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Why your knee pain isn’t getting better.

Posted by Nicole Mims PT, DPT on September 18, 2018
Posted in: Beginners, How To/General Info, Personal, Uncategorized. Tagged: advice, chronic pain, DIY, exercise, health, health and wellness, healthcare, how to, kneepain, movement dysfunction, pain, strength. Leave a comment

Have knee pain but didn’t suffer some kind of injury?  You’ve probably tried the standard interventions Rest, Ice, Elevation, Compression, maybe even a brace or KT tape.  Airrosti anyone?  Chances are, this hasn’t done anything for your problem, the pain keeps coming back, or any time you try to go without the brace/kt tape the pain comes right back.

Right behind back and neck pain the most common area I seem to treat in the clinic is the Knee.  The above is how the story usually seems to go.  The aggravating factors?…Squats & Stairs.  So why isn’t your knee pain getting better or why does it always come back?  Because you’ve been treating the symptoms rather than the cause.  We can’t just ice the knee without asking WHY is it inflamed to begin with?  What caused the damage?

The answer: Poor Movement Patterns. 

When your tires are wearing weird on your car do you just replace the tires or do you check the alignment?

Why?  – Inward Rotation of the Knee
This can happen either because of hip weakness, foot weakness, or both.

5fdbf5876dc9165f1928cd289793ba26

from: https://goo.gl/images/cALrnH

  1. Weak Hips
    • It is very common for people (even frequent gym goers) to have weakness in the hips, specifically the muscles that rotate the leg outward. When these muscles are weak the thigh will rotate inwards as the hip flexes, causing the knee to ‘turn in’ or move inward in relation to the foot and hip.  If these muscles are very weak, this will happen when a person is standing on a single leg.

      glutues-medius-minimus-and-piriformis

      From: netter atlas of human anatomy

  2. Weak Feet
    • If a person has weak foot muscles their arch will collapse when put under increased strain.  If the foot collapses, the knee will again move in relative to the foot and hip.

      Image result for foot intrinsic muscles netter

      From: Netter atlas of human anatomy

  • Summary: The knee is the joint caught in the middle of two very problematic areas and when there is dysfunction, its often the knee that takes the brunt of it.

So the question is, when traditional methods fail what do you do?

  1. Form Check – Try squatting in front of a mirror or film yourself performing a body weight squat. Does it look like the picture on the left?  If so we’re talking about a movement impairment problem.
Runners-knee-diagram

www.aphysio.com.au/runners-knee/

2.  Strengthen

  • Hips – clamshell
    • Clam Shell

      Position: Laying on side, knees bent, feet together
      Heels, shoulders and hips aligned
      Tilt body slightly forward (pointing navel toward the floor)

      Action: Squeeze through your glutes (buttocks)
      Keep your heels together and lift top knee up.
      Hold 5 seconds, slowly lower to starting position. (In this photo I have a resistance band around my knees, this is a simple way to increase the challenge but is not necessary to benefit from this exercise)

      Form: Do not arch your back.
      Do not allow hips to rock back & forth.
      –You may want to perform with a wall or other straight surface behind you
      Keep glutes contracted the entire time.

      To increase the difficulty you can add a resistance band around the knees or hold for a longer period of time.

      20180706_1658223928457104468406484.jpg

    • Glute Bridge

      Laying on back, knees bent about 100 deg,feet on floor & close to the buttocks. Squeezing your glutes and ab muscles, push through heels & raise hips off the floor until hips and knees are in a line. (if you feel your back working, don’t lift your hips quite as high)

      Hold position 2 seconds

      Slowly lower hips back towards the ground and repeat. (you can add difficulty by placing band around knees.)
      Feet – 

image_062375.jpg

  • Foot Muscle Energy Technique 
    • Sitting upright, curl toes passively, using hand.
    • Remove assistance of hand and continue holding toe curl with muscles in foot.
    • Hold for 10 seconds.
toes1
toes point 2

       Toe curl and point

  • Sitting upright, leg extended out in front of you. Curl your toes around a small towel (dish cloth), you may need to bunch up the towel a little.
  • Keeping toes curled/holding towel with toes, extend your foot as if pushing a gas pedal. Try not to drop towel. Hold for 1 second and return to starting position.

from: HEP2go public

Towel Curls

  • While seated, place a towel on a smooth floor under the arch of the foot (heel is in contact with the floor). Curl your toes in pulling the towel back towards you.
  • Be sure to keep your heel in contact with the floor the entire time.
  • Place a small weight or bag of rice on the towel to increase difficulty

3.  Stretch

hep2go public

Standing calf stretch

  • Start by standing in front of a wall about an arms reach away, feet about hip width apart.  Step one leg back about 3-4 feet, keeping the leg straight.  Point the toe of back foot slightly in, plant the back heel.
  • Lean forward towards the wall as you allow your front knee to bend until a gentle stretch is felt along the back of your leg.
  • Hold for 1 min each side, repeat 2x.

– Credit to: www.enhancephysiotherapy.net

Lunge Stretch: Start in a lunge position, with the hip you are stretching as the back leg. Move your hips and torso as far forward as you can and make sure your back knee doesn’t slide forwards. Keep your torso upright and chest forwards. You can add more of a stretch by incorporating an anterior pelvic tilt – by tucking your buttocks underneath you and moving your pelvic bone towards you.

Related image

TFL Stretch – kneeling

  • Kneeling position, extend leg closer to the wall back and to the outside of the outer leg.
  • Bend front knee and lean hip that is being stretched into wall.
tensor fasciae latae stretch graphic

The backfixer.com

5. Support

  • If your feet are an involved component I highly recommend addressing your shoe-ware.  Unstable/soft shoes allow the arch to collapse if these are the shoes you wear when you lift, this compounds the problem.  Try buying a pair of “stability” shoes and using a pronation orthodic insert to help correct this.

Image result for stability shoes

Image result for powerstep inserts

The above interventions should get you on your way to correcting the ACTUAL problem rather than just treating the symptoms.  Fair warning: This is NOT a quick fix. Its not a magic pill.   It takes weeks for your body to build real strength and it takes many repetitions of doing something properly to make it habit.  The question is, is it worth it?  If the old methods aren’t working, isn’t it time to try something else?

Dr. Mims  PT, DPT.

 

 

 

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Interview with Seismic Systems

Posted by Nicole Mims PT, DPT on October 7, 2018
Posted in: About me, Beginners, How To/General Info, Motivational. Tagged: aboutme, advice, exercise, health, informative, interview, life, motivation, professional, self improvement, training. Leave a comment

Adobe_Post_20180911_095418.jpg

Check out my recent interview with Owner/coordinator of Seismic Systems, Rob Kabrich.

Rob is a health and wellness advocate who, through Seismic Systems helps others develop patterns to achieve their health, financial, and professional goals.

 

Who is Dr. Mims?

Dr. Mims started as an RRCA certified running coach and a NASM certified PersonalTrainer before going to school for a Doctorate in Physical Therapy. When I was looking for a trainer to get me to that next level after a long plateau she was the most organized and motivating trainer I found. She structured a solid program for me and in the first 6 months I was in the best shape I’d ever been in my life. She also is excellent at explaining the science of what is going on in your body during each phase of the program and the fluctuation in nutrition needs. I wanted to share her story and also hear her insights on health and fitness.

Robbackafterpic1
robfrontafterpic

How did you get into health and fitness?

I initially got into fitness because of my mom passing away.  She was a lifelong smoker. A short while after she passed I decided I was going to run a marathon.  To me it felt like the opposite of lung cancer & copd was running a marathon. The only thing I’d done before that was run track in high school.  I didn’t really know how to approach the marathon distance so I felt that the best way was to get some sort of coach or mentor so I didn’t hurt myself.  I was about 20.

How was the training for the marathon?  

It was a very daunting goal, especially as I had only ever run like 3 miles max so I decided to set a shorter term goal as a half marathon.   My coach, Narissa, was just coming back from a knee surgery and I was so impressed with her. I loved how she was able to lead the group and teach and work with each of us for our specific needs.

How long before you ran the half marathon?

It took about 14-15 weeks.

That seems short…

No, that’s not terribly short to do.  The first long run is about 5 miles. In a given week your mileage would be 20-40 miles with about a quarter of it being on the long run.  It gets technical if you want to do it right which is part of the reason why I appreciated having the group. The plan was kinda laid out for you, but 3-4 months is pretty doable.

So when did you get into lifting?

I started lifting initially in college but not seriously until after becoming a coach.  After the first year or so of running and being really inspired by my coach with RunOn I decided to go through a certification program offered by RRCA (Road Runner Club of America) so that I could do that for others. That was my first certification and I decided I wanted to coach and go the health and wellness route at that point. I had all but a semester’s coursework finished for my undergraduate and so it made sense to me to wrap up my degree and then go the fitness route after.

I graduated spring of 2010 and decided to move to Austin a few months later  both because I had friends here, and there was a good fitness community. I knew that I probably wouldn’t be able to make a good income only doing running groups, so I had branched out towards PersonaI Training and was studying for my Personal Training certification through NASM.  I took my certification after moving to Austin and then got a job working for Gold’s Gym. As they say, the rest is history.

So then what made you decide to pursue a Doctorate?

It was kind of a lot of different factors.  Training requires a lot of “selling” and it really didn’t let me have the work-life balance that I wanted.  I was also a bit bored. I was able to help people achieve their goals but it was often a method of ‘just apply the formula.’.  Another component was that the gym environment is very testosterone driven. Success and respect had more to do with how much muscle mass you have and not necessarily what you knew.  A person could be a twig but that doesn’t mean they don’t know what they’re talking about. Vice versa you can gain muscle mass while doing things wrong. Just because you haven’t been injured yet, doesn’t mean you won’t.  So it ends up that because women don’t have the benefit of testosterone…a lot of us aren’t taken seriously.

 

I didn’t feel like I was having as much impact on people’s lives as I could and Physical Therapy seemed like a way I could do that, without having to deal with the things I disliked about training.  

Tell me more about a trainer not looking a certain way, cause I’ve felt that way about trainers myself

It’s understandable to, for example, want to go to a hairstylist that has good hair but in the gym it went further, it went into being female.  I was pigeonholed into being more about fat loss because I was female…still am, last time I checked anyway. There are plenty of women that do just fine, but it was another thing on the laundry list.   Now I can say “I’m a Doctor here are my credentials.” Also in PT I don’t have to sell, they’re already there to see me. And there’s never a simple formula which keeps things interesting.

What would you say to people about having a trainer?

First it’s about getting the right trainer.  Having a good trainer is a very valuable resource.  

Because…?

Trainers, when they’re doing their job properly, have a plan.  They take the information, they do an evaluation, and see what you need.  Which is easier for them than it might be for you to do for yourself. You might think you need a bigger chest but really there is a posture issue and you need to work on your back so you aren’t hunched forward and essentially hiding your chest.  Hopefully they know what they’re doing, and they’ll be able to advise you on how to lift, not just what to lift. Ballpark estimate, 75% of the people I see in the gym are lifting poorly. Lifting with bad form won’t necessarily affect you today or next week but eventually you’ll bend down to pick up a pencil and that’ll be the day your back gives out.  It wasn’t the pencil, it was years of improper movement and lifting. A qualified trainer can help prevent that by adjusting form.

 

There’s the variety as well.  Not doing the same thing everytime you go to the gym.  Being taught how to do new things and lift in new ways, well.  Having accountability. A good trainer is going to take initial measurements and do checkin measurements along the way to see if you’re headed in the right direction.  They’ll also grump at you if you don’t show up. They’re also the one that is going to make sure you’re doing your homework.

Any person’s success in the gym, or anything else in life really, is consistency.  So if you’re not doing the things you’re supposed to do when you’re not with your trainer, you’re just throwing money down the drain…a good trainer will emphasize that to you.

What are some examples of homework?

It could be the dietary changes you need to make.  Most often it’s doing your lifts outside of when you see the trainer.  Most people can’t afford to see a trainer all of the times they should be at the gym.  Your homework would be doing the workouts in between the times you’re seeing the trainer.  That may be repeating a workout or doing some specific exercise classes.

For example with fat loss clients, I would often have them check in with me before they went to a spin class.  They were getting accountability for those other workouts.

What would you suggest for people that can’t afford a trainer?

Using the resources trainers use.  ACSM, NASM, ACE, there are even PT’s that do videos on youtube about how to do specific exercises.  You can get a training program from a credentialed person or a book and then look up how to do the exercises properly.  Main takeaway is to get a program from a credentialed person not just your fit friend, ‘Joe.’ Just because someone has muscle mass doesn’t mean they are educated or qualified to give advice for your specific needs.  

 

You want the resource that you’re getting fitness advice from to be evidence based.  So if your fit bro tells you that ACSM says to lift 3 times a week and do 150 minutes of moderate cardio…they’re not wrong, and they have a resource. When it comes to fitness in general, people need to get better about asking “what is your source?”  

 

One of the frustrations about health and fitness is that everyone has opinions about things but most of the time they don’t have evidence to back it up.  You end up with a lot of conflicting information.

What are the most common misconceptions you heard as a trainer?

whew….One of the biggest ones I saw and was guilty of believing in myself for a while, was that you should do everything minimalist in the gym.  Wrist wraps were bad, weight belts were bad, supportive shoes were bad, gloves were bad. All of the things that in these people’s minds kept your body from adapting were bad.  The idea was that if you did unstable lifts without any assists, then you would overall become stronger and more stable. The thing is, doing a lift unsafely plus weight doesn’t mean you’ll adapt, it just means you’re more likely to get injured doing it. Many other things aside, does this make sense in a risk/benefit ratio?  In the end isn’t health/muscle building without injuring yourself, more important than bragging rights about being able to do a deadlift without a belt?

How do you work around this bro mentality of “I know what I’m doing?” Even though it’s wrong?

Again, I’d go with seek out credible resources and be ready with them.  Has someone done studies on this thing you’re interested in? Is it a group that has done credible studies in the past?  Are they independent, or will they somehow profit from the results? If an independent group has done a study that x number of grams of protein after working out has a maximum amount of benefit that’s different than if a company that sells protein supplements says it. Also, how recent is your information?  If it’s older than 5 years, you may want to check out newer studies.

I remember you talking about how magazine’s job’s are to sell you magazines

A magazine tells you you should buy this new type of shoe because the shoe company pays for ad space.  

What about the workouts in these magazines?

It depends on their credentials, those articles are written by people.  If someone has the education or experience to back up what they are saying, they will include that in the article.  To be clear, education doesn’t necessarily mean a degree, it means certifications, experience, references, etc.

Any other common misconceptions?

Tons…”fat is evil, carbs are evil.”  “If you want to lose fat you have to eat under 1200 calories per day.”  One of the biggest ones, that’s a pet peeve of mine, is that if women start to lift they will look manish.  I can’t tell you how many clients I’ve had that were worried about this. If you find a way to bulk up like a bodybuilder on accident, I want you to call me because I will sell that shit.  Women bodybuilders that are at that level put in tons of time and focus on their diet to get specifically to that point. It’s disrespectful to those women to think you’re just going to wake up stacked one day.  I think that myth is dying off somewhat but it’s still a thing.

 

One misconception/fad that I’ve heard of recently is you’re not lifting heavy enough if you don’t lose bladder control.  

That sounds like a terrible idea…

Yeah, no kidding.  I think this was another one of those lovely fads we can attribute to crossfit.  Occasionally the pelvic floor can become weak in some people and they can develop what’s called ‘urinary stress incontinence.’  The person may have bladder leakage when they bear down during a workout….but this is by no means healthy or a sign of ‘trying hardest,’ and glorifying it causes people (women especially) to ignore a real health problem.

O_0….holy crap!  So, yeah, there are tons of misunderstandings about lifting and nutrition.  The successful people that I know have good eating habits. Nutrition is like a whole huge thing and we could spend another interview just to go into nutrition.

True, it’s a topic that can get very complicated, very quickly.  One of the few cliches I’ve heard in the gym that actually stands up is the one “you can’t out-exercise a bad diet.” Most people eat more than they think they do and burn less than they estimate with their exercise.  If I had to emphasize anything I’d say “be conservative with your estimates and make good common sense choices.”

 

Check out Rob’s website at seismicsystemswork.com 

If you like this article you may also like: Max Strength – ‘How To’ and Sample Week

Safely transition between phases of training.

How to survive a busy gym AND get a good workout!

I want to lose body fat!  What do I do?

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Lead by example

Posted by Nicole Mims PT, DPT on September 11, 2018
Posted in: About me, Motivational, Personal. Tagged: fitness, health, lead by example, lifestyle, motivation, self improvement, self love, wellness. Leave a comment

Many of our health habits we get from how we are raised and what we saw adults do. You can choose to be an example of what to do, or what not to do.

Make a healthy choice today.

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Max Strength – ‘How To’ and Sample Week

Posted by Nicole Mims PT, DPT on September 3, 2018
Posted in: Beginners, How To/General Info, Personal, Workouts. Tagged: advice, exercise, fitness, gym, health, how to, informative, progress, resistance training, self improvement, sports, training, weightlifting, wellness, women, work, workout. Leave a comment

Ever heard people discuss their “phase” or “stage” of training and wonder what the heck they were talking about?  Like a lot of fitness buzzwords, people like to throw these terms around without much explanation as to the what/how/why.  If you are fuzzy on the purpose of training phases in general, please check out my most recent article on what the phases are, and how to transition through them.

As I discussed previously, progressing through phases of training can provide a structured way to change up your routine and continually challenge yourself, provided it is done with planning and care.  I myself use my own modification of the NASM’s phases for my personal and my client’s programs.  One of my favorite phases to work in is the one I just started last week called Max Strength, and what that entails is what I would like to discuss today.

Why: The purpose of Max Strength training is fairly self-explanatory with the goal being to increase the maximum amount you can lift in a single repetition or very short period of time (__<6 reps).  You do this by performing a relatively LOW number of repetitions, at a high intensity, for a high number of sets.   This increases the density of your ‘fast twitch’ or explosive muscle fibers by placing short time/high resistance strain on the body.

What:  Exactly what do I do to place this kind of strain on the body? The breakdown of structure is as follows.

Sets Reps  

Timing

(Ecc/Iso/Con)

 

Intensity

% of 1RM

Week 1

4-5

6

1/0/1

85%

Week 2

5

6

1/0/1

85-90%

Week 3

5-6 4-6 1/0/1

90%

Week 4

6 4 1/0/1

90-95%

Week 5 *

6-7 3-4 1/0/1

90-95%

Week 6 * 7 1-3 1/0/1

95-100%

*Optional

How: What does this look like in a day to day? Now that you have a basic idea of what Max Strength Training involves, here is a sample using my personal workouts from last week.  If you were interested you could take this week as an example and repeat it across your entire phase, changing reps/sets/ and weight as needed.

Week 1 – Day 1: Legs

 

 

 

Super-set 1

Set 1 Set 2 Set 3 Set 4 Set 5
Reverse Lunge 6/95# 6/95# 6/95# 6/95# 6/95#
Single Leg Calf Raise on decline 10/+20# 10/+20 10/+20 10/+20 10/+20
 

Super-set 2

Stiff Legged Deadlift 6/125# 6/135# 6/135# 6/135# 6/135#
Back elevated Glute Bridge, with band 10/BW 10/BW 10/BW 10/BW 10/BW
 

Final – Stand Alone

Sumo DL 6/155# 6/175# 6/155# 6/155# 6/155#

 

Week 1 – Day 2: Vertical Push/Pull (Lats, Shoulders, Legs)

 

Circuit 1

Set 1 Set 2 Set 3 Set 4 Set 5
Wide Grip Lat Pull down 6/105# 6/105# 6/105# 6/105# 6/105#
Shoulder Fly/abduction 6/12.5# 6/12.5# 6/12.5# 6/12.5# 6/12.5#
Functional Squat (to 90 deg, band below knees) 10/ BW 10/ BW 10/ BW 10/ BW 10/ BW
 

Circuit 2

Neutral Grip Lat Pull down 8/105# 6/110# 6/110# 6/110# 6/110#
Barbell Shoulder Press 8/50#

*no 60# available

8/50#

 

8/50#

 

8/50#

 

8/50#

 

Single Leg RDL 10/BW 10/BW 10/BW 10/BW 10/BW
 

Circuit 3

Underhand Grip Lat Pull down 7/105# 6/110# 6/110# 6/110# 6/110#
Post Delt cable pull back 6/40# 6/40# 6/40# 6/40# 6/40#
Monsterwalks, heavy resistance band 8/BW 8/BW 8/BW 8/BW 8/BW

 

Week 1 – Day 3: Horizontal Push-Pull (Chest, Back, and Legs)

 

Circuit 1

Set 1 Set 2 Set 3 Set 4 Set 5
Dumbbell Chest Fly 5/2×30# 6/2×25# 6/2×25# 6/2×25# 6/2×25#
Single Arm Dumbbell Row (lawn mowers) 6/50# 6/50# 6/50# 6/50# 6/50#
Back elevated Glute Bridge with band around knees 10/ BW 10/ BW 10/ BW 10/ BW 10/ BW
Jump Rope 30 sec 30 sec 30 sec 30 sec 30 sec
 

Circuit 2

Machine Chest Press (neutral) 6/80# 6/80# 6/80# 6/80# 6/80#
Machine Wide Row 6/2×50# 6/2×55# 6/2×55# 6/2×55# 6/2×55#
Monster Walks with heavy band 8 each direction 8 each direction 8 each direction 8 each direction 8 each direction

 

Week 1 – Day 4: Legs

 

Super-set 1

Set 1 Set 2 Set 3 Set 4 Set 5
Hex Deadlift 6/155# 6/165# 6/175# 6/185# 6/190#
SL calf raise, on decline 12/BW 12/BW 12/BW 12/BW 12/BW
 

Super-set 2

Leg press 6/315# 7/340# 7/350# 6/360# 6/360#
Single leg RDL 8/ BW 8/ BW 8/ BW 8/ BW 8/ BW
 

Super-set 3

Sumo Dead-lift 6/155# 6/155# 6/155# 6/155# 6/155#
Jump Rope 30 sec 30 sec 30 sec 30 sec 30 sec
 

Super-set 4

Hip Thrust with Barbell 6/135# 6/155# 6/155# 6/155# 6/155#
Low Ab-roll 8/bw 8/bw 8/bw 8/bw 8/bw

 

* Here is a short video I took of myself doing HEX dead-lift that night.

 

 

Week 1 – Day 5: Vertical Push-Pull (Lats, Shoulders, Legs)

 

Circuit 1

Set 1 Set 2 Set 3 Set 4 Set 5
Underhand Grip Lat Pull down 6/120# 6/120# 6/120# 6/120# 6/120#
Barbell Shoulder Press 5/60# 5/60# 5/60# 5/60# 5/60#
Functional Squat, band around knees 10/BW + heavy

Band

10/BW + heavy

Band

10/BW + heavy

Band

10/BW + heavy

Band

10/BW + heavy

Band

 

Circuit 2

Neutral Grip Lat Pull down 6/120# 6/125# 6/125# 6/125# 6/125#
Dumbbell Shoulder Fly 6/2×15# 6/2×15# 6/2×15# 6/2×15# 6/2×15#
Single Leg RDL 8/BW 8/BW 8/BW 8/BW 8/BW
 

Circuit 3

Wide-grip Lat Pull Down 6/105# 6/105# 6/105# 6/105# 6/105#
Posterior Delt Cable Pull back 6/35# 6/35# 6/35# 6/35# 6/35#
Back elevated, glute bridge. Band around knees 12/BW 12/BW 12/BW 12/BW 12/BW

 

Week 1 – Day 6: BEACH!!! (Arms, Abs, Calf)

 

Circuit 1

Set 1 Set 2 Set 3 Set 4 Set 5
Cable Tricep Extension, forearm pronation (bar handle) 8/30# 8/35# 8/40# 7/42.5# 7/42.5#
Dumbbell Hammer Curl 7/2×20 7/2×20 7/2×20 7/2×20 7/2×20
V-up core 12/BW 12/BW 12/BW 12/BW 12/BW
 

Circuit 2

Standing, single arm Tri extension, (neutral forearm) 8/15# 8/15# 8/15# 8/15# 8/15#
Preacher Curl with bar 6/40# 6/40# 6/40# 6/40# 6/40#
Single Leg Calf Raise on decline 12/BW 12/BW 12/BW 12/BW 12/BW
Leg Raise 10/BW 10/BW 10/BW 10/BW 10/BW
 

Circuit 3

Classic Crunch 30 sec 30 sec 30 sec
Oblique Crunch Left 30 sec 30 sec 30 sec
Oblique Crunch Right 30 sec 30 sec 30 sec
Bicycle 30 sec 30 sec 30 sec
Clam 3 20/bw 20/bw 20/bw
Band resisted Glute Bridge 20/bw 20/bw 20/bw

 

Keep in Mind that these are my personal workouts, and thus what you can do in the gym may be much more, or less.  Go based on how you feel, but always try to challenge yourself.

I hope this was helpful.  Please leave any feedback in the comments below.

Best,

Nicole Mims.  PT, DPT.

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Safely transition between phases of training.

Posted by Nicole Mims PT, DPT on August 26, 2018
Posted in: Beginners, How To/General Info, Motivational, Workouts. Tagged: advice, DIY, exercise, fitness, health, how to, informative, progress, self improvement, training, workout. Leave a comment

Changing up how you train is an important component in preventing plateaus and continuing to make progress towards your goals.

contemporary gradient handrails perspective

Photo by Pixabay on Pexels.com

In order to accomplish this in a structured way many trainers organize how they progress their clients through ‘training phases,’ each of which has its own ranges of sets/reps/and intensity (percentage of one rep max) meant to achieve a specific purpose. Each phase and its respective goals lead into and help you progress towards the next.  Every different trainer/ certification program has their own subdivided phases.

The primary phases of training that I use include:

  • Stabilization (muscle endurance, balance, joint stability)
  • Hypertrophy (gaining muscle size, building strength, some muscle endurance)
  • Max Strength (explosive strength, increasing the maximum you can lift in one rep)
  • Conditioning (power, fat loss)

phases of training

Changing up training should be approached carefully as you are (by its nature) putting a different type of strain on your body, and thus there can be a risk of injury. Here are a few guidelines to help.

1) Begin conservatively! You aren’t responsible to numbers. If, for example, the phase you are in has you lifting 65-80% of your 1 rep max, start off on the 65% end of this range and work your way up from there. If this feels easy the first day, give it a workout or so to see how your body responds and then increase.

2) Take rest breaks and days off as you need them (aka, listen to your body). Remember that even if you’ve been working out for some time (months, years, etc) changing your training places new stresses on the body and it might take a few days to acclimate.

3) Record your workouts including the weight/resistance you use for each exercise. This will help you track your progress and give you a good starting point the next time you perform that particular lift. For example, if I lifted 4 sets of 10 reps with 50 lbs last week, this week I might go for 4 sets of 12 or increase the weight by 5lbs.

4) Be patient to see change. It takes the body about four week to make visually noticeable changes. Don’t let yourself get caught up in measuring or comparing your physique everyday/ every lift. Instead set regular check in periods at the end of each phase or once a month. This will keep you accountable but prevent being disappointed because you can’t see a difference in your day to day.

This is my recent check in (about 4 weeks apart) and it was a huge motivator for me to compare these two photos.

5) Talk is cheap. Actually change your training! There are a lot of people who say that they are sick of plateaus; and yet they enjoy knowing exactly what they will do in the gym. “Bench at 135, then incline at _____, then triceps.” The idea of changing how they train and making gains sounds good, but its hard to break out of our comfort zones. When you get to the end of your cycle measure the change you made, review your previous workouts, and then move the f– on. If you stay in the gym consistently, your favorite phase will come right back around in a few months, and chances are good that you’ll perform even better the next time.

I hope you found this helpful and please reach out if you have any questions.

Nicole Mims. PT, DPT

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Break out of the Rat Race

Posted by Nicole Mims PT, DPT on August 19, 2018
Posted in: Beginners, Motivational, Personal. Tagged: #selfimprovement, advice, dedication, exercise, fitness, fuel, Sunday, training, Workouts. Leave a comment

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Working in Comfort without breaking the bank

Posted by Nicole Mims PT, DPT on August 10, 2018
Posted in: Beginners, How To/General Info, Uncategorized. Tagged: back pain, desk job, DIY, ergonomics, neck pain, positioning, posture, self help, self improvement, sitting, work, work environment. Leave a comment

group of people having a meeting

Photo by rawpixel.com on Pexels.com

Most people who work at a computer/desk job have experienced neck or back pain from time to time. Some people are fortunate enough that their company will invest in ergonomic experts and finance purchasing good chairs, standing desks, or elevating monitors… the rest of us mortals have to make do with what we have…many people equate that with “suffering through,” but it doesn’t have to.

Enter your friendly DPT!

There are some things that can be done to help you improve your ergonomics without investing in crazy expensive chairs or desks attached to treadmills. Check out my video and the info below for tips.

(working on the sound quality. Bear with me 🙏)

1) Position the monitor approximately 18-24 inches from your face. You can either move the monitor or the chair to achieve this effect. The center of the screen should be just below the level of the eyes when sitting up straight. You want your ear to be about in line with the point of your shoulder.

–If your monitor is too low, try putting it on either a stand or a couple of those books you haven’t opened in a while.

2) The Key board should be close enough that your arms can remain bent and you can ‘float ‘ your wrists while typing. You can accomplish this again by moving the keyboard or your sitting position.

— If you use a laptop at work try purchasing a separate USB plug-in keyboard. You can then put the screen of the laptop where you need it to be and move the keyboard around.

3) Shoulder position should be just slightly elevated so that the muscle that goes from your neck to your shoulder (trapezius) is relaxed. When your arms are out to type or on your armrests. If your arm rests don’t elevate, try rolling up a small towel and fixing them to the armrests you have. It may not look too pretty but at least it’s not a pain in the neck. (Pun intended 😂😂)

4) Sitting Position should be upright in your chair with the hips tucked under you. I explain in my video above how to find this position. After you find a good posture, then use a towel roll or a ‘lumbar roll’ to fill in the space between your back and the back of the chair.

5) Knee position relates to sitting posture above. You want the back of your knees to be about 2 inches from the front of the chair to make sure you don’t have pressure on the back of the knee. If your seat is too deep, try scooting forward and using a larger towel roll for step 4.

20180810_163502.jpg

6) Feet should be flat on the floor when you have a 90 degree bend in the knee. If you find yourself unable to touch the floor try putting your feet on a stool or another large book. This helps keep the legs relaxed and the weight of the legs from pulling you forward in your chair.

To review, try sitting like this:

Not this:

You may also like:

Stretching to Fix YOUR posture: correcting for rounded shoulders
Stretches to fix YOUR posture. – correcting ‘forward head’Flexibility Training – Part 1 (why do I care?)
Safe Strength Training – Classic Squat alternatives

Sincerely,
Nicole Mims. PT, DPT.

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How to survive a busy gym AND get a good workout!

Posted by Nicole Mims PT, DPT on August 8, 2018
Posted in: Beginners, How To/General Info, Workouts. Tagged: advice, alternatives, busy gym, circuit training, exercise, fitness, gym, health, how to, lifting, resistance training, sports, weightlifting. 2 Comments
time lapse photography of people walking on pedestrian lane

Photo by Mike Chai on Pexels.com

Scenario: You leave work and head towards the gym with all the best intentions… You pull up and the parking lot is PACKED… S#!T.   Immediately your brain starts coming up with reasons to turn your car around “it’s too busy to get in a good lift” “all of the equipment will be taken” “some one always gets on the machine I’m using between sets” “I feel like people are judging me” “I’ll go in a few hours”..etc.   (hint: you probably won’t go back in a few hours. )

adult dark depressed face

Photo by Pixabay on Pexels.com

As a person who used to work at a gym 4 am – 7pm I developed a few strategies on how to get in a good workout (or help your client get in a good workout) during the busy times.  So lets review and quiet those demons on your shoulder.

  1. Know the muscle groups you are trying to exercise, not just the exercises themselves and learn alternative exercises.  That way if  ‘x’ machine is being used, you have other options.  This reduces stress and waiting around.  So for example say the Bench Press is being used, you can grab a set of dumbbells or even a resistance band and do a press or chest fly. If you’re going heavier try putting some plates on your back and do push-ups, or challenge your stability with kettlebell push-ups or stability ball chest press.
  2.  Be flexible with the reps you are willing to do/ weights you’ll accept.  Remember that the most important thing is that you challenge yourself! So…if those 35’s you really would rather use aren’t available, try more reps with the 30’s or fewer with the 40’s.  Who knows, you might surprise yourself and hit a PR (personal record).
  3.  Try circuits which require 1 piece of non-movable equipment and bring the other things you need to that spot. People are much more likely to understand that you are using the seated cable row if you also have your dumbbells, towel, resistance band and barbell set up with you…. kinda like nesting but for the gym :’D.  Additional benefits are all those related to circuit training in general. Its faster, you hit more groups, its more efficient, you burn more calories and so on.

    gym1

  4. Integrate cardio and stretching into your sets.  Perform any stretching you feel you have to do (see my previous posts on flexibility first) during your warm-up sets. Additionally, try jumping rope, step-ups, wall jumps, or mountain climbers in between your sets if the cardio machines are taken.  This will keep your heart rate going and not leave you frustrated waiting for a machine or a mat.
  5. Finally: Don’t be afraid. Nearly everyone at the gym is there because they see something THEY need to improve and they are just trying to brave the crowded gym too.  Unless you are breaking gym etiquette, chances are they aren’t looking at you.  In that vein
    1. Don’t be afraid to ask someone to work in or when their sets will be done. Wait until they’ve finished their set (of course) and make sure you put their weights back how you found them. But otherwise its a completely normal thing to do if there is a type of equipment that you really had your heart set on.
    2. Don’t be afraid to tell someone that you are still using something.  Say you come back from refilling your water bottle and some lunk is taking off with your barbell.  You have the right to tell them that it is still in use and you will flag them when you are done.
    3. Don’t ignore a free bench cause its close to someone who is ‘more fit’ than you.  They were where you were once.  (if you’re the fit person in this scenario, keep the grunting and flexing to a minimum…you’re in public dude)

 

I hope you found this helpful.  If you have other tactics or questions, please feel free to leave them in the comments!

Best,

Nicole Mims. PT, DPT.

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Stretching to Fix YOUR posture: correcting for rounded shoulders

Posted by Nicole Mims PT, DPT on August 6, 2018
Posted in: Beginners, flexibility, How To/General Info. Tagged: exercise, fitness, flexibility, general health and wellness, health, healthcare, how to, informative, motivation, physicaltherapy, safe exercise, self improvement, stretching, training, wellness, workout. 1 Comment

Ever wonder why your shoulder or neck hurts when you reach overhead or while you’re lifting weights? Chances are good that posture is a contributing factor. One of the most common postures I see across age groups is where the shoulders (where the upper arm meets the collar bone and shoulder blade) are slightly rotated in. This happens often for 3 main reasons. 1) some muscles are long and weak 2) some muscles are short and/or stiff 3) You habits feeding into the above.

So we know that this can be an issue, the next question is “how can I fix this?”

Check out my video below where I target the flexibility portion of this question.

stretching to fix rounded shoulders

If you think you might have poor posture, you may find a prevous post helpful as well which addresses Forward Head Posture .

I hope this is helpful.

Best,

Nicole Mims. PT, DPT.

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Wellness: healthy body + clear mind

Posted by Nicole Mims PT, DPT on August 3, 2018
Posted in: Beginners, Motivational, Personal. Tagged: balance, dedication, effort, exercise, fitness, general health and wellness, health, motivation, motivational. Leave a comment

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