

Sit Ups and Back Extensions
They've done studies where they measure the pressure within the discs in your back.  Pressure is what leads to wear and tear and injuries.  The pressure drastically increases during flexion (bending the torso forward) and extension (bending the torso backward).  What does this mean?  Sit ups are bad for your back!  People always try to do a lot of abs when they have back pain.  Well you're doing more harm than good.  A lot of times it's the same with back extensions as well.  We'd do better to strengthen the core without increasing discs pressure by concentration on neutral spine exercises.

Neutral Spine Exercises
In the rehab setting, we start pain patients off on the low end with neutral spine exercises like:
-Cross Crawl
-Planks
-Side Planks
-Rolling Planks

Cross Crawl

Plank

Single Leg Briding

then we progress them to high end exercises like:
-Deadlift
-Kettlebell Swings

Deadlifting with a nice neutral spine which will activate his core and utilize his hips during the movement

The point is the core isn't what everyone thinks it is.  The way to train the core is to concentrate on proper form and alignment during exercises.  You shouldn't have to think about activating your core to do so.  It should automatically happen when you keep proper form during any movement.

To get your own core strength/stability evaluation call me at 561.997.8898 or email me at drscotthoar@gmail.com in the Boca Raton, Fl area. To check out more visit www.Mobility-4Life.com

Tabata Intervals

Today I'd like to write about one of the quickest ways to effectively burn fat without using wasting your own muscle.  They're called Tabata Intervals.  For those of you with extremely packed schedules, this is my favorite way to get a quality burn with a limited amount of time.

Tabata Intervals
-5 minutes of warming up
8 intervals of 20 seconds of max effort exercise followed by 10 seconds of complete rest
Cool down

What's great about Tabata intervals is that you can vary the activity, so it doesn't get boring.  I'd recommend starting with non-weight bearing cardio activity and gradually shifting towards anything else.  As well as you get better at the Tabata intervals, you'll want to increase the intensity.   You literally want to be going as fast and as hard as possible, like what you do during an all out sprint with an African lion chasing you....or maybe a hippo.

Recommended Exercises:
Stationary Bike
Rowing Machine
Running (outside)
Swimming (just don't drown)
Lunges
Step Ups
Box Jumps
Squats

etc:

High End Exercises:
Burpees
Kettlebell swings
Push Ups

Standard aerobic training (think going out for a 30 minute jog) never get's that intense.  Therefore your heart rate stays relatively level the whole time.  Doing that doesn't activate fat burning all that well.  Have you ever noticed a lifetime jogger/swimmer that just isn't all that fit looking?  The worst part about standard aerobic training is that once you exhaust whatever carbs are in your system, you start burning your own muscle as energy.  So your not burning fat that well, but you are burning your own muscle......great.

Tabata intervals initially came about in a study designed by....you guessed it...Tabata (a Japanese scientist), that compared 3 times per week of performing Tabata intervals 3x/wk and comparing it to the standard long duration type aerobic activity 5x/wk.  The study showed that the Tabata group had more gains in their aerobic conditioning (oxygen based) as well as gains in their anaerobic conditioning (glycogen/muscle based). So you end up burning more fat, and training your muscles better.  Don't forget that you saved over 20 minutes in your workout and have the ability to change it up whenever you'd like.

No matter your exercise level or comfort, I'd recommend trying Tabata intervals on your own.  Keep track of the number of reps/revolutions/etc so you can gauge yourself as you get in better shape.  Then get competitive with yourself.

WARNING - Be extremely careful if you decide to perform these intervals on a treadmill.  Personally I do these from time to time, but I still question my sanity while doing so.  Since the speed on the treadmill would be so high, it opens the door to accidents.  I've treated people that fell while on a treadmill and ended up getting severely burned by the cycling belt.  Check out this link to see what I'm talking about

Having said that, you should consult your doctor before beginning any exercise program.  If your in the Boca Raton, FL area, contact me at 561.997.8898 or email me directly at drscotthoar@gmail.com. To check out more visit www.Mobility-4Life.com

Why Grains Inflame

Would you like to be fat and unhealthy?  If yes, then eat this

Up to this point on my blog I've mainly discussed exercise and keeping the body physically healthy.  Well today I'm going to venture into the diet.  There is so much mis-information and inaccurate beliefs regarding nutrition that I thought I'd throw my two cents out there.  The number one concept that was made clear to me in grad school that doesn't seem to have widespread awareness is this:  

To check out more visit www.Mobility-4Life.com

All Wheat and Grains are bad for you!!!!

I'm sorry to be the bearer of bad news, but it's true. And here's why (be careful, we're going slightly scientific for a sec): 

1. Lectins - these are proteins in grain products that can't be absorbed through the gut.  Therefore they hang out in the lining on the stomach (making absorptions of good vitamins and minerals harder) and increasing the systemic inflammation of the body.

2.  Gluten - we all get that gluten is bad right?  A good percentage of the population is allergic to this and it's not good for any of us.  Another indigestible protein.

3. Phytates - this is how phosphorus stores in wheat and grain products.  However itis indigestible like the others but worse is that is actually binds to other nutrients in the body (like calcium, zinc, iron, magnesium) and makes them in-absorbable.  It literally saps you of the nutrients that you did consume.  We call these 'anti-nutrients'.  Other examples would be excess sodium and alcohol.

For a much more thorough description of this, check out this blog post.  It's actually pretty good:

Why Grains are unhealthy (don't get thrown off when he mentions "cereal" grains-in this context it just means that they are edible grains)

So what I'm saying is that all wheat and grain products are bad for you.  This includes whole grain bread, this includes couscous, oatmeal, rice, and whole wheat pasta.  I know this is difficult to deal with.  I mean my favorite food is still pizza.  I used to love going to the Olive Garden.  But it just doesn't work for my body.  The quickest way to look and feel the way you want is probably to take fish oil, a probiotic and stop eating wheat and grain products.  

Like always if you'd like to reach me please dial my office at 561.997.8898 or email me at drschotthoar@gmail.com.

Healthy Hips are the key

Doesn't this lady on the right remind you of your grandmother?

I consider it my job to be an expert in how people move.  Addressing that gives you the ability to reduce the stress on your body that ends up as pain, injuries, medication, surgery, canes, wheelchairs, etc......and it improves performance for athletes.  The number one issue I see on a daily basis is people's inability to use their hips!

This post is relevant to a number of people.  It might be you if:

1) Your knees ever hurt?
2) Your back ever hurts?
3) When playing sports, you want more power or strength?

The number one way that the body creates force is to move the hips from hip flexion to hip extension.  Think of a bridging exercise while lying on your back.  Check out the picture to the right.

That movement is utilized in so many movements when we're creating large forces.  Exercising, the golf swing, the baseball swing and throw, tennis, olympic lifting and the list goes on...

He starts with a bend at the hips, then ends without any.  That's the hips going from flexion to extension.

When performing any movement that puts a lot of stress on the body, it's important to keep the spine neutral.  That's why during a movement like deadlifting, you should notice a lot of hip flexion at the bottom of the movement, but no spinal flexion(bending forward).

This is the best picture I could find.  He's really doing more of a deadlift than a squat, but no matter.  Imagine starting in the standing positing, the descending into the position of the left.  Notice how far back the butt travels.  That's what we call a hip hinge.  It's keeping the spine neutral and safe, while keeping the knee from traveling too far forward beyond the toes.

To test if you have adequate hip movement, grab a broomstrick.  Align it behind your back with one hand behind your neck, and one hand in the small of your back.  Maintain contact with the broomstick at the back of your head, the middle of your back, and your butt.  Are you able to push your butt back until your spine is at approximately 45 degrees WITHOUT locking out your knees?

If you can't do this it's likely that you are hurting your knees and your low back, and decreasing your exercising and sporting potential.

To get your own person evaluation on your hip movement and how to address those concerns, dial my office at 561.997.8898 or email me at drscotthoar@gmail.com. To check out more visit www.Mobility-4Life.com