Exercise = Freedom

The word ‘exercise’ somehow has reached the status of a trigger word we collectively roll our eyes upon hearing as the solution to our problems.  It’s a tragedy!   This word should be synonymous with empowerment and freedom!  Exercise is the solution to 99% of pain relief.  What you will never fully understand unless you go through it is the liberating knowledge that pain is under your control once you have conquered it with exercise.  Your body is built to move and interact with the world.  Pain can be paralyzing and frequently cause the fearful reduction of movement.  Uncountable societal and family factors play into how pain is interpreted and expressed.  But the lowest hanging fruit (exercise) is also the most successful.  

Without question, other things can be completed alongside exercise:  chiropractic manipulations, dry needling, massage, cupping, even surgery!  But none of these things will solve your problem by itself.  They are universally paired alongside intelligent and purposeful exercise.  Where we often get lost is when we start with those things instead of exercise.  The number of issues that can be solved with exercise alone is staggering.  Yes, surgery is sometimes required.  But what happens after surgery?  What is recommended before?  DId the physician write you a script to watch TV for 12 hours a day?  The majority of the time they recommend actual physical therapy; the other they advise slow return to activity.  In both scenarios you’re going back to activity!  

Teach a man to fish and he will eat for a lifetime.  If you use surgery or any quick fix by itself you have effectively eaten for a day.  If you learn what caused your pain, how to fix it, and how to prevent it from coming back you now have the tools to eat for a lifetime!

Partnering with a professional who understands this relationship between your physical AND mental health is absolutely critical.  Truthfully they can be a Physical Therapist, Personal Trainer, Chiropractor, Surgeon, Masseuse, or anyone in the healthcare profession.

Why aren’t we all working smarter?

As odd as it may sound, this does not necessarily mean you have enlisted the help of the finest minds in the world to create a goal and plan to get better.  To me, this is intended purely to represent thoughtfulness and understanding.  You can apply working smarter to any pursuit but let's keep it Physical Therapy focused for now.  If you wanted to work as smartly as possible, we can probably agree some form of the following checklist would have to be hit:

• There is a purpose to each recommended exercise

• The recommendations are centered around your goals, experiences and limitations

• The plan takes into account your available time, finances, and access to equipment

Nothing here should be a shock to see on paper.  But if you can’t say your workout program takes into account each of these variables you aren’t working smarter.  You may be working exceptionally hard.  But smarter…no.  Experience, knowledge, and thoughtful consideration go into preparing programs that take all these variables into account; especially if an injury is present or a concern about technique during the performance of any of the exercises. 

By far the most common reason someone wouldn’t think to hire a physical therapist or personal trainer is the expense.  I consider the question rhetorical but ask yourself, how much money would you pay right this moment to magically attain your fitness goals?   Would you pay $1000?   $2000?   $5000?  $50?   Maybe think of that amount as a percent of your annual income.  Would you be willing to spend 10% of your yearly income getting healthier?  Getting stronger?  Getting out of pain?  Improving your quality of life?  If you’re like me that number sounds laughably small when you say it.  You’re only willing to spend 10% of the money you’ve earned on improving the only vessel you get in this life?  How much of your earned money do you spend on nice clothes, a car, a trip, taxes?   Not to diminish those things, they are important (and required in some cases), but would you enjoy them if you had unrelenting back pain (physical therapy)?  Would you enjoy them more if you dropped 5% body fat (personal trainer)?  Would you be able to do them at all in your 60’s if you avoided building up plaque in your arteries right now (eating better/dietitian)?  Yet every time I'm faced with an option to spend money on myself I hesitate.  And I'm a professional therapist and trainer!!  10% of 50,000$ is 5,000.  Your income may be notably more or less.  But use that as a reference.  Almost nobody will spend 5k on their bodies who isn’t a professional athlete.  You are spending money, I guarantee it.  Ask yourself where your health ranks on the list of things you are spending money on.   

Circling back; working smarter is simply looking broadly at your goals and making sure what you’re doing is in line with achieving those goals.  A massive number of variables go into achieving your health goals without taking into account the very likely scenario of not being able to accurately assess yourself.  To me, working smarter is making sure the right plan is in place.  If you can do that yourself, huge credit to you.  For the vast majority of us who need some help, consider hiring someone to help get you on the right track so when you put in the effort to start the train, it goes to the station you want.   

Blood Flow Restriction!

Blood flow restriction is an incredibly safe and useful tool to prevent the atrophy of muscle under any circumstance where resistance training is not appropriate or possible.  The most useful application is seen post surgically or after injury when the body is not able to provide a strong muscular contraction.  

The premise is eloquent in its simplicity; you restrict blood flow to an area in order to stimulate the release of hormones that will aid in strength, recovery, and pain modulation.  When you restrict blood, you restrict oxygen flow to the muscle tissue.  This causes a build-up of lactate and hydronium ion (from lactic acid which is the more mainstream precursor) giving that familiar ‘burning’ sensation in the muscle tissue.  The effect of this is the release of human growth hormone and insulin-like growth factor-1.  Normally this is experienced under high load or burnout sets or some sort of extreme muscle exertion.  Blood flow restriction makes it possible to experience this biological phenomenon under low load or no-load conditions making it the ideal add-on for injured or recovering tissue.   Body builders have been doing this for decades already and maybe as such, it’s taken longer to become accepted by the mainstream community.   The 4-inch cuffs are by far the safest on the vascular system (thank you physics) but the optimum frequency usage rate is still up for debate.  Currently the most researched format is 30:15:15:15 in terms of reps and sets with an identical amount of rest between each set.  

The chief concern as justification for not using blood flow restriction is from development of a venous thromboembolism.  There is a nice write-up in the Journal of Orthopedic and Sports Therapy on this exact issue taking the summaries of 4 experts reviews of the literature.  The conclusion was there is no increased risk over high weight training in the normal person.  

However, for the post-surgical candidate there isn’t any science to show a negative effect but, also nothing to show it is positive without increased risk.  The trick of it all, is what has been shown to be true is the longer you don’t use a muscle the faster it will atrophy.  In the case of surgery that is often unavoidable over multiple weeks!  But blood flow restriction, as noted above, can be an excellent way of exposing the body to stress without weight or heavy weight thus, severely shortening the negative outlook for this lack of use.   Due to the unique nature of each surgery and each patient, clearly let the surgeon and therapist recommendations drive the usage of such a modality.  But the upside is potentially huge, and you should absolutely ask you it if you aren’t doing it yet!   

In conclusion: this is a very exciting and safe (when implemented correctly) method of preventing the atrophy of muscle while it is injured or recovering.  If you haven’t tried it reach out and get educated today! 

Visualization

Maybe the headliner for a list of “Things everyone knows but doesn’t do.”

This does NOT get enough attention.  No, I'm not referring to success.  Yes, that is important and should always be part of your big picture.  I'm talking about visualizing failure.  If you’re someone who can reach every goal they make with relentless forward movement every single day, then…I would really love to see those goals.  Obstacles will come.  None more powerful than lack of energy, lack of sleep, not seeing results, more fun options that grab your attention, you name it.  You will not repeatedly overcome those obstacles unless you visualize them when you’re making your goals right at the start.  

If you’re like me, going to the gym does not come easy.  Being a trainer and physical therapist is a huge help I'll admit.  I’m in the gym all the time.  My hobbies circle around health and wellness so I'm exposed to this like a chef in a kitchen.  But when work is done and it’s just me at the end of the day I can assure you I'm just as excited to workout as you are…as in not.  But this isn’t a surprise to me.  It’s expected and planned for.  I know the work has to get done and I know sometimes I need a spark to get me excited to workout:  Disturbed, Metallica, energy drinks, youtube clips, inviting a friend over to join me…at least one of those will get used every time I need motivation.  But I have that list.  I know what works for me.  If I felt exhausted or defeated and then tried to brainstorm how to get me out of it I’m not going to be successful.  I can consult an actual list (weird, I know) I made when feeling energetic.  It’s much easier when I don’t have to think about it.  What do you like doing when you’re energetic?  Pull from that thought and you’ve already started your own list.  

Going up a flight of stairs is quicker when you don’t take any steps back.  Always work smarter.  

What gets you motivated?