Exercise, Experts and Spine & Joint Health
The health benefits of regular exercise are well known. We exercise for weight loss, physical therapy, enhanced performance, aesthetics, and general well-being. I see patients from all walks of life and each one of them faces his own unique set of challenges to health and fitness. Injuries can pose short-term or long-term challenges and frustration. It’s easy to feel as if you’re backsliding rather than making strides toward your fitness goals.
As a chiropractor, I know that spine and joint protection are key to avoiding injury during exercise. I look at exercise through this lens and attempt to educate my patients about the structure and function of their spines and joints. I also want my patients to enjoy the fulfillment which comes from exercising in a variety of ways while experiencing pain-free training.
With that goal in mind, I’ve created a 5-part educational series in which I interview a master Pilates instructor, yoga therapist, physical therapist, strength coach, and spin instructor. I want to introduce you to different types of exercise with an emphasis on spine and joint protection. I hope you’ll benefit from the unique insights provided by these fitness experts.
Michelle Wall, Doctor of Physical therapy
My third conversation was with Michell Wall, DPT, obstacle course athlete, and half marathoner. I talked with her recently about injury prevention, rehabilitation, and health and fitness. Head over to her Instagram page to see her in action! Here are the questions I posed to her and excerpts from her responses.
As a Doctor of Physical Therapy (DPT) what are some of the toughest challenges you face with patient rehabilitation?
Answer: As a DPT, there are tests we can perform to figure out exactly what is wrong with a patient. However, one of the toughest challenges that we face is that no two patients are exactly the same. Two patients might have the same symptoms, but the cause may be different. Or on the contrary, two patients may have completely different outcomes or recovery to the same surgery or injury. Therefore, being able to understand and effectively treat an extensive variety of different diagnoses and injuries is a big challenge. But it’s also one of the most rewarding part of being a PT…being able to take that challenge, figuring out the source of their symptoms and then helping them return to their prior level of function and/or independence.
On the same note, another challenge is coming across a patient that just doesn’t get better or doesn’t improve to the level of mobility that they want. This is frustrating for not only the patient, but also for us as Physical Therapists as we want to be able to rehabilitate all of our patients fully.
How do you measure success with your patients?
Answer: I feel that the best measure for success for my patients is the return to their prior level of function. Whether that be competing in high level athletics or just being able to walk around the block. Everyone’s activity level is different, however most people have a common goal, which is to be able to do what they could prior to injury/surgery. To build on this, I want to be able to instill in each patient the education to prevent re-injury in the future.
When you train (obstacle course athlete, marathoner, high intensity interval training (HIIT), climber) how do you incorporate what you know about biomechanics to prevent injury?
Answer: When I train, no matter what activity I am participating in, I am always aware of my body mechanics and always aware of what “my body is doing in space,” also known as proprioception. With any type of lifting it is very important to maintain good posture and a tight core to avoid injury. With any activities where my feet are in contact with the ground at some point (whether it be squats, running or HIIT workouts, ie), I am also always aware of the position of my knees. If our lower body is not aligned properly, then this can lead to injury anywhere along the Lower Extremity chain, as well as the spine. For example, if you let your knees fall in, say during squats (a common symptom of hip abductor and external rotator weakness), then your feet will also roll in and your hips will turn in, possibly leading to strain on the spine as well. Along the same lines, if you have flat feet, then your knees and hips will fall in as well. Therefore watching your biomechanics and keeping your body in the correct posture is very important when performing any kind of activity, in order to prevent injury. Most musculoskeletal injuries have a mechanical cause, so if you are not sure of what your correct biomechanics should be, then you should consult with a professional prior to performing that exercise or activity.
What are your thoughts on the group training rage?
Answer: I think it’s great and I actually participate in a group Bootcamp class, at OC Fit in Tustin, 5-6 times per week. I think it is great for all activity levels and can be highly motivating for both the elite athlete as well as the couch potato who doesn’t want to exercise at all. Seeing other people get up and move is motivating and everyone seems to encourage each other. I think it also holds people accountable to get up and get to class to workout. If you don’t show up to your regular class then the instructor and other class members question where you are. Of course this setting is not for everyone, but I think it is a great option to incorporate into a regular exercise routine.
As a woman that cross-trains, what is your strategy to avoid injury and protect your spine? Are there “don’t do rules” that can protect athletes when training?
Answer: One easy strategy I use to avoid injury and to protect my spine is to do just that, cross train! Repetitive use of the same structures of your spine/body actually makes you more prone to injury. Varying your movements with different activities or exercises, strengthens different muscle groups in different positions, and actually protects your body from injury by decreasing the strain on individual muscle groups. Having strong core muscles is also very important to provide support for the lower back and spine and to avoid injury.
Other important strategies include warming up and stretching appropriately, staying hydrated, maintaining good posture, and listening to your body so you don’t overdo it. Make sure you take rest breaks and rest days to let your body recover.
One “don’t do rule” as mentioned above…Don’t overdo it! A tired body can lead to poor mechanics and technique and therefore injury!
If you were forced to limit yourself to one activity or exercise what would that be?
Answer: Oh…that’s a tough one! Really, just one? I really love so many different activities right now from Paddle Boarding, to Obstacle Courses, to Rock Climbing. I think I would have to stick with my Bootcamp though and I say this because it is the best combination of strength training and cardiovascular training all packed into a quick (yet efficient) 45 minute workout. Both strength training and cardio are very important to your overall health and fitness. I love the group interaction as well, so I don’t get bored like I would training in a gym by myself. I also love the motivation of the coaches/trainers pushing you beyond your comfort level at times, which is difficult to do on your own.
What are some of the best decisions you have made related to your health and fitness?
Answer: I think the best decisions I have made related to my health and fitness are to workout (almost) daily and to eat right. While this may seem simple, it can be very difficult to stay on track. The benefits of regular exercise or physical activity are numerous…decrease risk of cardiovascular disease and diabetes, strengthen your bones and muscles, improve your mental health and mood, increase your chance of living longer. The list goes on. Many people will start on an exercise program and eventually lose interest. The key is to find something that you enjoy doing. You should look forward to exercising, it shouldn’t be a chore. Find a group class to join with a friend, go outside for a run with your dog, rent a kayak at your local beach or lake. Make it fun and that way you will stick with it!
As far as diet and eating healthy goes, the best thing I have done was choosing to “go Paleo” about three years ago. It was definitely a great fit for me and has left me feeling healthier and stronger now than I was when I played Division I Tennis in college. Now don’t get me wrong, I still believe in somewhat flexible eating and I definitely don’t stick to this 100% of the time. I like to say that I eat Paleo about 75% of the time. I feel that if you cut out certain things completely then it usually makes you want them more. I do avoid processed foods and artificial sweeteners all of the time though. I truly believe that abs (and overall health) are made in the kitchen! You can’t out train a bad diet!
As a mother, what one piece of advice would you give to other parents to help their kids avoid a sports related injury?
Answer: I think that communication is one of the most important things we can do as parents, to help prevent our kids from getting injuries. Encourage your child to communicate any pain or injury they may have to either you or their coach or another adult. Remind them not to play through pain. The sooner an injury is diagnosed, the more effectively it can be treated and the sooner they can return back to their sport.
Also, as a parent, watch their practices (at least from time to time). Make sure they are getting an appropriate warm up and performing with good technique. As mentioned before, poor technique or biomechanics is the cause of most injury. If you notice they are doing something wrong then mention it to their coach or invest in private lessons to correct it. Poor technique will only hurt them in the long run!
For parents of pre-teen to teenaged girls, who play quick sports that involve cutting, planting and then changing direction (such as basketball, soccer or volleyball) injury prevention is especially important. Female athletes, primarily in these sports, sustain non-contact ACL tears 4-6 times more often than boys in the same activities. This can be due to weakness in the hip region and/or the wider angle of their hip joint causing their knees to bend inward as they land. For these athletes focused conditioning/strengthening and proper biomechanics is crucial to prevent injury.
I thank Michelle for this interview! It's great to hear her perspective and learn about her own personal approach to fitness and injury prevention. The great thing about Michelle is that you won't get lip service, she devotes a great deal of her time working towards her own fitness goals and helping educate people in the process.