Athletic Therapy, Biomechanics, Chronic Pain, Free Workouts, Posture, Wellness

Knee pain: It’s not complicated (usually)

After seeing an older woman in the clinic the other day a few weeks into her post-knee replacement rehabilitation- her daughter approached me stating she knew she was headed in the same direction as here mom (aka, was already having knee and hip pain in her life) and wanted to know if there was anything she could do to prevent the process.. or if it was just inherent that she too would eventually have to replace a joint or two.

If there is one thing I want to get across to people it’s that nothing to do with our health is guaranteed.

What I mean by that is.. just because you have a family history of something does not mean it can’t be prevented or course corrected. ESPECIALLY when it comes to our movement health!

When it comes to the knees.. generally the actual problem is coming from the hips and/or feet. I refer to the knee as a bridge joint. It is designed to improve efficiency of transit, absorb and transfer force. If the lines of force get messed with (aka you lack stability in the joints above and below), then the efficiency of that joint and it’s movement go right out the window. Stress builds up and that leads to warning signs (pain), inflammation, stiffening, and of course eventually degeneration of the structures within the joint. This can present via tendonopathies, osteoarthritis, runner’s knee/jumper’s knee (both tendonopathies), patellofemoral syndrome or patellar chondromalacia, and even increase your risk of ACL/MCL and meniscal injuries.

Barring external trauma (but yes postural dysfunction can even contribute to the risk of this), pain and issues in the knee generally are coming from above or below.

This is why I always recommend those passionate about running or other repetitive movement based activities get their gait screened by a professional. Catching dysfunction early and prescribing appropriate corrective movements is key in preventing problems down the chain.

Here are 4 “simple” exercises I prescribe routinely to clients experiencing knee/hip/back pain or rehabbing a joint replacement.

1. Clamshells.

You’ve probably seen these before. Designed to activate the lateral stabilizers in the hip, you should feel the burn on the top side of your hip as that is where the activation should come from. Laying on your side with knees bent to approx. 90deg, hips and ankles stacked- clamshell the knee open lifting from the hip. Do not let your hips fall backwards, they should remain stacked and level throughout the movement. Hold the clam at the top range of motion (wherever you can raise to without your hip sliding back!) for 10seconds, slowly return back to the start position.

Repeat 3 sets of 10-15 routinely in your day. The more you activate the muscles properly, the more the brain makes it automatic.

2. Gait Activation

Laying on your stomach, tuck your chin to lift your head (nose should remain pointed down to the ground!), and squeeze your butt cheeks together. Holding and maintaining this position, press opposite arm and leg to the ground while lifting the other opposite limbs off the floor. Hold for 4seconds, switch and repeat process.

This activates Deep postural muscles and connects the brain to a proper gait transfer pattern. It also cues butt activation and neck stabilizers.

Repeat 3-5round of 20 a day.

3. Single Leg Bridging

If you struggle with regular bridging, this is a advanced progression- so work towards it with holds before movements. Glute activation is key here!

Finding your bridge, lift one leg off the ground maintaining your glute activation. Lower the pelvis down half way and then push back up to full bridge on the one leg. Your hips should be the pivot point, not your low back! Core should remain strong, and glutes should be the main push to full hip extension. Drive up through the supporting heel to help engage the back half of the body/butt.

Repeat 6-10/leg for 3 – 5 rounds.

4. Side Bridges

Classic hip hinging activation exercise. All these movements also double as releases for the front of the hip (tight hip flexors anyone??).

On your side, supported by your elbow, shoulder, and core activation, pivoting from the knees- use glutes to actively push hips up and forward through a hinge motion. Hold at the top for 5-10seconds, then sit back and down through the hip hinge.

Common mistakes here: slouching into the shoulder (push UP through the ground/elbow and squeeze shoulder blades together), lack of core activation/bracing allowing for the spine to hinge instead of the hips (think of a squat motion at the hips!), lifting up THEN forwards.. try and make this simultaneous, as if your hips are moving up and down a ramp.

Repeat 6-12x for rounds of 3-5. Great used as a warm-up to other activities.

You would also do well to add in some foot exercises! @thefootcollective on instagram is one of my fav resources- but you can also refer to our existing post about old person feet here!

Struggling to figure these out? We offer complimentary movement assessments and consults to new clients. Prevention and rehab programs for all sorts of clients are available. Have questions? Leave a comment or find us directly at katmahtraining@gmail.com. We’re always happy to help you get your movement right!

Have fun kids!

Athletic Therapy, Biomechanics, Chronic Pain, Conditioning, Equestrian, Free Workouts, Motor Learning, strength training, Weight Loss, Wellness

At your age…

Here’s a fun tidbit I hear OFTEN second hand from clients after their friends/family/peers find out what their training and therapy plans consist of…

“At your age, should you really be lifting weights?”

“Isn’t weight training dangerous for your joints? Does that really help you feel better?”

“Aren’t you worried about getting injured again?”

“I heard that weight training is bad for you- doesn’t it cause arthritis”

First off.. I’m honestly not sure where people are finding that last bit of information from, at this point in our history. Secondly I’m also endlessly grateful that I’ve stopped frequently hearing that weight training will make women bulky- at last that myth has been put out of it’s misery. Third off- weight training is highly effective for arthritis rehabilitation and management- WHEN IT IS DONE CORRECTLY. The only time it’s going to cause arthritis is if you don’t do it in good form. This is why having the guidance of a trained professional is imperative when starting any new program. At the very least get a movement assessment and see where you need to work!

Would I tell someone of ANY age to just go and start lifting weights (no matter how much)? NOPE.

Do I prescribe and coach programs for ALL ages (yes, all the way up to 90-somethings- seriously) that involve various amounts of loaded movements, functional movements, dynamic movements, and stability training? You bet I do!

Here’s the neat things about the body.. it works on an adaptation based system. Which means- invariably- to IMPROVE our systems we have to STRESS our systems.

Here’s the feedback I get from my dedicated clients:

“I don’t wake up at 3am anymore with back pain”

“I sleep through the night and don’t wake up stiff in the mornings anymore”

“I don’t get tired during the day”

“My joints aren’t bugging me as much since I started training”

“I’m making healthier choices elsewhere in my life since starting this training routine.”

“I FEEL GOOD”

When we apply GOOD, healthy stress to our system- things change for the better. We also develop a higher tolerance for negative stressors, which means we function just overall more kick ass.

It no longer new information that the mind and the body are one coordinating unit.

Exercise, movement- of any kind- is the BEST and most EFFECTIVE medicine. The stats support it. Check these out.

According to the Conference Board of Canada, if we were to decrease the number of inactive Canadians by even 10%, we’d see a 30% reduction in all-cause mortality and major savings in health care. It is in fact estimated that more than $2.4 billion, or 3.7 per cent of all healthcare costs, were attributed to the direct cost of treating illness and disease due to physical inactivity1. The financial impact of poor health amounts to a loss of more than $4.3 billion to the Canadian economy, and the negative repercussions of inactivity cost the healthcare system $89 billion per year in Canada2. According to several studies, properly structured and supported exercise program, designed and delivered by a kinesiologist can, among other benefits:

  • Reduce the risk of high blood pressure and heart disease by 40%;
  • Reduce the incidence of type 2 diabetes by 50% and be twice as effective as standard insulin in treating the condition;
  • Help the function of muscles for people affected by Parkinson’s disease and Multiple Sclerosis;
  • Decrease depression as effectively as pharmacological or behavioural therapy;5
  • Reduce the risk of stroke by 27%;
  • Reduce the risk of colon cancer by 60%;
  • Reduce mortality and risk of recurrent cancer by 50%;

(Based on year 2009. Jansen et al., 2012 2 Based on year 2013. 3 Cardiorespiratory fitness is an independent predictor of hypertension incidence among initially normotensive healthy women.
Barlow CE et al. Am J Epidemiol 2006; 163:142-50. 4 Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. DPP Research Group. New England Journal of Medicine 2002; 346:393-403. 5 Exercise treatment for depression: efficacy and dose response.
Dunn A et al. American Journal of Preventive Medicine 2005. 6 Physical activity and colon cancer: confounding or interaction? Medicine & Science in Sports & Exercise:
June 2002 – Volume 34 – Issue 6 – pp 913-919)

Weight training- when done intelligently for each individual- is just as effective as other types of exercise in improving health. It has it’s own set of extra benefits and of course risk factors. Just like that Tylenol you like to pop for your back pain.

There is no one way to utilize the benefits of movement. Some people to pick things up and put them down.. others like to yoga.. some like to do step classes, and others just like to go for regular walks and stretch. IT’S ALL GOOD.

The biggest emphasis I am trying to make is that adding weight to your routine when you’re doing it correctly for YOUR SYSTEM (this is where the help of a trained professional often comes in), you’re looking at more resilience throughout your body and mind.

Don’t knock it til you try it 😉

(With the correct prescription and educated advice, of course!)

Athletic Therapy, Biomechanics, Chronic Pain, Conditioning, Equestrian, Motor Learning, Posture, Weight Loss, Wellness

If it ain’t broke.. The right way to move

Is there a correct way to move?

This is a question that has plagued therapists, trainers, and clients since the age of time.

Actually.. probably not that long.

The evolution of health and movement is one to be admired- in that, we’ve gone from quadruped beings, to walking, running, bipedal masterpieces, to what we are now.

We’re at an interesting point in movement science. We’ve somewhat regressed in our movement ability. While yes, we are still bipedal, upright beings- we no longer spend much of our time moving around in a variety of ways.

Now we move from point a-b-c-d in condensed timeframes, spending majority of our time between 3 positions (or variations of..): standing, seated, and laying down.

The author of Sapiens, Yuval Noah Harari, points out that the Agricultural and Industrial Revolutions not only may have ended our movement ability, but also may have birthed the beginnings of the various chronic illnesses and pain that affects us today.

Modern Day practitioners have been preaching alignment for decades already, and certainly our posture and ability to move has a huge impact on our overall wellbeing.. but is there such a thing as the “perfect” posture or alignment? Is there one optimal way to move?

The truth is yes, but also.. no.

There is certainly a most efficient way to move- in that, we will put minimal stressors on our structure and expend the least amount of energy to create that movement. There is a general textbook answer to this optimal alignment.

As an aside- it’s common to hear practitioners saying that one of your legs is longer then the other, or your pelvis is out of alignment.. when often the truth is some asymmetries are NORMAL to a certain degree.

We all have one shoulder that will be slightly depressed based on our hand dominance. We all have slight differences in how our rib cage sits, because of our anatomy (the left side has less lung in it to account for the heart- causing a shift between left and right), and where the rib cage goes the hips follow. Our body works in a chain like system- one link compensates for the next.. and while many compensations cause other problems, not all asymmetries are bad or abnormal. This will also change based on the mental health and perception an individual holds on pain, stress, and their systemic health. The debates on these fuel many research articles and books already. Stay tuned for more discussion on those topics and how movement relates to them.

When it really comes down to it, our movement is as unique as we are- and what is the best way to move for one person may not always mirror the best way to move for another person. We’re designed to be adaptable beings, and our postures should be just as adaptable.

Wait.. haven’t you been preaching posture and biomechanics your whole career?

Yes.. and while there may be differences across our spectrum of movement- majority of us inherit similar postural dysfunctions.. it’s very rare to find someone who moves well, even though there is no set checklist for what exactly moving well means.

Moving poorly in relation to your body can create a vicious cycle of degeneration, causing pain, causing less movement, causing more negative health outcomes. You can get enough movement, but if you don’t move well- you can actually do harm to your body which results in less movement.

For that reason *usually the first step with clients is to assess and correct how they move. From there we build a foundation of efficient movement, and build their movement habits on top of that foundation.

While I can’t say there is one right way to move, I can say that it is very rare to find someone with obviously inefficient movement without some sort of history of pain. The thing about pain is that it may not even present as physical pain.. it may be present in the form of gastrointestinal issues, or undue mental states. Our structure represents our internal framework too- and that can be a chicken or the egg scenario.

Many movement based practitioners will offer within their consult with you a movement screen. If you’re looking for an assist with your health, this is one of the things you should look to your professional to do. Cookie-cutter exercise programs, apps, and group fitness classes are convenient and cost effective- but the grain of salt there is if you get injured or develop pain because you’re movement wasn’t properly screened before starting a program- they cost you more in the long term.

We routinely see clients at their wits end come into our care. They’ve tried everything and nothing works- they are even hesitant to try anything else. They can’t move enough because of pain, or- they’ve never been taught healthy habits around their lifestyle (including movement and nutritional practices). This is what plagues our healthcare system today, and the message I keep putting out there to clients and peers is that none of this is a difficult fix- it just requires a shift from expecting a quick, cheap fix, to some quality time spent investing in our own health and getting educated guidance.

If you have questions about your movement today- send us an email and we’d be happy to help. Consults are always free.

Athletic Therapy, Chronic Pain, Wellness

5 Reasons Why Integrative Movement is Different

1. Accessibility

We pride ourselves in providing a simple, affordable solution to health and lifestyle services. We also offer services out of four satellite locations covering South Winnipeg, the Pembina Valley, Charleswood, and Selkirk region. All our locations are partnerships with other likeminded health facilities. From full functioning gyms to yoga studios – we do the groundwork to develop a health focused community feel wherever we go.

2. Investment

How many of us have bought into a health program, rehab, or gym membership only to under utilize it and later feel like we’ve just wasted the money? Our job is to support you in whatever your health goals require. Whether it’s developing healthy habits in the gym or at home, recovering from an injury, or pushing yourself to a new level of health and fitness, we work hard to provide highly skilled and knowledgable support. As a bonus, new members at our Selkirk and Charleswood locations automatically get 6 weeks of coaching alongside their memberships. No longer will you be stuck not knowing what to do with your gym membership! Your health is an investment, and we believe that navigating those investments is best with accessible, individualized support.

3. Individuality

It’s all about YOU- At IM we are different then your average rehabilitation facility or personal training sales pitch. We take the time to figure out what makes you tick. From consult to regular sessions, you can expect to spend 45min-1hr with us in either dedicated one on one therapy, consult, or training sessions or in a small group of likeminded individuals working at a common goal. Keeping things personal allows us to make sure you’re getting all the resources YOU need to reach your full health potential.

4. Diverse Experience

We are a team of Kinesiologists and Athletic Therapists with years of education and a growing experience base. Each of us enters our practice with our own personalities, history, and interests. For that reason, we pride ourselves in working as a team to meet our clients where they are at- and when appropriate work as a team with other professionals you deem valuable to your healthcare team.

5. We get it.

Life happens. Injuries are tough. Pain messes with our heads. Taking the steps towards lifestyle change seems impossible some days. We have been there, and we understand. Even on the days where you think it’s never going to change, the pain will never leave, or you’ll never get your old energy back.. we’ve got you. We won’t give up even when you don’t know where you stand. As the therapists and coaches we are, we hold out hope even when all hope seems lost. We’re all in the same boat, us humans, and we approach your care on your side every single day.

Want to learn more about how we can fit seamlessly into your journey towards optimal movement and health? Book your FREE consult here or drop by any of our locations to learn more. Looking forward to meeting you!

Athletic Therapy, Chronic Pain, Wellness

5 Reasons Why Integrative Movement is Different

1. Accessibility

We pride ourselves in providing a simple, affordable solution to health and lifestyle services. We also offer services out of four satellite locations covering South Winnipeg, the Pembina Valley, Charleswood, and Selkirk region. All our locations are partnerships with other likeminded health facilities. From full functioning gyms to yoga studios – we do the groundwork to develop a health focused community feel wherever we go. We also offer online services and training for those at a distance or on a budget! 

2. Investment

How many of us have bought into a health program, rehab, or gym membership only to under utilize it and later feel like we’ve just wasted the money? Our job is to support you in whatever your health goals require. Whether it’s developing healthy habits in the gym or at home, recovering from an injury, or pushing yourself to a new level of health and fitness, we work hard to provide highly skilled and knowledgable support. As a bonus, new members at our Selkirk and Charleswood locations automatically get 6 weeks of coaching alongside their memberships. No longer will you be stuck not knowing what to do with your gym membership! Your health is an investment, and we believe that navigating those investments is best with accessible, individualized support.

3. Individuality

It’s all about YOU- At IM we are different then your average rehabilitation facility or personal training sales pitch. We take the time to figure out what makes you tick. From consult to regular sessions, you can expect to spend 45min-1hr with us in either dedicated one on one therapy, consult, or training sessions or in a small group of likeminded individuals working at a common goal. Keeping things personal allows us to make sure you’re getting all the resources YOU need to reach your full health potential.

4. Diverse Experience

We are a team of Kinesiologists and Athletic Therapists with years of education and a growing experience base. Each of us enters our practice with our own personalities, history, and interests. For that reason, we pride ourselves in working as a team to meet our clients where they are at- and when appropriate work as a team with other professionals you deem valuable to your healthcare team.

5. We get it.

Life happens. Injuries are tough. Pain messes with our heads. Taking the steps towards lifestyle change seems impossible some days. We have been there, and we understand. Even on the days where you think it’s never going to change, the pain will never leave, or you’ll never get your old energy back.. we’ve got you. We won’t give up even when you don’t know where you stand. As the therapists and coaches we are, we hold out hope even when all hope seems lost. We’re all in the same boat, us humans, and we approach your care on your side every single day.

Want to learn more about how we can fit seamlessly into your journey towards optimal movement and health? Book your FREE consult here or drop by any of our locations to learn more. Looking forward to meeting you!

Athletic Therapy, Biomechanics, Chronic Pain, Conditioning, Free Workouts, Motor Learning, Posture

Roll on, Sunday

I don’t know about you- but the end of the week leaves me exhausted. Sunday’s are generally my Wednesday’s- so I have to find ways to keep myself energized and ready to confront Monday’s no matter what (they still feel like Mondays, even if their mid week for me!). 

I’ve been working through some of my own aches and pains lately- and part of my rehab includes my trusty foam roller to loosen the muscles around my shoulders and thoracic spine- to help my lower spine and hips work a little better. Such a common thing to see among my clients as well, a poorly functioning upper spine causing issues up and down the chain. 

Here’s a couple of the moves I used tonight to loosen up my shoulders. Get your roller and try them out! 


Make sure your spine is aligned with the roller, with your chin tucked and pelvis tilted. First up is straight arm flexions- you’ll feel this between the shoulders as the muscles contract against the roller for a nice active massage effect. Repeat this movement 10-20times. 

Next is Angels. If you’ve done wall slides before this is the same movement. An excellent opener for the chest and the front of the shoulders, it doubles as an active massage for the upper back. Repeat 10-20 times. 

Both these make an fabulous warm up as well pre-workout, ride, or as an office break. 

Let me know how it goes! 

Athletic Therapy, Biomechanics, Conditioning, Equestrian, Free Workouts, Motor Learning, Posture

Pre-Ride Sequence #1: Stable Shoulders, Mobile Hips

If you have me on instagram (katmah1) or facebook, you’ll have seen these. If you don’t have me on either.. you should probably get on that!

I have recently started riding again, after a on and off two year break, and of course am practicing what I preach. As most riders, when I’m at the barn I mostly just want to get on the horse and go- but I do appreciate the value of a proper routine to get my body ready to go before I do so. I also know that the horse’s I ride appreciate it as well.

So, with time in mind, I’ve begun putting together short and sweet functional warm-up sequences that I’ll share with you as I get around to filming them. The first two, which cover all the basics of two or three movements that are key for us in the tack, will be featured in this post.

There are a few things that are important for a warm-up. We riders don’t necessarily need to go for your typical 5-10 min cardio warm-up, as often the routine tasks of grooming, tacking up, and other barn things get the blood flowing. Something that is great for us, though, is warming up the movement patterns we’re going to use in the saddle. Especially if you’re in the process of revamping your equitation, practicing the habits before you add in external factors like a moving, thinking animal will really go a long way in preventing injury, and enhancing performance.

Today we’re going to talk stable shoulders and mobile hips.

We’ll start with the hips, as the exercise itself gets the whole body involved. I talk about hip hinging a lot. It’s a big issue for a large population. We as riders use it in our posting trot, two points, and in various other tasks. Around the barn you SHOULD be using it whenever you bend over, lift, etc. This first warm-up movement is a variation of a squat. We’ve all done, or at least heard of, a squat. It’s a movement we as humans should be very proficient in, although most of us aren’t. This variation of a squat is designed to really cue the hip hinging back and down (with proper knee mechanics) and then up and forward- while keeping a strong core and stable shoulders, of course.

You’re going to start off with your feet facing the wall, a few inches away, hip width apart, standing up in a nice posture, and putting your arms behind your head- making sure the elbows stay back (**watch here that you don’t arch in the mid-spine).  From this start position, you’re sitting down and back into a squat (as deep as 90deg, or as deep as you can maintain form). Knees should remain straight and track over the ankles, without collapsing in. Weight should transfer through the heels. Knees shouldn’t cross the toes- or touch the wall. Torso should stay upright enough that you don’t knock your head on the wall. Back remains neutral and core remains active.

Click here for video! 

Do 10-15 of these, then get read for the second part of the sequence! Standing in a similar position facing the wall, place your forarms on the wall, with the elbows at 90deg. You should be standing close enough to the wall to do this movement without arching your back.

From here, activate your core and the muscles between your shoulder blades, and then slowly slide arms up the wall (only as far as you can maintain a neutral spine), followed by slowly lowering them down. Do this 10-15 times, you should feel the muscles in your upper back working. The video shows first the incorrect way, and then the correct way to perform the movement!

Click here for video! 

Repeat that sequence 2-3 times before you get on. The squatting exercise translates easily to the same motion we SHOULD be doing when we post the trot or hold a two point. The Forward Wall Slide teaches us how to use the shoulder girdle properly, and stabilize, so our arms and core can work independently.

Record your horse’s reaction to you doing this, for added hilarity.

Enjoy!

Biomechanics, Chronic Pain, Conditioning, Equestrian, Motor Learning, Posture

Mobility Monday: Hip Opener

  
As riders we spend a lot of time with our hips flexed, doing mini squats in the tack. Which means we are prone to chronically tight hip flexors. 

Why is this a bad thing? Not only do the hips flexors (psoas major and rectus femoris) attach to the lower spine and front of the pelvis, they also affect how we move. If they are tight they are pulling the pelvis forward and the spine forward. Creating a mechanically deficient posture, and enabling compensations in our movmeents. Signs of this can be low back pain, hip pain, knee pain, and even foot pain. 

So. A stretch for those beasts. In the “proposal” position as shown above, pushing the pelvis forward with the glute muscles until there is a stretch in the front of the hip and thigh. Then, rock in and out of that stretch.. Pushing farther into each time. 

Do this for 3 sets of 10 pre and post ride for a lovely feeling of freedom in your hips. This will help improve your spine posture and make your ride much more bio mechanically friendly! 

Athletic Therapy, Biomechanics, Conditioning, Equestrian, Motor Learning, Posture

Flexion/Extension #mobilitymonday

 

 
Try this out before your warm-up before your ride and your cool down after your ride. This flexion extension movement will help to open up and warm up your hips, core, spine, and back muscles. Getting all those things primed before you step into the stirrups is a great way to ensure your best performance. 

*if you have a back injury or known disc problems, please consult a professional before you attempt these movmeents!*