Monday, December 3, 2012

Searching for Booty

I write a column for a local magazine, Endurance Magazine, that targets an Endurance athlete readership. It is a great magazine where you can always find useful articles. Below is an article on strengthening. Make sure your MD is okay with you doing these exercises especially if you are pre or post partum!
Dear Doc,
Training takes a lot of time. I want to be stronger & more efficient, but still have time to swim, bike and run. What couple of exercises can you recommend that will give me the most bang for my buck for improving form & preventing injury?
FJ, Wilmington NC

Dear FJ,

We could fill up the entire magazine with pages answering this question, but the single best advice is glute strengthening. The glutes play a critical role in maintaining hip stability in multiple planes. I consider them an essential and often overlooked part of the core. Due to a lack of awareness and inability to activate, many people have weak glutes. You should definitely activate and strengthen your glutes this offseason!
The two exercises we recommend are the single leg bridge and the running man. The bridge focuses on single leg strengthening and stability on the mat while the running man is performed in a weight bearing position specific to running. Before you start either exercise, you must know how to contract the correct muscles. Otherwise you could compensate with other muscles that are already overworked.

Single leg Bridge

1.       Lay on your back, knees bent, one leg in the air

2.       Pull in your lower abs and squeeze your glutes

3.       Then, push your hips towards ceiling.

4.       When your hips are elevated, the foot, knee and hip of the working leg should remain in a straight line. This ensures the glutes are on and active through the movement.

5.       If you feel this in your back, hamstrings, calfs or quadriceps you may be compensating incorrectly. In that case, perform the movement with both feet on the floor and progress to the single-leg version once you can really isolate the glutes.

6.       Start with 3 sets of 8 reps for each leg and build to 3 sets of 20.
Feel the burn!

Running Man

1.       Begin with your right foot forward and your left foot back. Your left toes should be in line with the right heel.

2.       Squeeze glutes and pull in abs

3.       Bring the left knee up 45 degrees, just like you would when you run, and return.

4.       When your knee is elevated, the foot, knee and hip of the opposite (working) leg should remain in a straight line. This ensures the glutes are on and active through the movement. If possible, perform the exercise in front of a mirror.

5.       Start with 3 sets of 8 reps for each leg and build to 3 sets of 20.

Shefali Christopher PT, DPT, SCS, LAT, ATC  works for Proaxis Therapy at Southpoint and Carrboro. She is an endurance athlete and ironman finisher who recently dressed up like a pirate for Halloween to illustrate her love for booty. In her spare time, she can be found analyzing her one-year-old son’s running gait.

Sunday, November 18, 2012

Screen yourself!

After you have a baby in Germany, the new mom gets 4 visits with the physical therapist! New Zealand also has similar care. New moms should see a PT that works with women's health or sports. Blogger Kate Hall writes the PT "can help with diastasis (abdominal separation), posture, and pelvic floor strength and suggests appropriate exercises.  These interventions often result in reduced incontinence, back pain and diastasis, and provide a faster return to normal posture and body mechanics, including sexual intercourse". There are definitely valuable tips they can give you. If you are looking for someone close to you visit the APTA site.

My biggest tip is give an injury no more than 2 weeks to heal on its own. If you can't run/exercise without pain after 2 weeks, it's time to see a medical professional. In my biased opinion, you should see your physical therapist because we are the musculoskeletal expert.

If you are not injured and  just want to screen yourself, you can test yourself. Physical therapists use tests like 'single leg squat' to see what a patient's overall strength and flexibility look like.
  • Give your cell phone on video mode to someone
  •  do 5 squats on just the right leg (just small baby squats- if they hurt STOP).
  • Now do the same on the left. Stop reading till you have the video on-hand because if you know what it's suppose to look like, you might cheat.

    Look at your video, freeze the frame, and see if your hip, knee and foot are alingned. Watch for any rolling in or out (pronation/ supination) at your feet or any leaning at your trunk (shoulder in line with foot?). Basically, things should line up and if they don't, you might want to further investigate why

Good..shoulder, hip, knee and foot in line

Not so good..this is how your left foot lands during your run!
(knee rotating in, pronating foot, hip out, shoulder out)

Not so good..foot out, knee rotating out, hip in, shoulder in

Did the test generate more questions than answers? Is it weakness or tightness? Most women are flexible and the poor alignment happens due to weakness, especially post-baby. The posts to follow will walk you through my recommendations.

Got questions? email me ShefaliChristopher at gmail dot com :)

Tuesday, November 13, 2012

Who the heck are you??

In 2010 I was in the best shape of my life. As I crossed the finish line at Ironman Louisville tears filled my eyes. I had crossed an item off my bucket list. It was a painful, 15 hour ordeal, but it was done. If you are like me, it was time to look down the list and start working towards the next goal. So I picked an equally arduous sequel: having a baby.

I always thought that I would run till the day the baby was due, but as I got bigger muscles started getting loose and out of whack. I decided to be a smart athlete and I swam and biked to the best of my body's ability.

And then the ordeal began. Labor? No, labor was the easiest part!! After 15 hours of writhing in pain and no sign of the little guy I put my ego aside (more for the sake of my husband and mom, who were getting more upset with every contraction/mean thing I said to them) and I got the epidural. Then, I rested and prepared for the finish. Another 9 hours, later we started pushing and I got to hold the best thing that has ever happen to me.

I say labor was easy because the lack of sleep and the inability to exercise regularly during the year that followed was way harder for me (and my husband). On the occasional days I tried to run, I felt everything move in ways that it shouldn't (the curse of being a physical therapist!), so I decided to work on strengthening instead. TRX was my go-to sanity pill because it made me feel like I had a goal that I could conquer (I don't recommend it unless you have some understanding about form and body compensations because you can hurt yourself).

The real reason I write this blog is that in my years as a practicing physical therapist I have seen many, MANY athletes who started running after having a baby which, 2-5 years later, led to injury  All around me, good friends are having babies and "running" to get back into shape. I more than anyone understand this desire for normalcy, routine, endorphins, etc. but I urge you, YES YOU to do some strengthening, even if it's just a few exercises before and after the run to make sure you can stay injury free for a long time. Better still, look on the APTA website for a OCS or SCS PT near you and get them to look at your running form and decide if you are strong enough to run the distances you think you can handle. 

This Blog is going to take readers, step by step, through the process of getting stronger. I will keep it brief and simple and offer 1-2 tips a week (depending what the kid and work allow), which can help you identify weaknesses and work on them. I will also try and read the latest research and give you a quick, down and dirty synopsis of the article. I will provide the link so if you are nursing for the next hour you could read the article yourself. However, if you have 10 seconds to scroll through the best starter exercise for your hips, core, hamstrings, etc., you'll have them right in front of you as well.

In my perfect world every mom, soon-to-be mom or person who is new to endurance sports will have a fun, injury-free career. So lift up your glass (i'm done pumping today!!), and stay tuned for the next post!