Archive for the ‘Health and fitness professionals’ Category

The Core-Tex buzz continues…..

Saturday, May 24th, 2008

This past week I was invited by one of the top orthopedic groups in San Diego to give a demonstration of the Core-Tex for their physical therapists. As mentioned in a previous post, the fitness industry is chomping at the bit for the Core-Tex to be available. And it will be soon.

But this was the first demo for physical therapists only. What was supposed to be a 15:00 introduction and demonstration for 6 therapists, turned into an hour and half with about 20 more therapists, assistants and several patients getting in on the act.

The Core-Tex is one of those pieces of equipment that you just can’t ignore. If you see it, first you see the fun. But then through exploration and a little instruction, the incredible therapeutic value becomes apparent.

This group liked it so much they are interested in doing a study using a population with a specific lower extremity injury and comparing the benefits of the Core-Tex to an existing protocol. Obviously, it is very rewarding when others see the value.

We believe the Core-Tex has as much value to the rehabilitation field as it does to the fitness and sports performance fields. If you have any questions on the Core-Tex or would like to be on the Core-Tex interest list, email: education@functionfirst.com

Anthony Carey’s Top 10 List for Getting Medical Referrals

Saturday, May 10th, 2008

In my book, Relationships and Referrals: A Personal Trainer’s Guide to Doing Business with the Medical Community I write extensively about working with the medical community. I thought I would share my top 10 list of things to keep in mind when seeking to work with the medical community. Each of the top 10 are covered extensively in my book.

10. Be persistent

We’d love to believe that we are the most important person on the mind of your targeted referrals. The reality is that the “sales” cycle for getting medical referrals is often months. Sometimes many, many months. Plant the seeds consistently and when that first referral arrives, you’ll need to shine.

9. Nurture the best and forget the rest.

You will quickly realize that some doctors are advocates of exercise and understand your value. Others just don’t “get it” for a number of reasons. Nurture those that can help you help more people. Even get to know their practice and types of patients so you can have confidence providing reciprocal referrals.

8. Understand your certification doesn’t mean sh*t to a doctor.

Few if any medical doctors will know what the letters after your name mean. That doesn’t mean they are not of value (some of them anyway). Just don’t expect that to open doors for you. Use your education to help validate your work.

7. Don’t market to medical providers the way you would market to clients

Understand that medical professionals refer to whom they know and trust because you will be an extension of their care. They will not refer because of a brochure, web site, business card or ad. These collateral marketing materials are only supplementary to the person or business.

6. Provide them with documentation whether they ask for it or not.

Gather your client’s medical provider’s contact information. Get permission from your client to share your exercise plan with their doctor and send the doctor your assessment and plan. Send an accompanying cover letter and that exercise plan should end up in your client’s file with their provider. Your paperwork will be part your client’s discussion with their doctor at their next visit.

5. Let your reputation precede you.

Use your clients to open doors for you. If you are doing a great job with them, have them make introductions for you to their doctors. Your client should be your biggest advocate with their medical provider which can ultimately lead to more referrals once a relationship is established with that provider.

4. Don’t overstep your professional boundaries.

Most of us are in this business to help people and this may cloud our judgment when a client presents a physical complaint or limitation. Our relationships with our clients are often stronger than the client’s relationship with their doctor. Don’t attempt to diagnosis or “fix” your client because they trust you. Refer them to the appropriate medical provider.

3. Speak the language

Never communicate with a medical professional (oral or written) using terminology that you would use with your clients. An understanding of the terminology is a reflection of your level of expertise as well as being the form of communication they are accustomed to. Medical providers have professional standards they must uphold with their documentation. Providing correspondence to them in this manner also implies that you will comprehend any documentation received from them.

2. Find your niche

Working with medical referrals means working with special populations. Special populations have special needs and special risks. Know a lot about a little versus knowing a little about a lot. Do not attempt to be all things to all people.

1. Know your subject matter.

It’s not a good idea to promote to medical professionals that you do “post rehab” when you don’t know what occurs during rehab. This means from the therapeutic procedures, structures involved and contraindications. Please remember, POST REHAB IS NOT A FORM OF TRAINING. IT IS AN OBJECTIVE.

The Core-Tex is a hit!

Tuesday, March 11th, 2008

I just recently attended the IHRSA convention here in San Diego.  IHRSA is the largest fitness equipment trade show/convention in North America.  This show was the first time that I publicly demonstrated the invention that my good friend Olden Carr and I developed.

The Core-Tex was an amazing hit.  I couldn’t believe the response we got. Olden and I had been working on this project for many years never really giving it the effort it deserved.  We recently picked up the pace and had a pre-production prototype ready for this show.  And was it worth it!

We should have units available for retail in mid May.  Watch for the Core-Tex to be rated as one of the most innovative products for 2008.

If you want to see a couple of video clips of me using it, you can find them here on the Function First web site.

Anthony Carey interviewed by Rick Kaselj of Healing Through Movement

Monday, February 18th, 2008

I had the privilege of being interviewed by Rick Kaselj of Healing Through Movement in Vancouver, B.C. Rick will sponsoring my final public presentation of the Foundations for Function: Movement By Design course.

Rick did a great job of having me describe the course as well as our processes with clients at Function First.

You can listen to the interview here:

Check with your doctor before exercising? For what?

Friday, February 8th, 2008

It is the ultimate cover your a** statement placed on any piece of exercise equipment, exercise video, exercise book, exercise facility, etc. It comes in many variations, but the message is the same: You could die or get seriously hurt if you engage in this exercise related activity.

How’s that for encouraging our obese, lower back pain crippled society to exercise? I can’t think of a better way to scare off those who need exercise the most.

We’ve all seen a variation of this warning a million times. And anyone with a mild interest in exercise has probably become oblivious to it because they’ve seen it so many times.

This warning obviously is important to a very small percentage of the population. And even those in that small percentage should not be discouraged from starting a gentle exercise program (such as walking) before seeing their doctor.

But here is the biggest surprise of all: Your doctor is not going to tell you how to exercise because your doctor does not know anything about exercise prescription. As brilliant as he or she might be, the extent of their exercise knowledge is likely limited to their own personal experience (and for some, it’s not even that).

Even if the doctor is physically fit, there is little correlation between what he does to stay in shape and what his patient needs to do. Instead, what the physician should be doing is referring patients with risk factors to a degreed and certified exercise professional that has experience working with that type of client.

Too many physicians are not even recommending exercise in the first place. This begs the question, “Why not?!” Under what rock must a physician be living to not know about the countless studies that support the benefits of exercise on lifestyle related diseases and disabilities?

A survey, “Fitness American Style II” commissioned by IHRSA (International Health, Racquet and Sportsclub Association) found that 70% of Americans say they had an annual physical last year. But only 28% said their doctor suggested exercising regularly to improve their overall health, and only 41% said their doctor asked if they exercised regularly.

The American College of Sports Medicine has initiated a program in partnership with the American Medical Association that is “Calling on physicians to assess and review every patient’s physical activity program at every visit”.

It’s great to see this happening. But once the physician assesses the patient’s physical activity and finds out they are not doing enough-then what? This is where I believe the medical field over estimates the influence they have over their patients. Because most doctors believe that if they just tell their patients to exercise the patient will immediately follow that advice.

The reality is that these patients have never exercised or have not exercised for an extended period of time for their own reasons (whatever they may be). We refer to these as “barriers to exercise”. With all due respect to the doctors, they do not wield the same influence that their house-call making predecessors did. Patients now literally have to be scared to death before they see the consequences of their lifestyles.

One of the best ways to overcome barriers to exercise is for the doctor to provide the patient with clear directions for the next step. Since the doctor is not an exercise expert, those directions should involve a direct referral to a qualified exercise specialist.

Here is where the “check with your doctor part” becomes most valuable. The doctor’s referral should include what the patient should NOT do, also referred to as “contraindications”. This saves the doctor time and the potential embarrassment of not knowing what to tell the patient to do.

For example, the patient 6 months out from a hip replacement will have specific ranges of motion to avoid. This is great information for the doctor to include and for the exercise professional to be aware of.

Another example is the hypertensive patient on beta blockers who should not exceed 60% of their maximum heart rate. The exercise specialist can safely work within these parameters

That is step 1. The doctor documents this in the patients file and can follow up with them on their next visit.

Step 2 is when contact has been made with the qualified fitness specialist. Now that professional is in a position to use their expertise. Their expertise is not just about designing a safe exercise program. It also involves many of the skills necessary to help this person overcome many of the past barriers to exercise. Then it is the exercise specialist responsibility to communicate their assessment, objectives and plan to the physician.

During your next doctor’s visit, let them know your current exercise status. If they don’t ask, tell them anyway. Ask them for contraindications. And then ask them for a referral to an exercise specialist. If they look like a deer in the headlights with this question, tell them you know this group called Function First…..

Exercise specialist can find lots of great tools for working with doctors in my book, Relationships and Referrals: A Personal Trainer’s Guide to Doing Business with the Medical Community. Relationships and Referrals cover

Corrective Exercise is Functional

Saturday, January 26th, 2008

I’ve just submitted a HUGE article to PTontheNet.com titled “Corrective Exercise is Functional”. It was so big they have decided to divide it into 3 articles.

I’m really excited about this article and the justification I make for the need and role of corrective exercise in the total continuum of training….even for uninjured athletes.

The first part of the series should be online February 1st.

The article is certainly going to ruffle a few feathers. And this is a good thing.

We should all be open to challenging the thoughts and convictions of one another for the purpose of expanding our own knowledge.

If you’re not a member of PTonthenet.com, remember you can get a discount by going to the Function First sign up page:

http://www.ptonthenet.com/bam.aspx?P=79525

Stay tuned…..

Free Lecture!

Wednesday, January 9th, 2008

From foot pain to migraines: Exercise is medicine!

When: Saturday January 19th

Time: 9:00 a.m-11:30 a.m.

Where: Function First 2700 Adams Ave., #205, San Diego, CA

***Seating is limited for this event. RSVP is kindly required***

RSVP by emailing Melinda at mlacey@functionfirst.com

or call: 619.285.9218

 

Join us for an amazing morning that will inspire you with strategies for achieving your health related goals and educate you on the role corrective exercise plays in long term good health and athletic performance.

Migraine sufferers will get to hear about some of the best strategies for controlling and preventing migraines. Adrienne Navarra will discuss the role of postural correction to combat migraines along with an overview of some of the other leading interventions.

Athletes to computer users will hear Anthony Carey debunk the myth of overuse injuries and the contemporary methods of treating them. Have all your questions answered and come away with a new found hope for resolving your physical challenges.

RSVP by emailing Melinda at mlacey@functionfirst.com

Study: Employer Advice and Devices Don’t Prevent Worker Back Pain

Friday, January 4th, 2008

Here is a link to an article in the periodical, Occupational Hazards. It summarizes a study that looked at 18,000 employees from 11 different studies.

Click here for the article

The following is from the last section of the article and is right in line with the Function First Approach:

“This study confirms that much of what is happening at the workplace is well-intentioned but probably pointless,” said Christopher Maher, associate professor of physiotherapy at the University of Sydney in Australia, who was not involved with the study.

According to Maher, regulatory agencies as well as employers make the mistake of concentrating on equipment and policies that don’t work such as back belts, lifting devices and workplace re-design and fail to focus on the “only known effective intervention,” which is exercise.

“We also know that exercise has health benefits beyond prevention of back pain, so you are getting two health benefits (or more) for the price of one,” Maher added.

The hip bone’s connected to the back bone

Monday, December 10th, 2007

The following is an article Zac Marshall, one of our Corrective Exercise Specialist wrote for out newsletter. It got such great feedback from our subscribers, I thought I would post it for anyone else to read.

We regularly send out very informative articles for the general population as well as health professionals. Be sure to subscribe to our newsletters if you have not already.

“The Hip Bone’s Connected to the . . . Back Bone”

By Zac Marshall

We’ve all heard that well-known children’s song about bones: “The foot bone’s connected to the . . . leg bone” and so on. Little do we realize, , the wisdom of this song as it relates to our health. Over the last few decades, one of the most significant principles health and fitness professionals have come to discover about the body is, as this song states, the connectivity of the musculoskeletal system. If we humble ourselves and learn from this simple children’s song, the key to much of our pain and physical limitation may become clearer.

Let’s apply the “Bone’s Song” to the number one reason people visit the doctor behind the common cold: lower back pain. As the “Bone’s Song” develops a key line appears: “The hip bone’s connected to the . . . back bone.” Contrary to this line, when most people think about back pain, there is s common misconception: they only look at the back. The wisdom of the “Bone’s Song” tells us that to understand the back, we must first understand the hip, the back’s closest ally.

Traditionally, the hips have often been an ignored piece of the low back pain puzzle. After all, if the hips aren’t hurting, they’re not a part of the problem . . . right? Wrong.. To better understand the low back pain mystery, it is essential that we look to unveil all the possible culprits behind the symptoms. The possible culprits to low back pain are many, including the feet and ankles; the knee, the upper back, the shoulders, and even the neck. But what we can be certain that if the hips aren’t working, the back is hurting.

There are several reasons why the hips are so commonly connected to low back pain. For one, the hips and the low back are direct neighbors. Thus, when the hip misbehaves, the low back is one of the first areas affected. To make matters worse, the hips have a tremendous amount of responsibility in aiding general musculoskeletal function. Due to their large muscles the hips are appropriately referred to as the “cannon” of the body. The problem with this is, if the hip “cannon” is not contributing properly or adequately to body movement, the low back is left highly vulnerable to undesirable stress and strain.

The low back is left especially vulnerable when the hip experiences one of two problems. The first problem the hip may experience is not providing enough motion (inflexibility). The second problem is not providing enough strength. When either (or both) of these problems are present, the low back often takes a hit.

Let’s focus our attention on what can happen to the low back if the hips experience the first problem: inflexibility. In order for the body to move and function in space the way it was designed to do, the body requires hip flexibility in three dimensional space (front to back, side to side and inward and outward rotation). When the hip experiences limited motion in any one of these three dimensions, it’s neighbor, the low back, is commonly called in to make up for the hip’s limitations. When the low back is asked to make up motion for the hip’s limitation, excessive flexibility occurs in the low back. This excessive flexibility is typically coupled with excessive joint wear and eventually pain.

One common example of the low back achieving excessive flexibility (and pain) due to the hip’s inflexibility is the activity of walking. During walking, the hip muscles must lengthen in order for one leg to extend behind the other. If the hip muscles cannot lengthen sufficiently, the body still knows it needs to move one leg backward. In order to do this, the body will often resort to having the low back increase it’s movement (by arching) in order to aide the leg in moving backward. If this compensation occurs often enough, low back pain is likely to develop.

Another common example of the low back suffering as a result of limited hip motion is in swinging activities. During swinging, the body needs to “wind” up in order to reverse directions and accomplish the swing. The winding that is required is an accumulation of motion at all the major joints of the body, including the hip. If the hip is not able to wind up adequately due to inflexibility, once again the low back will often make up for the difference. In this case the low back will either attempt to rotate more than it is designed to or it will once again excessively arch in order to achieve the movement. Just as in the walking example, if this compensation is repeated often enough the tissues of the low back become irritated and cause pain.

It’s amazing to realize how much understanding we can gain when we take our eyes off the symptom and look elsewhere for the cause of pain. This process is as simple as repeating the words to a simple yet profound song: “The hip bones connected to the . . . back bone.”

My perspective on the BOSU

Wednesday, November 14th, 2007

Some of you may be familiar with the sarcastic remark I make on occasion about those in our industry that feel functional training means doing a one-legged stance on a Dynadisc or BOSU with the eyes closed, singing the Star Spangled Banner while holding a puppy overhead. If taken the wrong way, you might think I was anti balance devices. That couldn’t be farther from the truth.In fact, the inventor of the BOSU, my friend Dave Weck was at a talk I was doing here in San Diego in the spring. I made a similar comment regarding the puppy, etc. and Dave called me out on it. It was then that I realized that there might be a perception that I was not a fan of the BOSU or other air balance devices.

Dave is helping me with the development of my own balance device (and there is NOTHING like it available!). During a visit, Dave asked me to put my perspective down on paper. He asked me because there are hard line trainers and coaches out there that have put out a lot of negative comments about the BOSU. Which is absolutely ridiculous. So they following article is what I wrote putting things in perspective.

*********************************************************************

A BOSU Believer

By

Anthony Carey M.A., CSCS, CES

Function First

If you are a personal trainer, strength coach, athletic trainer or physical therapist, then you are also an environmentalist. Maybe not the recycling kind, but you are an environmentalist nonetheless. Webster defines environmentalist as “one concerned about environmental quality especially of the human environment”.

In this context we are not talking about air, water or trees. We are talking about the environment that you create to maximize your client’s function, performance and reduce their chances of injury.

The environment must match the goals and needs of your client or athlete. That’s why we don’t train our running athletes on their backs or our seniors with depth jumps. But the environment also must provide a way to challenge the body outside of its normal operating environment because that is where injury typically occurs.

Some in the health and fitness industry have polarized philosophies of training. On one end of the spectrum are those that believe either traditional machine and/or Olympic style lifting is the only way to go. On the other end are those that believe that every exercise must be triplaner and performed in an unstable environment.

Who is right? Neither. If you agree with the previous statement “…the environment that you create to maximize your client’s function, performance and reduce their chances of injury”, you can not justify either position exclusively.

Those that are anti training on unstable apparatus inevitably refer to the naïve professional they have witnessed who has their client/athlete doing an exercise on a BOSU that the client can not perform successfully on solid ground. And they make a valid point. That environment is not appropriate for that client at that time.

But to disregard the benefits of the BOSU is also naïve. If the body is not challenged outside its current modus operandi or “M.O.” via the training environment, when it does venture there out of necessity or as the result of the current environment (i.e. change in playing surface, opponents, momentum, etc.), the body is predisposed to injury.

Consider the linebacker whose training regime consists of traditional Olympic power lifts and plyometrics. Both of which are essential to power development necessary for the sport. All of these are movements in which the athlete has prior knowledge (feedforward) of where his base of support is or will land. He also has prior knowledge of where his center of gravity (COG) is based either on his current starting or landing position or as a result of the external weight of the barbell. And he has prior knowledge of the consistency of support surface he is training on in the facility.

Now consider that same linebacker who is engaging blockers while moving, who must control his COG in three dimensional space while working to overcome the mass and momentum of his opponents all with unpredictable arrangements of his body parts. These are situations that no Olympic lift or plyometric exercise can produce. The shear number of variables and combinations of situations make it impossible to physically train the body in every potential scenario.

Therefore, the next best thing is to train the body’s systems that will be expected to gather and interpret changes in the environment to give the body and opportunity to produce, reduce or control forces as necessary. That’s where the BOSU comes in. The BOSU demands that the user make use of the body’s three primary feedback mechanisms for the purpose of controlling it’s COG. These include:

     1. Somatosensory (muscles spindles, golgi tendon organs, joint mechanoreceptors, and cutaneus receptors)

    2. Visual

    3. Inner ear

It then requires the body to integrate the gathered information into an appropriate motor response (sensorimotor integration). If the body does not elicit the appropriate motor response or does not illicit the response fast enough, the user’s COG will be disrupted and they fall off of the BOSU or over correct with inefficient motions.

Many people view the BOSU strictly as a lower body (when standing on it) balance device using the somatosensory receptors. But it will also effect the visual feedback as the user’s gaze fixation is disrupted during involuntary shifts in the COG. The same will produce motion of the head that requires input from the inner ear as well. Neither of which are adequately challenged using Olympic lifts or even plyometrics.

The BOSU is an environment. And it is an environment that is a progression from solid ground and can be a progression from uniplaner balance devices. Although the BOSU surface does not reproduce the base of support for most activities, it does provide an environment to challenge and enhance the sensorimotor mechanisms at work on the ground.

Can anyone really argue that improving one’s reaction time, proprioceptive awareness and activation rate of stabilizing muscles is not beneficial? Of course not. But can they argue that the progressions to the BOSU ball or while on the BOSU are at times inappropriately applied? Absolutely.

To borrow a slang saying, “don’t hate the player, hate the game”.

I believe that we should never lose perspective on the roll of the BOSU or any other training device or environment. We use them. They don’t use us. They are a means to an end. If we attempt to structure any exercise program around a piece of equipment, the equipment is using us.

Anthony Carey M.A., CSCS, CES is the CEO of Function First in San Diego, CA. He has been using his approach to functional corrective exercise for the past 16 years helping people feel and function better.