Sore, not Sorry.

We all know the familiar feeling of post-exercise soreness.  The one that makes us dread sitting down on the toilet because we are afraid we might not get back up. The one that has us walking sideways down the stairs because we are worried we might just fall ass-over-tea-kettle if we have to actually use our legs. The one that has us using our arms as if we were a T-Rex because if we were to fully extend then they most definitely will fall off. 

Ahh yes - the hurts-so-good kind of soreness that has us cursing the day or two following a workout, but gives us bittersweet validation that has us begging for more. 

As a physiotherapist, I get feedback about soreness every single day. What is "good" soreness and what is "bad" soreness? How do we know if this feedback from our body is telling us we are getting stronger or that we are pushing too hard? It's a great question and one that you won't love the answer to. 

It depends.

I know. Total cop-out. So let me try my best to break it down in a few ways that might be somewhat less ambiguous. 

quality

"Good" soreness typically is of the achy, dull variety. It is the feeling of fatigue or heaviness in the muscles and it is typically felt most when you recreate the movement that you were doing during the exercise. For example, if you were doing a whole load of squats - the next day you would typically feel tired in the legs, but more noticeably when you had to squat down or get in and out of a chair (thus the classic toilet example above). 

For soreness that indicates potential tissue damage beyond what is productive, the soreness is usually sharper in nature. It may feel more "twingy" and might feel deeper in the joint. The pain also can intensify with specific movements, but the movements might be unrelated to the exercise you were performing. Again, if you had a heavy squat day and then were feeling sharp pain around your knee, it might get worse with doing a squat, but will likely also bother you in other positions/movements as well. 

duration

"Good" soreness is usually felt 24-48 hours after exercise. This is the classic phenomenon known as DOMS (Delayed Onset Muscle Soreness). It is theorized to be caused by micro trauma to the muscle tissue. The idea that it is caused by lactic acid build-up in the muscle has been refuted, as many studies have shown that lactic acid levels generally return to normal within an hour of exercise. This microtrauma can be beneficial stimulate growth of muscle fibres (hypertrophy) and we don't get too fussed about it. 

"Bad" soreness generally lasts longer than this. It can still be from the same effect, but the exercise load may have been to strenuous to the muscle and connective tissue and the micro trauma might be more significant. Alternatively, you could have already been experiencing pathological compromise to a tissue (i.e. tendinopathy), and loading this tissue excessively during a workout may have created more trauma to the weakened site. 

intensity

Although both "good" and "bad" soreness might have you walking like a penguin for a couple of days, the body is usually more intuitive about the "bad" variety. In this circumstance, the brain usually signals to the surrounding tissue that there is compromise to the body in a specific area, and the local muscles need to be on "high alert" to protect. This creates a lot of muscle guarding and tension. You may find the surrounding area to be very tender, stiff and tense. 

management

With "good" soreness, usually movement is your friend. It might feel tough at first, but the more you move the sore tissue, the more friendly it becomes. Usually some gentle stretching or light activity helps. 

When you exercise in a way that is new or at a much higher intensity than you are accustomed to, the muscle adapts fairly quickly to reduce further damage from the same exercise. This is known as the "repeated-bout effect".

Therefore, when you start a new type of exercise, it is common to feel more sore the first few times you perform it, but your body amazingly adapts quite quickly. This is why it is important to switch up your routine every so often to continue these adaptations. 

With "bad" soreness, movement of these areas might actually exasperate the pain. Rest is likely to help more, at least initially. It is important that if this is the type of situation you are in that you see a orthopaedic heath care practitioner (I know, shameless plug). The reason being, it is all too common that the muscle guarding and the "protective mode" that the body goes into in response to injury can usually cause more harm than good to your overall mechanics. Proper muscle and tissue balance needs to be restored and some simple treatment sooner than later will save you from a cascade-effect into further injury (I promise I am not trying to catastrophise - just wanting to get you feeling your best)!

the good news.....

Soreness is a great way of your body communicating with you. It is giving you feedback on your exercise - so start listening! Where are you feeling sore? Is it even in the muscles you were intending to work? Is it symmetrical? Is it in the areas you are typically weaker? All of these questions are so important and the answers to them will help you determine how effective your workouts are.

Your body is always trying to tell you SOMEthing and it is amazing how much more efficient your exercise can be when you listen and adjust accordingly. 

So, my sore friends, may you all bask in the enjoyment of a well-excuted and effortful workout with achy, tight muscles giving you a gentle pat-on-the-back for a job well-done. I hope we can all challenge our bodies in ways that give us this much-needed reminder about how fortunate we are to have them carry us through life - even if we spend much of it waddling like a penguin. 

 

P.S. Another shameless plug - if you would like to get sore with me in all the best ways, then head on over to my private Facebook page where I lead a weekly, live workout!

https://www.facebook.com/groups/1668737363145522/?ref=bookmarks

Posture Police

Hello friends. It is your friendly, neighbourhood physio here to give you the cold, hard facts about why you are struggling with any of the following: 

- Repetitive injury/pain to the same area of the body

- Plateaus in fitness, strength or performance

- Generalized soreness and ashiness that you just chalk-up to "old age"

News Flash: It's your posture. 

Now perhaps I've already lost you with my oversimplification, but give me a chance to explain. We tend to think of posture as binary;  either "good" or "bad". We also tend to think of it as the position that we sit in. Well let me broaden your awareness.

Think of posture as your foundation. It is the starting line of movement and function. It is your ground-zero. So, when we start in a position that is less than optimal, it is no question that so will our movements, our muscle forces, our joint loading, etc. 

Great. So you are saying I am doomed from the get-go. Thanks Meg. 

Well, not at all. Instead, I want you to rethink the way you approach the above issues. We tend to jump forward about ten steps and try to focus on "fixing" the painful spots without just observing, connecting and correcting our default positioning. 

Let me attempt to clarify with an example. 

The picture below is us holding our one-week old twins. They were just barely home from the hospital. At first glance, this is one of my favourite pictures. But now I will pick apart every detail of my shit Mom-posture to make a point. 

 Please note, for the record - this is the ONLY time my posture has been worse than DMO's (and I think I had a pretty good excuse). 

Please note, for the record - this is the ONLY time my posture has been worse than DMO's (and I think I had a pretty good excuse). 

In this position: 

- My pelvis is tucked under me -- which renders my glutes very useless to support me. 

- My torso is shifted back to balance the load of the baby (and newly acquired chest) in front -- which puts much more force/pressure through my lower back and takes my core out of the equation. 

- My hips are shifted forward to act as a "ledge" for baby to rest on -- which makes me hyperextend my knees

- My chin pokes forward to still be able to see directly in front of me -- which creates muscle tension at the back of my neck and upper shoulders. 

- My ribcage is flared out in response to my torso shifted back -- making it almost impossible to breath properly (and thus engage my core).

Need I continue? 

The point is that although I had all the reasons to have a compensatory posture (hello, newborn twins) it becomes problematic when our bodies start to adapt into this position as our "default" static posture. When those babies get bigger, or when you try to carry all the groceries into the house in one go (guilty), or you start to get back to high-impact activity - you are stacking the deck (or spine) against you and it leads to all the aches and pains listed above. 

Great Meg. What do we do about it?

Well, unfortunately the guy on the left has a much more exemplary posture, so all eyes on him. Better yet, connect with your body. Listen to what it is telling you, feel what it is feeling. Perhaps this sounds a little too ethereal and hokey. BUT, I promise you that most of our postural issues stem from the disconnect we have with our bodies. If someone took your picture right now, as you read this - you would see right away the issues with your positioning. What I challenge you to do is try to feel them instead. Where do you feel pressure in your body? Where do you feel tension? Where do you feel weak? Does your spine feel stacked? Where does your breath go? Feel it, then change it. Sometimes it is just that simple. When you feel better, you feel better. 

Ya feel me??

 

This Sh!t is Bananas. Being (banana) split up the middle: A fresh (produce) perspective.

Diastasis. Recti. Abdominus. My computer tries to autocorret each of those words because they don't register as English. Touche. It is perhaps the perfect analogy to what we do in reality with this disorder - try to autocorrect. The next thing you know you are texting your boss about your rectum and Bob's your Uncle. 

Perhaps I need to back-up....

Diastasis Recti Abdominus (DRA) is a fancy term for a separation in the abdominals (no need to send auto-corrected texts about your rectum. Cautionary tale - it happened to me). It is believed to happen to 100% of women at some point in their pregnancy (is this any surprise?) and while most will recover very well, up to 1/3 of women still have a separation at 8 weeks postpartum - of which most still have the same separation at 1 year postpartum. Great. Another perk of creating human life. 

With a lot of buzz circulating around about DRA (good), there is a lot of focus on the separation and how to "close the gap" and less about what the functional repercussions are (bad). 

I have made a video to perhaps shed light on what this separation really means and the implications on our core strength. I use bananas. It is mildly entertaining. Please give it a watch and if you feel so inclined - share with your mama friends. Not only to get a laugh at my expense, but to start the conversation because I am tired of treating women in their 50s and 60s that have had core issues that stem back to poor postpartum recovery (yes, it is something you need to RECOVER from, not bounce back from). That's all. Off my soap box (for now). Enjoy the show!

Super-Fascia-Realistic-Expert-Core-Control-sis

Put your hand up if you have ever woken up in the morning with a stiff back or a kink in the neck and thought, "gee whiz, I have some fascial restrictions to work through". Likely not. 

We tend to blame our body woes on the musculoskeletal system, but in fact that is just one of many systems that make this ol' body function. Today we will chat a little about the fascial system. 

Fascia is connective tissue that expands the body. It surrounds muscles, tendons, nerves, blood vessels, and bone and has two primary functions: 

1. It decreases friction between layers of tissue as they move relative to one another

2. It transmits tension and force from one muscle group to another to create functional movement. 

Basically it is responsible for effective and efficient muscle force generation and the freedom of mobility. Needless to say, it is pretty important stuff!

 The chains of fascia throughout the body. These functional chains link muscle groups together to transmit force and generate movement. Picture sourced from www.anatomytrains.com

The chains of fascia throughout the body. These functional chains link muscle groups together to transmit force and generate movement. Picture sourced from www.anatomytrains.com

The picture above is an incredible depiction of how essential it is to assess the whole body when dysfunction is present and how the core really is the control centre for every direction of movement. This is why releasing tethered fascia in the abdomen is so important for the whole body. 

In the video below, I have outlined one way that you can start to get an appreciation for what fascia feels like - both normal and abnormal.  It is amazing what we can feel/find when we spend a little time connect to ourselves. As mentioned, this is just one of several techniques, so if you struggle with it, please let me know and I would be happy to demonstrate alternatives. 

The Busy Person's Guide to Fitness

So who isn't busy these days? If you're not busy, you're nobody, right? At least that seems to be the culture we live in. Even if you ask someone how they are doing, the typical response of "good" has been replaced with "busy". It is a state of being, a status, a mind-set but most annoyingly, an excuse. 

I get it, there are a million ways we are fed information and a million-and-one things we are not doing that we think we should be doing, so it is no surprise we constantly feel overwhelmed by prioritizing life. However, "being busy" also serves as a really convenient reason to avoid getting sh!t done! Trust me, I hear it (and live it) everyday. Patients don't do their exercises because they were "busy". I'm too "busy" reading about the Kardashian baby-boom to do necessary paperwork. We are all guilty. 

I am not professing to be the authority on setting priorities. I think "busy" is the most overused adjective/noun/verb in my vocabulary. However, I have gotten much better at not letting "being busy" overwhelm me and prevent me from staying healthy. Perhaps the most frequently asked question I get is, "How to do manage to fit in working out with three young children and a business?". Well, I don't have a simple or concise answer for that, but I do have some strategies that have been moulded over time that seem to work well for me. So let me share. 

1. Find your jam and own it 

There are so many ways to get exercise, so find what you like (if you haven't found it yet, I promise it is out there). I like spinning, running, hot yoga and Pilates. I don't like Crossfit, kickboxing, bootcamps or folk dancing. I suppose it is somewhat like dating - you have to play the field, stay open-minded and break-up with the classes/activities that mooch all your time and energy and spirit. You will refine your taste and start crush hard on some form of exercise(s). I find I go in phases (I'm poly-amorous, that way;), and cycle through different classes and modes of exercise until I start to get bored and need to mix things up. 

2. Schedule your workouts

Even I roll my eyes at this one, so I get it. Hear me out, though. You need to work out way less then you think, but you need to be efficient with your time and energy. When you schedule your workouts, much like you would schedule a meeting, you have already dedicated your time and attention to exercising - and that is half the battle. I workout MUCH less now that I have children, but my workouts are much more focused and effective, which gets me stronger/faster/leaner all the same. WIN.  Each week (if I am not training for something specific) I aim to do: 1-2 spin/bike workouts, 1 run, 2 HIIT/resistance workouts (30 min) and bite-sized stability work interspersed in the day (more on this soon). This equates to ~ 4 hours / wk, which is probably less time then I spend scrolling Instagram (sad reality). 

3. Eliminate barriers

If you think the only way to workout is to get a sitter for the kids, drive to the gym and use fancy exercise machines - then you are creating barriers along the way that become easy excuses to miss a workout. I understand that many people cannot workout any other way and the gym is their escape. The IKEA "start the car!" commercials come to mind.....BUT how many of you sign up for a gym membership with the best intentions, have A+ attendance for all of two weeks and then your membership card becomes as useful as a Blockbuster card? Umm hmm. With the advent of the world wide web and social media, there are so many ways you can workout at home by following a program with minimal equipment and loads of guidance. If this peaks your interest, then stay tuned ;)

4. Be strategic

This one may not be obvious, but has been a game-changer for me. When I think of my workouts for the week, I informally rank a workout based on time required and how kid-friendly it is (these are my two biggest barriers/excuses to miss a workout - yours might be different). For example, doing a cycle or spin = 1 hour of time, out of the house, no kids present. Yoga is much the same. Therefore, for me these workouts have to be done (way too) early in the morning. Doing a HIIT workout = 30 min of time, in-house or outdoors, kids optional. This becomes a little more attainable to work into the day. Stability work = 5-8 min at a time, in-house, kid-friendly. Therefore, I know that I have the most flexibility with my stability workouts and choose to do them in small gaps of time when I am with the kids / cooking a meal / watching Netflix. With this system, I maximize my time when I workout without the kids around (early mornings) and then fit in HIIT or stability work at home or at the park. As a bonus, kids tend to find it very entertaining to watch you jump around and pant like a jungle animal.  When I am giving exercises to patients, I tend to follow this same system when recommending how they execute. Some exercises can be done at the office, whereas others require more focus or need to be grouped together.  This may seem incredibly complicated and over-analyzed, but for me thinking of working out in this way gave me much more clarity into what I was doing and when and helped to eliminate some of the barriers mentioned above. 

I'll save you from the "go easy on yourself" schpeel....but, go easy on yourself! Going hard out of the gates or trying to look like a Kardashian are recipes for failure. Learn to be flexible, be creative and most of all, be realistic. You got this.