At Lifemoves our Kinesiologists share their knowledge with you so that you enjoy an enhanced quality of life. Read articles about wellness, disease and injury prevention, exercise for chronic diseases, injury rehabilitation and disability management.
We also share what we find relevant and informing from other resources such as recent articles, news media, related web sites and other health/medical professionals.
Our blogs are inspired by the questions we are asked by our clients. Someone recently asked me -
"Where does fat go? What happens to our fat cells when we lose weight?"
Since, I am more of an expert at getting people moving and improving their durability, not at fat loss I thought I would ask this to my colleague and North Vancouver fat loss expert, Martin Bolduc, Personal Trainer.
Please read the first in a series of guest expert interviews.
Where Does Fat Go When We Lose Weight?
MB:
As you go about your fat loss journey, if you often find yourself wondering just where the fat goes, you aren’t alone. Many people often pose the question of what happens as you burn off body fat. Do fat cells release their stored fat as you burn them off and remain empty or do the cells themselves actually disappear? Let’s take a closer look at what happens as you burn fat so that you can gain a full understanding of the fat loss process.
When we lose weight, do fat cells shrink?
MB:
When fat loss begins to take place, which is due to fewer calories being consumed than being burned off throughout the course of the day, the body is going to be releasing stored triglycerides from the fat cells for use as energy, causing the fat cells to shrink down, as mentioned in the Human Fat Cell Lipolysis journal article. As this fat loss takes place, you may notice your fat cells becoming squishier to
the touch as they are emptied of their contents. These cells will never disappear so the chance of them expanding again if you consume too much food will always still be there.
Do we have the capacity for more fat cells?
MB:
Yes, fat cell hyperplasia is a very real thing, as noted in the Journal of Applied Physiology. The body can start to produce new fat cells as excess food is consumed and periods of inactivity are undertaken,which then means staying lean in the future may become much more difficult.This is a big reason why maintaining a regular exercise program and watching what you eat is critical to long-term weight control. While you can diet down and lose the contents of your fat cells, once those fatcells are created, they can never be destroyed without resorting to surgical measures.
References
Arner, P. (2005). Human fat cell lipolysis: Biochemistry, regulation, and clinical role. Best Practice Research Clinical Endocrinology & Metabolism. Vol. 19, Issue 4.
Roberts, C. (2006). Inactivity and fat cell hyperplasia: fat chance? Journal of Applied Physiology. Vol102. No. 4.
About Martin Bolduc
He is the author of The Ultimate Guide to Express Fat Loss and
the winner of the Lean Body Challenge 2008. Martin is a Certified Fitness
Nutritionist Specialist, Certified Personal Trainer ACE and BCRPA,
and a natural bodybuilder. Martin continues to help hundreds of clients reach their fat loss goals
their goals. Get more fat loss tips by reading Martin's blog at Express Fat Loss
In the space of one day I had two people approach me with completely different views
about what Lifemoves' Kinesiologists do. One did not see the difference between our exercise therapy services and
Personal Training. The other person I spoke with stated that they had used Personal Trainers for nearly a decade and the trainers' level of education and experience
has run the gamut from the weekend coursers with BCRPA to those with advanced training such as Kinesiology or Physiotherapy (they now know what to look for when assessing a trainer's qualifications).
From the outside perspective of those walking through and
observing some of what we do with our clients, our programs may seem to be “total body”
workouts, which in fact they are because 1. the body moves as a complete
organism; 2. those who are rehabilitation clients require the ability and
capacity to lift, push, pull, twist, carry and squat. What an observer doesn’t know is
the medical history of the client nor why the specific exercises are in the
program, why they are in the order they are in and what intensity they are
being performed at.
Unless they have some type of orthoses, prostheses, assistive device, mobility device or move with obvious compensations it is often difficult to know that someone has a medical condition,
disability or injury just by observing them for 60 seconds.
As the second person discovered, many trainers are “more
concerned about the amount of weight the client is pushing” instead of taking
into account the individual’s history of injury and illnesses. This can set the client up to complete exercises with poor technique which sets them up for overuse injuries.
A Kinesiologist first completes an assessment which includes a medical history and movement screen then designs, teaches and implements
an exercise program that incorporates all aspect of fitness and movement,
while accounting for an injury(ies), illness(es) and disabilities not just exercises for site of injury or resulting movement
compensations. Even defining rehabilitation as treating an injury is very
limiting. Also, an exercise therapy program
does not have to have isolated movements, joint manipulations or use exercise
bands to be defined as rehabilitation. Sessions are designed to restore function and durability.
What is Rehabilitation?
“Rehabilitation is a treatment or treatments designed to
facilitate the process of recovery from injury, illness, or disease to as
normal a condition as possible” Medical Dictionary – more information.
Rehabilitation treatments include exercise. These normal conditions range from
being able to continue to live independently, perform a very physically
demanding job and compete athletically at a high level.
What do Lifemoves’ Kinesiologists do?
A client with a back injury who has a highly active and
physically demanding job probably has some type of movement inefficiency that
created the injury in the first place. They also require a program to
rehabilitate them to the normal condition of being able to perform their job
demands. This means that yes, we would have to properly progress them towards
loaded dead lifts, squats and carries.
We have had clients approach us because their trainer was
aggravating a previous condition or injury because they were not paying enough
attention to correcting movement throughout the session. Exercise considerations for
someone who needs to lose weight to ensure that their hernia surgery is
successful are quite different than someone who wants to lose weight and has no
known medical condition. Both clients will most likely have a full-body resistance program, however the exercises, tempo, intensity, and volume for both programs will be different.
During each exercise we carefully observe how it is being executed then coach and cue proper
movement sequencing. If necessary we will progress or regress the exercise
until we achieve the appropriate level of challenge.
Our clients have or have had an injury; are recovering from
or have an illness; are regaining strength and function after a surgery or have
a disability. Their goals are to manage their medical condition(s) while
gaining as much physical conditioning as they can. These conditions include,
but are not limited to transplants, brain injuries, osteoarthritis,
cardiovascular disease, diabetes, Parkinson’s, total joint replacements,
scoliosis, thyroid diseases, cancer and mental illnesses (depression and post-traumatic
stress disorder).
Who are Kinesiologists?
“Kinesiologists offer a wide variety of assessments and
services to the public to assist with both injury/illness prevention and injury
management. Their practice is based on the core sciences of anatomy,
physiology, biomechanics and psychomotor behaviour. Kinesiologists work in the
fitness industry, clinically and in industrial environments” Canadian
Kinesiology Alliance.
In Ontario we are close to becoming a regulated health care
profession. A growing number of health benefits plans are providing coverage
for our services. ICBC and disability benefits providers such as Sun Life Financial, Manulife and Great West Life will pay for training services
when they are conducted by Practicing Kinesiologists registered with the BC
Association of Kinesiologists.
Other health care professionals, such as
Physiotherapist have the ability to prescribe exercises, however exercise
therapy is our area of specialty and expertise. We focus on the entire person’s
functionality not just the site of injury. We work in conjunction with the rest
of our clients’ medical team.
With
the end of 2011 approaching and those New Years Resolutions just around the
corner, it helps to review how successful you have been in reaching your health
and fitness goals this year so that you can move forward in 2012 positively. Be
honest with yourself when looking at what you have done well and what areas you
can improve. Keeping this in mind will help guide you to set realistic and
achievable goals for 2012.
Use the information provided below to answer the following questions:
1. Did you achieve
the recommended amount of physical activity each week in 2011?
If
you did not, write down what your barriers were (for example, lack of time,
work commitments, children/family commitments, low energy levels, poor
motivation).
2. What are your
health and fitness goals for 2012?
Just like in competitive sports make lists of A, B and C goals. Your a goals are 1-3
items that are MUSTS, Bs are 2-6 items that are important, Cs are 2-7 things
are are nice things to accomplish.
3. What steps do
you need to take to achieve these goals?
Now that you have a list of goals, think of each of these as projects. What are
some ACTIONABLE items you can do. Maybe it is hiring a Kinesiologist to help
design a program for you. The action step is to give as call to book a
consultation or assessment.
Another example is if your goal is to stop dropping in to the coffee shop for the scone
and coffee in the AM. Your action step could be to take another route to and
from work.
How Much Physical Activity is Recommended?
The
Canadian Physical Activity Guidelines (released January 2011) recommend that adultst at least 150 minutes of moderate to vigorous
intensity aerobic physical activity per week, in bouts of 10 minutes or more.
They also recommend muscle and bone strengthening activities (resistance
training) using major muscle groups at least 2 times per week.
The
recommendations for Children and Youth (5 - 17 years) are 60 minutes of moderate to vigorous intensity physical
activity daily, including vigorous intensity physical
activity at least 3 days per week and activities that strengthen muscle and
bone at least 3 days per week.
Our
expertise can help get you there and even beyond the minimum. Lifemoves clients are very active and want to
remain so despite any disability injury or medical condition.
Overcoming Barriers to Exercise
Most
people face barriers to exercise at some point in their lives. There are
many steps that you can implement to overcome these barriers and start to
successfully achieve your goals - here are a few examples:
Lack of Time
Schedule
activity into your day and make it a non-negotiable commitment. Doing exercise
first thing in the morning can be a good way to tick it off your to-do list
that day and ensure that other things don't prevent you from exercising (such
as work or family commitments).
Low Energy Levels
Exercise will actually help to increase your
energy levels and fight fatigue once you are moving because it releases
endorphins into your body that help give you energy and feel good. Next time
you are feeling like you don't have enough energy, force yourself to get out
and move and feel the benefits!
Lack of Motivation
Physical activity should be fun. Most of us are able to find an enjoyable activity that can elevate your heart rate and get
your body moving. For me, cycling, running, rock-climbing and soccer keep
me healthy and motivated to move. Others enjoy dancing to their favorite
songs, swimming, snow-sports, aerobics classes or working out in the gym.
Find something that you enjoy and learn to love exercise!
Some other tips on how to stay committed to your exercise plan include getting into
a routine, move wherever possible (e.g. take the stairs, walk to the bus, ride
your bike), see a Kinesiologist regularly to keep you on-track, join a team or
social group or exercise with a friend/family member/pet.
Lack of Knowledge
Clients often seek the advice of a Kinesiologist because they are unsure of how to
continue to stay active or become more active when they are managing a medical
condition, injury or disability.
Setting Goals to
Get Moving Forward
When
setting goals that should be SMART, that is Specific, Measurable, Attainable,
Realistic and Timely.
Specific: Answer the who,
what, when, where and why
Measurable: Put a value on
your goal so that you can measure your progress
Attainable: Identify a
goal that is important to you so you can develop the attitudes, abilities and
capacity to reach it.
Realistic: Is this goal
something that you are both willing and able to achieve?
Timely: Put a time-frame on
your goal to help measure it and track your success
An Example
of a SMART goal:
In January I am going to exercise at the gym before work
5 times per week for 30 minutes each session, performing moderate to vigorous
intensity aerobic exercise on the treadmill and bike to improve my health and
fitness.
How to Track Your
progress
Ensure
thatyou review your goals and progress regularly and celebrate your
successes! If you have a day or week where you have not achieved what you
set out to, start fresh the next day and try again
"The
journey of 1000 miles begins with a single step"
(Lao-Tzu, Chinese
Philosopher)
If
you require any assistance with your 2012 goal-setting or if you need help
getting moving or staying motivated, contact a Lifemoves Kinesiologist - we
are more that happy to help you develop a plan to achieve your goals!
References
Canadian Society of Exercise Physiologists (CSEP) Physical Activity Guidelines (Jan 2011). View.
Education is one of Lifemoves'core values. Thursday provided us with a teachable moment.
In the last 10 years the fitness industry has gone from fanciful movements with the BOSU and other devices to make a training session “fun-ctional” back to basic human movements of lifting, pushing, pulling and rotating with the feet on the ground. During the last several weeks I started to learn the art and science of the Olympics lifts which can be used under the appropriate circumstances with rehabilitation clients, the elderly and high performance athletes.
A video of VERY poor Olympic lifting technique has been circulating recently within my peer group of Strength Coaches, Personal Trainers and Kinesiologists (see below); the clients in this video will most likely end up with acute and chronic injuries as a result.The discussion about the quality of Personal Training and coaching provided in the fitness industry these days has been ongoing for several months.
We are concerned that clients who are paying good sums of money are not being provided with the value and quality they deserve.Part of the lack of value is little movement education or correction during their sessions which places the client in situations where they could get injured in the short or long-term.
Lifemoves’clients are generally overcoming an injury, illness or surgery which has forced their bodies to create movement compensations and pain.When there is pain the neuromuscular system reflexively prevents that muscle from contracting optimally during movement and co-contracts others to create further stability or the movement needed. Consequences are 1) the overuse of muscles that are designed for stabilization or as secondary movers instead of primary movers 2) these movement compensations have shifted joints enough so that there are poor joint mechanics which leads to long-term deterioration of joint surfaces (think of osteoarthritis). Pain is a signal that something is not quite right and that the training stimulus needs to be changed, such as a correction or load reduction.
Anyone with a basic level personal training certification can lead a client through a workout session which leaves them exhausted at the end. Our Kinesiologists are looking out for our clients’ long-term health, fitness and wellness. It is important to us that our clients use the appropriate levels of stability and mobility to lift, push, pull and rotate.
How to Identify a Great Movement Coach
When working one on with a client or even in a small group setting coaches will:
Breakdown movements into blocks and then piece them together much like the stages of learning to drive
Listen to you when you mention you have pain by stopping the lift, ask questions and adjust the lift by correctingor regressing it
Be less concerned about counting reps and more concerned about movement quality
Be analytical and attentive
Be moving around see your movements at various angles
Be able to progress or regress each movement depending how successfully you complete it. For example a kneeling plank to alternating knee lifts (feet on ground) to full plank and the other direction
Be consistently upgrading their coaching skills and knowledge via podcasts, discussions, webinars, workshops and conferences
As health care providers we don’t care how much you sweat or have a desire for you to collapse on the floor after your session.Our aim is to use an appropriate progressive level of resistance which improves your daily functional capacity and durability, but doesn’t not compromise exercise execution and technique.We are here to coach you and show how to move differently, more efficiently and more effectively.
Clients who have worked with Personal Trainers who made their client work hard, but didnt correct their form and did not adapt an exercise to manage their injuries have approached us due the lack of lack of attention they received. These intelligent clients seek training programs that will account for their injuries or medical conditions and help them navigate towards their goals.
We are always searching for the best methods of training such as exercise selection that meet our clients goals, needs and abilities.
If you are curious about the poor lifting video: click here
Excellent Coaching of the Power Clean
Thank you to our numerous peers around the globe who brought this to our attention and who helps us continue to improve our own movement coaching skills.
Did you know that chronic pain affects about 13% to 30% of Canadians and 10% aged 12 to 44? Chronic pain is a complex process that has lasted more than 6 months and this is after tissues involved in the original injury or surgery have healed.Those with chronic pain also often have other mood disorders such as anxiety and depression. This pain can be debilitating and prevents patients from doing or enjoying daily and recreational activities.
It is now understood that this pain originates in the brain, a very plastic and malleable part of the body that can be changed with appropriate training. Management of chronic pain needs to be multifaceted which includes stress management, nutrition, sleep, medication reduction and exercise. Watch this humurous five minute video to learn more.
Kinesiologists develop appropriate exercise programs to help clients become more durable, stronger and move more freely.
1.Fear Reduction and Confidence Building
Often people think that any type of movement will increase their pain. Keep moving by gradually increasing the frequency, intensity and duration of activities that don’t make the pain worse which helps you gain more confidence.
2.Movement Re-education and Mobility
Acute pain often creates movement compensations. Our bodies adapt to complete the activities we need to during the day. We develop further restrictions due to pain, which perpetuates the cycle. These dysfunctions will inevitably lead to further weakness, pain and myofascial tightness. Our first steps is to increase range of motion using Fascial Stretch Therapy and re-teaching the body how to properly sequence movements.
3.Strength and Endurance
Strength is the capacity to lift, push or pull an object once (using one movement to break a branch). Endurance is the capacity to resist fatigue through multiple movements and through-out the day (bending the branch back and forth until it breaks).These two will naturually develop during step 2. However, the next stage of this process to develop greater levels of strength and endurance. Enhanced durability means that your will be able to last longer at work and at play. Exercises include those that require the ability and capacity to keep the spine stable while pushing, pulling and rotating with proper technique.
Poor posture can be a pain in the neck; this posture related pain can be prevented and managed fairly easily.With so much of our lives being based in front of a computer or desk, it isn't surprising that many people have neck, shoulder and back pain that originates from poor posture. When performing a postural assessment, too often I see clients presenting with a kyphotic posture that includes rounded shoulders, a forward sitting head, an extended neck and an excessive curve in their lower back (lordosis). Most of these clients spend large amounts of their time seated at a desk (at work and/or home), driving, or sitting watching television or playing on the computer. So, the big question is how can you prevent these postural changes?
4 Tips to Prevent Postural Related Pain
1. Correct workstation set-up
Whether at home or work, it is essential that you have the correct desk set-up to enable you to achieve a suitable posture whilst working. WorkSafeBC have a fantastic step-by-step resource that will help you set up a computer workstation correctly. Download Workstation Setup PDF.
When sitting at a station that is not desk-based (e.g. on a sofa or in the car) it is also important to think about how you can achieve some of these recommendations if you are going to be in that position for longer than 60 minutes.
2. Awareness of body position
Being aware of your body's position is one of the keys to good posture. Most people will sit up straighter just by hearing the word 'posture'. To achieve good alignment ensure you are weight bearing through your sitting, that your sitting up tall with a long spine, that your shoulder blades are sitting back and resting down in your back pockets and that your head is over your shoulders and hips.
3. Stretching during your day
If you need to spend large amounts of time seated, a stretching routine can help to prevent and alleviate aches and pains. Perform the following stretches throughout your day as required:
Neck: Slowly tilt your head to away from the tight side, then rotate your head so that your sniffing your armpit. Continue to roll your chin down to your chest and stack each vertebrae on top of each other until you are looking forward again.
Shoulders: roll your shoulders gently up, back, down and forwards 5 – 10 times.
Chest: reach your arms straight out to your sides with the thumbs up the gently squeeze your shoulder blades together. Very the angle of the arms to the floor.
Hips: Stand up and place one foot forward, tuck your bottom under and lean forward to stretch out the front of your hips.
If you need something to remind you, Stretch Prompter is a tool that you can download from WorkSafeBC here
4. Movement every hour
Movement helps to improve your circulation and it can help keep your muscles long and strong. Break up your day by trying the following: stand up and walk around for a few minutes, refill your water, deliver a message in person, take the stairs, stretch and try to move around on your lunch break.
Back pain can be a difficult condition to manage. One cause of lower-back is lumbar spinal stenosis (LSS). Anyone with LSS would agree that it is a painful and debilitating condition with limited treatment options: surgery or more conservative measures such as exercise, physiotherapy or pain relieving injections. Lumbar spinal stenosis (LSS) is defined as a narrowing of the spinal canal in the lower back and can cause pain and numbness in your legs and back, limb weakness and loss of sensation of your extremities (Mayo clinic, 2011).
If you choose exercise therapy as part or your treatment for LSS (and the research recommends that it should be included), there is some basic information that you should know. The good news is that current research shows if you can decrease the extension forces on the lumbar spine caused by certain tight muscles and weak muscles, a reduction of the lumbar lordosis can be achieved which can decrease the level of pain experienced (Goren, 2010).
It has also been found that extension(bending backwards) of the lumbar spine (e.g. excessive lumbar lordosis) causes a 20% reduction in the intervertebral foramenal cross sectional area (spinal canal space) which exacerbates LSS, therefore exercises that promote lumbar flexion are encouraged (Iverson et al, 2010). This explains why for someone with LSS, bending forwards slightly is relieving and bending backwards increases the pain experienced.
So how does this translate into specific exercises that you should be performing at home or at the gym?
Aerobic Training: low intensity cycling at 60% of HR max ((220 – age )* 0.6) is recommended initially. Walking can be included if it is pain-free and more success has been shown with supported walking (e.g. nordic walking poles, shopping trolley, etc).
Flexibility Training: Stretching the hip flexors, hamstrings, adductors, quadriceps and lumbar paraspinal muscles will help to correct excessive lumbar lordosis.
Resistance training: All exercises should be performed with a neutral spine or posterior pelvic tilt (where suitable) and ideally exercises should be supervised by a qualified trainer or Kinesiologist to ensure you maintain the correct spinal positioning.
- Abdominal exercises: choose exercises that do not over-activate iliopsoas. Training the deep abdominal muscles, multifidus and pelvic floor should provide a more stable trunk position. Progress these exercises to include trunk flexion and work on strengthening the lumbar extensors in an isometric position (without actual extension).
- Lower body exercises: initially exercises like leg press, wall squats, leg extension and leg curl should be able to be performed as the lumbar spine is supported. These can be progressed to DB squats, swiss ball squats, lunges, cable leg extension, swiss ball leg curl and dead lifts provided that the correct lumbar posture can be maintained (e.g. neutral or posterior pelvic tilt).
- Upper body exercises: initially choose exercises that are seated/supported such as machine based chest press, seated row, seated shoulder press, bicep curls and triceps extensions. These can be progressed to dumbbells and unsupported exercises once enough trunk support has been developed and the correct lumbar posture can be maintained.
Postural correction and balance training are also recommended.
As you can see there is a large amount of exercise that can be done safely (and the list above is only a sample). The most important part about exercise with LSS is that is must be performed correctly. Many people will need to be supervised for the majority of their exercise sessions and even the experienced gym users require a few sessions to ensure they have correct spinal positioning throughout the movements.
If you have Lumbar Spinal Stenosis and require help with an exercise plan, contact one of the Practising Kinesiologists at Lifemoves Health and Rehabilitation – it is never too late to start exercising.
2. Goren, A. (2010). Efficacy of exercise and ultrasound in patients with lumbar spinal stenosis: a prospective randomized controlled trial. Clinical Rehabilitation. 24, 623 – 631.
3. Iversen, M., Choudhary, V., & Patel, S. (2010). Therapeutic exercise and manual therapy for persons with lumbar spinal stenosis. International Journal of Clinical Rheumatology. 5 (4), 425 – 437.
