I had an operation
about 20 years ago. She is very cautious of doing
any flexion work as she feels it puts extra pressure
on the hernias. She has very weak abdominals as
a result and I am trying to strengthen them with
leg work while in a supine position with head
down and isometric exercises.
Do you have any recommendations or suggestions
regarding training with this client?
Many thanks
ANSWER:
There is a lot you can do with a client with all
these dysfunctions. Here is what I would research
and look into to help a client with this dysfunction.
Nutrition: This is key in any clients healing
process. There are a lot of organs within the
anterior aspect of the body that lay posterior
to the inner unit (transverse abdominus, internal
oblique, multifidus, deep erectors, pelvic floor
muscles, diaphragm and external oblique, in which
Vladimir Yanda describes as a functional inner
unit muscle). Anytime there is inflammation in
any of the organs, the muscles that lay over them
will be inhibited. This creates inner unit dysfunction,
inner unit to outer unit synchronization, altered
motor unit recruitment, instability’s in
the low back, facet inflammation, SIJ dysfunctions
and so forth. As well, anytime we have surgery
and MD’s cut through fascia and muscle,
these muscles get sensorimotor amnesia.
To regain sensory-motor unit synchronization,
nutrition and lifestyle principles need to be
in alignment. Here are some recommendations for
you to get started. If you feel your client needs
more, I would refer out.
1. THOUGHTS: Everyday you wake up, the first
thing that is turned on is your thoughts. If you
follow the Law of Cause and Effect (thoughts?words?deeds),
then it should all make sense. If you begin the
day with good thoughts, then your words and deeds
for that day will be positive and lead to success.
2. BREATHING: After you wake up and have a thought,
the second thing you do is breath. Most of us
yawn, as well as have an increase in respiratory
rate secondary to the release of Cortisol (a stress
and awakening hormone). The average person breaths
20K times/day. If you are stressed or you are
a chest breather, you breathe 40K times a day.
It has been shown that 70-75% of most visits to
the MD are all related to incorrect breathing
patterns. Call me and I can easily explain this
to you!
3. HYDRATION: Most wake up and race for the coffee.
What you should do and need to do is go for WATER!
You have been dehydrated for 8hrs and coffee with
just exacerbate that leading to headaches, constipation,
decreased concentration and performance. Water
helps to stimulate digestion, eliminate toxins
and hydrate the body.
4. FOOD: The next thing most do is or think about
is food. This is simple; focus on the quality
(organic vs. conventional) and quantity (do you
eat or skip meals, as well as what are your ratios
of protein, carbs and fat). But most people wake
up late and are too lazy to cook a meal, so they
grab a bar.
5. EXERCISE: This is the most confusing area for
many. Some work out too much and some don’t
work out at all. As a society, we work, sit, and
eat more, but move less! Whether it is Qi Gong,
Yoga, Tai Chi or just plain old exercise, get
out there and move!
6. CIRCADIAN RHYTHMS: This is a fancy word for
sleep. I would have to say the most common complain
of all my clients, is that they are fatigued and
want more energy. A great place to start is here
with sleep. When you sleep, you release hormones
to repair and regenerate. Up to 24% of the population
falls asleep at the wheel each year.
Massage: With any surgery, there will be scar
tissue and adhesions. This is secondary to the
body’s healing process, but as well with
oxygen getting into the tissues during surgery.
If you try to facilitate healing without relieving
the scar tissue, the brain cannot get motor or
receive sensory signals to and from these muscles.
You can start by teaching your client to rub Rose
Hip oil on the scars 4-6x per day. At the same
time, they can begin massaging the scars. To learn
more about this, refer your client to a Neuromuscular
Therapy Specialist or a skilled massage therapist
in your area.
Exercise: First thing is first with a client
such as this or any client for that matter. You
must assess and not guess. This will provide you
with a blue print of their body. This will allow
you to design and individualized flexibility and
corrective exercise program. I will give you some
basic recommendations of what to do, but every
body is different. If you feel this is out of
your knowledge, than I would refer out.
I would begin treating her in a Base Conditioning
Phase that is targeting slower twitch muscles
fibers, with functional movement patterns. Slow
twitch or tonic muscles respond to time under
tension (>70 total time under tension, require
about 60s rest, and begin fatiguing at around
3-5 min). So you have to make sure that your tempo,
sets, and reps get her beyond the 70s TUT. An
example of this (and that is all it is) would
be:
a. 10 reps x 333 = 90s x 2-4 sets = 3-6m
You can use exercises such as the supine lateral
ball roll, forward ball roll, 4pt tummy vac, lower
abdominal series from Paul Chek, horsestance series,
etc.
As well, since she is human like all of us, you
should begin her program with more functional
movement patterns such as squatting, lunging,
bending, pulling, pushing, and rotating. Just
make sure you regress or progress these patterns
to meet her needs. I would still design it to
target her slow twitch muscle fibers. This will
correct posture and facilitate motor unit synchronization/inner
to outer unit synchronization.
After doing the above for 6 weeks, I would reassess
and then move her into her Base Conditioning 2
phase. This should target more fast/phasic twitch
muscle fibers (40-70 TUT, 30-120s rest and fatigue
at around 30-120s). An example of this would be:
a. 10 reps x 202 = 40s x 1-3 sets = 30-120s
Good luck and I hope I helped you some. For more
information, I would refer out to a CHEK, Poliquin
or MAT Practitioner in your area.
Joshua Rubin
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