Shaq attack...your back

I always loved witnessing those moments of Shaquille O'neil total beastitude on the court. Well today is the day when I finally get to square off against one of my childhood idols. Shaq v. Gorinski yeeah!

Here is an action shot of him:


"
Icy to dull the pain. Heat to relax it away."

What on earth is that supposed to mean? Is IcyHot hot? Or cold? Well kind of both. Why of course it's BOTH! And neither.

It's a bit of marketing genius. The product is always at room temperature (unless you take specific measures against that) and therefore neither hot nor cold. It does, however, "trick" our sensory receptors and feels like...something.

Most importantly, IcyHot doesn't hurt anything. So why not?

Today I saw Shaq making the claim that Smart Relief pads are "The same therapy used by doctors and physical therapists." That's true in the same way that my physician friends and I playing 2-on-2 in the driveway is the game played in the NBA.

There are a handful of physical therapist that pride themselves on using no modalities to treat their patients. No electronic stimulation or ultrasound or whatnot. And that make sense given the fact that these modalities do practically nothing to address the root cause of poor movement patterns and other mechanical issues. But I also know that these treatments do have some physiological basis and can often provide temporary relief of symptoms. And even temporary relief is valuable when you're in constant or chronic pain.

At best, modalities such as electric stimulation is an adjunct to treatments like hands-on work and select exercises that do address root causes. But why bother with all the effort when you can...

"Turn on Smart-Relief, and turn off pain." 

 Really, it's as simple as that.

But then again, if your painful condition IS as simple as that, more power to you and Smart-Relief!

Still, I'd much rather see Shaq promote products like this:

Exercises for Flat Feet

This video presents a few of the best exercises to strengthen the intrinsic foot muscles (the muscles IN the feet) as well as the other lower leg muscles that support the arches of the foot. Please be aware that they are not all appropriate for all feet at all times, so please use caution and let pain be your guide.

The exercises performed generally fall into three categories as follows:

A. Light non-weightbearing activities
  1. Toe "creeps" pulling the foot ahead with the toes.
  2. Toe "split" big toe opposite of lesser four toes.
  3. Thereband supination and pronation - down&in, up&out.

B. Weight bearing foot strengthening
  1. Calf raises - mid range of motion using small elevation
  2. Nose Leans
  3. Heel walk - Toe walk

C. Global lower extremity strengthening with careful attention to alignment
  1. Squat variations
  2. Lunge variations
  3. Hip hinge (dead lift) variations

PLEASE NOTE that successful management of structural foot issues may warrant detailed attention to footwear as well as a off-the-shelf or custom orthotics.

Video here:

  

My Day with Leonidas

I imagined that Leonidas paid me a visit. Poof, Λεωνίδας himself, right on my front porch! A crest of horse hair topped his helmet. His spear and hoplon shield appeared heavy, legit. But I wasn't afraid.

"Hey Leonidas!" I extended my right hand. "Please come in."

We shook hands and he stepped inside. We stood in awkward silence (well, Leonidas is never awkward) examining each other. He agreed that a drink would be good. I poured him a Diet Coke and he leered at it with skepticism.

"It's good. But yeah, some would say it's poison." I reconsidered, tried to change the subject while getting him a glass of water.

"Sooo, what do you have in mind to do today?" Leonidas stared dumbfounded at the kitchen sink. I held my impulse to throw some ice in the glass, until we establish better rapport. Leonidas was a man of few words. He finished drinking then stood at attention, fully armored, as if awaiting orders.

"I know! Of course we're going to do a Spartan Race." Leonidas nodded and asked, "What is our enemy?"

"It's at a ski resort that's almost 100 miles northeast of here. But it's not a real battle. It's just this obstacle course where you have to run and do various tasks that require physical and mental strength and endurance. Kind of like being a Spartan, right?"

Leonidas looked at me with half of his lip upturned like, "you're serious."

"Won't it be cool to see how an actual Spartan fares in a Spartan Race?" I assumed his lack of response meant that he understood, so we moved on.

"First I need to feed the kids before we leave." He seemed highly disappointed with me because of this, and stated that he was going outside to dig a hole.

"Dig a...Leonidas wait. You can do that right here." I turned on the bathroom light and explained what to do, again to a flat countenance. When I demonstrated the flush Leonidas jumped back and partially withdrew his sword.

"Woah. Easy there."

When Leonidas returned I encouraged him to try a peanut butter and jelly sandwich, like the kids were eating. He devoured it and I noticed him eying up the sandwich crusts that the kids left on their plates. He took me up on the offer of a second sandwich.

"You guys are known for being ripped, like, having muscle definition. What kind of diet, I mean, what do you eat?"

"We eat only according to the regulations."

"Even the lieutenants? The warrior kings, like you? Surely you have special privileges."

"All athletes and warriors must refrain from over-indulgence, and usually from wine and cold water."

I was glad I held off on the ice cubes.

"Lets get going."

I grabbed my gym bag and Leonidas grabbed his shield.

"Are you prepared? Do we march to the battle race?"

Leonidas reluctantly got into the passenger seat of the Subaru after plenty of explaining. The drive would afford much time to get to know Leonidas, but I waited until he settled in a bit. He sat clutching the seat with white knuckles.

When we arrived at the scene of the Spartan Race, everyone was giving Leonidas high-fives for rocking the most authentic costume ever. Passersby held impromptu photo shoots with him, each photo revealing a baffled Leonidas. One girl signed his helmet. A guy tried to grab his shield and caught a the upper edge to the throat.

"Dude, he was trying to be friendly. Don't cause a scene."

The moment of the race came and we approached the starting line. I begged Leonidas to drop his shield and weapons, but he was obsessing over something about forming into units of 8 X 4. Some of the contestants were getting annoyed, but most laughed. They asked Leonidas to say it.

"Come on man, let's go, the race is about to begin! Say it."

I nudged him, "C'mon, say it."

"Oh, alright."

"THIS. IS. SPARTAAAAAA."

And with that everyone beat their breasts and pounded fist bumps.

Leonidas had plenty of mental and physical aptitude to handle the race. But from the beginning, he was in too much disbelief to perform very well by our standards. Leonidas wildly charged the man who fired the starting gun. He crushed the spear throw, balance, and climbing tasks, but the tire flips, the barbed wire fence, and the hoses were too otherworldly for him.  He almost broke the neck of one of the big guys guarding the finish line beating weary racers with pugil sticks.

Immediately after the race, when volunteers thrust water and beer and fruit in your face, Leonidas clearly had enough. I figured that hitting the road home was the best refuge. After a time of silence, I mustered the confidence to take a stab at conversation.

"So, Leonidas, what did you think about our adventures today? I'd like your opinion on anything..."

He raised his eyebrows. He noticed my cringe, the "Give it to me straight" look.

Leonidas inhaled deeply and said "You people don't truly think that you're..."

"What? No, of course not. We know we're not really Spartans."

After a pause, he continued.

"The West has come a long way. The diversity of people and their physical attributes are stunning. But none of you are warriors. Some of you still suffer in many ways, but clearly, your enemy is comfort. Your concern over how your body appears and performance within tight boundaries - this is not the way of Sparta. There is no women and children, land or slaves on the line here. Not one of you has been forced to prepare and perform as if your very life depended upon it. In most ways this pursuit of fitness is much easier when it does."

"Most of the people at this race either exercise so they can eat or eat so they can exercise, yet they have practically nothing to show for their labor and the resources they consume. Is this not an offense to the earth and your people and your god?"

"What do you suggest we do then, Leonidas?"

"Being a Spartan is impossible in your world. A new, far better way has come. Enjoy it, your freedoms and your food and the work you have to do. Do not forget your extremely rare privileges. So do not worry so much about your lives, what you will eat and drink and wear. If your work is not of the physical variety, the best you can do is seek out some discomfort. Find a battle of sorts because your mind and body still need it.

He went on, and I wanted to thank Leonidas. But when we got to the front porch he was gone.

Physical Therapist Caught On Camera Neglecting Posture

Mechanicsburg, PA

Upper Allen Township police have recorded a local physical therapist failing to maintain good posture as he sat down to eat his lunch last week. Not only did the rehabilitation specialist have a forward head with protracted scapula, but it is alleged that his lumbar spine approached a slumped position and remained there for minutes.

The man was arraigned and taken into custody where he demanded a lumbar support, and he is seeking damages due to shoulder impingement suffered as a result of being placed into handcuffs. 

"This glenohumeral internal rotation is causing impingement of my rotator cuff" the man stated. When reached for commentary, he said that he would never again make the mistake of sitting down like a human being to relax.

The state of PA mandates that licensed physical therapists maintain a certain level of fitness and postural aptitude at all times, and that they make posture judgements and offer commentary regarding every nuance of your personal biomechanics. PTs are also required to ask others to perform specific movements and then keep telling them they're doing it wrong. 

 - - - - - - - 

But in truth, physical therapy is not a "No Judgment Zone."

There truly is a reason why a physical therapist will hound you about the position of your body and your exercise technique, and it's not just to make ourselves feel important. You see, we are trying to get you to move differently; to learn and ingrain new movement patterns. We're trying to wake up and call in under utilized muscles while turning off the muscles on overkill. We're trying to stretch and loosen up the tight areas and stabilize the areas that need to be strong and stable.

We cannot "fix" arthritis. But could it be that if you move differently, you change the pattern of wear and tear, and add years to your quality of life? You may indeed need to be on guard about your posture for some time, because we want you to live a little.

Health and Wellness Disease

America is a nation of illness, much (but certainly not all) of it due self inflicted behavioral patterns. America is also affluent, with standards of living, health expectations, and "wellness" behaviors that are frankly obnoxious in the grand scheme of things.

There has to be some middle ground. That life consuming thing that you're following to be healthy and feel better and get in shape - Is it worth the time, the money, the mental energy? Is it really necessary?

- - - - -

I hacked and wheezed and sniffed twice per year. For all of my childhood, late October and early April were ugly, with upper nasal passage and sinuses filled with cement. My eyes itched. My mouth was dry, from both breathing through it and the side effects of ineffective decongestants.When this pattern lasted into young adulthood, well past the completion of years of allergy injections, I accepted it as a normal part of life.

In my early twenties I experienced three or four years of intermittent acne and severe gastrointestinal distress. A deep, hardened lump would appear on some random part of my face, gradually ascend into a small mountain, then develop into a scab from being picked at.

On two separate occasions I took months of a strong anti-inflammatory steroid for the treatment of lower abdominal pain, diarrhea, and severe anemia. Lower and upper GI tests were inconclusive, and the GI specialist diagnosed ulcerative collitus (UC). He said UC is a lifetime diagnoses and the best I would do is manage it.

But then...

I switched to eating a completely organic paleo diet. They didn't call it paleo back then, but it was definitely a gluten and dairy issue. My abs came in and the allergies cleared up almost over night. When I added significant amounts of kale and Quinoa, and went with only free range sources of protein (mostly chicken and salmon) the acne and GI issues both resolved within 6 months.

I wish that were the truth. But it's absolutely not. The allergies and acne issues did clear up sometime between the ages of 25 and 27. After a few years of symptom-free management, I stopped taking UC medication around my 30th birthday.

And the truth is, I have no idea what happened. Whatever changes I made to my life in that time, they certainly were not diet, medication, or exercise-related. Even the GI specialist, who warned me and did follow-up blood profiles, upper- and lower GI tests was baffled.

This is what I do know.

If I went gluten free or organic or what-have-you and experienced such a dramatic difference, I would be a huge believer. If I went to the right church and prayed specific healing prayers and was wiped down with special, God-ordained oil, I would be a huge believer. If I did the Tony Little Gazelle while watching Lifetime specials, I would be a huge believer.

But I did none of that. Here is what I did.

I kept on, (mostly) listening to my doctors, and began listening to my body. I came to a more stable season of life. The house, the job, and community of friends was established. One day I looked back and saw getting all As and one B in seven years of college as evidence of an unhealthy college life.


So with the help of my wife I decided to loosen up and have fun. Sometime in there I did make a conscious effort to think more of others. This treatment would be forced upon me in much greater dosages with the birth of our first child. I stopped obsessing about fitness and such (though training continues to be an important part of my own "life management" to this day). If anything, I slackened my "healthy" diet by 30%.

I gradually became more acquainted with perspective, gaining some appreciation for the place and times in which I live, and my small place in the world. I did earnestly pray. I found a gentle and wise, challenging and provocative Jesus who always points to a type of obedience that ends in love, grace, and peace.

Ah, peace.

And yet these are only a few of the things that occurred in my late twenties. Again, I have no idea exactly how or why those illnesses resolved. Nothing in this essay is meant to be proscriptive. Many people struggle with various health complications through no fault of their own, and not for lack of trying to do whatever it takes to feel better. But I do want to point out the complexity and mystery of our autoimmune system and life in general. There is so much going on in your life journey right now that is so far beyond any one medical specialist much less poorly evidenced or otherwise anecdotal advice.

-Most of the time try to eat minimally processed foods.
-Manage stress.
-Get enough rest.
-Move better so you feel better and can be more active (my specialty).
-Listen to your body. ALSO listen to your doctor (especially if you have a doctor that takes the time to know you and listen to you). We don't know nearly as much as we think we know, so listen to your doctor, if only for an exercise in humility.

There's no short-cut to these and no magic in them, but I would say the net effect is miraculous. We would do well give all of them a serious and honest effort before ascribing to some restrictive, lack-of-perspective advice, dietary or otherwise.

exercises for flat feet (part 1)

Is it possible to exercise your way out of fallen arches or flat feet? Well, yes and no. We'll try to keep this simple.

The first thing to appreciate is the various types of flat feet, which can basically be divided into issues primarily with the rearfoot, the midfoot, or the forefoot. Whether or not you have a structural foot issue it's more important to know whether or not it's creating a functional issues (problem in the timing and/or extent of joint movement). And that's something Dr. Scholls WalMart Foot Computer can't tell you.

What happens when you move? For example, many people have a mild to moderate flat foot but function very well when they walk, run, and jump. When they move the arch lifts to some extent. Their muscles adequately stabilize the joints in fairly good alignment and lock the associated bones together into a rigid lever. 

On the other hand, someone with a more severe structural issue will likely need a specific type of shoe and/or shoe insert to function at a high level. For these folks, stretching and strengthening exercise may still be of some benefit. Don't get me wrong, all the exercise in the world is not going to fix the low arch. But they may improve the strength and stability enough to get the person to function below injury threshold.

The people who benefit most from doing "arch" exercises are those with a mild to moderate structural or functional low arch. These are the people who function fairly well until they really over-do it with new exercise, or they have become weak, over weight, or use poor quality footwear.

What "low arch" exercises look like will be saved for part two. Many of them can be found with a quick on-line search. Examples include using your toes to bunch a towel up under your foot, picking up small objects with your toes, and pressing your big toe down into the ground as you raise the four lesser toes up. These kind of activities will make the muscles in the arch work to some extent. 

But I think that they're overrated and usually only prescribe them for those who are very weak and/or have a highly sensitive/painful condition in their feet. Examples of higher level and plain better exercises include theraband work, standing and seated calf raises within a controlled range of motion, and something we call "nose leans." [Again, more to come on these.]

Lastly, for many people, the best exercises for the arch are activities that work the entire lower extremity in good alignment. Arch issues tend to be much less of a problem if your hips are strong. Because if you're strong and efficient proximally, your femur won't buckle inward when you step and run and jump, which leads to less inward rotation of the lower leg bones, which leads to less collapse of the bones of the ankle and rearfoot. 

Image: Yes, a low arch causes the leg to roll inward, but likewise, the leg rolling inward does contribute to a low arch!

This idea of giving attention to the alignment, strength, and stability of the entire lower extremity seems to work particularly well with younger populations. But it's never too late to try. Given the fact that you should regularly practice some strength and balance training anyway, why not do something proactive for that flat foot?

Coming in part 2: Suggested exercises for the foot / ankle and general lower extremity, and at least one example of it working to "fix" a low arch.

big girls - big weights

Sorry ladies, but I have to say it. You're plain weak. The far majority of you are, anyway. Hear me out, though. You still got the eye of the tiger, fighter, dancing through the fire.

I'm calling you out regarding physical strength; the ability to accelerate mass. And sure, some would tell you there's more to life than generating a lot of force...But seriously - many of you want to be faster or jump higher or go further. Most of you want to look good and function well. None of you want physical activity to hurt.

Some of you know that strength is important. But the Pilates, the yoga, the Zumba, the machine-based training, the toning circuits, and the spinning are not cutting it. I'm not saying these things are inherently bad or worthless. What I am most definitely saying is that these inadequately transfer to functional strength that makes a difference when you go to run, jump, cut, lift, and carry things. The years have showed me that it's next to impossible to become functionally strong with these alone.

I see the evidence every day, women who claim to be strong but they're not. We're not talking about hundreds of pounds on a barbell. Most cannot control a basic squat or lunge or jump without their knees buckling inward. They cannot lift 10 pounds off the ground or perform a high step up without their lower back bowing or hips jutting sideways. Most cannot do even one solid push-up with their shoulders in proper position and without their core crumbling, much less a chin-up.

The great news, ladies, is that physical strength is a state of mind! I caught Maggie dead lifting (close to) her bodyweight in the basement last week. Then I asked her a question.

Maggie has never heard that she needs to stay toned. In her mind, pink two pound dumbbells are for babies - her two year-old sister. And she's right. I hope that some day, if she cares, she understands that muscle toning is a myth, that having muscle tone first requires having muscle. Maggie hasn't been told that weight training will make her legs look big. I hope she really doesn't care about the size of her legs.

Maggie hasn't yet heard that heavy lifting is for nose tackles and shot putters. She already understands that heavy is relative. I hope she doesn't experience the alternative that many women and men learn the hard way; the cycle of eating less and less to maintain a caloric deficit and in the mean time feeling and looking utterly deflated. 

Ladies, there's no reason why you cannot be strong. Getting strong is not rocket science. It doesn't demand enormous chunks of time.You can (and should) keep with the activities that you enjoy. Big girls have much to gain by adding some focused strength training to the weekly routine.

And I grieve the day Maggie learns that you don't work out in your jammies.