Your ability to sit on the floor and get back up is more important than you may think!

Getting to the ground and back up is a fairly complicated motor skill which can vary in difficulty based on one’s surroundings and physical limitations. There are many ways to accomplish this task involving movements such as squatting, lunging, kneeling, or bending over, and it requires lower body mobility, strength, and stability as well as a certain amount of comfort being on the floor. Not only is one’s ability to get to the floor and back up an important predictor of mortality, but it is also crucial for many activities of daily life as well as for recovery in the event of a fall (de Brito et al., 2012; Wang et al., 2016). Fall risk is a great concern, especially in older adults due to the injuries, disability, and reduction in quality of life that a fall can cause. Many studies have reported that reduced muscle strength in the lower extremities raises the risk of failing (Wang, D. et al., 2016).

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A study by de Brito et al. (2012) scored 2,002 adults ages 51 to 80 years old on their ability to sit down on the floor and get back up. They were scored out of 10 possible points and deductions were made for the use of another body part or the floor for support while getting down or back up. The researchers followed up with the individuals over the next six years, and 159 of the participants died. Every point increase in a person’s test score correlated with a 21% reduction in his or her risk of death in the next six years. While this is a correlation study and evidence of correlation isn’t evidence of causation, the association between movement ability and mortality is hard to ignore.

Try it out now. Start by standing up. Sit down on the floor using your hands or other objects as little as possible. Every time you use something for assistance, subtract one point from five. Stand up from the floor using as little help from hands and objects as possible. Subtract one point from five each time you use hands or objects for assistance. Add your results from getting down (a number out of 5) and getting up (a number out of 5) for your score out of 10. Each point less than 10 increases the probability of death in the next six years by 21%. Are you ok with your score? Keep reading to learn how to improve!

If getting down to the floor and/or up is nearly impossible for you: 

Here are three simple exercise progressions you can work through over the next 6-8 weeks.

  1. Sit to stand
  2. Lowering and raising in a split stance (similar to a lunge)
  3. Step ups

Sit to stand

Select a box or chair that is a comfortable height. Sit down to it and stand back up without using your hands or assistance. Progress to tapping your butt on the box instead of entirely transferring your weight onto it, and gradually lower the box to increase the distance you raise and lower yourself. This increases comfort with getting down to and up from progressively lower seats and strengthens the leg muscles necessary to do so. If you progress to the point where you can lower and raise yourself to a point at more than 90-degrees of knee flexion, progress this exercise to include lying down. In this variation, sit/squat down to the low position, transfer all your weight to the box, and lie all the way down. To reverse the movement, sit up from lying supine and squat up from that position.

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Lowering and raising in a split stance

Slightly lower and raise your body (bending the front and back knees) in a split stance position using TRX straps for support. With practice, increase the distance you lower and raises your body, and then decrease the amount of assistance used to stabilize from two TRX straps to one strap to no assistance. This exercise increases comfort and stability in the split stance position one uses to get up from the ground, and it strengthens the leg muscles which are important for the movement.

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Step ups

Step up to a small platform using one leg. Similar to the other exercises, this will increase leg strength, stability in a single leg stance, and comfort in a movement pattern one can use to get up from the ground. Progress by increasing the repetitions of step ups performed on each leg and the height of the platform you are stepping up to.

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The next step:

Once you can get down to the ground and back up with relative ease, I’d suggest including a Fall Matrix in your workout warm-up once a week.

  1. Start standing. Place one hand on your same-side knee. Lay down, with your back against the floor and stand back up without removing the hand from your knee. Then lay down with your stomach on the floor without removing the hand from your knee, and stand back up. Optional: Lay down with your right side on the floor, and stand back up. Then repeat on the left side.
  2. Repeat these 4 variations touching the other side’s hand to its same-side knee.
  3. Repeat these 4 variations touching one hand to the opposite side knee.
  4. Repeat these 4 variations touching the other side’s hand to its opposite side knee.

Progress these exercises by touching your hand to a body part lower than the knee, for example, place your hand below the knee, on your shin, on your ankle, on your toes.

Like many things with our bodies, if you don’t use it, you lose it. Get on the ground and back up regularly so you don’t lose your ability to!

References
de Brito, L. B., Ricardo, D. R., de Araujo, D. S., Ramos, P. S., Myers, J., & de Araujo, C. G. (2012). Ability to sit and rise from the ground as a predictor of all-cause mortality. European Journal of Preventive Cardiology. doi: 10.1177/2047487312471759
Wang, D., Zhang, J., Sun, Y., Zhu, W., Tian, S., & Liu, Y. (2016). Evaluating the fall risk among elderly population by choice step reaction test. Clinical Interventions in Aging, 11, 1075-1082. doi: 10.2147/CIA.S106606
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Osteoporosis, Age, Parkinson’s decrease dynamic balance and increase fall risk

Motor abilities influence an individual’s success in the performance of certain motor skills (Magill & Anderson, 2013). A motor ability of interest is dynamic balance, or the ability to maintain stability while one is in motion, as there is a strong correlation between poor balance and falls (although it is not the only factor), which are a large health concern among many populations (Ünlüsoy et. al 2011). I have had many clients with various conditions, including age, Parkinson’s disease, and osteoporosis, who were unsteady during locomotion due to poor dynamic balance.

All three of these conditions, age, Parkinson’s disease, and osteoporosis, have a negative influence on the dynamic balance category of motor abilities (Paolucci et. al 2014; Ünlüsoy et. al 2011). Age-dependent change in the musculoskeletal, sensory, and neural systems decrease balance ability in older adults (Maki & Mcllroy, 1996). Parkinson’s disease occurs in the brain’s basal ganglia when there is a lack of dopamine production in the substantia nigra, and it causes bradykinesia, akinesia, tremor, and muscular rigidity (Magill & Anderson, 2013).  Paolucci et al. (2014) state that a “balance disorder is one of the most important impairments” in this population due to statistics showing substantially greater incidence of falls among those with PD (70% of individuals with PD fall once a year and 50% of them fall twice a year in comparison to only 30% of healthy adults over the age of 65 who fall once in a year). Osteoporosis is a bone disease where bones become increasingly fragile from microstructure impairments in the bone tissue and decreases in bone mass. Ünlüsoy et. al (2011) demonstrated that dynamic balance in osteoporotic women was significantly worse than in healthy individuals.

There are many factors influencing one’s ability for dynamic balance during locomotion including muscle strength, interpretation of vestibular and proprioceptive information, and visual feedback (Paolucci et. al 2014). In terms of defining dynamic balance or any type of balance as a motor ability, Magill and Anderson (2013) state balance is a “multidimensional ability that is specific to the task or skill in which balance is involved,” and the specificity of motor abilities hypothesis postulates that individual motor abilities are relatively independent of one another. Given these assumptions, it is challenging to articulate the specific balance ability or abilities influencing locomotion.

If a client or patient came to me requesting help with dynamic balance while walking, I would perform various tests to rule out (or in) factors that may contribute to difficulty walking. I would assess muscular strength and endurance, especially in the lower extremity, observe the patient’s normal walking gait for noticeable abnormalities, and inquire into the patient’s medical history to rule out diseases or conditions, including those previously discussed, that may impact dynamic balance. I would also question the patient about lifestyle factors (i.e., recent accident or trauma, change in medication, etc.) that may be contributing to the deficit. If the patient has good muscle strength in the lower extremity, adequate gait mechanics, and no red flags in his or her medical history, this would indicate a problem with the motor ability of dynamic balance.

Additional ideas of assessments for dynamic balance related to gait were reviewed in a study by Bloem et. al (2016). This study recommended clinical tests including the UPDRS-derived Postural Instability and Gait Difficulty score, Berg Balance Scale, Mini-BESTest, Dynamic Gait Index, Freezing of Gait Questionnaire, Activities-specific Balance Confidence Scale, Falls Efficacy Scale, Survey of Activities, Fear of Falling in the Elderly-Modified, 6-minute and 10-m walk tests, Timed Up-and-Go, and Functional Reach (Bloem et. al, 2016). Further research on my part is needed into these methods, but any would be reliable assessments of dynamic balance.

Motor abilities limit a person’s success in performing a motor skill. In the case discussed, dynamic balance is a motor ability that, if affected, can decrease one’s success at walking without falling. I believe it is important to note that while motor abilities may limit achievement in another skill, motor abilities themselves can be practiced, coached, and improved which would also benefit the motor skill performance. The most important part of treating a motor ability deficit is identifying and distinguishing it from other possible causes of poor motor skill performance.

References

Bloem, B. R., Marinus, J., Almeida, Q., Dibble, L., Nieuwboer, A., Post., B.,…Schrag, A. (2016). Measurement instruments to assess posture, gait, and balance in Parkinson’s disease: Critique and recommendations (abstract only). Movement Disorders. doi:10.1002/mds.26572

Magill, R. A. & Anderson, D. I. (2013). Motor learning and control: Concepts and applications (10th ed.). New York, NY: McGraw Hill.

Maki, B. E. & Mcllroy, W. E. (1996). Postural control in the older adult (abstract only). Clinical Geriatric Medicine, 12(4), 635-58.

Nakano, W., Fukaya, T., Kobayashi, S., & Ohashi, Y. (2016).  Age effects on the control of dynamic balance during step adjustments under temporal constraints. Human Movement Science, 47, 29-37. doi:10.1016/j.humov.2016.01.015

Paolucci, T., Morone, G., Fusco, A., Giuliani, M., Rosati, E., Zangrando, F., & … Iosa, M. (2014). Effects of perceptive rehabilitation on balance control in patients with Parkinson’s disease. Neurorehabilitation, 34(1), 113-120. doi:10.3233/NRE-131024

Ünlüsoy, D., Aydoğ, E., Tuncay, R., Eryksel, R., Ünlüsoy, İ., & Çakcı, A. (2011). Postural Balance in Women with Osteoporosis and Effective Factors. Turkish Journal Of Osteoporosis / Turk Osteoporoz Dergisi, 17(2), 37-43.

All About That Bass!

Everyone loves a nice, strong booty but getting one takes work!

Activation Drills

The first challenge many face on the road to booty gains is muscle activation. A great percentage of our days are spent, not generating power through our bums but sitting on them! For many, getting those gluteus muscles firing properly takes some persistence with activation drills. Try one or all of these at the beginning of your workout:

  1. Prone Scorpions (8 reps on each side)
    Lie facedown with legs together and arms out to a “T.” Squeeze one glute to initiate the movement, then swing it over toward the opposite hand. Touch toes to the ground and return to the starting position. Focus on keeping the opposite shoulder and hip on the ground.
  2. Birddog (6 reps on each side)
    Start on all 4’s, keeping the core tight by drawing the belly button toward the spine. Extend opposite arm and leg while keeping torso still and straight. This exercise has a bonus of also being a great core activation drill!
  3. Supine Bridge (10 reps)
    Position feet slightly wider than hip-width, push through the heels, and raise hips up. Squeeze your booty at the top position and hold for a second or two. Then lower to just above the ground before repeating.
  4. Bowler Squat (5 reps on each side)
    Balance on one leg, keeping that knee soft (slightly bent, not locked out). Push your booty back and use the opposite leg for a counterbalance as you reach down and across the body with your opposite arm. Keep your back straight! This exercise has an added benefit of reinforcing proper hip-hinge technique.
  5. Wall Marching: Glute Isometric Hold  (2 reps on each side, holding each rep for 5 seconds)

Booty-Building Exercises

The next step is building strength and size in the glute muscles. Here are a few of my favorite exercises.

  • Barbell Hip Thrust (3 sets of 8 reps)
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    For everything you need to know about hip thrusts, Bret Contreras is your guy! Check out this article.
    As a side note, this may not seem like the kind of movement you want to do in gym…in public, but trust me! The benefits far outweigh the potential awkwardness, and when in doubt, just avoid eye contact!
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  • Banded Squats + Side Steps (2 sets of the following sequence)
    Step 1: Place mini band above or below the knees (I prefer below)
    Step 2: Take 10 steps sideways to your left, maintaining tension in the band at all times.
    Step 3: With legs a little wider than hip-width, perform 10 squats.
    Step 4: Take 10 steps sideways to your right, maintaining tension in the band at all times.
    Step 4: With legs a little wider than hip-width, perform 10 squats.
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  • Bulgarian Split Stance Squat (3 sets of 8 on each leg)
    Start with this exercise unloaded- Good luck!
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  • Kettlebell Deadlifts (3 X 10 Reps)
    Sit back, keep your heels down, and back straight. Push through your heels while coming up and squeeze your booty at the top.
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Also, check out Bret Contreras’s (Known as the Glute Guy) 30 Day Ultimate Better But Challenge!

Give these a shot! Take a video/picture of yourself! #k8irelandactive

Strength Training for Fat Loss

So, you want to lose weight?

To start out, let’s make an important clarification:

  • Weight Loss: Doesn’t specify where weight is coming from. Weight can be lost from all sources including muscle, fat, water, limb amputation, organ removal, etc.
  • Fat Loss: Specifically, losing body fat, preferably while maintaining muscle mass and all limbs.

You want to lose fat, but how?

Option A: Spend countless hours of your week on a cardio machine

A 2011 study found that, on average, it takes 86 hours of  (steady state) aerobic exercise to lose 1 kilogram (about 2.2 pounds). If your goal is to lose 8 pounds (about 3.5 kilograms) that is 301 hours of cardio, or 3 hours and 20 minutes of cardio every day for the next 90 days. No thanks!

Option B: Embark on a strength training program. This is my choice. I’ll tell you why!

Reason 1: You’ll burn more calories doing nothing

Basal metabolic rate (BMR) is the number of Calories the body burns at rest on a daily basis, and it is directly dependent on the amount of lean body mass (i.e. muscle mass) one has.

Lean body mass: mass of the body not including fat.

The more muscle one has, the higher his or her lean body mass, the higher his or her BMR. Research estimates that each pound of muscle burns an extra 30-35 daily Calories. If a person gains 5 pounds of muscle, he or she will be burning an additional 150 Calories every day and losing an additional pound of fat every 3 weeks or so.

Reason 2: Excess Post-Exercise Oxygen Consumption (EPOC)

After periods of intense exercise, one’s metabolism can remain elevated for several hours after training. Oxygen is the currency of the body during exercise. During periods of intense, anaerobic exercise, the body depletes its oxygen reserve and goes into oxygen debt. After finishing the training session, the body must continue working to pay back this debt and does so by taking  in more oxygen over a period of time. The more oxygen debt, the longer the body takes to repay it.

Lifting weight can have a much greater effect on EPOC than other types of exercise. With enough intensity, this EPOC can last more than 38 hours after a workout.

For those of you who doubt the intensity of weight lifting, I suggest wearing a heart rate monitor during your heavy deadlift or squat sets. My heart rate gets as high as 170 beats per minute on those.

Reason 3: Strength Training Decreases Hunger Hormone

Ghrelin is called the “hunger hormone” because as its level rises, one feels hungrier and as its levels decrease in the body, one feels full and satiated. A recent study found ghrelin levels fell 13 to 21 percent after an intense strength training workout.

Reason 4: Muscle is required to look “toned”

Many desiring fat loss envision having a “toned” physique. A healthy diet and a lot of cardio can get you fat loss but not the “toned” look you desire. Muscle is required for this, and it doesn’t just show up- it takes months of work!

Not only is strength training important for building muscle, but it’s also crucial for maintaining muscle. Many fat loss strategies (cardio, eating less, exercising more) put the body into a catabolic state where it is breaking down tissue for energy. Unfortunately, these tissues include muscle tissue that the body doesn’t think it needs (because it isn’t being used on a regular basis). Strength training promotes anabolic processes in the body where muscle is built (or repaired), which helps in maintaining the muscle one already has.

Too often (especially with drastic weight loss strategies) a person will lose a lot of muscle in addition to fat from his or her fat loss efforts. The result is a skinny-fat appearance and lowered resting metabolism (remember Reason 1? Your BMR is dependent on lean body mass) making it more difficult to A) continue losing weight (because of slowed metabolism) and B) keep the weight off (because the body’s Caloric maintenance level is so low).

How to lift weights to lose weight:

  1. Prioritize exercises that use many muscle groups or large muscle groups
    For example: 
    Row Variations (Working the upper back, shoulders, and biceps)

    Chest Press Variations (Working the chest, shoulders, and triceps)

    Squat Variations (Working glutes, hamstrings, quads, core)

    Deadlift Variations (Working the legs, glutes, core, back)

  2. Lift Heavy Weight
    If you are a new to weight lifting, I suggest sticking in with “easy to medium” realm as far as weights go, for the first 2-3 weeks as you learn technique and your body adapts.
    Anyone else should lift weights that are in the “medium to hard” difficulty (as long as you can maintain good lifting technique). For example, if you are performing 3 sets of 10 reps of an exercise, your last 1 or 2 reps of sets 2 and 3 should be challenging. If you get to rep 10 and feel like you could have done 5 more reps, increase the weight on the next set.
  3. Vary your repetition ranges
    If you are new to weight lifting, stay in the 8-12 rep range to learn proper form.
    More experienced lifters can play with other rep ranges. I find myself starting workouts performing 4-rep sets of an exercise and finishing a workout with a couple sets of 12-20 reps.

 

 

 

 

Further Reading

Training Guidelines for Beginners by Sohee Lee

Eat, Lift, and Condition to Lose Fat and Maintain Muscle by Bret Contreras


 

  1.  Friedenreich CM, et al. Adiposity changes after a 1-year aerobic exercise intervention among postmenopausal women: a randomized controlled trial. Int J Obes (Lond). 2011;35:427-435

 

Wednesday Workouts Body & Mind

Body Workout

My current workout schedule is a 4 day resistance training split with one day of interval cardio per week. My split is:
-Upper Body
-Lower Body
-Full Body A
-Full Body B
and my focuses are increasing strength on bench press and deadlift and increasing repetitions on pull-ups. I’m using a programing technique called daily undulating periodization for increasing strength on the deadlift and bench press, so I include both lifts in two workouts each week and for each lift, I have one heavy day and one lighter day each week as well. My hope is that increasing my frequency of performing these lifts will result in some awesome strength gains!

Here is the workout I did yesterday, my upper body workout. I did these exercises after my 15-20 minute warm up routine that involves foam rolling and 8-10 dynamic stretches or mobility drills. This workout took about 70 minutes including the warmup.

A. BB Bench Press (Heavy) 5-6 X 1-3 Reps
B. Pullups 3 X Max Reps
C. Plank (arms on airex mat, Legs in TRX) 3 X60”
D. Inverted Row (TRX) 3 X 8-10 reps
E1. DB Bicep Curls 3 X 8-12 reps
E2. Bench Dips 3 X 10-15 Reps
E3. Prone T’s 3 X 10-15 Reps

To explain some of my shorthand: BB=Barbell, DB=dumbbell, exercises with the same letter (E) are performed in sequence like a circuit, and the first numbers to the left of the “X” are the number of sets.

Strangely, in the aftermath of my workout, I’ve been most sore in my chest (probably from the heavy bench press) and my mid/lower traps (from the prone T’s, the lightest exercise on there, but truly a weak point for me).

Mind Workout

Becoming the best fitness coach I  can be involves continuously learning. I’m currently reading Training for Strength by Chris Beardsley. It’s a review of the scientific research studies that exist on strength training.

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My other favorite brain-stimulation lately is the Physique Science Radio podcast hosted by Layne Norton and Sohee Lee. It’s free. I stream it in my car through soundcloud and nerd-out on their fitness Q&As and interviews with notable exercise physiologists, nutritionists, and fitness psychologists.

I’d encourage you to check out either, but especially the podcasts, and always be learning (through reputable sources)!