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Weight Lifting Belts: Do You Need One?

body builder doing a heavy deadlift

We had a blast this past Saturday at our Keep Training from Being a Pain in the Back workshop here in Bethesda. Dr. Immermann and I had the pleasure of working with an amazing group of people and a great question came up.

What is your opinion on weight belts? Is it bad to be using them to lift weights?

As physical therapists specializing in sports medicine, this is not the first time we have been asked this particular question!

As with most questions, there is not a simple “yes” or “no” answer.

Weight lifting belts help us create and maintain more pressure in our abdominal cavity. This provides more stability to the spine and allows us to lift more weight.

Therefore, a lifting belt is a great tool to use when training for maximum effort.  Examples of this would include trying to set a personal record in the gym or competing in a weight lifting sport (Olympic lifting, Powerlifting). In these situations, the goal is to lift the most weight possible and a belt will help with that.

However, it is problematic if you rely on a weight belt to create intra-abdominal pressure (pressure within the abdomen) and support the spine during sub-maximal activities. You should possess enough strength and trunk control to perform moderate level work in the gym without the assistance of a weight belt.

As with most things, the usefulness of a weight belt is situation dependent. Sometimes they even have a place in the physical therapy process!

It is okay to use one as long as you do not rely on it and become the person in the gym with the weight belt performing 10 reps of lat pulldown.

For more information regarding similar topics please contact us at CHP and/or check out the links below!

Essential Pillar Strength 1

Essential Pillar Strength 2

Here is what to do if kettlebell swings hurt your back

Here’s What To Do If Kettlebell Swings Hurt Your Back

picture of multiple people doing kettle bell lifts

“Kettlebell swings hurt my back.”

This is something that I commonly hear from our physical therapy patients in Bethesda. 

Many participate in Crossfit, sports or simply enjoy exercising. Regardless of their exercise preference, kettlebell swings often find their way into the regimen. 

This is for good reason as the kettlebell swing is a great exercise. However, like all exercises, when performed improperly it can result in discomfort. 

The swing is an activity meant to train the hamstrings and glutes to be explosive via a “hip hinge” motion. This powerful motion is generated at the hips and creates momentum to propel the kettlebell. 

However, the kettlebell swing is not simply a glutes/hamstrings exercise. A large amount of stiffness must be generated in the trunk to control the spine against the forces created by kettlebell’s momentum. 

The bell is pulling the trunk towards the floor (into flexion), as it swings downward and between the legs. Trunk control/strength is required to prevent the back from rounding into flexion. The first step to mastering this portion of the movement is to learn the hip hinge. This way you know what it feels like to have your back in the proper position. To master this, simply use a stick for feedback as seen in the exercise below. 

Hip Hinge with a Dowel

The next step is to remove the stick and use a wall for feedback as you reach your hips towards it.

RDL Wall Reach

Finally, master the hinge by working on the Romanian deadlift as seen below.

Romanian Deadlift

People also experience low back pain at the top of the swing when standing tall. This is commonly due to hyperextension of the low back as it compensates for a lack of hip extension. This lack of hip extension can be a result of poor form or a mobility limitation with hip extension. 

If you feel like hip extension mobility is your problem, give the activity below a shot!

Hip Extension Mobility Drill (quad focus)

These are just a couple of different reasons that a kettlebell swing may be giving you pain. The good news is that there are always things that you can work on to get back to the exercises that you enjoy.

For more information about lower back pain or why any exercises may be painful on your back, contact us or check out the articles below!

Essential Pillar Strength 1

Essential Pillar Strength 2

Essential Pillar Strength for Rehab

Physical Therapy, Exercise Best for Low Back Pain  

Knee Pain With Running: Is It Inevitable?

a woman running with mountains in the background

Knee Pain with Runners: Is it inevitable?

Short answer, no! 

As performance physical therapists in Bethesda, we often see runners that have knee pain. Many runners simply view this pain as inevitable and part of being a runner.

However, we at Cohen Health and Performance disagree. Admittedly, runners are at an increased likelihood of experiencing knee pain. This is due to the large amount of running that often occurs in a typical training program. Furthermore, each running stride looks similar to the one that follows and is performed over and over again. This places strain to the same areas of the body repeatedly.

However, with proper cross training, this can be minimized. 

It is important for a runner to work on improving the movement qualities necessary for effective running. This includes; single leg stability, single leg landing mechanics and lower body strengthening. 

When running, the body is constantly transitioning from one leg to the other. During this transition time, there is no foot contact on the ground. For this reason, it is important to be under control when initially coming into contact with the ground. This will minimize pounding on the knees and result in a more efficient running stride. Forward bounding is a great drill to work on these qualities. Check out the link below!

Linear Bound

Single leg stability and lower body strengthening can simultaneously be addressed with weight training. Weight training increases the stress tolerance of soft tissues such as tendons, ligaments and muscles. When these exercises are focused on the lower body, they will increase the resiliency of what these areas can handle. A great example is a reverse lunge. This activity requires a great deal of single leg stability, as well as the strength to control the descent of the body and subsequent ascent back to standing. This activity can be performed as a bodyweight drill or when holding dumbbells to increase the challenge. Furthermore, the reverse lunge places less strain onto the knees when compared to forward lunging! When performing this activity, begin standing and descend into the position below with the back knee slightly above the ground. Next, stand back up using the front leg to push your body back to the starting position.

Healthy and successful running is possible, however, it requires a well-rounded approach that includes much more the just running. 

For help designing your cross-training routine please contact Dr. Cohen or Dr. Immermann via the information below!  

What Is Limiting Your Pull Ups?

Demonstrating a good pull up hang

Pull ups are an incredible exercise. The ability to perform a strict pull up with quality technique is a great measure of upper body strength and relative strength per body weight. This is also an exercise that many struggle with. This can be due to a lack of strength, increased body mass or lack of shoulder mobility. How do you know what is your limiting factor?

It is often assumed that strength or an increase in body mass is the issue. If this is the case then the solution is relatively simple. Focus on strengthening your pull ups! This can be done a number of different ways and with a number of different strategies, however, it doesn’t need to be overly complicated. If body mass is the issue, then strengthening will also help. However, decreasing the weight that you are pulling also makes things easier.

The most overlooked component to pull ups is shoulder mobility. Many active people that participate in weight lifting, CrossFit and various other fitness approaches lack full overhead shoulder flexion.

180 degrees (full overhead) of shoulder flexion is required for a strict pullup as the body begins hanging directly below the bar with the arms straight. The wrists, elbows, shoulders, trunk and legs should all be in one line. The body is then pulled up until the chin is above the bar.

When 180 degrees of shoulder flexion is not present, the shoulders often begin behind the body and a larger arc of motion is required to pull up. This requires much more muscular effort and causes the body to tire more quickly. Many active people train multiple days per week and therefore, possess the strength and low body mass required to perform a strict pullup.

Thus, the limiting factor is often shoulder mobility. To test your mobility, attempt the back to wall shoulder flexion test. Simply stand with your lower back very lightly touching a wall and attempt to raise your arms overhead. Can you touch your hands to the wall without arching your lower back away from the wall? If not, some overhead mobility work may be warranted.

Why Would You Celebrate Your Anniversary At Disney?

Dr. Zach Cohen and Dr. Debra Rios

This past weekend my wife, Debbie and I went on quick vacation to Disney World. We chose to escape the fast-paced environment of DC, turn back the clocks, and celebrate our anniversary like little kids.

Debbie and I are typically able to remain consistent with exercise and healthy eating however it is a challenge to avoid the stressors that life in a metropolitan area can bring. A constantly high level of stress may interrupt sleep, contribute to fatigue and decrease the ability of the body to positively adapt from exercise.

A strategic break is a wonderful way to battle this challenge. Strategic breaks are necessary in the lives of any hard working, driven individual. People often feel guilty for taking a break from the grind however research has proven that great ideas com during “off” time and/or immediately after. For example, Bill Gates is famous for constantly taking weeks off without cell phone or internet access to simply disconnect.

After my strategic break, I am feeling rejuvenated and ready to give everything I have to our patients to help them get the best results possible. This most recent vacation had the added benefit of allowing us to take a break from the serious and laugh at ourselves which I find hugely valuable.

Adjusting your exercise routine and approach to nutrition is important however when was the last time you evaluated your life balance?

Do You Need To Warmup?

woman stretching before a run

This is probably a good idea; however, this does not mean that you need to stretch, roll around on the ground and perform “activation” drills for 15 minutes prior to being ready for exercise.

There is no perfect warmup for everyone. The best warmup depends on what your activity level had been that day and the specific activity that you are preparing for (among many other things). If you are getting ready to run, perform activities that practice things necessary to run effectively. If you are going to lift weights, practice movements similar to the lifts you are going to perform (ie. If you are going to squat, then squat in your warmup!).

Furthermore, if you have been sitting at a desk for the majority of the day, you may need a more comprehensive warmup. On the other hand, if you have an active job requiring you to move in a variety of different ways then your warmup can be the activity itself.

Animals don’t require extensive warmups prior to sprinting. They have been walking, standing and moving all day prior to ramping things up when nature necessitates it. If you have been active the majority of your day prior to training, be like a cheetah!

A small warmup is often necessary however be purposeful about it rather than mindlessly performing the same thing each workout.

For help creating a customized workout for you, feel free to contact us via e-mail info@cohenhealth.com or phone (240) 686-5609