Archive for the 'Physical conditioning' Category

Oct 15 2011

Why You Can (and Should) Stop Doing Sit-Ups

Do you hate doing sit-ups or crunches? Then I have some good news for you. According to Stuart McGill, a professor of spine biomechanics at the University of Waterloo, you shouldn’t be doing them because they can be bad for your back. Sit-up and crunches create a lot of compressive force on the intervertebral discs in your lumbar spine. How much compressive force? As much as 3,350 newtons. If you’re not into the metric system, that more than 750 pounds of compression!

The U.S. National Institute for Occupational Safety and Health (NIOSH) recommends a limit of 3,400 newtons of compressive force to help protect your intervertebral discs. They acknowledge that even at that level up to 20% of the population might suffer a disc injury with repeated exposure.

How is it that an exercise that’s often recommended to strengthen your abdominals and protect your back turn out to be bad for your spine? Think about what a sit-up or crunch involves. You’re strongly contracting muscles that compress the spine while it’s in a flexed position. That’s the same type of exposure you would have if you were lifting something heavy from the floor by bending forward at the low back. That’s just the kind of thing we’re always telling people not to do.

You’re not off the hook for exercising though. It’s still important to maintain good core strength and endurance to help protect your back. What are some core exercises that won’t be so hard on your disks? Look for yoga and Pilates moves that you can do with your spine in neutral. Bridges, planks, “bird dogs”, and similar moves engage your core without requiring spinal flexion or really strong muscle contractions. And don’t worry about it if you aren’t seeing those “six-pack abs.” Genetics and body type have as much to do with having that “ripped” look as conditioning of the muscles does.

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Aug 22 2011

Exercise Smart to Save Your Hands

Maintaining good physical conditioning is very important as part of your personal injury prevention strategy. Strengthening exercises and stretches should be part of your conditioning program, but not all exercises and stretches are appropriate for massage therapists to do.

For most massage therapists, the hands and arms are overtaxed by their work. So as a general rule, you’ll want to avoid any exercises that:
• Place a great deal of pressure on the hands, wrists or forearms
• Require repetitive movements using the hand, wrist or forearm muscles
• Put your hands or wrists into awkward postures

A great example is push-ups. Push-ups are a great core strengthening exercise. But when you do a push-up, the weight of your upper body is supported by your hands. When there are so many other great core strengthening exercises you can do, why put so much stress on your already overused hands and wrists? Try a plank instead. You can do the plank on your forearms, which form a broad, flat surface that is much less likely to be injured by the weight of your upper body.

What about the exercise where you hold a small weight in your hand and do wrist curls (either in flexion or extension)? This is a good exercise for therapists who are just starting out, to help them develop strength in the forearm flexors/extensors. But for therapists who have already been working for some time, it’s just too much repetitive movement on top of the repetitive movements you already do all day long with your hands as you massage.

You’ll also want to make sure you keep your wrists as straight as possible with any exercise you do. Your muscles work best with your wrists in this neutral posture; flexing, extending or deviating them more than 10-15° reduces your strength and can lead to injury.

Remember to also be careful with your back, neck and shoulders as you exercise and stretch. These are also overused in massage work and can be easily injured by exercises or stretches that are too strenuous for these vulnerable body parts.

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Jun 03 2011

For Better Body Mechanics, Strengthen Your Core

Most of us have heard about the importance of strengthening your “core”. But what exactly does that mean, and why is core strength important for massage therapists in their efforts to prevent injury?

When we talk about the “core” in terms of preventing injury, we’re referring to the deep muscles of the trunk that stabilize the spine. Many people who have back pain have weak core muscles (including transversus abdominis and other abdominal muscles, the deep spine extensors, etc.). Since manual therapists have increased rates of back pain and injury due to the demands of their work, it makes sense to strengthen the core muscles to provide great stability to the spine and make it more resistant to injury.

In addition, the core muscles play a role in balance and the feeling of being grounded and centered. You need good balance to use proper body mechanics as you work, and your body mechanics will be better if you have a firm sensation of connection to the ground and are aware of your center of gravity as you work. Core strengthening can help with this.

Finally, strong core muscles help create better posture. Manual therapists tend to get into forward head and neck postures, in part due to a lack of core strength. With better general posture, it’s easier to find a neutral working posture and work within a range of near-neutral postures which allow you to use your body efficiently and effectively as you work.

The classic core strengthening exercise is the “plank”. This exercise works nearly all of the core muscles at once, and is simple to do. Lie on your stomach on a foam mat. Lift yourself up onto your forearms and toes (if it’s too difficult to be on your toes, you can be on your knees instead). Your forearms should be parallel to each other, and your elbows should be right under your shoulders Your back, neck and head should be aligned and flat/neutral (neither flexed nor extended) – look straight down at your hands. Tighten your abdominal muscles. Hold this position for 30 seconds, then relax and return to lying on your stomach. Do another two repetitions. Work up to 45 seconds, then 1 minute. Make sure you keep breathing normally throughout.

For an additional challenge, do the plank with your legs on a large, Swedish exercise ball. You’ll have to further engage your deep core muscles to keep your balance on the ball!

There are many great core strengthening exercises. Give them a try, and in time you’ll see a difference in the ease of your body mechanics. Your back will thank you!

Is there a core strengthening exercise that you particularly like? Write a comment and share it with other therapists here.

PLEASE NOTE: consult a primary healthcare practitioner before starting any exercise regimen.

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Oct 02 2010

Great exercises to open up the chest

We all spend a great deal of time working with our arms in front of our bodies, often hunched forward. We type on the computer, wash the dishes, change the diapers, make dinner, etc., all in this position. Massage therapists and bodyworkers also work much of their time in this position. The result is often muscles that are shortened in the front of the body (especially the pecs and abs), stretched-out and weak in the thoracic (like the rhomboids), and tight in the upper thoracic/base of the neck (upper traps, levator scapula).

I’ve found two wonderful exercises to counteract this problem that I’ve started doing every day, and I’d like to share them with you. They use a product called the OPTP Pro-Roller-Soft (about $32), a tool that was recommended to me by a physical therapist (www.optp.com – I’m not affiliated with the company). It’s basically a solid foam cylinder that’s fairly firm but has some give to make it comfortable. If you feel any pain or discomfort as you do these exercises, stop doing them.

Exercise I: Lie down with your coccyx at the bottom of the roller and your head at the top. Let your arms fall straight out to the sides, perpendicular to your body, and bend your knees so your feet are flat on the floor to let your low back relax against the roller as much as possible. You’ll probably notice that your low back (lumbar spine) doesn’t lie completely flat against the roller at the beginning. As you balance on the roller, raise one foot about 6 inches, then place it down and raise the other foot – keep going as though you were marching in place, alternating feet. This works your abs, and you will probably also notice that after you’ve done this for a few minutes, your low back will lie flatter against the roller. Also, your arms will gradually lie flatter against the floor – at that point, you can try to move them along the floor toward your head as far as you can go, to get a greater stretch through the chest and back.

Exercise II: sit on the floor with the roller horizontal behind you. Clasp your hands behind your head with your elbows out to the side (this is to support your head – don’t pull forward on your neck). Lean back on the roller, lifting your butt slowly off the floor, and start rolling back and forth on it, which will give you a nice, fairly deep massage. You can roll on your lower thoracic/upper lumbar spine, then work up to the top of the thoracic spine. Then roll to where the roller is just below your shoulder blades, and lean your shoulders and head back (still supporting your neck with your hands) to get a good stretch through the entire front of your body.

When you get up after doing these two exercises, your posture will be much improved, and your chest will feel lifted and open. Your upper back and neck muscles should also feel more relaxed. Keep your roller at work with you, and do these exercises (which take only two or three minutes) on your break between massages!

Let us know how these exercises work for you. If you have any other exercises that you find really help counteract the effects of your massage work, please post them here.

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