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Myths busted: Is your spine “Out of Alignment?”

So many time clients with spine issues tell me the following:

“I’ve had this in the past and my spine was out, so it had to be put back in place”.
Usually, they refer to a manual therapist or chiropractor that did that for them.

I believe this needs to be addressed since it’s simply not true and it can create problems which I’ll explain.

But first let me point out that the spine is a very strong and robust structure. It cannot simply be pushed into and out of alignment by quick thrust. If that would be the case, Rugby players and MMA fighters would be in serious trouble after nearly every match.
Also, in Australia, recently some students tried to take apart an SI joint. It took them more than an hour, 2 students, a hammer and lots of sweat to do it. There’s a small chance that if that’s the case, a microsecond and a quick thrust will provide any structural change.

As a matter of fact :

“No supportive evidence is found for the chiropractic subluxation being associated with any disease process or of creating suboptimal health conditions requiring intervention. Regardless of popular appeal, this leaves the subluxation construct in the realm of unsupported speculation. This lack of supportive evidence suggests the subluxation construct has no valid clinical applicability.” 

Why is this misconception a problem?

Saying that a client’s spine “is out” creates two problems in my opinion:

  1. dependency on the practitioner or technique used to “correct” the problem.  It’s the practitioners duty to inform the client correctly and in my opinion, and provide information and/tools to empower the client to take manage or restore their own bodies’ function. We as health professionals can and should help this process but dependency on us should be avoided.
  2. False beliefs about a structural “dysfunction” of the spine. Saying something is “out of place” and “needs to be adjusted” creates the idea that there is something wrong with the spine. The next time a client deals with pain, a logical consequence would be to think “my spine is out again”, which will result in thinking that manipulation is needed to fix the problem.

Both of these issues can be avoided simply by not using these terms anymore. Spinal manipulations definitely have clinical value but we should aim to provide information that is accurate and beneficial to the clients beliefs, aside from just treating them.

The Epidemiology of low back pain. (Hoy D1Brooks PBlyth FBuchbinder R.)

 

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Shocking Facts about running #3 – EM Sportscience updated research

EM sportscience released a video that broke down new research on running shoes so it’s time for an update on my -now- blog series on the topic.

After #1 and #2 , here’s a video that does a great job at explaining what current evidence is showing. Below you’ll find the bullet-points of the talk but if you have the time, I’d recommend watching it all (maybe during your next treadmill run?)

Injuries in running have not gone down over the last 10 years, despite shoe technology

No conclusions can be drawn by comparing former research to now since injuries have changed and runners changed.

Impact force peak doesn’t seem to be a causal factor in running injuries 

Most impact doesn’t happen on landing but later in stand phase. Which means cushioning the heel makes less sense than assumed.

There is no good evidence that loading rate (or faster running) leads to higher change of injury. 

There is no significant connection between anti pronation properties in shoes and injuries. Actually, it seems that sometimes pronation can be an advantage 

New suggested ways of looking at running injuries and shoes might be the “comfort filter” theory and the “preferred movement path” theory.

 

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Shocking facts about Running #2

#1 The most expensive shoes are the worst.

 

According to a study done by Bernard Marti, a preventative medicine specialist at Switserlands’ Universtity of Bern, runners wearing A-quality running shoes are 123% more likely to get injured than runners in cheap shoes.
That’s right. Seems crazy right?

He and his team analysed 4.358 runners in the Bern Grand-Prix, which is a 9.6 Mile race. The first thing that struck them was that 45 percent of the studied group had been hurt in the year leading up to the race.
The rest of the information from the study wasn’t any less surprising:

The most common variable between the runners wasn’t training surface, running speed, body weight, age, motivation or previous injury.

It was the price of the shoe.

Runners in shoes over 90$ were twice as much likely to get hurt as runners in shoes of 40$ and below.

For me, it’s not that much of a shocker. I’ve been running on 20$ fake (don’t tell anybody 😉 ) Nike Free running shoes and I’ve never felt better during my runs.

#2 Feet don’t respond well to cushioning

 

We believe that the more cushioning in our shoes, the more comfortable the feet will be. We might be wrong.
First off, all the cushioning in our expensive running shoes do nothing much to reduce impact. When you think about it, that’s not so strange. During every step we take during a run, the body weight that comes down smashing onto the ground can go up to 10 times your body weight.
In my case, that would be 1500 pound of force coming down onto a half an inch of rubber. It’s very unlikely that piece of rubber is going to absorb it all.

“You can cover an egg with an oven mitt before rapping it with a hammer, but that egg ain’t coming out alive”- Christopher Mcdougall (Born to Run)

Secondary, more cushioning make our landing mechanics worse. During some studies on gymnasts they found that the thicker the landing mat, the harder athletes would slam down, trying to find balance. A comparable thing happens when we run. The feet sense a soft underground and instinctively pushing through to find a hard, stable surface to land on.
This is often found when multiple types of shoes are used while running on a force plate. Often, force absorbed by the plate changes significantly while changing between well cushioned shoes, thin soled shoes and barefoot running shoes. Just not the way you’d expect.

Often impact levels are the least in bare foot of thin soled footwear, and highest in cushioned shoes. And that’s because with less cushioning to rely on, we use our bodies’ own shock-absorbers  and they happen to be really good.

And even better, it can be trained to become even better.

If you want to know how your shock absorbers are functioning, click here

 

I’ll upload some stability exercises to my channel soon.

 

Mark

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The Reason Kettlebells are awesome.

Let me be straight upfront. If I only had to choose ONE piece of equipment to train with the rest of my life, it would be a Kettlebell. And that’s coming from a skeptic.

In a relatively short period of time (I’ve been working out for over 15 years and have been using Bells for the last year or so) I completely fell head over heels for Kettlebells in all shapes and sizes.

okay that might be a lie * 

 

So what are Kettlebells and why are they so special?

Let me break it down for you.

Kettlebells are canon-ball-shaped weights with a handle on them. They should remind you of a tea-kettle.
Their shape allows you to perform movements that can’t be replicated with dumbbells or barbells, giving you an all-round fitness experience which no tool can do better.

One of the key benefits is that it makes the entire body work together in most exercises, which makes it possible to train strength ánd cardio at the same time. How convenient is that?

forget about those hours on the crosstrainer 

Because most movements put the entire body to work, the workout is very time-effective. A short 30-45 workout will give you all the effects that a 90 minute machine based gym session would do, and most probably more.

Kettlebell workouts increase athletic performance, melt fat and dramatically increase the cardiovascular health.

oh, and did I mention it gives you abs and glutes of steel?

…There’s a downside to all of this. HARD WORK.

The movements are not easy since multiple joints and muscles are being put to work. So getting someone experienced and certified to teach you would be strongly recommended. (like me)

 

“Kettlebell training is not for sissies but it is not elitist. Dr. Krayevskiy, father of Kettlebells, took up training at the age of forty-one and twenty years later he was said to look fresher and healthier than at forty”

-The Strongfit Certification Handbook

 

If this is you, contact me and we’ll make it happen.

The price of admission is a strong spirit and attention to detail.

 

* Because of their movement types, Kettlebells should start at around 16-20kg for men and 12-16kg for women. 

for lower weights, you may as well grab a dumbbell.

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Week 2: Progress Update

 

Week 2 Progress:

Weight : 82 KG

Fat % : 14% (-2 %)

Good:

  • Missed 0 Workouts ( Weights 3x, Bjj 2x, Boxing 1x)
  • Increased Weight on all lifts
  • Getting 7+ hours sleep daily
  • No drinking

Needs work:

  • Not eating enough, need more meals
  • Practice patience
  • Fat% still a bit high

Notes:

Everything moves too slow. Which I guess, is a good thing because if my clients are anything like me, they will struggle with this as well. It really helps to keep track of objective progress ( see stat page of 5×5 app ) and imagining what that progress will look like on the broader scale of things.

 

Progress on Big Lifts

 

 

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Shopping list : Quick and Easy

A good diet starts with shopping. Don’t buy crap, don’t eat crap. It’s really that easy. Here’s a list with all the good stuff that needs to be in your basket.

Good Protein Sources:

 

Eggs
Liquid Egg Whites: More convenient but more expensive
Skinless Chicken Breast: high quality lean protein
Lean Ground Turkey: Lean high quality protein
(Wild) Salmon Healthy fatty fish: costly but quality protein + tons of healthy fatty acids
Canned Tuna: Lean, easy and inexpensive. Get the water based one, not oil.
Lean Ground Beef
Cottage Cheese: Source of Casein protein. Slow digesting so will provide the body with protein for a long time.
Pork Tenderloin: fairly inexpensive medium lean protein.
Protein powder: Convenient, usually tasty and pure (if you get a good brand) also helps sweet cravings
Protein snacks: protein bars / nuts / seeds

Good Sources Of Carbohydrates

 

Oatmeal— cooked or overnight. Slow digesting, tons of fiber and nutrients. Learn to love it!
Fruit— Favorites for me are Blueberries (lots of nutrients / antioxidants ), bananas and apples. Best eaten around the workout because they’re mostly quick digesting carbs.
Vegetables— The more the better really. Tons of fiber and nutrients.
Sweet Potatoes
Brown Rice
White Rice: Fast-carb. Best eaten around the workout
Whole Wheat Bread

Good Sources Of Fats

 

Olive Oil
Flax seed oil
Fish Oil—Staple source of omega 3/6/9
Almond Butter
Cashew Butter
Peanut Butter (watch the sugar content)
Almonds
Pecans
Walnuts
Cashews
Macadamia
Avocados

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Back pain: What type are you?

Okay, we can not put labels on people.

After all, we are all different and move differently. But the truth is that people mainly move in 3 directions, which are the following:

rug pijn hulp stap 1, bepaal welk type je bent

I will not make it too technical but the planes mean the following:

Sagittal (Blue): Move forward / backward, bend forward to pick up something
Frontal (Red): Sideways movements, such as when we raise our hands to wave to someone
Transverse (Green): Rotatory movements, such as when we reach to open a door.

The vast majority of our movements take place in the so-called Sagittal plane. Or often, actually to be more precise …

… the vast majority of our non-movements.

Een slechte houding plaatst 40% meer druk op de wervelkolom

 

Fact: A bad posture places 40% more pressure on the spinal column

When we move much in the same directions, the body adjusts to it. In practice, we see that this often results in 2 different archetypes: extension type and flexion type.

As you can see in the picture, there are a number of things that belong to these types.

Not everybody has all the features, but they often influence each-other . As a result, they are often seen together. The more features you have, the more you belong to this pattern.

Extension Type

The features or this type are:

-An enlarged arch in the lower back
-“Flaring out” the rib cage
-The pelvis tilts forward (“Water spills out on the front”)
-The knees are fully extended

Possible Issues:

Extension types often come with compression problems, or complaints related to pressure when joint surfaces are close to each other. -and thereby imposing excessive pressure on the connective tissue.

Flexion Type

The Flexion type has the following characteristics:

-The shoulders often “roll” forward
-The head is on the front and the neck is extended
-Upper back is rounded
-Lower back is flattened, or even rounded
– There is “no ass!”
– Knees are bent

Possible Issues:

The Flexion types are often the people with an office job. Working behind a desk easily pulls your body to this archetype . Mostly if you are not aware of your posture while sitting. This habit is then taken to the car and home where the “working posture” is continued to the “couch posture”.

This often passive posture can adversely affect the connective issue that hold the vertebra together. The inter-vertebral discs may also suffer greatly. Because there is little active support of the muscles, almost all of the strength ends up directly to the so-called “passive structures” such as the joints, ligaments and cartilage.

Herniated discs and instability problems are often seen complaints in this pattern.

 

Which back type do you have?

Which pattern is most like you? Once you know this, you can start balancing your posture through targeted exercises.

Under this article, please let me know what kind of type you are and what complaints you may experience!

I’ll be able to help you out from there on.

 

 

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Quick Snacks: MCT oil Coffee Gummies

 

5 Tbs of Coconut Oil / MCT Oil
5 Tbs of Grass-fed Butter
2/3 Cup Gelatin powder
4-5 Cups of coffee (quality beans)
2 Tbs  raw honey/stevia (adjust to taste)
Vanilla extract to taste

-Blend for 30 seconds
-Put in oven tray and refrigerate for 3 hours

 

 

Ready to snack !!

Source: Livestrong

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Nutrients: B2 (Riboflavine)

Vitamin B2 (riboflavin) What, why and how much?

This vitamin is important for energy metabolism and optimal functioning of the central nervous system.

RDA is 1.1mg for men and 1.5mg for men.

Products with a good source of B2 include:

– milk and other dairy products
– Meat
– organ meats such as liver
– whole grain
– Green vegetables, broccoli, spinach, asparagus
– Eggs
– some fruits like bananas
– mushrooms
– crustaceans

 

Vitamin-B2-rich-foods

source: Healthbeckon

Vitamin B2 is fragile and disappears from food when it is exposed to UV light. Long-term exposure can be 50-80% of the vitamin loss!! Hence milk is often found in a carton and not in a plastic bottle!

B2 deficiency can cause digestive problems and skin. Also, inflammation of the eyelids and mouth occur.
Symptoms of an excess if B2 are not well documented.

 

Mark Chen
Markchenmovement.com

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5 Questions: Dry Needling

If I tell somebody “I think you may be a good candidate for Dry Needling, often their eyes open wide accompanied with a painful facial expression. The word “needling” doesn’t seem to trigger the best of responses even though “acupuncture” seems to have a more benign effect.

That’s a bit strange because by definition they’re the same thing:
Acu = Needle
Puncture = The act of piercing through 
As a Physiotherapist and Dry needling therapist, I’ve come to understand it’s mostly about understanding what’s going on during a dry needling treatment and what the differences/similarities are with acupuncture.
1. What is dry needling?
Dry needling is a so-called intramuscular- treatment performed by a specially trained physical therapist. This treatment method is often used for muscular complaints that have existed for a long time and is part of a total treatment. Examples can include chronic headaches, low back pain, RSI, neck problems, tennis elbow and other long-standing muscle problems . The physiotherapist uses thin acupuncture needles, which can help to quickly and easily fix “knots” in muscles.
2. Is it similar to acupuncture?
“There are similarities between acupuncture and dry needling.  For example, the same needles are used and the needle placement technique matches. However, there are also obvious differences.
The biggest difference is the approach. Chinese traditional Acupuncture is mainly used from an energetic concept. The idea is that the body has a wide map of “meridians”, which function as energy channels between different body charts. Blockages in these energy pathways can lead to problems and acupuncture needles are inserted to unblock the problematic areas.

A map of the meridians used in Traditional Chinese Medicine

Dry needling works from a physiological and bio-mechanical concept. There are many muscles that work together as a team through the body. Since all these muscles are connected, they strongly influence each-other. Sometimes some of the muscles in the team can hold “triggerpoints”, which are commonly known as “knots”. These points can cause pain, stiffness and dysfunction in the muscle and the joint it works for. But it can also affect the entire line it belongs to. With dry needling, the aim is to insert a thin acupuncture needle in the triggerpoint to release it from the muscle.

The Myofascial “arm line” muscle connection (From the book “Anatomy Trains”)

Another difference is that classical acupuncture often uses multiple needles, which remain in the body for some time. Dry needling uses one or a low amount of needles and they usually are in and out in a matter of seconds. 
3. When is dry needling applied?
“For long-term muscular complaints, dry needling is effective, especially if myofascial (muscle tissue and fascia = connective tissue) trigger points are present. These trigger points can be explained as a painful hardening or muscle node. Often these trigger points cause not only pressure pain , But also pain in other parts of the body.
The physical therapist is looking for these places because they can be the main cause of your complaints. In addition to pain, a triggerpoint can also provide movement limitation, stiffness and reduced activity of the particular muscle. Sometimes even reactions like sweating, dizziness, headache, blurred vision, tingling or cold hands can occur from an active Triggerpoint.

Low back muscles and their referred pain patterns

Most patients with muscle problems can be treated with DN, but in some cases dry needling is less suitable. Pregnancy is a reason not to treat, just as fear of needles. Acute injury due to an accident, for example a muscle tear, is also excluded from treatment.
4. How does it feel?
“In order to release trigger points, the physiotherapist will cause them to “twitch”, which will force the muscle to relax. The insertion of the needle will not or hardly be felt. The treatment of the muscle is often accompanied by a Sudden short tightening of the muscle. This “cramping” can be a bit painful but is usually short-lived,  and a positive effect of relief follows immediately after. The muscle may be more flexible, the mobility in the joint improves and pain decreases.
5. What is the effect of a treatment?
“After treatment, the treated muscles usually feel quite tired and heavy.” Strong muscle soreness” is a common phenomenon, which is quite normal and often disappears within a day. Sometimes, some general fatigue occurs after treatment. Regularly, patients experience a deep sleep on the night after treatment.
During a first treatment , the therapist usually only treats a small number of points. This way he/she can see how you react to the treatment before the intensity is built up.