ITB Syndrome and Pain: Causes and Relief

As many of my clients know, I have been preparing for competition in September.  Because I am limited for time between clients, training, and business; I have not been blogging or writing as much as I would like.   I am going to keep this fairly to the point.

Relevant Anatomy

The Glutes have three main parts:

1. The Glute Major: Pushes your leg back
2. The Glute Medius: Pushes your leg to the side, stabilizes the pelvis when standing on one leg, and externally rotates the leg.
3. The Glute Minor: Helps stabilize and externally rotate the leg

The ITB is a tendon that attaches to the tensor fascia lata.  Ironically the tensor fascia lata has connections with the glute medius.
Therefore when your glute medius is under performing, your ITB is probably overperforming.  There are other causes such as running
on the same side of a sloped road and cycling but both seem to return to your hips mobility and strength.

Symptoms

• Tight feeling on the outside of the knee that becomes a burning or stinging sensation when you run
• Pain on the outside of the knee after running, cycling or other activity
• Snapping or popping sensation
• Increased pain or burning when walking or running downhill
• Pain that subsides when not running
• Walking with a stiff leg to relieve the friction

What Do I Suggest?

Take a rest.  Stop whatever your doing that causes the pain, this doesn’t mean stop everything, just whats causing the pain.

Ice: 20 minutes up to 2-3x per day.

If appropriate stretch and foam roll your ITB’s

To strengthen I suggest the following exercises:

1.  Glute Bridging
2. Clam Shells
3. Standing External Rotation

I suggest adding 15-20 of these (2 sets with 5 second isometric hold at the top) to your workout.

If your symptoms aren’t subsiding in two weeks, seek professional care.

Summary

It takes time to heal.  Sever cases may take a month or two.  The idea is to warm up properly with hip mobility work (lateral squats, knee pulls, heel pulls, and rotational or lateral squats) and gradually increase your workload (don’t boom or bust).  If you are my client, just ask if you want to know how to do these.

Hopefully, I can get some video up soon.  Perhaps after the competition?  🙂

Are You Motivated?

What Do We Really Need?

Anthony Robbins tells the story of Sylvester Stallone (Sly) so well.  I have included it below in a YouTube video.  I really recommend you listen to it.  The just of the story is the same old idea: “If you want it bad enough, you will make it happen.”  The truth was never more precise when considering a person’s health.

According to Maslow we have a hierarchy of needs.  That needs pyramid looks like this:

Physiological

Safety

Social

Esteem

Self

The basis of Maslow’s motivation theory is that human beings are motivated by unsatisfied needs, and that certain lower factors need to be satisfied before higher needs can be satisfied. According to Maslow, there are general types of needs (physiological, survival, safety, love, and esteem) that must be satisfied before a person can act unselfishly. He called these needs “deficiency needs.” As long as we are motivated to satisfy these cravings, we are moving towards growth, toward self-actualization. Satisfying need is healthy, while preventing gratification makes us sick or act evilly.

Now I am not going to jump into how each of these is important.  But what I will do is speak about how we can tap into these for understanding change behaviour.

Do I Really Need To Change?

This is an excellent quest.  As a health coach, I hear this quite often.  I used to get upset, because internally I thought, “yeah you dummy, unless you want diabetes!” However, overtime I matured in my thinking and really thought about the question, “do I really need to change?”  I came to the conclusion that, in fact, no you don’t need to change.  What you need to do is prioritize and recreate a reality.  Is this change?  Yes and no, its change in the fact that you will need to rethink your current strategy, especially if it is making you sick (and being overweight is making you sick). Lets think about this for a moment to understand the addiction.

An alcoholic, do they think they have a drinking problem?  The ones I have met personally do not think so.  However, what is the problem?  Is it the alcohol?  Is it the person?  Is it both?  Confusion insets and the meaning can be lost.  However, the problem lies within the need to drink.  What need are they not fulfilling?  What are they trying to substitute through the use of alcohol?  Answer this and answer the problem.  Its not as hard as you think.  Ask yourself, “What do I need?”  What is my reality?  Others are NOT my reality, I am my reality and what do I need to exist?  Often the answer can be as simple as love.

I Told Them Once But They Didn’t Listen

This is a fatal error of many trainers, health coaches, health care professionals, whoever may be trying to “help”.  In fact many people become “enablers” in that, they think they are helping but in actuality they are making worse.  Motivation doesn’t happen overnight.  Let me paraphrase and say it this way: “change doesn’t happen overnight.”

Smokers are a prime example.  The odds of someone successfully quitting cold turkey is slim however powerful it may be.  In fact, smokers will try to quit about 9 times before they are completely successful.  Typically the thought process is like this:

1. Denial about the fact
2. Someone starts to nag (influence)
3. The addict tries to change for someone else’s reality
4. Failure
5. The addict try to change for themselves
6. Possible Failure
7. The addict overcomes their brain/thought process
8. Success

The take home story is this:

1. Realize that a new reality may be necessary
2. Realize there may be a need to satisfy
3. Realize that you are in control of your mind
4. Realize you are your own reality and no one else is responsible for it

The graph above works for eating addictions as well.  Are you overweight?  Unless you have a metabolic or genetic problem (which most don’t) you are addicted to eating.

Your thought process changes your physiology

Stress, worry, anxiety; all of these causes the release of chemicals into the blood stream that result in a lowered immune system and pain.  More than not, you CHOOSE this reality.  You choose to respond with rain and not sunshine and just like nicotine, these chemicals are ADDICTIVE!

So start switching your reality by becoming positive.  I don’t mean Prozac, weird happy, positive.  This type of positive is like those people dancing down the street and beating a drum while wearing rags.  You don’t need to do that.  Think of a leader you admire when you get upset.  Save face and put on that leadership mask.  You will be amazed at the changes around you when you don’t respond.

Summary

1. Don’t try to bite off more than you can chew.
2. Set one fundamental goal (loose 20kg in 8 months) and several small technical goals (go to gym 2-3 times this week, make healthier food choices)
3. Don’t lie to yourself.  This only makes it worse.  If you are overweight don’t be in denial.  Don’t look at the next fat guy and say but he is bigger than me.  Accept your need for a new reality.
4. Count your blessings.  Name three things you are happy for when you go to sleep at night.
5. Don’t be SICK!  If you are a food, sex, nicotine, alcohol addict, then you are sick.  If you are constantly negative, you are sick!   Get well by simply starting to rethink your strategy.  Don’t expect a change overnight but expect to make it.
6. Don’t let people change you, change yourself.

Carbohydrates

Author: Amanda Carlson

Editors Notes:  Amanda states that carbohydrates are “easily stored as fat.”  While this is not the truth, they do inhibit the breakdown of fat.  We will touch on this in the next blog.  We don’t fully agree with some of the views expressed in this blog but feel it is well written for a general understanding of carbohydrates.

Overview

Along with protein and fat, carbohydrates are one of the three main classifications of foods (macronutrients). A main source of energy for the body, carbs are mostly sugars and starches that the body breaks down to the simple sugar glucose to feed its cells. There are, on average, four calories per gram of carbohydrate.

Tetra Images / Getty Images

Carbs provide energy for muscle function and act as the primary fuel for the brain. Carbs like whole grains, fruits and vegetables are rich in fiber, so they help control appetite, slow digestion and improve heart health. Processed carbs, on the other hand, such as white breads, pastas and baked goods, provide little nutritional value and are converted quickly to sugar and easily stored as fat.

Good Carbohydrates Vs Bad Carbohydrates

There is a trend to categorize carbohydrates into “good carbs” and “bad carbs.” The science behind the categorization is the glycemic index or glycemic load.

The “good carbs” are typically those that are high in fiber and less processed (whole grains, fruits, and vegetables) with the more official name of low glycemic index carbohydrates. The glucose from these types of carbohydrates is released slower, therefore providing energy for a longer period and producing less of an insulin spike.

The “bad carbs” are those that are typically more processed (white breads, pretzels, candy) or high glycemic index carbohydrates. The glucose from these carbohydrates is quickly released, causing an insulin spike and the quick removal and shuttling of glucose from the blood stream into the cell.

Nutrient Timing

For an active person, both the high and low glycemic index carbohydrates are important for ensuring a proper amount of energy for optimum performance. The trick now is figuring out the timing. It is optimal to have lower glycemic index carbohydrates in your meals throughout the day and before training or activity. During intense and prolonged exercise (exercise lasting an hour or more), it may be advantageous to have a high- glycemic-index sports drink to maintain blood glucose levels. The optimal time to have higher glycemic index foods is when you have finished your exercise or activity. After activity, there is about a two-hour window of optimal recovery. During these two hours, your cells are most receptive to nutrition to replenish the glycogen stores that you have depleted. The replacement of these stores is crucial for the next workout.

How Many Carbohydrates Are Enough?

The place where people often go wrong is eating too much carbohydrate—or just too much of anything. Different sports require different amounts of available fuel. The marathon runner is going to need much more fuel than the golfer, so each type of athlete needs to base his or her carbohydrate intake throughout the day, before, during, and after their exercise or event on their actual activity level. Even regular exercisers need to base their carbohydrate intake on the amount of activity they are engaging in. If you are enduring longer, harder workouts, you need more carbohydrate. If your workouts are less intense, you need less carbohydrate.

Carbohydrate Serving Sizes

A healthy portion of carbohydrates should be about the size of a baseball. Here are some examples of standard serving sizes of carbs:

• 1 slice whole grain bread (whole wheat, pumpernickel, rye)
• 1/2 of a hamburger bun (whole wheat )
• 1/2 of an English muffin (whole wheat or sourdough)
• 1/2 of a whole-grain bagel
• 3 cups popped light popcorn
• 1/2 cup cooked oatmeal
• 1/2 cup cooked rice (brown)
• 1/4-1 cup of dry cereal depending upon type (high fiber)
• 1/2 cup cooked vegetables
• 1/2 cup mashed potato
• 1 small (3 ounce) baked potato
• 1/2 cup cooked lentils, split peas, or beans
• 1 small apple
• 1 medium banana
• 3/4-cup blueberries
• 1/2 grapefruit
• 1 medium orange
• 1 cup cubed cantaloupe
• 1/4 cup cubed watermelon
• 2 tablespoons of dried fruit

Carbohydrates: Fruits and Vegetables

Fruits and vegetables contain powerful antioxidants, helping to protect the body from the cell-damaging effects of free-radicals:

Apples, avocados, beets, bell peppers, black beans, blackberries, blueberries, broccoli, Brussels, sprouts, cantaloupe, carrots, celery, cherries, cucumber, eggplant, field greens, grape fruit, green apple, green beans, green peas, honeydew, kiwifruit, mangoes, mushrooms, oranges, papaya, peaches, pine-apple, plums, pomegranates, raspberries, red grapes, romaine lettuce, snap peas, soybeans, spinach, squash, strawberries, sweet potatoes, tomatoes, watermelon, yams

Carbohydrates: Breads, Cereals, and Grains

• Brown rice
• Cheerios
• Couscous
• Kashi
• Oatmeal
• Pumpernickel bread
• Quinoa
• Rye bread
• Sourdough bread
• Whole wheat bread

Carbohydrates in Fiber

Fiber, found mostly in carbohydrates, is essential to overall health. It improves gastrointestinal health and function and helps prevent colon cancer, regulates blood sugar, and promotes long-term cardiovascular health by reducing cholesterol. People who follow low-carb diet plans deprive themselves of this vital source of nutrition. Non-processed, fiber-rich, colorful carbs are essential to a healthy lifestyle. Eliminating carbs produces sluggishness, along with long-term negative health effects. Try to consume a lot of fiber. Fiber improves your body’s digestive function, regulates blood sugar levels, and promotes long-term cardiovascular health.

Fiber is found in oatmeal and green, leafy vegetables, beans, whole grain products, as well as in bottled form. You can sprinkle it on your meals to improve their nutritional value. Because fiber is found mostly in carbohydrates and is essential to overall health, people who follow low-carb diet plans are depriving themselves of this vital source of nutrition.

Low-Carb Diets

Several popular diets advocate that you don’t eat carbs, and that’s one way to lose a lot of weight in a hurry. After all, for every gram of carbohydrate we eat, we store 3 grams of water.  But that’s a good thing since it keeps us hydrated and satiated.

If you go on one of those diets without carbs, it’s like taking a sponge and wringing the water out. You’ll lose the water weight, but as soon as you eat carbs again—and you will at some point, because you need energy to function, and you can only go so long without carbs—then the sponge is going to fill up with water.  Research shows that the weight will come right back, and with a vengeance; people often gain back all the weight they lost while following a diet that severely reduces carb intake—and more. As with dieting, you’ll likely lose some of your lean mass in the process.

In addition to the decrease in performance associated with low carbohydrate diets,  those following the low carbohydrate diets often omit many of the high-fiber whole grains and the vitamin, mineral and phytochemical loaded fruits and vegetables.

A better approach is to eat carbohydrate based on your activity level and understand what makes up an actual serving size of carbohydrate. Carbohydrate equals fuel, and the body prefers glucose (what the carbohydrate is broken down into) for energy to fuel both the muscles and the brain. Without enough carbohydrate you are bound to sputter along like a car that is about to run out of gas. This becomes particularly important to the athlete who needs to have a full supply of energy at all times. During exercise or sports activities, the body will use available glucose in the blood for energy. Once that supply of glucose is depleted, the body will begin to break down glycogen, which is stored glucose, for energy. After that is gone, the body no longer has an efficient way to release glucose and your ability to perform at a high level will be compromised.

Throughout the day and before training, choose mainly lower glycemic index carbohydrates including high fiber whole grains and fruits and vegetables. After your training, eat enough carbohydrates by choosing some higher glycemic index carbs to replenish your glycogen stores. By using carbohydrate as your training and performance partner and not as the forbidden nutrient, your energy stores and your diet will achieve a more appropriate balance.

Tags: Food, Carbohydrate

References

1. Verstegen, Mark, and Pete Williams. Core Performance Essentials: The Revolutionary Nutrition and Exercise Plan Adapted for Everyday Use. Pennsylvania: Rodale Press, 2006.
2. Verstegen, Mark, and Pete Williams. Core Performance Endurance: A New Fitness and Nutrition Program that Revolutionizes The Way You Train for Endurance Sports. Pennsylvania: Rodale Press, 2007.

http://www.coreperformance.com

Metabolism and Exercise Myths

Hi Guys and Girls

I wanted to do an exercise of the week but I have gone over on my internet usage which is making it difficult to upload my video. 😦  Its so rainy outside, I just want to stay home (hence not going to the Internet cafe) 🙂

So I decided to take a look at some old material that everyone seems to enjoy.  I originally read the metabolism info from Dr. Jeremy Krebs from Otago Uni (New Zealand).  So here we go:

1.  Slow metabolisms aren’t to blame for the overweight population (unless there is a thyroid or metabolic dysfunction).  If you are overweight you actually have a faster metabolism.  Think of this like a small car and a truck.  It takes more to move the truck.

2. The hotter it is the more fat you burn.  NOT TRUE.  The colder it is the more it will spike your metabolism so as to keep you warm.

3.  Being overweight can be healthy.  This is false, excessive fat is a factory of inflammation causing molecules called myokines.  Myokines cause diabetes and other problems.

4.  Spot Reducing.  This is a huge bag of rubbish.  See Dr. Closes previous post.

5.  Some people have “fast” metabolisms and thats why they are skinny.  Not true they just eat proper amounts and are more active.  Research has shown time and time again that overweight people have a gross misconception about amounts of food.  What I mean is that, overweight people, think that they are eating small amounts (and keeping on the weight) but in reality they are consuming WAY too many calories.

6.  Food before sleep causes weight gain.  This is a myth.  Albeit, it seems that high carb intake prior to bed may have an effect due to insulin spikes.

7. Age causes a slow metabolism.  This is debatable.  While is will slow it slightly, it can be combated with regular activity.

I hope this helps shed some light on myths.  People are funny and like to believe what makes them comfortable.  Unfortunatelly its not always right.

Consider this before you eat your next pie or muffin:

• 60 minutes of gardening burns 300 kcals
• 60 minutes of walking burns 200 kcals
• 90 minutes of football burns 600 kcals
• 45 minutes of dancing burns 450 kcals

Keep fit, keep active, keep sane.

Glute-Girl

Abs Don’t Grow on Trees

In order to keep your abdominals showing you have to keep two things in mind.

1. Your DIET is the key to uncovering your “undercover” abdominals
2. You can hurt your lower back if you are not careful with your “abdominal” exercises.

There are a few myths as well that haven’t been dispelled and its personally, driving me nuts.
Firstly, you CAN NOT spot reduce. People that sell creams, ointments, or lotions (or anything for that matter) that supposedly reduce fat at that area; ARE LYING. This is the same as selling an ointment that will make your legs grow. Pure and refined B.S.

Secondly, you can not exercise your way to sexy abs. That’s right, I said it. You must eat right and exercise regularly. There is no magic combination of “core” movements that’s going to cause a six-pack to sprout overnight.

So how do we get abs then?

Well, to be truthful, they are already there. They are just hidden under kg’s of fat. I suggest by reducing your caloric intake and starting to be more active with your work-outs. This does not mean you can jump on your ab machine you bought on TV and expect a washboard to appear.

So here are a few tips:

1. Involve your whole body and keep your heart rate up around 65% your maximum. What it is your maximum heart rate? HRmax = 205.8 − (0.685 × age). You will need a heart rate monitor. Polar makes a great heart rate monitor.

2. Keep a structure to your workout. Most people fail at their workout because quite simply, they have no clue what they are doing. If you don’t know, get a trainer. Otherwise try this template:

A. Movement Preparation: Spend 5 minutes warming up.

B. Muscle Facilitation: Spend 10 minutes doing elementary movements (i.e. back bridge, push ups) Only do one set of ten reps.

C. Main Work Out: This can be 25 minutes of structured exercise. Try the following circuit (no rest between exercises):
Repeat 3 times (rest for 1 minute after completing one circuit, no rest between exercises):
1.  Lunges 20 reps
2.  Push Ups 20 reps
3.  Front Plank :15 sec hold

Repeat 2 times (rest for 1 minute after completing one circuit, no rest between exercises):
1.  Swiss Ball Wall Squats x20
2.  Single Arm Rows x10 per arm
3. Side Planks :15sec per side

D.  Regeneration or the Cool Down:  Spend 5 minutes lightly stretching tight areas or foam rolling the legs, hips, and back.

3.  Be consistent.  Do NOT do the work out for one day every other week.  People that think they can get away with that are dreaming.  Clinically I see people with bad joints that expect the pain to go away with a massage and a pill.  This isn’t realistic.  The sooner people realize that they aren’t made out of plastic the sooner they will appreciate what God gave them.  Besides, you only get one body.  Try doing the above work out  4 times a week for 5 weeks.  Weight in before and after, but, keep your diet locked in as well.

Summary

1.  Caloric intake should be less the amount of energy expended every day to drop fat. USE THIS CALCULATOR
2. You can not spot reduce fat.  You can spot increase muscle but who wants to walk around looking like one giant ab?
3.  Increase your bodies metabolic demand.  Keep up your heart rate during exercise.  Don’t rely on what you feel either, get a heart rate monitor.  Stop being cheap with your health.
4.  Stop making stupid excuses.  You are in charge of your brain and your choices.

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Author: Dr. Anthony H Close

Dr. Anthony Close is a much sought after health coach and doctor of Chiropractic Rehabilitation.  He is the founder of Wellington Allied Health, a consultancy firm that helps other practitioners implement rehabilitation systems into their existing clinical structure.  He has taught and consulted in multiple countries including, Japan, Bolivia, USA, New Zealand, Australia, and Indonesia. He has lectured at Massey University (New Zealand) in the past and currently holds seminars for multiple gyms across New Zealand.  He is a lifetime member of the NSCA and the International Society of Clinical Rehabilitation Specialists.

www.anthonyclose.com

3 Steps to a Better Bum

Here are 3 steps to a better bum, easy and to the point.

1.  Eat Properly.  Is vanilla pudding bad? In large amounts, yes it is.  Solution?  Use a smaller spoon.  Changing your plates to a smaller diameter and choosing a teaspoon instead of a regular spoon proves to be better, according to research.

2.  Exercise Properly.  Don’t just run.  Running isn’t going to do it alone.  The bum is a muscle, in order to better the muscle you need to work it.  Work the bum by selecting the proper exercises.  Back bridges and split squats are a great start.

3.  Cloth Properly.  Selecting the proper jeans is an art not a science, or is it?  It seems the research shows that jeans should have the following qualities: 1. Dark washed 2. Small Pockets 3. Fall 2 inches below the belly button (avoid “high-rise” or “mommy” fit jeans).

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Exercise of the Week

Building a sexy bum sometimes starts by taking a few steps back and learning how to use the bum.  The exercise of the week is the back bridge.  Simple, yet effective.  Make it a bit harder by wrapping a theraband around the knees or raising one leg.  Add in 2 sets of 20 to a three day program to begin building the foundation to a super sexy backside.

Starting Position

• Loop a mini band around your legs, just above your knees and lie face-up on the floor with your arms at your sides, palms facing up.
• Bend your knees 90 degrees and pull your toes up toward your shins so only your heels touch the floor.

Procedure

• Contract your glutes to raise your hips off the floor until your knees, hips, and shoulders are all in straight line.
• Pause, then lower back down and repeat for the prescribed number of repetitions.

Coaching Keys

• Squeeze your glutes and maintain a neutral spine throughout the movement.

You Should Feel It

• Working mainly your glutes and to a lesser extent in your hamstrings and lower back.