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Fitness Question: Neck Surgery, now what?

Neck Pain

I just got operated for a herniated disc between the 6th and 7th vertebra along the back of the neck. A part has been removed. I had a nerve failure in my left arm because the nerve was compressed by the herniation. Now I have one problem; I walked 2 or 3 times a week for 1 hour but according to the doctor that is not very good for my neck because I have osteoarthritis between my 5th and 6th cervical vertebrae (strongly narrowed intervertebral space with slight disc herniation) and the other cervical vertebrae have small disc protrusions)

My question now is whether it is wise to buy a cross trainer and to maintain my fitness level that way. I mainly did fat burning and endurance.

I am 50 years old and still want to be active and have no overweight bmi = 21

Christine

 

 

Mark Chen, Physiotherapist:

 

Hi Christine,

I think it is certainly a good idea to keep the condition up to date via a cross trainer. I would certainly also put the advice of the GP to the test.
The idea that osteoarthritis should be a reason to be careful is very old-fashioned. To get an idea of what I mean, take a look at the next image.

 

Recent scientific research has tested the causal relationship between abnormal findings and pain by allowing people to take an MRI scan without any symptoms.
These studies show that there are a huge percentage of deviations that in these cases are totally unpaired with pain.
For example, for a disc “bulging” as you describe, 87% !!!
For degenerative changes of the discus, such as dehydration/desiccation, as many as 96%!!! of the older population.
This group, again, does not experience any pain.

This should be a reassurance. The findings in your neck are normal, and not necessarily responsible for any pain.
Of course, from my position I can, not determine whether there is actually a connection!

My advice would be to find a sporty physiotherapist who can help with this process. The neck must be tested slowly to see what is and is not possible!

In this way you will probably be surprised at what is possible. The idea to reduce a basic activity such as walking at such a young age (provided there is a good reason) does not seem sensible to me.

I hope this helps!

Mark Chen

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Fitness Question: Shoulder pain

“I suffer from a bursitis in my shoulder. Now I have heard that an injection does not always work. Can I benefit from physiotherapy?”

-Astrid

Mark Chen, Physiotherapist

How annoying that you have bursitis: They can, especially in the shoulder, be very persistent.

Injections are an often used treatment for bursitis and other inflammatory issues. The results are variable, but generally very good. With such an injection, corticosteroids are injected into the joint, with the intention of reaching the bursa, or whichever structure is the problem. A good placement of the injection is, therefore, very important.

The cortisone that is used is a variant of a hormone that the body itself makes to combat inflammation. When cortisone is administered from the outside, the immune system is suppressed and the body temporarily stops with production. In the short term, so with a single injection, that is generally not a problem. But the use of cortisone in the long term can have adverse effects, such as atrophy (decrease) of muscle tissue, decrease in bone quality and susceptibility to infections.

Physiotherapy

If you opt for treatment by a physiotherapist, you will probably look at the underlying cause. When the bursitis in your shoulder is not caused by a trauma, there is often a reason to find in the mechanics of the shoulder, posture or behavior. You can identify and solve these types of causes together with a therapist. In many cases, an injection is not required.

I myself always advise people to take a close look at the immune system. Are there ways, for example in your diet, to support the body in its own abilities to heal? When the shoulder is relieved, the body is well hydrated and provided with sufficient building materials, then you are often perfectly able to solve an inflammation by yourself.

Of course, one does not have to exclude the other. The physical therapist can inform you if and when it is wise to choose an injection.

 

Hope this helps!

 

-Mark Chen

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Fitness Question: Exercising with worn joints?

I have lost cartilage in my knee and a little bit in the hips, can I still do spinning? I’ve been doing it for years.

-Diny

Mark Chen, physiotherapist

The advantage of spinning is that it is not a weight-bearing activity (except the standing parts , of course). That makes it a ‘safer’ option than, for example, running, in which your knees and hips have to endure huge impact for miles. So if you look at it purely from a mechanical perspective, no problem at all.

You indicate that you have been doing spinning for years.

Could it be that the amount of years and intensity have contributed to the amount of wear?
Ultimately, spinning is  a very one-dimensional and repetitive form of sport. Do you clearly have more issues immediately after spinning, or the morning after? In that case you can question how beneficial spinning is for your body.

I am personally in favor of variety, not only because I like to do different things myself but also not to stress my body too much in one way. I also recommend this to the majority of my clients. Ask yourself the above questions and if spinning does indeed cause issues to you, then consider reducing or varying with a different sport.

 

Mark Chen

Physiotherapist / Personal Trainer / Nutritionist

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Burn & Learn : (anti) Depression

 

Four things to consider when you’re trying to make sense of never-ending contradicting pieces of health information:

1. The History

2. The Context

3. The Mechanism

4. The Short Term vs. Long Term

Using these points, the video gives some quick examples of how this can be applied to different nutrition information, but the reoccurring example for medications is antidepressants.

 

 

▲Patreon: https://www.patreon.com/WILearned

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The Tess Holiday Issue and What I should have done better

I got a lot of backlash from the Tess Holiday post I did this week. Even though the initial post said “This cover can be called controversial”, which is obviously is looking at all the discussion that followed, I instantly felt regret posting it.

The conversations that followed were intense. There was no, or very limited, intellectual debate. Instead, there was a lot of attacking, generalizing, taking things out of context, and projecting of some of my friends’ own problems on the issue.

As Corbett mentioned correctly, Facebook is not the place to have this discussion. However, there are some points that I’d still like to make and there are some things that I should rectify. (And thank you, Rachel, for bringing this to my attention).

My problems with the Tess Holiday issue:

  • My problem is not with Tess itself. Even though I do believe that she is not sincere. I know many overweight people that do, in fact, embrace their heavier frame and they are okay with that and I believe and respect that. They also do not celebrate or promote their weight, and they definitely don’t tell me or other people to quote “Kiss their fat ass”. Tess pretends to fully embrace her weight and pretends to be proud of “who she is and how she is”, but at the same time, she is on a Cosmopolitan cover wearing make-up and heavily photoshopped. The hypocrisy here is flat-out annoying to me and it’s a big part why I simply do not buy into the facade.
  • Obesity should not be promoted or embraced. I’m just baffled by how I need to explain to people that the being morbidly obese is a disease. It’s affecting the quality of life, decreases lifespan, affects people around them and costs an INSANE amount of money, and this is in the states alone. And this is 100% preventable.

What I should have added:

  • I’m all for accepting a wider view of what’s “normal” when it comes to beauty standards. I don’t think that our former standard with overly skinny catwalk models was healthy at all. Maybe I should have stated this but haven’t we long passed this idea?
  • Rachel brought up to me that I could be sending out the wrong signal and brought Ashley Graham to my attention. I’ve looked into her and I think she is the perfect example of what being a plus sized model that can also still portray a healthy lifestyle.

 

My view on the Cosmopolitan issue stands. I think they’ve pushed the narrative too far to the extreme by putting Tess on the cover. Being overweight to the point of killing yourself from the inside is not something that should be glorified. Instead, attention should be more towards women like Ashley Graham that can demonstrate self-acceptance, health and a couple of pounds more.

 

Always appreciate thoughtful discussion,

 

Mark

 

 

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Cambodia makes Jiu Jitsu History

Jessa Khan makes history as she is the very first athlete to put Brazilian jiu-jitsu on the map. This is a major event for sport in the country and hopefully will give some momentum to young athletes and especially women to pursue a career in sport.

I’ve had the pleasure of working with both Vivadhana Khou and Jessa Khan in their final preparation weeks in which the goals were very clear:

The icing on the cake

 

Let’s make one thing clear: Jessa was already READY when she came in to finalize the strength and conditioning

 

Finalise the strength and conditioning without the athletes getting injured. This, from my perspective is a MAJOR point and is too often overlooked. In the last 2-3 weeks of competition preparation, you won’t get significantly stronger on your squat, deadlift or bench. In other words, there is no significant GAIN in strength that can be translated into better performance on the mat. Pushing it in those weeks, especially after a long camp, will, however, increase the chances of overload and possible injury. The trick here is to work on the “icing on the cake”. Focus during training was a lot more on neuromuscular control, mobility and tensegrity. In other words, how the body and the mind work together.
With the right training dosage and exercises that are challenging without being too stressful on the body, the athletes can prepare safely and arrive on competition day with the ability to perform optimally.

 

Relax the body and the mind

 

Personal Trainer Mark Chen works with Jessa for Asian Games preparation

 

This is where I teamed up with my friend and mentee Sokvat Van. At the start of the preparation, both athletes were screened on existing injuries or risks for injuries by identifying muscles that are possibly overworked.
The talented masseur would unleash his healing hands on the muscles immediately after training and even though the athletes had to grit their teeth at times, came through with a smile and a supple body and mind.

Weight Cut

A lot of effort went into this, by means of water-flushing, sauna, running, Tabatha and all without any water or food intake.

 

Not many people understand how tricky it can be to manipulate your body weight at the right amount at the right time. This is of crucial importance though, since many athletes are on a different weight when they go through their daily life “walk around weight” compared to when they weigh in. Depending on the case, athletes can sometimes drop 5-10kg in a matter of days. This takes an extreme toll on the body and has to be done with a thought-through process.

The actual work

It’s as tempting as it is easy to toot my own horn when it comes to the performances at the Asian games and even though I’m proud, I realize my part of the journey was very small. The real credit belongs to Jessa and her team of coaches that have been able to detect this massive level of and cultivate it.
Another huge part of it is Vivadhanna Khou with his H/art Brazilian Jiu Jitsu academy. Not only did he start the momentum of BJJ in Cambodia and get the first Athlete to dominate the Asian games here, no.

He put together a group of like-minded, passionate people who are not only dedicated students but also friends. While he has been “living his dream” building this all, he has dedicated so much time and energy to it that it is hard to even experience the dream.
His effort deserves to be seen and respected.

I’m happy to have been part of this and am excited for what is to come!

 

Want to try BJJ in Phnom Penh?  Here are some reasons why!

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Fitness Question: Hardcore boot-camp training bad for me?

“Do you train your muscles better if you first ensure that you are experiencing fatigue and then go all out? We do this at my Bootcamp class: first, we have to feel fatigue in a squat and then we sprint at full effort. I find this very heavy. Is it really better?

-Maartje

Bootcamp Training

Mark Chen, Physiotherapist

‘Better’ is a difficult word, because that depends entirely on the goal you want to achieve. Still, I can be quite clear about creating fatigue in preparation for an explosive effort. Don’t, unless there is a very good reason for it.

Fatigue in a muscle involves a number of physiological changes in the circulatory system around the muscles. Simply put, it negatively affects the control of the muscle and therefore it will function less efficiently. You’ve probably felt that already!

Muscles with fatigue also lose their ability to contract and relax properly. If you demand an explosive action in that state, the performance you can deliver will always be below your actual capacity. I can even go one step further and say that at such moments, strains and tears occur most often. Take a look at football matches and the number of cramps and injuries that occur in the later stages of the match. It’s a very obvious percentage.

Creating fatigue in the muscle system can certainly have positive aspects, but should usually be kept until the end of a Bootcamp class. Ask yourself if your trainer has a good reasoning for this way of training. It is difficult for me to estimate how far your athletic ability reaches! If he can not explain it in a way that is sensible, I would be very careful with this combination. Listen to your own body and play the long game, don’t risk an injury.

 

 

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“Knee Pain, what to do?” – Readers Question

knee pain fixed

“I have osteoarthritis in my knee but am a fanatical athlete. Running I have to give up, but otherwise, I do everything from strength training to spinning, and daily cycling to lubricate the knee. Lunges are too stressful just like certain yoga exercises. Doctors advised me to do a procedure. But I am not ready for that yet,  although the pain comes back more regularly. I am 53 and my weight is fine. Do you have any more tips to improve my knee condition?”

– Caroline

 

Mark Chen, Physiotherapist:

A number of factors are important in the discomfort caused by osteoarthritis. Of course, the way of stressing the knee is very important and also the amount of rest that the joint gets to recover. Running is an activity that generates enormous impact on the knees. It is therefore not very surprising that you get a lot of problems with that particular choice of sport.

Strength training is indeed a good way to relieve the joint. You describe that lunges are too stressful, does the same apply to squats? If so, are you sure that the technique is correct? A large part of the load on the knees can be reduced by making these kinds of exercises more hip-dominant versus knee-dominant. If you use the hips more, the knees will taxed less. A good trainer can advise you and adjust if necessary.

Another option is so-called ‘open chain’ exercises. Thanks to machines, these exercises can train the muscles without having to carry the whole body weight. A disadvantage is that this way of moving often does not match how you use the knees in daily life (rising from a chair, climbing stairs). We call these exercises “non-functional” but that doesn’t mean they are not valuable.

Nutrition is also important. There is more and more research that shows that a balanced diet has a big effect on the discomfort that arthrosis brings with it. Consume a balanced diet and try to supplement with a multivitamin and possibly glucosamine. In the field of glucosamine, scientific studies are contradictory, but I have seen that a good quality glucosamine supplement can definitely add value.

A final option is an injection with Fermathron (hyaluronic acid). This is a kind of gel that can be injected and acts as a pad. It can both reduce pain and increase mobility and lasts for up to six months

If you’d like some extra help with your knee, make an appointment here!

I hope that helps,

 

Mark Chen