“This is a functional exercise.”……“This is functional training.”

How many times have you heard this? Have you ever wondered what is meant by “functional”? What does “functional” even mean for you?

There is not a single exercise that is universally functional for every person.

A back squat is functional for a powerlifter because he/she performs this activity as part of his/her sport. This same activity is not as functional for a runner due to the different demands of the sport.

Your training should be functional for YOU.

This is something that is paramount in the rehab process. Dr. Immermann and I keep this in mind with every physical therapy or training client that we work with.

Let’s take our previous example of a powerlifter versus a runner. If each person is experiencing knee pain, then the goals of the rehab process will be different. The powerlifter needs to be able to squat and deadlift without pain, while the runner needs to be able to perform single leg activities and run without pain.

Regardless of the differing goals, each person must learn to perform activities to keep themselves healthy throughout their training careers and life.

Therefore, the question you must ask yourself is…what is functional for you?

Physical therapy clinics throughout Bethesda and other areas like this are now crowded with people that have injured themselves shoveling snow.

Back injuries are the most commonly injured area when shoveling however many other areas can become irritated as well.

Why does this so commonly occur?

These injuries are often due to the approach that people take to shoveling snow. Most do not think of this as a workout however our body’s experience many of the same stressors as when weight training.

Do you warm up to shovel the driveway as you would to train? Do you think about your lifting technique when shoveling snow as you would when in the gym?

If the answer is no to either of these questions then it may be time to change your approach the next time there is a heavy snowfall.

Furthermore, are you trained to perform outdoors in cold weather?

If you are constantly training in a warm gym then you likely are not. Your body functions differently in the cold. It likely is prioritizing staying warm over performing optimally. The body does not need to worry about this when training in the gym.

This does not mean that you have to begin working out in the freezing cold like Rocky in Rocky IV.  However, it does increase the need for a comprehensive warmup.   Furthermore, a well-trained body with a solid baseline level of strength will make you more resilient to injuries in higher risk situations such as these.

Therefore, do not ignore the basics of good strength training in your exercise regimen!

If you are reading this, you likely are already aware of some of your shoulder mobility limitations. These limitations may affect your ability to overhead press in the weight room, serve on the tennis court, or swim.

Perhaps you have been working on these limitations but have seen little improvement.

A joint’s mobility will be limited for a reason and in physical therapy it is our job to figure out why this is occuring.

The body will create stiffness in a joint and limit its ability to move through a particular range of motion when it does not feel safe there.

If your overhead mobility is limited, it is likely because you lack control of this joint when your arm is overhead. Therefore, your efforts to stretch the shoulder with the goal of gaining better overhead mobility is futile.

This is until you learn to generate the muscular forces necessary to control the shoulder in these positions. Once you can do this, the body will then reward you with more mobility as it now feels safe doing so.

The video below is a great example of how to utilize these principles to work on your shoulder flexion limitations. Give it a shot!

Shoulder Flexion PAILs/RAILs

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

“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 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!