Recently a couple of my friends have been needing surgery. One had torn ligaments in her knee, another one had a damaged disc in the lower back, and the third one crashed on his bike and broke his collarbone. This brought upon a discussion of “can you do anything to make things easier before and after having surgery?” Well, YES!
Anytime you need surgery, whether you are having a smaller problem dealt with, like dental surgery, or something larger like a knee replacement, preparing the body for what is about to come will have a huge impact on your recovery.
By failing to prepare, you are preparing to fail.
No matter how good the surgeon is, having surgery will always be a very traumatic and unnatural event for the body. This is not the time to slack off, lying on the couch all day, feeling sorry for oneself and eating crappy food. Think of this as your mini Olympics. The stronger and better prepared you are for the event, the better you will do.
MobilityWOD has done a really cool and easy to follow infographic on the subject. I strongly suggest you check it out, and also, why not share it with your friends. You never know when you might need it.
Of course, you never plan to have an accident. Especially not one that requires surgery. In this case you probably will not have any time to prepare for the surgery. However, you can still do the most with your rehab, post surgery. MobilityWOD has another great infographic for that as well. You can check it out here.
Another thing to keep in mind (see what I did there) that is very powerful, is using visualization or meditation. Do not underestimate the power of your mind. Think about what you want to happen, and visualize a great result. Do this preferably in short increments during many times of the day, to set the stage for the outcome that you want. If you are not familiar with any of these techniques, I think the app Headspace is a great way to start. You can read more about it here.
I hope you will not need any of these strategies, but that you will find them useful in case you ever do.
Take care of yourselves, and have a great weekend! 😉
Rather than just doing even more of the same, maybe it’s time to rethink your strategy?!
The way I see it, the origin* of your pain can be located either externally (think muscles and ligaments) or it can be internally (think organ, organ-systems and nerves), even though the symptoms look the same, like back pain.
It is important to know where the origin of your pain is, because how you go about treating the problem should be different depending on what most likely caused it.
How to tell the difference?
Let’s say you overdid it in your last work out session with 100 pushups. Or maybe you spent the whole day digging in the garden. The next day you will have a hard time getting out of bed, your back hurts and you are in agony.
If this is an external problem (muscles, ligaments) you will feel better if you go into the sauna, take a hot bath, get some massage, and do some mobility work. You may not feel back to awesome the first couple of days, and even though your recovery is not a straight line at 45 degrees on the graph, you are constantly and consistently improving. Like on graph 1.
Graph 2 on the other hand represents more of an internal problem. You think it is an external problem because your back hurts, so you treat it just like in the example above with a hot bath, sauna, massage, mobility work etc.
But, you don’t get much relief. Maybe it feels a bit better for a day or two, or maybe even a week, but then you are right back where you started. This is when you need to ask yourself how is my digestive system really working? How are my kidneys and liver doing? What can I do to help my digestive system and organs?
Did you know that: Constipation can cause low back pain and often a deep pain into the hip.
If you are dehydrated your kidneys don't like it and you could feel tenderness and pain in your low back.
An overwhelmed liver will indirectly cause pain in your right shoulder.
Tired kidneys will refer pain to the area of your shoulders and neck.
Any kind of digestive issue can also cause neck pain via the X cranial nerve, aka the Vagus nerve.
The pancreas, our super hero of blood sugar regulation will refer pain in between the shoulder blades.
If you have already seen a couple of different physios, and a chiropractor, and so on and it doesn’t seem to have helped, finding yet one more will not “fix it”. By now you should have gathered that their working tools are not suited for your particular issue.
If you have had your problems for a longer period of time, and you cannot solve them with your usual methods, it’s time to be smart and start looking at the functions inside the body. Take responsibility for your own health, get involved in the solution, and figure out what you can do daily to help yourself.
Next week we’ll discuss this further by looking at two different case studies.
Don’t kill an ant with an atom bomb. Think more like a ninja, and make a better targeted effort instead. 😉
*The origin of your pain does not have to be (and seldom are) where you feel the pain, which is the symptom. If you only put band aids on the symptom but never look for the root cause (the origin) you might never solve the problem at hand. Assuming you didn’t just break your leg in an accident, then of course your pain is where the problem is!
Constipation is a topic that we don’t really talk about, but that doesn’t make it any less important. Actually, being able to poop easily every day should be standard. It is a very important function within our body and it can immediately tell us a lot about the state ofour internal health.
So what does good bowel movement look like? The frequency should be once or twice a day. It should not take any effort, the shape should be like a large sausage, with the consistency of soft clay. Too frequent visits, just like too few, is an indication that something is off balance.
If you are not able to go daily you are constipated. If it also takes a long time and effort when you do go, then you should really pay attention. Your poop is your comprised internal garbage, and if it hangs out for too long in the large intestine it will cause problems. It’s like you have an open trashcan completely full, just sitting in your hallway. Within a short amount of time that garbage will make your whole house smell like s**t and nasty stuff might seep over the edges and spread into your house. Yuck!
When too much water gets reabsorbed your soft clay turns into very hard balls making pooping very difficult and even painful. Also, the longer the garbage hangs out in your intestine, more of the nasties and yucky stuff will get reabsorbed. Your intestines are very thin walls made of cells, and they are not completely solid. Meaning, it is possible for particles to seep through the walls of the intestine and get into other areas of the body. You do not want old trash hanging out in the wrong place. Hence, why you want to get the garbage out on time.
So, what can you do to assist your body in this process? The easiest thing to do is to make sure you are drinking enough water, eat plenty of vegetables and fiber. I like adding ground flaxseed to my food for added fiber. You can also improve on your position on the toilet by putting a small box or similar under your feet. It may sound silly, but as you will see in this video, it really does make a difference.
Frequently I get asked if there are particular times of the year where my work is extra busy. There sure are, and one of them is just about to come up. It is the same, year after year, and it typically starts around the third week of January and runs through February. What could be the reason for this injury season?
Maybe you think it is because of all the skiing holidays? Sure, they add up as well, but no that’s not it. It is because of all the New Years Resolutions. What do I mean by that?
Typically we completely overestimate our body’s ability to adapt to new changes when it comes to fitness. Often we are not realistic about where our current fitness level is. We tend to focus on strength and speed and forget about any other component, like the importance of flexibility, and having full range of movement. You may have been the superstar athlete back in school, and that is awesome! But, if you haven’t continuously taken care of your body during the last 10 or 20 years, you cannot expect to jump right back into your old work out routines. And if you do, you should not be surprised if (when) you get injured.
Let’s use “Sarah” as an example of what it typically looks like. Sarah is in her late 30’s, has a desk job, used to be really sporty but has completely gotten out of her routine in the last year(s). She makes a New Years Resolution to get fit again, and to get back into a routine. She is super motivated and starts with running 5 times a week between 30-60minutes, even though she hasn’t really been running in the last year. She doesn’t warm up or cool down, because she doesn’t have time for that. Besides you get warm while running, right?! The same goes for mobility work. It’s only running, right? It’s not like she she going to do gymnastics or anything, so it cannot be that important.
Towards the end of January Sarah shows up at my practice. She tells me that she has been taking ibuprofen and that helped her through last weeks training sessions, but now it’s not enough to help her with the pain. She has low back pain, her left knee is sore when she runs and she thinks she might have heel-spurs, as her feet are painful. Upon examination it is very clear that her hipflexors, quads, and calves are super tight, and she does not have proper range of motion in several joints.
I will talk to her about the importance of slowly increasing the intensity and duration of a training program. And also the importance of a warm up, cool down, mobility work, nutrition and hydration.This typically goes in one of two ways.
#1. Sarah actually listens, makes the needed adjustments, and starts with a less intense training program after 10 days of active recovery and mobility work. She took a look at her nutrition and hydration. She added some strength training, is working on her running technique and does daily mobility work. I see Sarah about once a month for preventative work, and am happy to hear that she has registered for a half marathon in 5 months time. She is using the Nike Run App to help her prepare correctly.
Scenario #2. After the treatment Sarah feels better and decides to “test her body” on a long run to make sure everything is alright. Towards the end of the run she is in pain again. She goes to the Doctor and gets anti-inflammatory drugs and is not allowed to run for at least 14 days. On the 15th day she goes out to “test her body” again, but is not able to finish her run as the pain is back. She goes back to the Doctor, who gives her another round of anti-inflammatory drugs, and says that if this continues she will need injections and potentially surgery. After a few weeks on this roller coaster Sarah gives up on sports and concludes that she is just too old, unlucky, and there is nothing she can do about it.
This is just one example, but I see it all the time. We all think that we are immune to injury until it happens to us. This year, why not be smart about your New Years Resolutions. Get yourself a good coach who can help you, or use Apps like Nike Run and Nike Training to help you out at YOUR CURRENT level. Be honest with yourself here! Make a plan for the long run and slowly increase your training. Make sure that you add all the other components to being a great athlete, like warming up, mobility, hydration etc. Be kind to your body and give it a chance to adapt.
If you are interested in some serious goal setting, then check out this video with Coach Ben Bergeron.
I wish you all an excellent start to the New Year 😉
It is winter time and for most of us that means a lot more time spent indoors. That usually means that we are sitting a lot more, and moving less. This can lead to tight hamstrings, which in turn can lead to back pain. Christmas also brings along a lot of traveling for plenty of people, so now is a good time to start some prevention work. Especially if you have a ski holiday coming up. Here are three very short videos on how you can test, smash and stretch your hamstrings. Your hamstring is a common name which includes these three muscles m.semimenbranosus, m.semitendinosus and m.biceps femoris.
What to think about when you do the hamstring test:
The leg that is on the ground should stay straight and in contact with the floor the whole time. The leg you are raising up should be straight at all times, no bending of the knee. When things are good you should get to at least 90 degrees without any problem. If not you have got some work to do.
Is there a big difference in flexibility in the two legs? Make sure you put in some extra work on the side that is less flexible. Asymmetry is harder for the body to deal with, as the side that moves a bit better has to compensate for the side that does not move well. The guys from MoveU are a little bit crazy, but they are energetic and to the point, and that I like!
*Unfortunately the videos from MoveU are currently not available on YouTube. I have added three different ones instead. As soon as the original ones are back I will post them here.
What to think about when you smash the hamstring:
The automatic reaction from the muscles when you try this is usually to tense up a bit. Therefore you may not “feel any tightness” right away. If this is so, take a couple of deep breaths and really let your leg sink into the ball. Once a bit more relaxed, start moving the leg in search of those tight spots. If you find yourself tensing up again, just go back to taking a few deep breaths, and then try again.
What to think about when you stretch the hamstring:
Try to keep the movement dynamic. Meaning, slowly move the leg from one position to the next (bend and straight the leg). From my experience the body seems to adapt quicker when we do it this way, and there is a lesser chance of overdoing it, rather than just holding a static stretch and pulling on the muscle.
Finish with a re-test to make sure that you did a good job, and have improved the flexibility of your hamstrings. If you do not have someone who can help measure your improvement, putting up some temporary marks on the wall with tape, can be a great visual.
If you are a runner, or on your way to your ski holiday, it is extra important to pay attention to a proper warm-up. Going straight from sitting into doing sports in cold weather will take a lot of extra effort from your body. This can be a killer for already tight hamstrings, as it takes longer for the body to heat up. A good warm up will significantly decrease your chances of getting injured. Here is a reminder of what a quick, good warm-up looks like.
Take care of your hamstrings, and they will take care of you. Enjoy your weekend! 😉
Photo by Osman Rana, Asogqetti and Natia Rukhadze on Unsplash
Every couple of weeks or so I get the question -Can I work out after a sports massage? Of course you can, but should you? My suggestion is don’t do it, because the body cannot do two things at once.
-Can I work out after a sports massage?
If you remember from one of my earlier posts, I was talking about why you often feel tired after a deep sports massage. It is because the deep massage helps the body to start its own cleaning and healing process. If you go and work out later that day, that cleaning process will stop. Instead, the body is now focusing on supplying oxygen and glucose to the muscles so you can do your training. Typically you will feel very tired and sluggish if you choose to work out after a deep tissue massage. It’s because the body has to switch from repairing mode to action.
If you feel like you absolutely have to do some type of training the same day, keep it light and short. Think of it more like active recovery than actual training. Do something like a short easy bike ride or go for an easy walk with a friend.
What about exercising before a sports massage on the same day? I would say that it’s ideal. It is a great way to get rid of the extra lactic acid that have been built up during the training, and get the blood circulating. It will speed up your recovery a lot and leave your body recovered and better able to adapt to the following training session.
But what about pro athletes, don’t they get massages all the time? Well, yes and no. It all depends on when and what kind of a massage. For instance when I work with tennis players they might need some massage to warm up a tight and tired shoulder before a match. That’s very different from a deep tissue massage, which they would have after the match. The goal before the match is just to warm up the muscles, which means that the time spent on that area is shorter and the intensity is lower.
If it was me, I would not do any training after a sports massage. If you have never had a deep sports massage before, or it was a long time since your last session I would even suggest taking 2 days off, with just some very light active recovery work on the second day. Give the body some time to adapt.
Enjoy your weekend! 😉
Photo by Braden Collum, David Marcu, Christopher Burns, on Unsplash
Recently I have seen a lot of shoulder wear and tear in my practice, often directly related to the amount of push ups my clients have been doing. With today’s many Fitness Challenges going viral, one of the popular ones being +100 push ups a day for 30 days, I have also seen shoulder problems increasing.
Why is that? Shouldn’t more push ups just make you stronger? The answer is poor technique! Just because you can do a lot of repetitions does not automatically mean that you are doing it right.
Are your fingers pointed forward? Are your elbows locked out? Are your forearms staying straight at 90 degrees from the floor at all times during the movement? Is your shoulder moving forward first (not your elbow!)? Is your core braced so that your spine and upper body moves as one unit pivoting from the floor?
Did you nod your head in agreement while reading those questions? Or, are you not really sure what I mean by them? If so, you should take good look at your push up technique right away. Unless you did higher levels gymnastics as school, or just happened to have an amazing coach, most likely this is all new to you. That’s OK. Don’t feel bad about it – get smart instead, and learn to do it right.
Doing push ups with poor technique is like driving a car where the wheel base is off. You can still drive it, but it will always pull a bit to the side and the tires will wear out unevenly and quickly because of the uneven weight distribution. You can think of your shoulders as your upper wheelbase (your hips being the lower) and the same uneven wear and tear will happen there. However, it’s not so easy to “change out the damaged tires” in a human body.
So what’s your game plan? Are you going to blame it on the tires, or are you going to invest some time and energy making sure that yourwheel base is solid? Think of it this way. A well functioning machine with good alignment might need some extra oil once in a while but it will not break down just because you increased the repetitions. If it does, something is wrong with the mechanics and you need to fix it.
Coach Carl Paoli is an excellent movement coach, whom I have tremendous respect for. I think it would be a smart move on your part to pay attention to his teachings in all things movement. Practical tip: When you are practicing this, it is a great idea to put a book, block, ball or something behind your forearm. This is to make sure that your forearm does not move backwards during the push up. If your forearm comes in contact with the object, you know it moved, and you can adjust accordingly.
If you are not able to do a complete push up yet, follow this push up scale video. Pay good attention and don’t worm yourself out of this one 😉
Ok, so you think that you already have great mechanics? Great, check yourself in the push up lie detector test by turning your hands the opposite way, having the fingers pointing toward your toes. Also, find out why doing push ups on your knees is not good for your shoulders, and why it will not lead you into a proper push up.
We all need to pay attention to good technique, especially when it comes to the basics as they lay the ground work for all other movement. When it comes to injury prevention there really is no substitute for a solid foundation with great mechanics.
Last weekend I had the great pleasure to run the half marathon “halvevanhaarlem” in the Netherlands. Haarlem is situated in between Amsterdam and the ocean, and it is a very nice and laid back city. The running route was really fun, going through narrow city streets, cute neighborhoods, through the sand dunes on smaller trails, and we even ran on some gravel roads next to the canals.
The Plan and Preparation
I had never ran a half marathon before, and I knew I needed a plan to follow when I made up my mind to go for it. I decided to try the Nike+ Running app, NRC. With people like Ryan Flaherty behind the app, who is a brilliant coach and really knows what he is talking about, I wanted to see if the app could get me prepared. I went to the “coach” in the app, set the date for my half marathon, and put in the details of my running at the time. The app then set up a plan for me to follow, making sure that I did not increase the kilometers too soon. So far, so good.
Most common mistakes
Often people are so motivated, that they increase the mileage way too soon, only to get injured, and not being able to run at all. A second fault I see most people do is that they don’t change up their training with intervals, or any kind of strength training. For half marathons and beyond people typically just try to collect a lot of kilometers. This will not really make you a lot faster or stronger. It’s more of a surviving the grind kind of a thing. I think that it is neither fun nor smart training.
It is much better for the body to change things up, and do different things. The app does this very well, and I can tell you that on my own I would not have run so many different intervals as I did with this program. Sure, intervals are hard work, but it is also fun and the training sessions goes by a lot faster. And, it is really cool when you notice that your speed is improving.
The Nike+ Running Club App is also connected to the Nike+ Training Club app. I think it is a brilliant concept to put these two together, to build a more well rounded athlete. Because of this some of my scheduled training sessions were flexibility and strength training, and no running. It’s a great way to keep the fitness up, but letting the body adapt to more running step by step.
My goal for the half marathon was to be as well prepared as I could, so that I could enjoy the day. I did not want to have to worry about injuring myself. I really think that all the interval work I did was key, because I only had 2 longer runs in the whole program at 14.5km and 16.5km. On the day of the race I felt really great and was able to enjoy the event. My goal was achieved! Two days after the event I was out with my friend playing catch with her dogs, and she said “you don’t move like someone who just ran a half marathon!” Trust me, I am no natural gazelle so I contribute that to the good programming and not increasing the kilometers to soon.
Running with the phone
Practically, I really do not like to run with my phone though. I don’t like the arm wrap from Nike, and the best solution so far that I have found is a sports bra from Lululemon that has an extra pocket for the phone on your back. If you have any other good suggestions do let me know. Instead I used my Garmin watch to get the length and time of my run, and then I just added it manually in the app. I would only run with my phone on the days where I had to do a “bench mark” to see how I had improved. This worked well enough for me. However, I believe that you will get the most out of the app if you always use the phone.
A really good running coach is of course never obsolete. But most people are probably looking for more general guidance. As these apps are free and will help you to be smart with your training, there really is no reason not to use them. It would also be smart to work on your running technique for your long-term plan. Maybe there is a workshop somewhere close to you?
For your next running goal, whether it’s just for you getting off the sofa or taking part in a race, I would say you have two good options. 1. Get the app and follow the instructions as best as you can. 2. Find a real knowledgeable running coach who can help you.
Having a plan behind the training will make you better, less prone to injury and the training will be a lot more fun – what’s not to like?
“Failing to plan, is planning to fail”
Enjoy your weekend! 😉
The question just recently came up from one of my new clients. “Why do I feel so tired after a sports massage?” It was her first session of a sports/deep tissue massage in a very long time, and she was in bed by 9pm that night. If it’s your first time in a while since a sports massage this might often be the case. It will get better after a few sessions, as the body starts cleaning out the gunk that has been stored in it for so long. Gunk, what gunk?
Stored gunk We store heavy metals, pesticides, pollutants and other toxins in the fatty tissue in our bodies. When there is an overexposure of these toxins, or the liver is under too much stress for other reasons, it cannot clear out all the toxins right away. As a protective mechanism the body then stores these toxins in the fatty tissue. This may be a good short term strategy, but with all the toxins that we are faced with everyday, we just keep accumulating toxins in our fatty tissues. The liver is under constant pressure to catch up with all the cleaning. This is on top of all the usual waste products that the liver has to clean up as well, like for instance lactic acid.
A thorough deep cleaning
As you are getting a sports massage, it’s in a way like a deep spring cleaning of your house. You will find dirt you didn’t know about and it will take some effort to get the house cleaned. Going deep into the tissues will help liberate stored toxins and waste products and get it out of storage and into the bloodstream. From there it gets transported to the liver, who can safely disassemble them and make sure the garbage leaves our body through the urine and poop.
It gets worse before it gets better
I had a client who used to smoke a lot and had recently quit, and the first couple of times she felt really nauseous after the massage. This was due to the built up of toxins from years of smoking that now were released out of the fatty tissues and into the bloodstream. As the toxins enters the bloodstream, it can make you feel worse at first, before the liver can take care of it. For the body it is like you just ingested all those toxins again.
Another client works as a painter and is constantly in contact with toxic fumes. Changing his line of work is not an option, even though from a body-toxicity exposure that would be better. Instead he has created a preventative strategy that works very well for him. On a regular basis he goes to the sauna, gets deep tissue massage, runs a couple of times a week, stays well hydrated and takes herbal supplements to support his liver. Twice a year he does a week of detoxification as well.
“It is unrealistic to think that we can all change our work or where we live based on the amount of toxicity that we are exposed too. But, we can certainly have an influence on how well the body is prepared to deal with it all.” 
It takes a lot of work and energy for the liver to deal with all the extra cleaning that comes from the toxins that just entered the bloodstream. By getting a deeper treatment you are helping the body to start the process of self-healing through detoxification and an increased blood circulation. Therefore it is very common to feel extra tired due to the energy expended.
From my experience, the better shape your body is in all around, the less tired you will be. Feeling relaxed after a massage, which you should be, is different from being tired. The life of your liver is very much like being M-O, and you are the one that keeps bringing in the dirt. So, take very good care of M-O. Help him out by bringing in as little dirt as possible, as he is doing his very best continuously taking care of you!
It is common to feel extra tension for 1-2 days in some areas of the body that felt very tight during the massage. After the very first couple of sessions you may even feel it for a few more days, but that should subside as your body gets used to the treatment. You should not have any bruises after a sports or deep tissue massage. If that happens let your massage therapist know so that they can adjust their work with you accordingly.
Make sure you are hydrated before the treatment and hydrate well after. It is the quickest way to make sure that the body has enough fluids to easily transport and disassemble all of the gunk that is coming out of storage. You will help the body to recover quickly and you are making it easy for M-O (the liver) to do his job. If you are, or know that you have been exposed to a lot of toxins, it might also be a good idea to support your liver with some herbal supplements.
Take good care of M-O and have a great weekend! 😉
quote from Nathalie Visser
Photo by Jeremy Bishop, Hernan Sanchez, Pan Xiaozhen, Tim Mossholder and Matt Hoffman on Unsplash
As we are all using computers and phones more and more frequently and we often tend to loose sight of our posture as we do, it is important to take care of our neck. When we are in a position of our head hanging forward out in front of our shoulders, it creates a lot oftension in our neck. Over time this compresses the discs in the cervical spine (neck) which can in turn irritate different nerves in that area. This is most likely no news to you, but are you being proactive and doing something about it?
Since we lean forward with our head so much of the time, it is important to lean back in the other direction too, to even things out a bit. This takes some of the pressure off the discs that are being most compressed, and helps the fluid in the discs to re-position itself. It also helps to open up some of those tight muscles in the front of the neck and upper chest area.
In this video you will see an example that is very easy to replicate at home on your own, using your bed or sofa. You could also use a foam-roller if you prefer. If so, lay down on the floor, put the foam-roller underneath you along the length of your spine and let your head hang over the edge.
Below you will learn different techniques for loosening up the area in the upper chest and front of the neck that you can do yourself. A lot of the times the reason for pain in the back of the neck can be found in the front. If I were to follow both of these videos, I would start with this one loosening up the area in the front of the neck first and then lying down on the sofa and letting my head slowly tilt backwards.
I hope you will find these tips useful.
Remember, pre-habis better than re-hab!