Clinical application

During clinical treatment, emphasis should be on relieving fascial tension in the diaphragm and its surrounding structures. Over time treatment should result in healthy tissue changes within diaphragm, and unlocking of the upper lumbar segments.

When treating I use a 4 step approach:

1. Treat the diaphragm as both a left and right diaphragm. Treat the diaphragm in an unloaded position first (less influence of gravity and posture).
2. Always be sure to address lumbar segments L1- L3 during treatment. One or more of these segments may not be moving well.
3. Be sure the diaphragm is in a correct postural position during treatment. Applying techniques with a patient in a dysfunctional position will decrease the effectiveness of your treatment.
4. Be sure to coach correct breathing mechanics. This will allow for adequate contraction of the diaphragm, allowing for a more even distribution of tension throughout the muscle.

Rehabilitation

To reinforce an adequate amount of stability by the diaphragm on the lumbar spine the therapist should coach a full contraction and relaxation of the muscle. This allows maximal dynamic restraint of the crus tendon, and adequate mobility of the upper lumbar segments. For this to occur correct breathing mechanics should be coached, as it will minimize influence of secondary respiratory muscular.

To enhance function of the diaphragm:

1. Keep the neck in a neutral position
2. Breathe in the through the nose and out through the mouth
3. Keep the ribs down (towards the spine), this will allow for a more forceful breath through the diaphragm
4. Keep the lumbar spine in a neutral position

Remember if the diaphragm is engaged correctly it will exert a significant force on the lumbar spine. Without the ability of the patient to maintain a neutral spine during breathing they are unable to progress to more advanced stages of exercise.

References

•Bogduk N, Percy M, Hadfield G. Anatomy and Biomechanics of Psoas Major. Clinical Biomechanics. 1992; 7:109-119

•Dianbo C, Wei L,  Bolduc JP, Deslauriers J. Correlative Anatomy of the Diaphragm. Thorac Surg Clin. 2011; 21(2);281-87

•DiGiovanna E, Schiowtiz S, Dowling D. An Osteopathic Approach to Diagnosis and Treatment. Lippincott Williams & Wilkins. Philadelphia, PA. 2005

•Downey R. Anatomy of a Normal Diaphragm. Thorac Surg Clin. 2011;21(2):273-79

•Kapanji AI. The Physiology of Joints – The Spinal Column, Pelvic Girdle and Head. Churchill Livingstone. Toronto, ON. 2008

•Myers T. Anatomy Trains. Churchill Livingstone. Toronto, ON. 2009

•Schultz R, Feitis R. The Endless Web – Fascial Anatomy and Physical Reality. North Atlantic Books. Berkley, CA. 1996.

The Diaphragm – Functional Anatomy and Clinical Application as it relates to Lumbar Stability

 The lumbar spine is a complex structure, requiring stability in movement, while resisting forces in a variety of planes. Several mechanisms assist the lumbar spine in maintaining stability. Adequate mobility in both the hips and thoracic spine set up the lumbar spine to succeed in maintaining stable segments.

One very important structure that helps integrate lumbar stability is the diaphragm. While many practitioners focus on the ability of the diaphragm to maintain an adequate breath, they forget it plays an integral part in providing stability and mobility to the lumbar vertebrae.

Anatomy

The diaphragm is attached to lumbar spine via the crura tendon. Although thin, this central tendon is a very powerful force producing structure.  The right crus tendon attaches to the anterior surface and intervertebral fibrocartilage of spinal levels L1-L3. The left crus tendon has attachments at spinal levels L1-L2. Since there are two separate tendinous insertions the left and right sides of the diaphragm can act independently of each other.

Through the work of Myers, Stecco and others we have discovered the diaphragm has many connections that influence function of the lumbar spine. The crura tendons connect fascially to the anterior longitudinal ligament. This area, according to Myers, is the meeting point of the upper and lower portions of the deep front line where, “walking meets breathing”. Here the diaphragm also shares connections with the quadratus lumborum, psoas major, and kidneys. With such a complex series of attachments the diaphragm not only affects the musculoskeletal system, but can also influence the adrenal glands and digestion. On the right side of body the falciform ligament forms a connection between the diaphragm and the liver. This dense structure is often mistaken as an abnormal adhesion during treatment.

Lastly, the diaphragm is innervated by nerve roots c3-c5 in the cervical spine. It is imperative that the clinician rules out the cervical spine, as well as phrenic neuropathy prior to integrating lumbar stability and breathing pattern re-education. The presence of such lesions may lead to mixed results while trying to achieve optimal lumbar stability.

Mechanics

Although clinical emphasis often centers on lumbar spine stability it still requires movement. Through adequate balance of static and dynamic restraints the lumbar spine is able to flex, extend and rotate in a precise and intricate manor. The primary balancing act occurs between upward tension exerted by the diaphragm, and downward force exerted by the psoas major. An optimal balance of this mechanism contributes to efficient co-contraction of the small segmental stabilizers and large abdominal musculature. This helps provide a strong stable abdominal cavity. Failure to achieve this results in inadequate motion of individual lumbar vertebrae, and compensatory movement patterns.

Dysfunction in the diaphragm and lumbar spine may present for a number of reasons. The inability to breathe properly, will certainly affect function. Breathing is taken for granted, as it is automatically driven by our nervous system. A clinician should be mindful that the nervous system, like any system, can get lazy, injured and adapt. If a patient needs more oxygen, the body has to supply the demand.  A change in respiratory rate or increase in the use of secondary respiratory muscles will alter the length of the thoracic cavity. This will increase oxygen delivery to tissue, but not without sacrificing thoracic cavity mobility. Without correct rib expansion and movement of the thoracic spine the diaphragm eventually loses strength, and the body begins to adapt.

Stability – Mobility – Dysfunction

The joint by joint theory used in the functional movement screen [FMS] and selective functional movement assessment [SFMA] states that certain joints require mobility while others are designed to be stable. Stability does not mean that segments remain fixed and stable, unless such a demand is placed on the body.  More often the body is required to have controlled stability as a joint rolls, tilts, or glides.

In cases of low back pain patients can easily alter stability and mobility of the diaphragm. With optimal function tendinous and fascial structures at attachment sites remain healthy. This allows for interlayer sliding and normal joint motion. Adequate joint mechanics drive proprioceptive input to the brain and creates optimal function. With prolonged postures tissue and joint health changes. Tissue under sustained low grade mechanical load becomes of poor quality and can develop fibrosis. Fibrotic tissue does not move well and creates increased tension in muscles and fascia.

The following actions can occur while attempting to achieve balance between all sides of the spine. When the amplitude of a diaphragmatic contraction decreases, the aponeurosis of the crura tendon can increase in tension. This not only drives dysfunction in the diaphragm, but restricts motion of the L1-L3 segments. In response to upper segmental fixation the lower lumbar spine, segments L4-L5, can become hypermobile.

In an attempt to normalize itself, the body will recruit a number of restraints that if not balanced, create faulty stability. As the psoas major opposes the diaphragm it creates both a compressive force and anterior shear on the lumbar segments. To equalize, the spine activates posterior spinal restraints. The multifidi help to counteract the psoas major and control anterior shear forces.

If this mechanism becomes dysfunctional the nervous system attempts to increase lower lumbar stability through recruiting static restraints, the ilio-lumbar ligaments. When short the ilio-lumbar ligaments prevent anterior glide of L4-L5 and restrict motion of sacroiliac joints. The end result can be a lumbar spine that is partially or fully fixated and dynamically very unstable.

A patient may present to you in any stage of this balancing act. In most cases the patient is no longer able to safely flex or extend the lumbar spine. As the spine needs to bend, compensatory patterns occur at the thoraco-lumbar junction. In time permanent positional change of the diaphragm can occur relative to the lumbar vertebrae. Soon after symptoms arise, these can vary from general soreness and fatigue to discopathies or derangements at L4-L5-S1. Sprains to the ilio-lumbar ligaments are also common, and may indicate more advanced staged dysfunction as there is distinct loss of dynamic lumbar stabilization in these cases.

Next week I will follow up with a simple blog (with videos) on clinical application and rehabilitation, in treating patients with similar clinical presentations. As always questions and comments are appreciated. Pass it around if you enjoy it!

May was a rare month for me. I had two long weekends, I do not recall the last time that happened. I was able to get away for a golf weekend with friends. It was nice to relax and catch up, as work has been very busy lately. You can tell summer is officially on it’s way, as Ancaster is booming with runners, walkers and cyclists. This town has a great atmosphere in the summer. One of the big reasons I moved here was for how active the community is. It is nice to see people get out and stay healthy. Remember some activity is better then no activity. Start small and build as you go, I promise you will enjoy the change!

Summer also brings about some great sporting events. Being a huge soccer fan, I am looking forward to the start of the European Championships.  I am an English supporter all the way! This may in fact lose me some newsletter readers but it is a chance I have to take. I do think they are in tough against a number of top flying countries including Spain, Germany and the Netherlands to name a few.

Lastly, if anyone is looking to train this summer I am searching for people to run with. I will also be developing some interesting work outs involving hills and weight vests as I prepare for tough mudder in August. If this torture sounds like something you would enjoy, shoot me an email and we can arrange something.

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TIP OF THE MONTH – Check out our commercial. Big Thanks to Box of Toys Productions!

As our excitement grows for Reid Coolsaet’s talk at our clinic here is a great video of him killing a work out.

79 DAYS left: featuring Reid Coolsaet from Michael Del Monte on Vimeo.

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REMINDERS – SUGGESTIONS

Spectator Article – Here is an article I wrote on gardening and injuries.

Running Room Magazine – I have been given a great opportunity, and have a article being published in the July/August issue. Check out the magazine HERE

Guelph Lake Triathlon – This is a weekend event with numerous distances. Register Here

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RECIPE OF THE MONTH – Chickpea Salad

Ingredients

2 Cans of Chickpeas

Handful of Fresh Basil

Handful of Grape Heirloom Tomatoes

4 swirls Olive Oil

2 tsps of lemon Juice

2-3 swirls Balsamic Vinegar

Salt and Pepper

Bocconcini Cheese

Avocado (optional)

Preparation: Drain and rinse chickpeas. Chop everything else up in a bowl. Dress and serve! The longer is sits the better it tastes. Chickpeas are packed with protein power, 13 grams per can! A great post workout snack for meat eaters, vegans (no cheese) or vegetarians. I cannot take credit for this. Thanks to my colleague Alexis for passing this on!

Attention citizens of Ancaster, Hamilton and Burlington. COOLSAET warning! That’s right folks, the Foot Knee Back Clinic is very excited to announce that Reid Coolsaet will be at the clinic June 7th. Reid will be discussing his training and road to the 2012 Olympic games. This is a once in a life opportunity to meet and listen to a world class athlete. The talk will be limited to 30 people and tickets are already going fast. As of right now we believe the talk will start at 6pm. To reserve your spot you can either e-mail or contact the clinic at 905.304.6556. Tickets are 20 $ and all of the money goes back to Reid to support his dream. If you are unable to attend but would like to donate to Reid, you can certainly drop off a donation at the clinic.

In other news the clinic just shot our first commercial. Sunday morning after makeup, costumes and dress rehearsal, clinicians spent a grueling day of acting. We hope to have the commercial out in the coming weeks, with some additional videos to highlight all the great aspects of our clinic. Special thanks to Boy of Toys Productions who shot the clip. The whole shoot was so well organized, timely and turn around time on the editing was so fast.

For those of you following my spectator articles I have a gardening article coming out. That’s right gardening is a sport also, and injuries creep up during gardening season. Be sure to look for it just before the second or third weekend in May. I will release the exact date on our facebook pages that you can like below.

Lastly, myself and other members of the team have been doing many on site educational talks. From the Hamilton Spectator to Ancaster Crossfit we have been there. The response has been incredible. Talks are individual to each group, are interactive in nature and more importantly free. If you are interested in injury prevention for you staff, students or friends please contact the clinic and inquire about hosting a talk.

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TIP OF THE MONTH – Have a great Career!!

I consider myself very lucky. I have found something I love to do. Larry Smith an economist at the University of Waterloo gives, in my opinion, one of the best lectures ever. Have a listen. What do you think?? Comment below!

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REMINDERS – SUGGESTIONS

Spectator Article – This article was well received in the office community. Check it out

OldMill Race – Coming soon. Both a 5km and 10km. Register HERE 

Moon in June – A nice, fast, flat run in Burlington both 5km and 10km. Register HERE

Element Racing Series – There are number of summer races both local and abroad. Simply put great company with well run races. Register HERE

Facebook Page – Come on. We are good people like our page!! Spread the love! Like us HERE and HERE

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RECIPE OF THE MONTH – VEGETABLE SOUP

Ingredients

4 cups vegetable stock

2 cups of water

3 stalks of celery

2 carrots

1 onion

3-4 cloves of garlic

Large handful of spinach

1 large can of tomatoes

1 can of mixed beans

1 bay leaf

1 tbsp of chili powder

3/4-1 cup of brown rice

1 large handful of green beans

Preparation: The hardest meal for me is lunch. I am sure I am not alone. Everyone has a busy schedule in the morning and evening. It is always hard to prepare ahead of time. This is soup is so simple, and tastes amazing. The beans and brown rice definitely make this more filling than traditional vegetable soups. Saute your onions and garlic until the onions are clear. Add chopped celery, carrots and spinach and cook for 2 minutes. Add tomatoes, beans, bay leaf, chili powder, stock and water. Simmer for 20-30 minutes then add rice. Simmer another 20-30 minutes, add the green beans with 5 minutes left to cook. This recipe easily makes a weeks worth for two people. Enjoy!!!

Newsletter time! Starting off, I have had to pull out of the mississauga half marathon. Everything was going according to plan, and I was feeling great. Then one Sunday night at soccer I pulled my groin quite badly. I have been following my own orders, which at times is difficult. I have not run in 3 weeks while I receive treatment and rehab it. I am hoping to get back to running this weekend. I did however sign up for Tough Mudder, so as soon as I am back training will begin.

Congratulations to all the succesful runners that finished Around the Bay. It really was a great year for it. There were a lot of personal bests. Also this year, there were NO serious injuries suffered following the race. This is awesome which means the majority of patients had very successful training programs. Next up for local races is the Paris to Ancaster bike race and the Oldmill run. If you are interested in registering the links are below.

In other news at the clinic we have hired a new part time receptionist named Tracy. Tracy brings a wealth of experience to the table, and we are glad to have her join the Foot Knee Back team. We also have our new social media posters up in the clinic. We would really appreciate it if you would “like” us on facebook. Take some time while your in the waiting room, to log onto the laptop and “like” away. Feel free to tell all your friends as well. Lastly, at the end of this month we are shooting our first ever commercial. Look for it in the coming months on our facebook newsfeed and in the waiting room, it is going to be GOOD!____________________________________________________________________________________________________

TIP OF MONTH - Running Drills

Canadian marathoners Reid Coolsaet and Eric Gillis provide a portion of their running workout. These are great exercises and can be used in all types of sports.

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REMINDERS – SUGGESTIONS

Paris to Ancaster – Great local bike race, tough also. Register HERE

Oldmill Run - Tough run in Ancaster, 5 and 10km. Register HERE

Facebook Page – Like our facebook page and receive clinic updates. LIKE US HERE

Mississauga Marathon – I won’t be there anymore, but you can be! May 6th Register HERE

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RECIPE OF THE MONTH- Veggie Flatbread Pizza

Ingredients

Green and Red Peppers

Salt and Pepper

Olive Oil

Tomato or basil pesto

Red Onion

Balsamic Vinegar

Spinach

Any other vegetables you want

Tortilla shells ( I use brown rice ones)

Preparation: Again this is a really easy one. The brown rice tortillas are key. They are wheat free and gluten free so they work great for people with celiacs disease or wheat intolerance. They also help fill you up. At times vegetable rich meals have a hard time making people feel full. Not if you use these. I am not a vegetarian, but try and and eat one veggie meal a week to mix it up.

In a frying pan saute your onions with salt and pepper and a tsp of olive oil. After about 10 minutes add some balsamic vinegar to the mix and cook for five minutes. In a separate pan fry all your other vegetables, throwing the spinach in near the end of cooking. Heat the tortillas at 350 degrees for 2-3 minutes. Take out of the oven and spread with pesto (you can buy ready made pesto or make your own, I’ll have a recipe in coming newsletters). Top with all your veggies and put back in the oven at 275 degrees for about 5 minutes. EAT!

This blog has been sitting on my Iphone for some time now. I have decided to post random thoughts on not only how to improve your business but yourself as a therapist, teacher or coach. Although easy I think we often take for granted what simple things can do.

I hope you enjoy:

1. Regularly treat, coach or counsel one patient for free: There is so much focus today on marketing. In a social media driven world we often forget why we are here. As we attempt to keep up with eachother, we often lose what we stand for. I recently told a student I regularly treat people for free. She looked at me as if I was an alien and replied, “when I leave here I will never do that”. I simply replied, “You don’t get it”. Health care is about CARE. If someone comes to you in pain they need to be fixed. We have a gift and that is fixing people. A person’s healing should not be dictated by social class.

2. First impressions are everything. The brain is our most active organ. It is our control center. It’s responsibility is to react and screen stimuli. If a stimulis is regular and simple a green light is given. If the brain recognizes something as different it stops. A red light is not always bad. A red light simply means you have my attention. With every new patient I greet them with, ” Pleasure to meet you” Why? Because 99.9% of people say “Nice to meet you”. By changing “Nice” to “Pleasure” you change the colour of the light. The brain will automatically perceive you as different from everyone else and your first impression is made. Equally as important is your last impression. Always thank a patient for coming in. If they question you, simply explain that without them you would not have a career that you are passionate about.

3. Trigger points exist far less than you think. In my years of teaching the term “trigger point” seems quite misunderstood. Trigger points are classified by meeting certain criteria, and are ”hyperirriatable band(s) WITHIN a taught band of muscle”. This does not mean every taught band is a trigger point. Trigger points illicit the following symptoms: A local twitch response, referral pattern, jump sign or autonomic phenomenon. If non of these are present a trigger point is not present. It should therefore NOT be treated as such. Furthermore once a trigger point is found how to treat it effectively will certainly serparate you from the rest. I wrote a 3 part series on this last year (part1, part2, part 3).

4. Research is necessary. In saying that recognize that research to has it flaws. Like all of us research studies are trying to prove a point, and do so through controlling variables. It is important to recognize potential flaws in studies, challenge them and speak to smart people. Mark Young is a smart person (Mark Young is not paying me to say this, nor does he know I am saying this about him). To learn from Mark click here. Ultimately recognize that injuries, ailments and diseases are multi-factorial. A global approach to treatment with a group of qualified providers will always yield the best results. Attempting to find the next magic pill will only find you swimming in the deep end.

5. Be diligent in your exercise persciption. Why? Because it makes a HUGE difference. What is your patient or client doing the other 23 hours of the day?? Provide exercises the reinforce your goal. When coaching be specific and hands on. Tony Gentilcore, a smart dude wrote a great blog on this. Read it and learnify!

6. Evolve, learn, teach and make mistakes. WHY? Otherwise you will not get better. Nobody is perfect. If you are please e-mail  me as I would like to know your secret. I look back and laugh at how I treated patients 5 years ago. I certainly did not do them an injustice, but I have learned from my mistakes and grown as a person. Also be original. There are many tools, systems, devices out there. Some are better then others, but no one is superior. Grab elements from all and build your craft. At the end of the day it is not a tool that fixes a person, it is our knowledge of tools that fix people.

7. Do not put down other therapists, coaches or people. It is very easy to judge people based on their “experience”. Always accept a fellow colleagues opinion. If you feel there are off track, educate. If someone asks you a questions answer it. If you are not familiar with their background ask them. There are no “ranks” in the industry, and you can learn valuable lessons from everyone.

8. Be sympathetic to your clients and patients. Simply put pain is debilatiating and complicated. Be open minded. This simple gesture may be the thing that saves them from a life long struggle.

9. Foam rolling, although a great tool, does not replace the knowledge of a great coach or therapist. If you have find someone with a serious injury that is outside of your scope of practice, refer out. It may be the best decision you ever make.

10. Always return a phone call, email or inquiry. You never know who that person could be. Everyone wants to take on “big” clients, and the world is a very small place. The old lady who’s call you didn’t return could be Sidney Crosby’s, Lionel Messi’s or Lebron James’ mom. Treat every inquiry as a potential to improve your career and someone else’s quality of life.

I hope you find something from this post. Continue to be great! Because good isn’t enough.

This month I received the news that I was nominated under the “best massage therapy” category for the Hamilton Readers Choice awards. To who or whomever nominated me I really appreciate it. Secondly, for all of those that voted thanks again! The results have not come in but I will be sure to keep you all posted.

Construction has begun on Wilson street. The project is supposed to last until the beginning of July. Wilson street between Fiddler’s Green and Halson has officially been closed. The entrance to our parking lot off Fiddlers Green is the easiest way to get into the clinic. Detours exist along Garner road (Hwy#53) and Sulfur Springs. Please take these to avoid headaches while trying to get to your appointments.

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TIP OF MONTH – If you want something, you have to work!

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REMINDERS – SUGGESTIONS

Around the Bay Spectator Series- For article one CLICK HERE. For article two CLICK HERE. Article three should be in this Friday’s or Saturday’s paper.

Mississauga Marathon – May 5-6th. Come and race me! Click here to register.

Toronto Marathon – Same weekend as Mississauga. Click here to register.

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RECIPE OF THE MONTH – Roasted Red Peppers

 Ingredients

4 Red Peppers

Salt and Pepper

Olive Oil

Preparation: This week’s recipe could not be simpler. Roasted red peppers are great to have in bulk. I will make 4 at a time, and store them in my fridge. I use them on salads, crackers or throw them in an omelet in the morning. Red peppers are a huge source of vitamin C, about 3 times that of an orange!!!

Cut and seed your peppers. Rub with olive oil and season with salt and pepper. Place in a 425 degree oven for one hour. Take out of the oven, put in a bowl and cover with plastic wrap for 5 minutes. The peppers will blister allowing you to remove the skin. Place in a storage container, be sure to pour any of the collected oil in the bowl back into the container, this allows them to marinate. These are awesome, enjoy!!!

I continue to write for the spectator and soon will be releasing a 4 part series for the Around the Bay road race. These articles will range from race tips, to injury prevention for common running injuries. I will post the projected dates for the articles below in the reminders-suggestions column.

It looks as though I will be running the Mississauga Half Marathon in May. I just got back from meeting with a friend and we have to decided to register. To be perfectly honest I am not a winter person. The thought of running in winter weather makes me cringe. Since the weather so far has been reasonable I have decided to take the plunge. I really hope this doesn’t back fire and I will be forced to run through 3 foot snow drifts. That being said I hear its a great race so I am looking forward to it.

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TIP OF THE MONTH – Feel Like You Are Falling Down, GET UP!

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REMINDERS – SUGGESTIONS

Spectator Article – Read my New Year resolution article HERE

Upcoming publication dates - My 4 part spectator series for Around the Bay is scheduled to be published on Feb 10 and 24, March 9 and 16 or 23. Those dates are tentative, but look that week and you will find them!

Plan B Organics - A great local vegetable co-op. Reasonably priced and allows you to enjoy a variety of fresh vegetables www.planborganicfarms.ca

Element Racing – As mentioned check them out www.elementracing.ca

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RECIPE OF THE MONTH – Salmon with salsa, spinach salad and grilled asparagus

 Ingredients

Salmon Fillet

Salsa (make your own if you are motivated!)

Bunch of Asparagus

Spinach

Cucumber

Salt and Pepper

Balsamic Vinegar

Preparation: This meal is simple. Remember that you do not always need a traditional carbohydrate in every meal. I am a big fan of meals with a salad, a cooked vegetable and a lean meat. Although it may look light, trust me its filling. You can prepare the spinach salad ahead of time, with whatever vegetables you enjoy. For the salmon pan fry it for 1.5 minutes on both sides, then finish it in a 350 over for 15 minutes.  In the meantime you can either steam of grill your asparagus until fork tender. Fork tender is key, if over cooked it does not taste great. I like to add my salsa to the fish when it is still warm. A really great meal, ENJOY!

Official first writing of 2012! Happy New Year Everybody. I hope everyone had a safe and happy holiday season. As the clinic was closed the week between Christmas and New Year, I was able to relax and recover. My arms had a break, which is rare but necessary. My new years resolution is to attempt to take more vacation this year. I have also committed to working on myself daily using a foam roller or other soft tissue tools.

Doing soft tissue work on yourself daily is a great way of maintaining your health. This especially great if you are not able to get into the clinic. Soft tisse work when paired with stretching becomes even more effective. If you are looking for a foam roller, remember we now have them available at the clinic.

To everyone training for the Chilly half marathon and the Around the Bay I hope it is going well. Be reminded that January is a prime month for running injuries. Runners are getting into heavy parts of their programs, neglecting stretching and running in the cold. Warm-ups and cool downs are key at this time of year.

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TIP OF MONTH

Stretch Correctly – Stretching is a very important thing that can increase flexibility and mobility, decrease pain and improve your over all health. The problem people run into is they do not know what muscles stretch or how to stretch in the most effective and safe manor. Stretching incorrectly can cause injury, and can aggravate symptoms and pain. Although you have the best intentions, you may be unaware that  you continue harm yourself.

If a muscle is weak, our brain can tell the body to shorten it as protective mechanism. We perceive this as tightness and stetching as the solution. If you continue to stretch weak structures they will continue to shorten, and your injury will continue to get worse. Think about this the next time you stretch. If you are unsure whether what you are doing is right, stop by the clinic or shoot me an e-mail!

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REMINDERS – SUGGESTIONS

Spec Articles – Read my holiday spectator article here

Tough Mudder – This is an early reminder but this race just looks awesome. You are only as strong as your weakest link, a great new years resolution. Click here for more info

Valentines Day Couples – In Burlington. Be healthy and in love! Register here

Chilly Half Marathon – March 4 2012 in Burlington. Nice out and back, pretty flat for the most part and great prep for Around the Bay. Register Here

Around the Bay – Going fast! Better Register relays have been sold out for some time. Register Here

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RECIPE OF THE MONTH -Mashed Cauliflower

Ingredients

1 head cauliflower

Thyme 1-2 sprigs

Garlic 1-2 cloves

Salt and Pepper

Hot Pepper Flakes (optional)

1-2 Tbsp Butter (can replace with chicken or vegetable stock)

Splash of balsamic vinegar (optional)

In the spirit of the new year and  healthy eating I give you mashed cauliflower! People cringe when they hear it, trust me its good! I add all of the ingredients above. You can also add cheese, but that makes it less healthy (sorry). This is a perfect replacement for families that eat potatoes every night of the week. For the chefs in the crowd you can roast the garlic before, which makes them even better!

Directions: Boil or steam a head of cauliflower. Strain the cauliflower. In a pot simmer garlic and thyme with butter or stock for a couple of minutes. Add cauliflower and rest of ingredients to the pot, mash cauliflower. You can add additional stock to change the consistency of the mash. Salt and pepper to taste and there you have it, ENJOY!

Well folks I did it! Road 2 Hope was a success. Finishing time 143:13, 1 minute and 47 seconds better than my goal. I had three major goals for the race. The first was to be under 1:45, second under 142:30 and third a sub 1:40 half marathon. Race day was perfect weather and I got off to a great start, feeling comfortable. I didn’t want to pay that much attention to my pace, but more how I felt. I think this approach might have ended up being a mistake.

I was running really well. At 14km,  the 1:40 pace bunny caught me. It was here I realized I had run a 1:39 pace for the first 14 km. That was really fast, so I decided I would just settle in behind the pacer, who would pace me to the finish line, simple right? At 16km I bit the dust hard, hitting the dreaded “wall”. Meanwhile all the pace bunny was doing was bragging about how great she felt. I couldn’t keep the pace anymore, and had to stop and walk. I collected my thoughts had a motivational conversation with myself, and dragged myself around the last 5 kms. It was an amazing experience and great mental battle. It was great to see all the familiar faces on race day, and I will definately do it again.

It is not long now until the holiday season. The clinic will be taking it’s regular shut down between Christmas and New Years. I will be in the clinic on Friday the 23rd until 2pm, returning to regular hours Monday Jan. 2nd. If I don’t see you, have a safe and wonderful holiday season. Take time to relax and enjoy yourself, see you all in the new year!

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TIP OF THE MONTH

Stay Active - For some reason people use this time of year as one big excuse. “Christmas is coming, I am going to put on a bunch of weight, but don’t worry I have a New Years resolution to take it all off again”. Why do you set yourself up to fail? This year I enourage you to think differently. Try and be active over this holiday season. If you partake in a current exercise routine don’t give it up. Try and stay on track, and if you can’t committ to the same frequency of exercise reduce it, do not eliminate it. Do the best you can to monitor what your eat. Remember the more water you drink the less you eat. I know you have probably heard all this a million times. Just try it and let me know how it works out!

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REMINDERS – SUGGESTIONS

Spec Articles – I have been writing an article a month for the spectator. To read my last two click here and here.

Tough Mudder – This is an early reminder but this race just looks awesome. You are only as strong as your weakest link, a great new years resolution. Click here for more info

Santa 5km Burlington – December 10th. To register click here

Boxing Day 10 miler – Very popular local race ! To register click here

Resolution Run – Start the New Year off right! To register click here

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RECIPE OF THE MONTH – Chocolate Pecan Macaroons

Ingredients

3 large egg whites-room temperature

Pinch of salt

1 cup of sugar – this can be reduced to half a cup

6 ounces unsweetened chocolate

1 cup flaked coconut

3/4 cup of pecans

Confectioner Sugar for dusting (optional)

Preparation: Beat egg whites and salt in a mixing bowl, until frothy. Gradually add sugar and continue beating until soft peaks form (about 5 minutes). Gently fold melted chocolate, coconut and pecans into the egg whites. Drop 2 teaspoons of batter per cookie about 1 inch apart onto baking sheets. Bake for 10 to 12 minutes at 350 degrees. Let the macaroons cool 30 minutes. Dust with confectioners’ sugar if desired.