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Re: Rehab / Training Myths
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Re: Rehab / Training Myths - March 19, 2005 4:14:00 AM
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jma
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With long periods of sweating for those professional athletes who really put themselves through their pre-season workouts, I would think it would be more than advisable for those who sweat.
JMA
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Re: Rehab / Training Myths - March 22, 2005 8:43:00 AM
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rn8711
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Mike T and Jason,
IMHO, every exercise movement, "real life" activity and athletic event IS neuromuscular training. Learning how to sprint, sit, stand, throw a ball, walk the dog, lift a box, dig a hole, clean and jerk, full squat, chop wood, throw a punch, carry groceries, blah blah blah isn't something everybody is born knowing how to perform safely, efficiently or optimally.
Thus, just as with learning any skill early on it requires a repeated conscious and deliberate focus on the activity UNTIL it becomes an unconscious, automatic skill that the individual can perform 'safely'.
Once that motor skill is firmly established though, "focusing on the firing of a particular muscle group" especially during fast paced events such as Olympic weightlifting, football, baseball, etc. is not only unnecessary but potentially harmful to the athlete. "Paralysis by analysis" if you will.
The feedforward mechanisms and not the feedback mechanisms are crucial to injury prevention and the successful performance of practically every sport. However, a properly designed training program should address this and the comprehensive structural/functional strength needs of the individual as well.
IMHO, the whole argument of avoiding specific joint actions (for a non-traumatized joint or soft-tissue injury) is problematic. Injury prevention isn't just avoiding certain movements that the "experts" deem unsafe but teaching people to perform them effectively and to recover from them if something should go wrong. For illustration, why just teach people to strengthen themselves to avoid falling when I think we should also teach them how to fall safely should the situation present itself.
In addition, the assumption that patients are 'safely' performing all those kinds of "real life" activities outside the clinic needs to change as well. How can a repertoire of limited exercise instruction make up for a lifetime of faulty movement habits? Then again, "faulty" isn't readily agreed upon is it?
Finally, aside from the "avoidance" fallacy, we professionals need to stress that injuries can result not just from an activity itself but the "fear" of performing the activity as well. A "fear", in many instances, propagated by fitness trainers, PT's, PTA's, MD's etc. The general public love to listen to "experts" and when those "experts" say "never", "always", "shouldn't" etc and then disagree with the other "experts" confusion and distrust flourishes. IMHO, get patients/athletes structurally and functionally "strong" but give them some confidence about it too.
Again, just some ideas.
Russell
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Re: Rehab / Training Myths - March 22, 2005 9:03:00 AM
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rn8711
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JMA,
You wrote, "They are not taught to lock out the joints at all." I wanted to ask you, does that mean you don't teach your patients how to properly "lock out" at all or does that mean you teach your patients not to "lock out" at all?
Russell
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Re: Rehab / Training Myths - March 22, 2005 9:17:00 AM
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JLS_PT_OCS
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Russell-
I think we are on the same page there.
I think teaching someone proper form from a biomechanics perspective has a lot of value, and I would agree that the volume, speed, and intensity of rehab has to match that of the activity....
J
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Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: Rehab / Training Myths - March 22, 2005 9:26:00 AM
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jma
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When it comes to heavy weights, working with knees, I do not let patients lock out. However, if there is a lack of total knee extension, they have to lock out when reverse walking on an incline or pulling a sports cord, as examples.
JMA
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Re: Rehab / Training Myths - March 29, 2005 7:30:00 AM
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BillHartman1800
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Russell you sound like you've been reading some Mel Siff? Well said.
JMA,
I respectfully disagree with your premise that not "locking" joints is somehow injury preventative. Articular cartilage is very tolerant of compressive forces and will in fact strengthen under such conditions of full extension. By not locking knee joints, you may be exposing the joints to unnecessary shear which can promote premature wear on the articular cartilage. You'll also limit the acquisition of strength at end range extension which may have an injury preventative effect when the joint is exposed to such a joint position on a daily basis in loaded and unloaded situations.
I've not seen "not locking" supported in any literature other than perhaps a Muscle & Fitness magazine.
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Re: Rehab / Training Myths - March 29, 2005 8:53:00 AM
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JLS_PT_OCS
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I think it's important here to clarify what we might mean by "locking joints".
I take jma's statement to mean not locking the joint and resting there with the joint structures carrying the axial load and the muscles relaxing.
I would agree that it probably has more to do with reducing the time under tension of the muscle and therefore the efficacy of the strength workout than it has to do with injury prevention.
Though, in real life, someone carrying something heavy and attempting to manuever it will be much better able to do so by keeping lower body muscles turned on and keeping the weight supported by the muscles as opposed to the joints.
When moving or carrying a heavy object (and in rehab that's usually the kind of thing we're training someone to do, not get back to a competetive weightlifting meet), if you rest the weight on your joints by locking them and then attempt to move or walk, you may very well end up with some rotation or shear forces at the joint, this time with a greater axial load through them. So it isn't hard to see that's not a good thing.
I don't think "not locking" means not attaining full extension of the joint, that's a different thing, at least to me.
I think we all agree on this, just the definitions are hard to be specific on. Did that help?
And Mel Siff is the man.
Jason.
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: Rehab / Training Myths - April 12, 2005 7:46:00 PM
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Randy Dixon
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ok, a new one. One pound of added muscle will burn 50 (or 150) calories per day even while resting.
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Re: Rehab / Training Myths - April 12, 2005 7:48:00 PM
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Randy Dixon
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220-age equals the actual maximum heart rate.
(or any prediction being accepted for the actual figure)
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Re: Rehab / Training Myths - April 12, 2005 7:50:00 PM
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Randy Dixon
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longer aerobic exercise is better for weight loss because after 20 minutes the body uses fat for fuel.
Not wrong, just not actually significant.
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Re: Rehab / Training Myths - April 13, 2005 1:33:00 AM
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JLS_PT_OCS
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Good ones, Randy.
Very applicable to our fitness clients, who come with all sorts of wrong-headed ideas, many of which are actually perpetuated by some clueless members of the fitness industry.
Here's another myth:
Anyone who is a certified personal trainer must be an expert at fitness and exercise. (!!)
We've all seen the weekend cert programs...for anyone who works in the fitness area, what certifications would you respect in the personal training arena?
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: Rehab / Training Myths - April 13, 2005 3:50:00 AM
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Shill
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Randy,
I believe that the calorie one is actually true, though I am not sure of the number, nor whether it is per day or per some other time frame. I am sure that the calories are just that, NOT the Kcal that we have come to call a calorie. It is simply metabolic activity, which is higher in muscle than fat, and more muscle = more metabolic activity, even at rest. Makes it seem much more plausible.
I will see if I can find the reference.
Steve
OK, I found it. it is 35 calories, taken from a course I went to a couple of years ago, I still need to find the study from which it came:
Strength training can have a weight reduction effect
Muscle simply burns more calories at rest
(35 cal burned by 1 pound of muscle per day, whereas 1 pound of fat burns only 5 cal per day. I believe this is measured in calories, not Kcal)
_____________________________
Steve Hill PT
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Re: Rehab / Training Myths - April 13, 2005 5:10:00 AM
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Alex Brenner PT MPT OCS
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Randy,
I also thought that longer aerobic activity (I seem to remember 25 minutes taught to me at PT school) increased fat burning and ultimately weight loss.
What is the truth? Why is it not significant?
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Alex Brenner, PT, MPT, OCS
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Re: Rehab / Training Myths - April 13, 2005 5:12:00 AM
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Sebastian Asselbergs
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But the advantage of fat is, that a body has to lug around extra resistance all over hell's half acre and thus burns more ..... :-)
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Mundi vult decipi
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Re: Rehab / Training Myths - April 13, 2005 8:15:00 AM
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jma
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At least when I learned it, I was told that 30 minutes minimum of physical activity would start to utilize fat as an energy source
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Re: Rehab / Training Myths - April 13, 2005 8:30:00 AM
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JLS_PT_OCS
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OK, let's straighten this fat burning thing out. Of course, I did learn this backwards and forwards while studying for the CSCS test, but who knows what that's worth (right Wags?).
:)
Anyway, it's important to realize that at all times, the body is using all 3 energy systems. What matters is the relative percentage contribution from each energy source.
The supposed "fat burning zone" or longer duration aerobic activity means a greater "percentage" of the energy is coming from fat. Not a greater number of calories.
Let's use an example, and this is just for argument's sake to illustrate the principle.
Let's say you work out at low intensity for 40 minutes and burn 200 calories. Since you are doing low intensity work, much of that, say 50%, is coming from fat stores. So you just burned 100 calories of fat.
Let's say you work out at a higher intensity for 20 minutes and burn 500 calories. Since you are working out at a lower intensity, you get a lower percentage of fat burning, say 25%. So you just burned 125 calories of fat.
Which workout burned more fat?
Make sense? Now that is just for illustration, as the percentages vary widely depending on age, type of exercise, fitness level, etc.
So Randy is correct in his statement that someone will not burn "more" fat at a lower intensity, just a larger percentage, and that that fact has nothing to do with total calorie burning, and as such is insignificant.
If we are really expecting others to consider us as experts in fitness AND rehabilitation, isn't this key information to know?
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: Rehab / Training Myths - April 13, 2005 10:33:00 AM
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apolipo
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I think Jason is on the right track. I have read recently that short bursts of high intensity activity interspersed with low level aerobic activity (intervals) will burn a greater number of calories in less time than the standard low intensity aerobic exercise.
The thing is, the articles seemed to be saying that more fat would be burned in the interval workouts, but didn't really back this claim up with evidence.
Personally, I like to do days of long, slow runs and days of short, fast runs and then come home and do some weight work for UE & LE, along with a variety of uphill sprints. It keeps me from getting bored.
mike t
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Re: Rehab / Training Myths - April 13, 2005 12:20:00 PM
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srcase
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I agree with Jason and Mike. The research shows that high intensity interval training (HIIT) is the most effective way to burn fat. According to Doug Kelsey at the Sports Center in Austin (Fat Burning 101), glycogen-sparing exercise is the best way to burn fat. (It is the right combination of exercise intensity and duration that is most effective). Long duration aerobic activity is not intense enough to get an afterburn. HIIT training forces your body to burn fat after the workout (for up to 2 days if combined with strength training). It also signals your body to increase the number of fat burning enzymes for use next time, making it easier to burn fat. This is the same principle behind the Body For Life program by Bill Philips and it does work (I've tried it).
Sarah
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Re: Rehab / Training Myths - April 14, 2005 3:27:00 AM
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Shill
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Sarah,
Im with you on this, anecdotally, as through the "Body For Life" diet and exercise program, Ive found my abdominal muscles that I knew were shrouded in secrecy under a substantial layer of fat. I can actually SEE them. Ive lost my "dad gut", and kept it off for 2.5 years so far. My "aerobic" portion of this program was 20 minutes of relative interval training (for me, running is always interval training, because I hate it, and my HR is jacked up with nearly all intensities) 3 times per week, with the strength training 3 days, 30-50 minutes each day as well.
The 20 minute exercise bursts pretty much shred the old adage of "more is better". Its really a no-nonsense approach which appeals to me.
My experience with this program really makes me think that the recent surgeon general report on exercise needs is way, way off, and will likely drive more people away from exercise, as the expectations for the amounts of time per day/week needed are unrealistic.
_____________________________
Steve Hill PT
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Re: Rehab / Training Myths - April 14, 2005 4:16:00 AM
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JLS_PT_OCS
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Well, I think the jury is still out on HIIT as it applies to exercise training, but it is based on very sound and proven exercise science principles.
Therefore, for those interested, I do recommend it.
Mike mentioned that I'm on the right track. It's not so much that I'm on the track, as I am just quoting what I know to be true from the exercise science literature.
I have found my involvement with NSCA to be key in getting better at this stuff, and still recommend that for those interested. I surf on over to their forums everytime I think I understand exercise science really well, and I am continually humbled by the base of knowledge many of those people (many with PhDs) have.
I think the "afterburn" Sarah mentioned may be the post exercise oxygen consumption, which stays elevated much longer from weight training or high intensity intervals than from steady state aerobic training.
So we all know and should be reinforcing to our patients/clients that the optimum fat burning/wt loss program consists of both aerobic AND resistance training components.
And leave the long, steady state aerobic training for the marathon people...
:)
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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