Piriformis and Obturator Muscles Connection

I recently posted a short little tidbit of information on my Facebook Fanpage Stop Chasing Pain that said, 'If you always have a tight piriformis muscle, try activating the obturators.'  

Well this little post kicked off a firestorm of questions and comments that prompted me to expand a little more. I will be making a video of this activation protocol and posting it so you can see it in action, but this will be a quick summary of the how and why.


It all comes down to Motor Control Theory. This is based on pioneering work of Vernon Brooks 'The Neural Basis of Motor Control' and it's clinical application by David Weinstock and his NeuroKinetic Therapy. The Motor Control Center located in the cerbellum receives information from the limbic system and then the cerebral cortex before passing the information to the spine.

Your body’s Motor Control Center – the Cerebellum

The cerebellum is like central command controlling every muscle in your body. It is connected to each of your muscles via the somatic nervous system – sort of like control wires. Your cerebellum is where your body stores the information necessary to perform complex movements easily and naturally. 

Sometimes things happen to you that cause your body to protect itself – accidents, pain, and overwork etc. In response to these stimuli, your body creates a new program, or a compensation pattern. These patterns are exactly what your body needs to create in order to protect itself from that trauma. It goes into survival mode. The problem is that your body has no mechanism to let go of the compensation pattern when it is no longer needed Your nervous system has adapted to the dysfunction.

The body has no mechanism to let go of compensation patterns that you no longer need. Long after the trauma has passed, your body continues to over-use the bracing muscles that it relied on during the trauma, and continues to inhibit the muscles that were shut down. This creates a vicious cycle: The inhibited muscles actually start to weaken from lack of use, causing you to use the bracing muscles even more. Eventually, the bracing muscles simply stay tight all the time, lose their ability to fire efficiently, and they hurt. Now you start to CHASE PAIN! And we don't chase pain...we FIX PROBLEMS! 

Pain is where your problem ended up...NOT where it started!

So what we do is very similar to Muscle Activation Techniques where we test the strength of various muscles in relationship to pain. You can stretch and rub that tight muscle all day long, but until you reset the motor program it will not let go. Hence pain always returns.

So for the Piriformis we evaluate antagonistic and synergistic muscles for weakness and then reactivate them. 

Antagonist

Evaluate internal rotators of the hip

Synergist

Usual Culprits: Gluteus maximus, medius, obturator internus/externus, quadratus lumborum and hamstrings.

Once you find the weakness, you have 30-60 seconds to reset the Control Center via muscle activation. Once we reset and reactivate the obturators the MCC lets go of the piriformis so it can heal. The nervous system wins every time.

The video will show you how I test the obturators....and how I test them is how I activate them in conjunction with releasing the spasm.

You will see what I mean on the video...it all comes down to isolation and positioning. Got ya curious now don't I?? 

****Special Thanks to Jeff Elam, CBW for information referenced in this post. Visit his website for more information about his work.

JEFF ELAM

See ya soon!

Doc P.

Hormone Optimization Podcast with Mike Mahler

Awesome interview with Mike Mahler about optimizing hormones for fitness, health, and physique development. Mike is a leading expert on how to balance hormones via nutrition, fitness, and lifestyle. Hear his personal story and discover some great tips to start you off right away.

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Visit his website to learn more about his great information.

http://www.mikemahler.com/

A sample video clip of Mike in action.

My Review of David Whitley's 'Kettlebell Fundamentals: Deepening Your Getup Skills'

This DVD is the second in a series of four from David Whitley, and Mark and Tracy Reifkind from On Target Publications. Other DVD's in the series include the following:

1. Lessons Of The Old-Time Strongmen 
2. Kettlebell Fundamentals: Deepening Your Getup Skills
3. Programming The Kettlebell Swing 
4. Lats: The Super Muscles                                                                                                          

(See my previous review of Lessons Of The Old-Time Strongmen)

Most all of my Stop Chasing Pain fans and every single one of my patient's know that the Turkish Getup is my favorite exercise. It is also my favorite movement pattern. I love the Getup, and anytime I have the opportunity to learn more about it and do it better, I jump on the chance! 

I have seen many DVD's, workshops, seminars, and YouTube videos (don't get me started) showing different variations and instructions on the Getup.  I have to say that this version was the most in depth, yet simple explanation of the who, what, where, when, and why of the movement. 

Dave Whitley is a Master RKC Instructor and CK-FMS Specialist, so you can rest assured he is an expert on Kettlebells and movement. That meant a lot to me, because so many people put themselves out there as experts and they do not have the credentials to back it up! And with the Getup, you want to learn from an expert. David teaches a step by step system for mastering the Getup by breaking down each movement and explaining 'why' you are doing it. He is not just showing you the move, he is teaching you the move.

Here is a taste of what he teaches:

• How did the Turkish Getup get it's name? Fascinating...bet you hardly any one can tell you that answer. Dave will!

• The critical importance of hip mobility in the Getup and how the movement can actually assess mobility (movement)

• The subtle 'windshield' wiper move that can make all the difference in the hips

• Setting the pelvis to correct your vectors

• A really cool way to bridge the hips so you can sense the direction of movement on the initial phase of the Getup (Dave stresses many times that it is NOT a sit-up motion)

• Why he prefers the 'High Bridge' in the Getup and why it was added

• Demonstration of the KB Arm Bar for shoulder and T-spine mobility/stability     (Yes there is a right and wrong way to do the arm bar for best results)

• The importance of the wrist and grip for KB success

• Understanding your 90 degree angles during each phase of movement (quality...not quantity)

• How everything ends up being related to the Getup and Swing...such a great insight into recognizing how it all ties together so you understand that's it's more than just an exercise.

Take time invest in your education with this DVD.  So many products are out there that promise you everything, and yet deliver nothing. How many times have you purchased DVD's and been sorely disappointed with the quality and content of information? If you are like me, tons! Trust me, on this DVD you will be not be disappointed. 

I am giving David's DVD 5 Stars ***** . Why five? Because I know the content will help me transform the health, body and well-being of my clients. And that my friends is what it's all about. The only thing better than this DVD is if you get the pleasure of seeing Dave teach it in person. That is a good goal to have! 

In summary...I highly recommend this DVD. So go get one ASAP and see for yourself!

A sample video clip from the DVD talking about hip mobility.

Click here to purchase the 4 disc set from On Target Publications.

CLICK HERE TO ORDER

 Stay tuned for my next review of Mark and Tracy Reifkind's DVD's.

New Podcast on Movement with Tommi Paavola

Here is my newesst podcast with with movement expert Tommi Paavola of Discover Movement.com Enjoy! Awesome information! Soak up that knowledge.

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10 Ways Laser Heals You Quick

1. Accelerated Tissue Repair And Cell Growth.
Photons of light from lasers penetrate deeply into tissue and accelerate cellular reproduction and growth. The laser light increases the energy available to the cell so that the cell can take on nutrients faster and get rid of waste products. As a result of exposure to laser light, the cells of tendons, ligaments and muscles are repaired faster.

2. Faster Wound Healing.
 Laser light stimulates fibroblast development (fibroblasts are the building blocks of collagen, which is predominant in wound healing) in damaged tissue. Collagen is the essential protein required to replace old tissue or to repair tissue injuries. As a result, LT is effective on open wounds and burns.

3. Reduced Fibrous Tissue Formation.
LT reduces the formation of scar tissue following tissue damage from cuts, scratches, burns or surgery.

4. Anti-Inflammation. Laser light therapy has an anti-edemic effect as it causes vasodilation, but also because it activates the lymphatic drainage system (drains swollen areas). As a result, there is a reduction in swelling caused by bruising or inflammation.

5. Anti-Pain (Analgesic). Laser therapy has a high beneficial effect on nerve cells which block pain transmitted by these cells to the brain and which decreases nerve sensitivity. Also, due to less inflammation, there is less edema and less pain. Another pain blocking mechanism involves the production of high levels of pain killing chemicals such as endorphins and enkephlins from the brain and adrenal gland.

6. Improved Vascular Activity. Laser light will significantly increase the formation of new capillaries in damaged tissue that speeds up the healing process, closes wounds quickly and reduces scar tissue. Additional benefits include acceleration of angiogenesis, which causes temporary vasodilatation, an increase in the diameter of blood vessels.

7. Increased Metabolic Activity. Laser therapy creates higher outputs of specific enzymes, greater oxygen and food particle loads for blood cells.

8. Improved Nerve Function. Slow recovery of nerve functions in damaged tissue can result in numbness and impaired limbs. Laser light will speed up the process of nerve cell reconnection and increase the amplitude of action potentials to optimize muscle action.

9. Immunoregulation. Laser light has a direct effect on immunity status by stimulation of immunoglobines and lymphocytes. LT is absorbed by chromophones (molecule enzymes) that react to laser light. The enzyme flavomono-nucleotide is activated and starts the production of ATP (adenosine-tri-phosphate), which is the major carrier of cell energy and the energy source for all chemical reactions in the cells.

10. Trigger Points and Acupuncture Points. Laser therapy stimulates muscle trigger points and acupuncture points on a non-invasive basis providing musculoskeletal pain relief

www.stopchasingpain.com

High Intensity Cardio Strategy

Cardio must be done, but done correctly.  By that I mean only for a short period of time, but with great intensity.  Banish the 30-45 minute sessions and replace them with 15-20 minutes.  Do HIIT CARDIO (High Intensity Interval Training). This involves alternating periods of all out intense effort with a much slower pace. 

Base your intensity on a verbal conversation sliding scale of 1-10.  (Not Maximum heart rate!)

Number 1 being a slow walk with minimal effort and exertion.

Number 5 being a power walk where you can carry on a conversation without heavy breathing and feeling like your lungs will explode.

Number 10 being an all out sprint/run at 100% maximum effort. 

Example: A 15-minute session would be 1:30 seconds at pace #5 and a .30 second sprint one at level 10 and then repeat this cycle for 15 minutes.  GREAT WORKOUT.  No warm-up necessary because you should be performing cardio work after weight training.

So when is the best time for cardio and how should I do it?   The answer is any time! The most important thing is that you just do it. If you want to get the maximum benefits possible from every minute you invest in your workouts, and then you should consider getting up early and doing cardio before you eat your first meal - even if you're not a "morning person." Early morning aerobic exercise on an empty stomach has three major advantages over exercising later in the day:

The primary benefit you'll get from early morning cardio sessions is what I call the "afterburn" effect. When you do a cardio session in the morning, you not only burn fat during the session, but you also continue to burn fat at an accelerated rate after the workout. Why? Because an intense session of interval style cardiovascular exercise can keep your metabolism elevated up to 24 hours after the session is over.

 If you do cardio at night, you will still burn fat during the session, so you definitely benefit from it. However, nighttime cardio fails to take advantage of the "afterburn" effect because your metabolism drops like a ton of bricks as soon as you go to sleep. While you sleep, your metabolic rate is slower than any other time of the day. 

Perry Nickelston, DC, SFMA

Move Smarter...Move Better...Perform Great!

stopchasingpain.com  

Foam Rolling Bashing?

Ok, so there seems to be some bashing going on around about foam rolling. Some say it's not really effective and that it can hurt ya, and it's better to do all these other techniques. Well, let me tell ya from my perspective from being in the real world trenches everyday with clients needing help...foam rolling is crucial. Most people never do anything for their facial system and few have ever used the foam roll.

In our fitness world it may seem different because we see people use it all the time, but for the average person, it ain't happening. Being in the healthcare field I understand human nature of dealing with pain. If nothing hurts, people think they are healthy...and if it does hurt, ignore it until it goes away...when it comes back again, then seek help and want to get fixed in one visit. Hello reality!!

 Foam rolling is an art form and you can get hurt if you do it wrong or are not a candidate for it. It is up to you, the professional to teach people the correct techniques for rolling. I will have another post coming that talks about techniques and when to not do foam rolling.

I can change  persons life with a foam roller, tennis ball, rope and a mini-band. Addressing soft tissue in any format is always a positive. So, don't be so quick to be hard on the foam roll...in my opinion it is one the most effective form of self treatment therapies available to the public.

How Laser Therapy Works Podcast

My first podcast with Dr. Brian Pryor of LiteCure lasers. Learn how they heal and take away pain.

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Your Ass is Your Foot

Say what Doc? Have you finally lost your mind? Well sort of...What do I mean by this statement? As a society WE SIT ALL DAY, so instead of being on our feet all day we are on our ass all day! We were designed to move and stand on our feet...not sit. In essence with this much sitting, we have a cascade of dysfunctional movement and muscle symmetry.

The body typically ends up with quad dominance, tight hip flexors, anterior weight shift, decreased hip extension and glute activation, weak hamstrings, restricted ankle mobility and hyper-kyphotic thoracic spine. Now imagine trying to go workout and train hardstyle with this movement pattern. This is what the average person does...They go to the gym and ask their trainer to 'kick their ass' or go to crazy bootcamps and crossfit workouts where the body cannot tolerate the movements. What happens...injury usually...BUT you also have decreased movement and lack of muscle control meaning your performance suffers. Don't even get me started on a lack of durability.

One thing most people do when they train is they come to the gym after sitting on their ass all day, sitting in their car to get to the gym and then sit down on equipment to train even more with resistance. HELLO!! See anything wrong here?

So how do you see how bad your movement is? Get an FMS Functional Movement Screen. And if you have pain get the SFMA. Get evaluated before you start moving. Movement Screen

Top 5 Functional Movement List for Crossfit Workouts

Yes, Crossfit is a workout with many raving fans and yes it can kick your ass pretty good. And yes, you can get hurt doing it if you do not take the time to assess proper movement in 5 essential areas. Crossfit has some very cool and unique training programs that are rooted in some base foundational exercises which stress all the vectors of human movement. Theses 5 vectors are:

1. Pushing
2. Pulling
3. Rotation
4. Level Changes
5. Locomotion

Now most people who begin an exercise program or want to step it up and train even harder, do not have adequate mobility (movement) in their joints and even less stability (controlling movement). We are a very sedentary culture sitting on our butts all day, so in essence our butt becomes our feet. This leads to tightness, restrictions and compensations. Because of this fact compensations and quality of movement suffer in order to reach a quantity of movement (reps/sets/tempo). This applies to all forms of intense exercise, not just Crossfit. I talk about Crossfit because I like the program and people really move during a workout and that's a good thing. But I want to make sure they can keep working out without injury, and also increased performance. If you move smarter...then you move better...then you perform great.

Ok so what are the Top 5 Movements?

1. Proper ankle Mobility---Now this is a big one. If the ankle is restricted in movement there will be massive compensations up the chain of joints and muscles. Try doing massive squat reps with a locked down ankle and your knee and back will pay the price. The knee should go 4 inches out over the toe if the ankle moves well when assessing movement. Click here to do my favorite Ankle Mobility Drill. Mobility Drill
2. Hip Mobility---Locked down hips are a huge problem for most people. Locked down means stuck. Th hip is supposed to be very mobile. If it locks down the knee and back become less stable and get injured. But you never feel pain in the hip. Internal rotation is the vector that is lost the most.  Every person who works out must have hip motion assessed. i see high end athletes who look awesome and they cannot move their hips. Can you say compensations. Click here to see my favorite hip mobility stretch: Hip Stretch
3. Thoracic Spine Mobility---Lack of rotation and extension in the thoracic spine can kill a shoulder. It is actually one of the top reasons for chronic shoulder pain because of the lack of stability in the shoulder blade from faulty mechanics of the T-spine. One of the most powerful things you can do to help with upper body power and motion is the tennis ball technique which I will show you. Think about how many overhead presses, cleans, snatches and shoulder moves you to with a workout. If your T-spine is locked down....kiss that shoulder and neck goodbye soon. Tennis Ball Secret
4. Upper Cervical Fascia---The soft tissue connective tissue in your body called fascia can cause many chronic pains if it is too tight or restricted. One very common place for this is at the back of the skull. Rub behind your neck right now and I bet it will be pretty tender. This tightness or pulling affects your line of site since it pulls the head back, this causes a compensation of rounded shoulders and mid-back humping. It is very important to have adequate movement in the neck. Ty this test. Keep your mouth closed and teeth together. Can you touch your chin to chest? Look up to the ceiling, is your face within 10 degrees of being parallel to the ceiling? Can you touch your chin to each collar bone without raising your shoulders? DO any of these moves hurt? If you have pain or cannot get full motion in these areas, you have dysfunctional movement. An injury may be headed your way. 
5. Plantar Fascia: ---The bottom of your foot (plantar) is full of soft tissue fascia. If it is tight or restricted you will be tight all the way up the back of your leg into the back and even neck. This is one of the most powerful areas to look at for movement. The foot is the foundation of everything. Try this: Roll a golf ball on the bottom of both feet. Is it tender? You should roll a golf ball on your feet daily for several minutes regardless of tenderness. It only makes you better.

Ok, there ya have it. These are just a few of the things I teach in my upcoming book on Recovery, Regeneration and Performance Enhancement. Little things make a big difference. learn to move better and I guarantee you will look better too. Feel free to contact me anytime via my website or facebook Fanpage page. Both key worded as 'Stop Chasing Pain.' have fun moving!!! Now go Crossfit with proper movement.

Perry Nickelston, DC, SFMA

Hip Huggers

One of my favorite dynamic moves to open up the hips. External rotation of the upwards leg and extension of the downward hip. Contract glute on the downward leg.

My Top 5 Exercises for Legs

Ok, so I admit to having a love hate relationship when it comes to training my legs. I dread doing it, but when I get there and in my ZONE, it's the best. Due to so many years of what I like to call 'stupid training' I messed up my knees and lower back from knucklehead moves like squatting with crappy technique. So I started learning about single leg training from Mike Boyle's stuff and really liked the results. Plus it helped with stabilizing my hips and turned out it was a tougher workout than using both legs. This is called a win-win. So after trying different exercises I ended up with 5-favorites and here they are. If you dont' know how to do them just let me know or Google search it. Worthwhile to play around with these and watch how your legs and ass change for the better. Have fun.

1. Single Leg Box Squat
2. Single Leg Deadlift
3. Single Leg TRX- Crossover Squat
4. Single Leg Reverse Lunge TRX
5. Box Step Ups with Overhead Press

TRX is one of the most awesome investments for your fitness toolbox. It is invaluable in my leg training. GET ONE! http://www.fitnessanywhere.com/

Top 10 Things I Learned Working Out for 29 years.

1. More is not better...better is better.
2. Recovery and regeneration is crucial to muscle development
3. Nutrition is THE KEY to fat loss
4. Steady state cardio does little to burn fat...metabolic acceleration from weight training is better
5. Proper deadlifting is a full body exercise secret
6. Quality is more important than quantity
7. Looking good does not mean you have a freaking clue about proper training
8. Training longer than an hour is detrimental to growth hormone and testosterone production
9. Hydration is a missing link to muscle hypertrophy and fat loss
10. Proper stretching makes you move smarter...so you move better...so you look great!
11. Bonus: Just because you have nice abs does not mean you have a strong core...it just means you have a cleaner diet.

Reverse Lunge with a Twist (No olive)

One of my favorite dynamic stretches. The key is to activate the rear leg glute for the entire movement. This relaxes the hip flexor and gets a much better stretch in the anterior hip during extension. Do 10 reps both sides. Alternate sides for a total of 20-reps. Lunge deeper and further back to enhance the move. Have fun!

Foam roll on your glute and hip structure at least 3 times per week. Great for soft tissue release of trigger points and adhesions in the hip. Can do wonders for helping lower back pain. The magic of rolling. Only thing better would be naked rolling....but alas that is for another blog. lol So get rolling and make it a habit!!

Is your car worth more than you?

Isn’t it amazing that people take better, more proactive care of their cars than their bodies? We spend big money on a car and do everything to protect that investment from Day One. We dutifully change the oil every 3,000 miles. We rush to the shop at the first sign of trouble. We buy extended warranties and insurance, all because we want to protect an investment we know will most likely provide us no value after 8-10 years. And yet we visit the doctor or think about our health only when things go wrong. Cars and all other material things won’t make a difference if we don’t have the quality of life we want. The richest person in the world can’t buy health. There has to be an investment of time and effort in a plan-not just any plan, but one that will provide the greatest return on investment!

Omega 3's...use em'

In order to have a significant impact on boosting your metabolism, burning more fat, and enhancing your overall health, there’s no better “supplement” than omega-3s. I put the word supplement in quotes because omega-3s, in actuality, should not be considered a supplement—they should be considered essential. Sure, many people take a fish oil supplement to boost their omega-3 intake, but most don’t take nearly enough. How much should you be taking? I suggest one gram of omega-3s per ten pounds of lean body mass. I can’t speak highly enough of the benefits that omega-3s have to offer. Please make a point to get an adequate supply of omega-3s every day and I guarantee that you’ll like the results.

You must eat with a purpose if you want to see a difference in your body.

Small is Big!

In today’s economy, bigger isn’t always better. In fact, it’s often the small little things that customers notice which can put your business on the fast-track to success. Small seemingly insignificant acts are powerful catalysts of change and growth for your practice. Unfortunately, we often make the mistake of not having a system in place to implement and monitor daily small action steps for success. We think it has to be big to make a difference. But business and life rarely follow such a grand scheme.

Attitude drives actions. Actions drive results. Results drive lifestyles. If you don’t like your lifestyle, look at your results. If you don’t like your results, look at your actions. If you don’t like your actions, look at you attitude. If you don’t like your attitude, look at your philosophy. If you have no philosophy and you have a lousy attitude, what kind of actions are you going to take? People will sense your attitude without a single word being spoken. So make it a good one!

All About Movement

The dreaded swimsuit season is upon us. It’s the time to see just how much our bodies have changed over the course of a long winter and it can be an eye opening experience. One where you just want to close your eyes and hope it goes away. The fitness industry knows how traumatic this can be for you and every year there are books, diets, videos, and magazines dispensing advice on how to get in shape for summer. Unfortunately, most of them are quick fix starvation diets and equipment intensive workouts that are just too difficult to follow. Inevitably, the weight comes back (with a few extra pounds added) because these quick fix programs lower your metabolic set point, making your body more prone to storing body fat. And that’s the last thing you want to do! So what’s the answer? Well, it’s really quite simple and I can answer that with one word; MOVEMENT!

My new logo ready for T-Shirts. They are coming soon! The Stop Chasing Pain express train is on the way.