Injury Free- Box Jumps

Box Jumps are a fantastic way to exercise.  It's a whole body exercise that works on your strength, power, conditioning and burns fat.  Unfortunatley many people struggle with them and end up hurting themselves.  Here are a few quick tips to get you in performing box jumps without hurting yourself (and having better performance too!)

1.  Swing Your Arms
        When one jumps, it's not the ability to push the ground down that has you jump high.  People with huge squat one rep maxes aren't the people that can jump the highest.  It's the ability to coordinate all your forces upward while transferring your forces through your core.  A highly effective way of accomplishing that is by getting a great deal of momentum going with your arms.  The more force your arms create, the less your hips, knees and ankles have to.  It's a fantastic way to keep the stress off your body.

2.  Don't Let Your Knees Travel Inward

Whether its your takeoff, or your landing, don't let this happen.  You might even want to concentrate on having your knees travel to directly away from each other, as this increases stability in the foot, ankle, knee complex.  It will minimize the stress on your body.

3.  Step Down
         Now if you're a highly competitive Crossfit type you might not like this one.  It's true that if your just going for performance, jumping down is faster.  However it adds so much force to the calf, achilles tendon, ankles and plantar fascia that it significantly increases the chances of you injuring yourself.  Alternating which foot you step down off the box will allow you to minimize the stress on your body without wearing down either leg.  

If you have any questions or are injured, please email me at drscotthoar@gmail.com.  If you are in the Boca Raton area, you can visit us at www.Mobility-4Life.com

9 Rules to Returning to Exercise after Injury

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 after we start feeling better.  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, walking, 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 injured 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.  Explore some yoga!

Rule #9 - Don't wear braces.  Now take this with a grain of salt.  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

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

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

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

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

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