Author: Christopher Jones

By Christopher Jones, LMT, Worcester Fitness

I was standing on the top of Cannon Mountain in Franconia Notch State Park this past weekend. It was a sunny and clear afternoon with a reported visibility of about 75 miles. No matter how far the visibility actually was, it was a beautiful view. It was, however, also about 28 degrees and there was a coating of that all too familiar winter malady – snow.

Whether we want to admit it or not, winter is fast approaching. This means that soon the snow will begin to fall and we will all break out the shovels. As with any other seasonal activity, many of us will start scooping and throwing snow without giving much thought to the safety and health of our bodies. People often joke about “weekend warriors” and the injuries that they accumulate for their sporadic physical activity, but this is just as likely for seasonal activities like spring gardening, fall leaf raking, and winter shoveling.

In 2011, the American Journal of Emergency Medicine released the results of a 17-year study detailing the most common health hazards associated with shoveling snow. Some of the results showed that:

• The most common reasons for getting hurt were overworking your muscles, falling, and being hit with the shovel.

• The top injuries were to the soft tissue of the body - muscles, ligaments, and tendon

• The low back was one of the most common areas to be injured.

• In addition to various cuts and scrapes, the arms and hands were the most common areas for bone fractures.

• Although only 7% of snow shoveling injuries were heart-related, all deaths due to snow shoveling were caused by heart problems. Individuals over the age of 55 were 4.25 times more likely to have heart-related symptoms while shoveling.

Those findings are sufficient to encourage all of us to think about our health and safety when it comes to shoveling snow. If you are healthy enough to head out and tackle the snow, consider these guidelines from the American Academy of Orthopedic Surgeons:

• Warm up with some light exercise first.
• Wear slip-resistant footwear.
• Shovel at a sustainable pace and take frequent breaks.
• Instead of lifting the snow, try to push the snow out of the way.
• Avoid throwing the snow over your shoulder or to the side to avoid twisting.

To those guidelines, I would also suggest staying hydrated while shoveling, wearing adequate clothing for the weather, and making sure your shovel is of the proper size and in good repair. Also, if you have a heart condition, an injury, or aren’t someone who regularly engages in exercise, this may be the time to get to know that family down the street who has teenagers in need of some extra cash. There is no shame in preventing an injury.

A lot of fun can be had in the snow. Shoveling can also be an extra bit of physical activity to add to your winter activity plans. If you question your readiness for show shoveling, consult with one of our trainers for an evaluation and a plan to get you ready. Perhaps even try an Advanced Therapeutic Stretching (ATS) session to really prime your body for action! If, however, it is already too late and shoveling has gotten the best of you, our massage therapists are available to aid you in pain relief and rehabilitation.

Winter is a wonderful season, and no one needs to spend it hurt over a bit of snow. So let’s be smart about it, let’s be safe, and let’s get outside!

Advanced Therapeutic Stretching

By Chris Jones
Licensed Massage Therapist
NASM COrrective Exercise Specialist
cvjones@gmail.com

Stretching can (and should) be a regular part of a fitness program. We’ve all probably heard this statement many times from a variety of sources. It seems that every monthly health and fitness magazine has an article or two on stretching, it appears as a topic on daily talk shows, infomercials try to sell books and tools for stretching, and there are even chains of facilities dedicated to nothing but giving people a good stretch. So with all this information bombardment, why is stretching often absent from people’s lives?

Let us be honest with ourselves for a moment. If we wake up feeling great and our bodies aren’t screaming at us that we are in pain or that movement is difficult, we don’t really think about stretching our joints and muscles. When we are confronted with pain or tightness, maybe we default to some ibuprofen and a quick round of the stretching we remember doing in our grade school physical education classes (it was a couple or neck rolls and shoulder shrugs for a stiff neck, right?). And with so many types of stretching, where do we even begin?

We can categorize stretching in many ways, but for simplicity sake let us look at stretching in two big categories – simple stretching and Advanced Stretching (this will be defined in just a moment). Simple stretching is probably something that will seem very familiar and something you are likely acquainted with whether you remember the proper terminology for it or not. This category includes traditional static stretching (where you bring yourself to the point of stretch and then hold that position for a long period of time, anywhere from 20-60 seconds, and repeat 3-4 times), ballistic stretching (the use of repetitive bouncing movements at the point of the stretch), and dynamic stretching (the active use of continually increasing movement patterns that can mimic the exercise or sport that will be performed later). These are all types of stretching that someone can perform on their own or with some basic equipment (rope, towel, chair, etc.).

Advanced Stretching is based upon utilizing the body’s own nervous system to enhance the stretches being performed. There are a myriad of named techniques advertised in this category, but they all make us of one of two neurological triggers – the Golgi tendon organ (GTO) response or the muscle spindle reflex. The GTO is responsible for protecting a muscle’s tendon attachment from excessive stress. Have you ever lifted something so heavy that your muscles just gave out on you? That was the GTO response protecting you from tearing your tendon from the bone. Against a lesser degree of force, as would be encountered during a stretch, the GTO response enhances a muscle’s ability to lengthen after a sustained contraction. Some of the techniques that use the GTO response are Proprioceptive Neuromuscular Proprioception (PNF), Post-Isometric Relaxation (PIR), Muscle Energy Technique (MET), and Contract Relax (CR).

The other type of advanced, neurologically-based, stretching uses the muscle spindle reflex to produce what is called reciprocal inhibition. Simply put, if one muscle group contracts to produce movement, muscles that would oppose that movement must relax and lengthen. In trying to turn your head to the left, for example, the muscles that would turn your head to the left must not contract at the same time. This can be used as an advantage for stretching because the muscles will be prepared for lengthening. Some common names for this type of stretching are Active Isolated Stretching (AIS), Agonist Contract (AC), and Muscle Energy Technique (MET). Both types of advanced stretching require assistance for maximal effectiveness.

Information overload? Do not get too caught up in the names right now. Your best bet if you have not stretched before or wish to get back into it is to consult with a fitness professional (physical therapist, fitness trainer, massage therapist, yoga instructor, etc.). It will be worth the investment to have the advice of a professional who can explain and demonstrate these techniques to you in a concise manner and get you set up with a program that will meet your individual goals. Stretching can range from a simple activity to a highly nuanced activity, but when paired with a good fitness plan can be an enjoyable and worthwhile experience.

Feel free to stop into Worcester Fitness and ask to meet with one of our staff to talk about adding stretching to your fitness program. Send an email to our Fitness Director Andy Sharry, andy@worcesterfitness.com for more information.  If you have already decided and would like to begin right away, schedule an appointment with Massage Therapy Director Steve Dozois, or myself Chris Jones under our new Advanced Therapeutic Stretching program. Both Steve and I are are specially trained and experienced in these advanced stretching techniques. We will tailor a session specifically to meet your needs, and will design with you a plan to carry forward to meet your long-term goals.

The best overall advice for stretching is simply this – breathe, do not force movement, and be patient with yourself.  A good stretch is not out of your reach!

We can help you determine if you might be overtraining

You can’t flip open a magazine or turn on the television without seeing or hearing someone going on and on about the multitude of benefits from getting regular exercise. No doubt each of those messages will be accompanied by recommendations of what to do, how long to do it for, and what results you might see as a result. And so we piece these recommendations together and suddenly find ourselves working out hard every day, sometimes multiple workouts in the same day. But is that much exercise a good thing?

 

In short, it depends. Many athletes engage in multiple workouts every day. For the non-athlete, however, doing that much without the proper coaching can do more harm than good. The term we use to describe exercising too much is “overtraining”. It is likely that almost every athlete and most health-conscious exercisers have experienced this to some degree, even without realizing it. If ignored, overtraining can set you back and even lead to injury.

 

We recognize overtraining by noting certain symptoms that tend to cluster together. For example, lack of energy, being easily fatigued, and feeling irritable are strong indicators of overtraining. Other reliable gauges are a lack of motivation to exercise, frequent sickness, prolonged muscle soreness, and lack of progress. These symptoms, especially when experienced together, make a convincing argument that you are overtraining.

 

There are an array of remedies for overtraining, and most are quite simple and economical. Rest, taking a few days off for an extended recovery period, is often the most effective intervention. Take the time to analyze your nutrition and hydration to make sure it is sufficient for the activities you are engaging in. Meet with a certified personal trainer to examine your exercise program so that it can be made more efficient and specifically tailored to your goals. Have session with a licensed massage therapist to help with muscle soreness and fatigue. Try a Pilates, yoga, or a spin class if these are not in your usual routine.

 

If after reading this article you are questioning whether you might be overtraining, please consult any member of the staff here at Worcester Fitness. We can help you determine if you might be overtraining and can recommend an appropriate intervention to get you back on track. As they say in medicine, “the dose makes the poison.” This is as true of exercise as it is with everything else. Be vigilant, work hard, play hard, and never be afraid to reach out and ask a professional for advice.

As much as we would like to avoid it, the numbers show that back pain will visit most of us in our lifetime. There is, however, no need to sound the alarm bells. The most of the common cause of back pain - simple muscle strain - is usually treatable at home. Strains heal reasonably quickly and do not always require treatment from a medical professional. By utilizing a few pain-management strategies, this temporary condition can heal and soon be a distant memory.

 

Here is a list of self-care treatments that can help with back pain:

 

  • Rest: Pain can be in indication that you have done something too strenuously. The muscle(s) may need a chance to recover, and a short period of rest may assist in this recovery. Do keep this rest period short (one to two days) to avoid possibly contributing to a different problem (tightness/pain due to inactivity).
  • Ice/Heat application: Generally speaking, ice has been advised in the first 24-48 hours after injury, and heat recommended for time periods after that. Alternating between the two (heat/ice/heat/ice), known as contrast bathing or contrasting therapy, can also provide some symptomatic relief.
  • Pain medication: For back pain due to injury (especially acute/recent injury), the class of medication called non-steroidal anti-inflammatory drugs can be helpful for temporary relief of symptoms. These medications include ibuprofen (Advil), naproxen (Aleve), and aspirin (Bayer). A pain reliever, such as acetaminophen (Tylenol) may also be helpful.

 

The next step in recovery is to get moving again! There is no need to fear movement during or after an episode of back pain. The best research in back pain recovery and prevention has shown that movement is the best tool in the arsenal. First, start with awareness - notice what positions and movements relieve pain, increase pain, or have no effect at all. Move in those pain free zones and see if you can expand them over the course of a couple of days. Gentle stretching may also help relieve discomfort and help restore your normal movement patterns.

 

To be clear, physical activity is vital to maintaining a healthy back. Even during an episode of pain, regular activity and exercise help maintain joint health and muscle strength. These activities also help maintain a healthy blood flow to the tissues to promote healing. During an episode of back pain, walking and other low-impact aerobic exercises (water aerobics, for example) are appropriate as they will minimize any jarring of the spine.

If your back pain does not begin to subside within two weeks, you may want to consult with your physician. You will want to meet with your physician immediately if any of the following symptoms are also present: severe abdominal pain, fever, loss of bowel or bladder control, numbness in the legs, muscle weakness in the legs, bloody urine, or the pain suddenly travels to other areas of the back. These are all serious symptoms that require examination by a qualified medical provider.

Aside from the self care strategies mentioned above, there are many other common therapeutic interventions that can be used with back pain. There is no one correct course of action, and each person will likely respond differently to these options. Less invasive treatments include physical therapy, chiropractic care, massage therapy, and personal training. More complex interventions can  include prescription pain medications and steroid injections. The most invasive option of all is surgery, but that is often the last resort after trying all other avenues.

 

Please do not let all this talk of complications and surgery scare you. Most back pain is treatable, recoverable, and in many cases preventable with the right strategies. Any of the professionals here at Worcester Fitness are ready to advise you of your options for managing back pain. In house, we have personal training, massage therapy, stretching programs, yoga, water fitness, and and many other offerings that can fit into your plan of care. So be active, stay engaged, and don’t let a little back pain stop you.

Back Pain Action Plan

By Christopher Jones, Worcester Fitness Massage Therapist

Low back pain is one of the most common pain complaints in the United States, with about 80% of people having at least one incident of back pain in their lifetime. Globally, back pain causes more disability than 291 other health problems. In one study conducted in a joint effort between Australian and US-based researchers, 20 years of data from 187 countries showed that just over one-third of work-related disability was related to low back pain. That is a lot of missed work, missed play, and missed opportunities every day. So how did we get to a point where back pain is so common?

Let’s start with a quick look at the back. The back is a strong, supportive structure made up of the bones of the spinal column (24 vertebrae, sacrum, coccyx,) the shock-absorbing discs between the vertebrae, and all of the muscles and connective tissue responsible for movement and stability of the spine. Housed within the protective confines of the spine is the spinal cord, and between the vertebrae are the nerves that extend out to all parts of the body. When the back is strong and healthy, all of these structures work harmoniously to let us work, play, and live our lives. When back pain is experienced, however, it can make it difficult to engage in even the most basic of activities.

Back pain can have many causes, including degenerative joint disease (also called osteoarthritis), disc degeneration, bulging disc or disc herniation, spondylolisthesis (one vertebrae slips forward), spinal stenosis (narrowing of the canal inside the spinal cord), tumors, and infection. Please note that these conditions can be present and produce no pain symptoms whatsoever. Unfortunately, the most common type of back pain is what is called “non-specific low back pain” where there is no apparent cause for the pain. Other factors that can contribute to back pain include prolonged periods of inactivity, poor lifting techniques, high-impact sports and activities, excessive sitting, and previous back injury. A growing body or current research also points to many psychological factors (anxiety, depression, job satisfaction) as contributing to back pain.

The good news to all this is that the best preventative strategy and treatment method for back pain is to keep moving! Regular physical activity, even something as simple as walking, has been shown to be the most effective tool to prevent and recover from episodes of back pain (especially non-specific low back pain). The best evidence for back pain management shows the effectiveness of a positive outlook on recovery, engaging in as many normal daily activities as possible, maintaining an active lifestyle, and the strategic short-term use of medication when needed. Interventions like heat, physical therapy, massage therapy, yoga, and psychotherapy have also been shown to be effective additions for the treatment and prevention of back pain.

Here at Worcester Fitness, we have a team of professionals ready to help with the prevention and treatment of back pain. Whether you are looking to improve your fitness with one of our experienced trainers, looking for pain relief from our expert massage therapists, or are wanting see if yoga or one of our pool exercise classes is a good fit for you, our team is ready to answer your questions and guide you in the right direction. Back pain, despite the numbers, does not have to be something that “just happens” or keeps you from enjoying the things you love to do. With the right steps, and some expert guidance, you can get back on track!