Category Archives: Evidence based facts

Do This, Not That

by Colleen Morgan, PT, MS, OCS, CSCS

Whether you are a weekend warrior or competitive athlete,

a life-long “gym rat” or exercise newbie, it’s important to know which gym exercises are worth your time and energy.  Learn what exercises most physical therapists would categorize as worthless (perhaps even downright dangerous) and explore some healthy alternatives in our recurring blog column “Do This, Not That!”

Do This!

Not That!

Bird dog may look (and sound) like a weird exercise, but similar to the plank, it’s a great “whole body” exercise.  This is a surprisingly functional exercise: Remember how tired you were after you knelt to clean the bathtub?  Stabilization of your core, upper body, and lower body occurs as soon as you get onto hands and knees.  The exercise becomes progressively more challenging as you lift just one arm, just one leg, alternating arm and leg, and finally same-sided arm and leg.  Keep that tummy tight to support your back! Seated back extensions against resistance.Sitting imposes the greatest compressive load through the lumbar spine.  Forcefully extending your back against resistance creates a compressive force rather than a stabilizing force through your lumbar spine.  Add on the fact that you are sitting and you have a potential recipe for harmful spinal compression!
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What is a burpee?

 By Mike Kwong, PTA, CSCS

Ever overhear a personal trainer at a gym tell his/her client to perform 10 burpees as a part of their training program? Do you have a kid in team sports moan about the amount of burpees that his/her coach made them do during practice? Have you ever wondered what a “burpee” actually is? It sounds like a cross between a 7-11 Slurpee and the noise you make after drinking it! So, what is this infamous burpee that people are talking about?

The Burpee, also known as a squat thrust, is a full body exercise used in strength training and as aerobic exercise. It is performed in the following steps:

  1. Begin in a standing position.
  2. Drop into a squat position with your hands on the ground. (count 1)
  3. Extend your feet back in one quick motion to assume the front plank position. (count 2)
  4. Return to the squat position in one quick motion. (count 3)
  5. Return to standing position. (count 4)

Burpee

A Brief History of The Famous Mr. Burpee

According to the Oxford English Dictionary, the exercise was named in the 1930’s for American physiologist Royal H. Burpee, who developed the Burpee Test. He earned a PhD in Applied Physiology from Columbia University in 1940 and created the “Burpee” exercise as part of his PhD thesis as a quick and simple way to assess fitness. The exercise was popularized when US Armed Services adopted it as a way to assess the fitness level of recruits when the US entered WWII. Consisting of a series of the exercises performed in rapid succession, the test was meant to be a quick measure of agility, coordination and strength.

There are several variants to the traditional burpee, with the more popular ones adding a push up, jump, or pull up to the exercise. Here are a few:

  1. Burpee push up: the athlete adds a push up after assuming the plank position
  2. Jump up Burpee: the athlete jumps up as high as they can at the end of the movement and before they start their next burpee
  3. Long-jump Burpee: the athlete jumps forward, not upward
  4. Jump-over Burpee: the athlete jumps over an obstacle between burpees
  5. Pull-up Burpee: the athlete combines a pull-up with the jump or performs the pull-up instead of the jump
  6. Double Burpee: instead of 1 push up, do 2 in a row. This cancels the drive from landing after the jump and makes the next jump harder. Each part of the burpee may be repeated to make it harder.
  7. Side Burpee:  The athlete bends at waist and places hands shoulder-width apart to the side of right or left foot. Jump both legs back and diagonally to the right. Jump back in, jump up, and repeat. jumping back and to the left side.

Here at CPMC’s Physical Therapy and Sports Wellness Clinic, we use the burpee (and variations of it) as one of our exercises in our Total Body Fitness classes. Recently, we have been holding our own fitness challenge: how many can you do in 30 seconds? The results have been amazing!  Come try it out for yourself!

Sports Wellness Center
Physical Therapy Clinic – Pacific Campus
2360 Clay Street, San Francisco, CA 94115
wellness@sutterhealth.org
415.600.5860

Jumping: What Goes Up, Must Come Down

by Thommy Chui, PT, MS, OCS, CSCS, TPI CGFI MP2

Growing up with two older brothers and a lot of neighborhood friends, jumping was just something we did during play: over lines on the sidewalk, on trampolines and even daring each other to leap off progressively taller benches and rocks. Eight year old kids with supple joints and no fear of injury tend not to worry about things like proper jumping mechanics.  As I got older and involved in competitive sports, more emphasis was placed on being able to jump higher and farther, but with little or no instruction on how to do it properly.  Although I survived these athletic endeavors of my youth relatively unscathed, as a physical therapist I see unsafe jumping mechanics contributing to injury in many of the young athletes I work with.

The act of jumping seems innocent enough: springing up from the ground into the air by force from your legs. Regardless of how you take off or how high you jump, everyone has to land on the ground.  What comes up, must come down after all.  Did you know that the body must absorb an impact 2-4 times its body weight in that landing?  In my experience, coaches and athletes devote lots of time on developing the mechanics and explosiveness necessary to jump from the ground, but very little if any on training the body to safely absorb the impact of landing.   In fact, the majority of sports injuries involving the lower extremities occur not during the take off phase but during landing, particularly in sports such as gymnastics and ice skating where accurate landings are crucial.  To prevent these injuries, it is essential that athletes work to develop proper strength and landing mechanics.

Common Landing Faults:

  • Landing with flat feet –  limits the ability of the musculature around the ankle and knee to shock absorb. The balls of your feet are the last part of your foot to leave the floor when jumping—they should be the first to touch the floor when landing
  • Landing with our knees facing inward- loads the joints unevenly and can lead to injury. Your knee caps should stay aligned over the middle of your feet when landing
  • Not incorporating hip and knee flexion – not bending hips and knees upon landing adds stress to joints and ligaments.  The goal is to land with “soft” knees and hips

Improving your landing mechanics:

  • Practice!  Start with small double foot jumps (vertical) or hops (horizontal).  Focus on landing softly, keeping knees aligned over your feet and allowing the knees and hips to bend upon landing to shock absorb.  Try to make your landings as quiet as possible, if you hear a thud on impact you’re landing too hard
  • Progress with bigger jumps and hops or practice landing only on 1 leg to simulate what might happen in a game setting. Stand on top of a bench or box, step off and practice your soft landings
  • Surface makes a difference. Practice ideally on the type of surface you’ll be performing on.  Grass, rubberized mats and gym floors are best for reducing impact forces.  Try to avoid repetitive jumping/landing on hard surfaces like cement
  • Having adequate core and leg strength is vital.   Injury can still occur with perfect landing mechanics if your muscles are not strong enough to absorb the impact.  Strengthen your glutes, quadriceps, hamstrings and calves to protect your joints and ligaments


Check out our video library for the core and lower extremity strengthening exercises listed below and many more ideas on how to develop better strength for jumping mechanics!

1.  Band sidesteps in standing and crouched position

2.  Double leg squats

3.  Lunges

4.  Calf raises with eccentric control

5.  Squat hops with eccentric control

References

Prapavessis, H. , McNair, P.  Effects of Instruction in Jumping Technique and Experience Jumping on Ground Reaction Forces.  JOSPT 1999;29 (6) 352-356.
Umberger, B.R. Mechanics of the Vertical Jump and Two-Joint Muscles: Implications in Training Strength and Conditioning 1998.
Mostafa, A., Hinrichs, R.N.  A Mechanics Comparison Between Landing From a Countermovement Jump and Landing From Stepping off a Box. Journal of Applied Biomechanics 2012, 28, 1-9. 

Do This, Not That!

by Colleen Morgan, PT, MS, OCS, CSCS

Whether you are a weekend warrior or competitive athlete,

a life-long “gym rat” or exercise newbie, it’s important to know which gym exercises are worth your time and energy.  Learn what exercises most physical therapists would categorize as worthless (perhaps even downright dangerous) and explore some healthy alternatives in our recurring blog column “Do This, Not That!”

Do This!

Not That!

Lunges help to improve quadriceps strength using a functional movement pattern your body may use throughout the day.  You can vary the degree of knee bend depending on your comfort level and stability.  Since you are standing, you are also working on your balance and core stability.  If you’ve mastered your forward lunges, progress to lunges in multiple directions. Seated knee extensions against resistance.  Upon mentioning this popular exercise to a physical therapist, expect their reaction to include the following: redness of the face, difficulty speaking, and spontaneous combustion.  Okay, so that’s an exaggeration, but if you know anything about the knee joint, you will loathe this exercise.  Seated knee extensions against resistance isolate your quadriceps, but put unnatural, excessive load and stress on your patellofemoral joint and ACL, which can lead to knee pain and injury.
 Lunge
 Seated Knee Extension Machine

Ski/Board Strong, All Day Long: Week 6

Welcome to the FINAL week of the Ski and Snowboard Series. This is a progressive strength and conditioning program specific to snow sports injury prevention and performance enhancement.  If you have not been skiing this year yet or are feeling like you need a little zip in your technical moves, the following blog is for you!

The previous blogs in this series direct you in beginning hip, core, and balance exercises.  Here are the links to the blogs and videos:

Week 1: Glut med and balance progressions

Week 2: Front plank and squat progressions

Week 3: Clams and side plank progressions

Week 4:  Bridge and hip power progressions

Week 5: Lunge and rotational stability progressions.

If you have not done any of the previous weeks exercises, you may not be fit enough to safely perform the following plyometric exercises just yet.  If you’re just tuning in, we strongly recommend going back to cover the basics before attempting these advanced exercises.

What are plyometrics?  A plyometric activity occurs a muscle is lengthened quickly and then shortened quickly (called a stretch shorten cycle).  This is highly effective in developing power.

Unfortunately there is little understanding by many on how to prepare for and how often to do plyometric training.  We do know that the most important component of plyometrics is ensuring that you warm up with dynamic stretching and mobility work.  It is also important to perform a consistent strengthening program for 1-2 months (similar to weeks 1-5 above) prior to the first session of plyometrics.

Perform the following exercises in the video 1-2 sessions per week at most.  Start with moderate intensity/speed and increase as you feel that your body can accelerate in a controlled manner.  Perform on a solid surface using two feet and progress towards the unstable surface (BOSU ball) and to one foot.  Perform each exercise for 1 minute and repeat 2 times each.  Make sure that you do not have any pain while performing these exercises.

Continue performing the exercises above for the remainder of the snow season including 3-5 of the most challenging exercises from the previous blogs listed above.  This will help keep you healthy and strong for the entire ski and snowboard season.

Check back with our blog for the next few months as we outline common injuries and exercise remedies.

Happy Skiing and Boarding!  Own the slopes!

Still not motivated or don’t have enough time to practice every day?  Come to Total Body Fitness every Tuesday and Saturday where we will feature specific exercises geared towards snow sports fitness.

Ski/Board Strong, All Day Long: Week 5

Welcome back to the fifth week of the Ski and Snowboard Series.  This is a progressive strength and conditioning program specific to snow sports injury prevention and performance enhancement.  By now you should have a good base strength to protect you from injuring yourself the first day out on the slopes.  Also by now, hopefully you have made it to the slopes!  The previous weeks direct you in beginning hip, core, and balance exercises.

Week 1:  Glut med and balance progressions

Week 2:  Front plank and squat progressions

Week 3:  Clams and side plank progressions

Week 4: Bridge and hip power progressions

The coming ski and snowboard posts will be emphasize development of your speed, agility, and power necessary for some seriously technical moves!

Lunge Progression – Week 5

The lunge exercise is one of the best total lower body exercises there is.   Eccentric muscle contractions in the gluts, hamstrings and quadriceps occur while performing the lunge, which creates strength for powerful movements.  The lunge will prepare your legs for more technical moves such as jumping and moguls.

Start: Stationary lunge.  Step one foot forward making sure that your front knee does not go beyond the toes.  Keep the trunk upright and abdominals engaged while lowering the back knee towards the ground.  Repeat 2 sets of 10-20 repetitions on each side.

Progress:  Perform the dynamic lunge by stepping back between each repetition.  To further advance it, add a rotational twist into the front leg.  Perform 2 sets of 10 – 20 repetitions or to fatigue.  

Squat and Rotation Progression – Week 5

Since much of our time on skis and snowboard are spent in a slight squat, this is a very sport specific exercise to improve your stability with shredding, moguls, or for creating power prior to aerial moves.

Start: Squat with rotational chop.  While holding a squat, use a weight or medicine ball to perform a low to high diagonal movement.  To progress in intensity move the weight faster without letting your hips/trunk sway.  Perform 2 sets of 30 seconds or to fatigue.  Repeat the other direction moving the weight low to high from your opposite side.

Progress: Single leg squat with rotational chop.  Perform 2 sets of 30 seconds or to fatigue.  Repeat the other direction moving the weight low to high from your opposite side.  Perform on each leg. 

Still not motivated or don’t have enough time to practice every day?  Come to Total Body Fitness every Tuesday and Saturday where we will feature specific exercises geared towards snow sports fitness.

Check back for next week’s installment of the ski and snowboard series!

Ski/Board Strong, All Day Long: Week 4

Hooray for SNOW!!!  Welcome back to the fourth week of the Ski and Snowboard Series.  This is a progressive strength and conditioning program specific to snow sports injury prevention and performance enhancement.  By now you should have a good base strength to protect you from injuring yourself the first day out on the slopes.  Also by now, hopefully you have made it to the slopes!  The previous weeks direct you in beginning hip, core, and balance exercises.

Week 1:  Glut med and balance progressions

Week 2: Front plank and squat progressions

Week 3:  Clams and side plank progressions

Now, we are going to work on power development:

Bridge Progression – Week 4

If there was a single exercise we’d perform on a deserted island, it’d be an exercise called bridging, or just, the bridge.  The bridge reverses so many deficits that can be detrimental to our level of conditioning.  The bridge will strengthen your core, gluteals, hamstrings, and stretch the hip flexors.  This exercise progression is great for prepping for the slopes and can be a lifelong injury prevention exercise.

Start: Double or single leg bridge.  Perform 2 sets of 10-20 repetitions or to fatigue.  Make sure your lumbar spine and pelvis is neutral and that you engage your lower abdominals.  During the single leg bridge keep your pelvis flat like a table top.

Progress:  Perform the progression above on a physio ball

Hip Power Progression – Week 4

Last week, we introduced the clamshell exercise to help stabilize the hip joint and ligaments during movements requiring change of direction.  The large outer layer of the hip musculature (the gluteus maximus) along with the hamstrings are responsible for large bursts of power.  The squat below will help develop this movement, and work on upper body muscle imbalances at the same time.  To work on hip extensors, power, AND balance, perform the RDL progression.

Start: Overhead squat.  Make sure to keep your elbows locked and arms right overhead.  Squat down as far as you can before your arms start migrating forward or your heels start leaving the ground.  Perform 2 sets of 10-20 or to fatigue.

Progress: Single leg Romanian dead lift (RDL).  Perform 3 sets of 10-20 reps or to fatigue on each side.

Still not motivated or don’t have enough time to practice every day?  Come to Total Body Fitness every Tuesday and Saturday where we will feature specific exercises geared towards snow sports fitness.

Check back for next week’s installment of the ski and snowboard series!