A Dose of Reality From Mauro Pilates


 

It was embarrassing.

I considered myself a reasonably fit guy, but suddenly I was being asked to do things my body just couldn’t figure out. Not only that, but it was happening routinely.

I’m not talking about a bootcamp, crazy calisthenics, or the next breakdancing craze. I’m describing straightforward, well-intentioned Pilates instruction from Liana Mauro of Mauro Pilates.

Sometimes, balance and coordination are key.

Sometimes, balance and coordination are key.

I was okay with the basic movements. A leg press on the reformer, or a straight arm pulldown from overhead to my sides (like a lat pulldown, for those familiar) came relatively easy.

But then, Liana took me through exercises that I had apparently swept under my strength-and-fitness rug. Balance on opposing hand and knee on an unstable surface? Simultaneously engage my core and twist through my trunk? Or, god forbid, work the muscles on the side of my pelvis with a leg-lift or hip rotation? Forget it. Not happening.

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Liana Mauro on 10 Ways Pilates Can Help You


Mauro Pilates

Let’s get one thing straight: I am not a Pilates expert.

I do know a thing or two about staying healthy and injury-free, however.  And I know when I’m out of my league when it comes to knowledge about a particular discipline, especially in the health field.

So, when I wanted to learn more about Pilates, and how it could help both me and my patients, I tracked down Liana Mauro.  I’ll be posting a full run-down of my experience with Liana and her staff at Mauro Pilates soon.

For now, know this: Liana is patient, careful, observant, and knowledgable about putting together a Pilates regimen that is effective, fun, and safe.  I don’t hand over the reigns of my blog frequently, so trust me when I say that you’re in excellent care with the information presented below.

Be sure and read down to the end of the article, where Liana has included an enticing offer.  This wasn’t solicited, and I include it here only because Liana is a practitioner I respect and think should be more widely known.

Welcome Liana Mauro….

10 Ways Pilates Helps Heal and Prevent Injuries

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Choose your exercise wisely


We choose our life activities – including exercise – based on what makes us feel good. If it feels good, does that also mean it’s good for us?

Staying Injury Free in the Weight Room


Image by Vox Efx

Photo by Vox Efx

Let’s talk about weight. Not the kind you lose, but the kind you lift to get stronger. We’ve got crossfitters, bootcampers, triathletes, marathoners, and just plain old gym rats all moving the heavy stuff around in an attempt to look good and be fit.

Really, we’re talking about any kind of resistance exercise, so this also applies to anyone using only their body weight as a means to build or maintain muscle. Hear that, all you yoga types?

Here’s the thing: as a doctor who sees all types of patients, and particularly working for 7+ years on elite athletes at the University of Texas, I’ve seen injuries in all shapes and sizes, and from any number of places. I have the “privileged” position of seeing exactly how athletes break — long before they reach the point of needing surgery or extensive rehab — more than just about any other kind of doctor out there.

Of all the injuries that I see, resistance exercise is the single most common cause, for any type of athlete.

Do I have your attention now?

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Why exercise and Ego should not go together


Rocky Balboa

Photo by Scott Welch

I went running this morning.

That normally wouldn’t be news to anyone, but for me it was big.  I’ve been fighting a foot injury for the better part of 10 years — yes, 10 years — and it has largely kept me off the trails.

As many of you know, I have access to some of the best healthcare practitioners on the planet, and I’ve had all of them, and more, help me with my foot.  For a long time no one could figure it out.  Then, I had a breakthrough and I’m now able to get back out there — but that’s a topic for another post.

What my run bluntly shoved in my face this morning was the pervasiveness of ego.  Yes, ego.

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The Risk of Training


jumping-off-dock_460x460

If you’re training for a race, you probably understand that you will have to push yourself outside of your comfort zone in order to get better. You’ll have to increase your training volume, intensity, or both. You’ll have to add in new exercises or modify others.

However, most of us also understand that though we feel good with a certain level of training, if we add too much too soon at some point we will break down. We know that while we could perhaps handle 50 miles in the saddle, for many of us, attempting 150 would leave us sore, sick, injured, or all of the above.

Sooner or later what we all find out is that there is a risk/benefit ratio to exercise. Almost all forms of exercise have some benefit, but there are none that don’t also carry risk, either short or long term.

Working with both weekend warriors and elite athletes in my office and at the local mega-university, I have the unique perspective of seeing athletes at their worst. That is, I see them when they’re broken. Being in this position rapidly teaches you certain lessons about what kinds of training potentially have the most detrimental effects.

Since it’s much better to be an informed decision maker, let’s run through a short list of high-risk activities. These are things to which you should never let your guard down if you’re interested in maximizing both your training longevity and performance. Here they are, in increasing order of risk…

Eccentric Training

I’m not talking about exercises that make your friends think you’re strange, but rather movements that emphasize eccentric muscular contraction. When you raise a bar bell (or a beer for that matter), the bicep muscle in your arm is shortening while it bears the load. This is a concentric muscular contraction.

When you lower the bar bell, your bicep is lengthening while it bears the load. This is an eccentric muscular contraction. Eccentric muscular contractions are far more damaging to muscle tissue. Some amount of microscopic tearing is thought to happen with eccentric contractions, especially when under significant load.

This is the reason downhill running beats you up far more than going the other way. Explosive, jumping-type movements – what plyometrics are largely based upon – can be risky because of the heavy eccentric load your muscles are put under. This is true not because of the jumping involved, but because of the landing, which is an eccentric activity.

Weight Training

Among athletes, I see a huge number of injuries come from the weight room. Much (though not all) weight work is designed to isolate particular muscles or muscle groups, loading them in a specific, measured fashion, such that they will adapt and respond to a far greater degree than they might otherwise.

While this is arguably a great way to gain strength and fitness, it is a form of load that our bodies don’t generally encounter in nature. Bodies are “designed” for cooperatively combining the action of many muscles at once, to produce complex, multi-joint movements. Loading up a specific muscle without the aid of his neighbors places a higher likelihood on the risk for injury.

High Intensity Training

This one’s a doozy. Increasing training intensity too much at one time is one of the most frequent causes of sickness and injury. How many runners have we all encountered who were doing just fine plodding along at 20-30 miles a week, only to get injured the first time they attempt (usually unsupervised) speedwork?

Intensity needs to be increased in careful, measured doses. When starting out, if you’re having second thoughts about whether you can handle a planned workout, you may be biting off more than you can chew. Never increase volume and intensity simultaneously, and be sure to get guidance from veterans of high intensity work or a good coach before jumping off the deep end.

Poor Technique

This may seem obvious, but poor technique is by far the biggest cause of athletic injuries. Using good technique means performing a movement in a way that doesn’t place joints, ligaments, and muscles in mechanically disadvantaged positions.

Most people understand that complex movements like a golf swing or a power clean in the gym require excellent technique in order to both perform optimally and avoid injury. The not-so-obvious part is that people frequently assume their technique needs no adjustment for relatively more simple movement patterns like a running stride or pedal stroke. This is a dangerous assumption to make.

Adding poor technique to any of the other activities mentioned above creates a true recipe for disaster. Attempting focused eccentric movements, weights, or high intensity training without regard for proper technique is a sure way to end up on the couch for weeks, if not longer.

No matter what your sport, spend the time to develop good technique habits, and regularly seek guidance from those who have the knowledge and willingness to help you learn the best movement patterns.

It should be noted that, with the exception of poor technique, all of the methods mentioned above can be applied carefully and deliberately to achieve excellent fitness gains. However, getting better at an athletic activity, particularly of the endurance variety, is largely about staying healthy long enough to allow prolonged, consistent training uninterrupted by injury or sickness. That is, you have to survive long enough to get good. Keeping your guard up to these common pitfalls will help you do just that.

Why You Have An Athletic Injury


It might seem as though I’m being loose with my article titles, but I assure you I’m serious. If we really stop and look at the kind of injury that befalls your average athlete, we’ll find that this kind of impairment afflicts most of us at one time or another.

To start though, we have to know what we’re dealing with. The easy, broad way to define athletic injuries would simply be as an injury an athlete gets.

More specifically, it would be something that impairs the ability of that athlete to perform. The movements athletes perform — running, jumping, throwing, swimming, etc. — are the same ones the non-athletes utilize, only less often and less vigorously.

Some confusion arises over how injuries are diagnosed and classified. For example, the cause of your average case of tendinitis — inflammation of a tendon — is frequently chalked up to “overuse”. What does this mean?

It could certainly be said that an athlete might tend to work a body part a little more than the average Joe. A pro tennis player will exercise and put much more stress on her elbow as part of hundreds of serves in practice and match play.

But this doesn’t explain why she got tendinitis and her teammate, performing the exact same regime, did not.

Two players are as different as their genetics, environment, and training, but beyond this there must be some mechanism by which the tendon of Player “A” became inflamed and that of Player “B” did not.

I suspect the “overuse” classification of athletic injuries is frequently the descriptor added to an inflammatory condition for which the causal factor is unknown.

Evaluate Function, Not Pain

The impairment of the athlete is no different than any ache or pain you might have from time to time.

A wrist that hurts when opening a jar.

A shoulder that stings when you reach for something in the back seat.

A knee that “talks to you” when you climb a flight of stairs.

The ankle that still hurts from time to time after you twisted it years ago.

All of these ailments have a cause that goes beyond the stand-by “getting old” or “the same thing my Dad used to have” explanations.

More information can be garnered — and a more distinct cause perhaps identified — if time is taken to evaluate a person’s function, and not just their pattern of pain. By this I mean looking beyond where it hurts to try and ascertain, for starters, what movements are restricted, how posture has shifted, and what muscles are not working as they should.

The more specifically movements and muscle function can be evaluated, the better we’ll be at isolating the things that need to be addressed to improve function. If function is improved, the pain almost always takes care of itself.

How can I assume that you have an “athletic injury”? From the above it follows that athletic injuries result from impaired function. I haven’t seen a patient walk in the office yet who didn’t have an area that, once thoroughly evaluated, didn’t have some impairment of function.

We never walk around in a perfect state of function. Rather, we’re always in some state of adaptation to the stresses that befall us, both past and present.

The Fix

Whether we experience pain is determined in large part by how well we are able to adapt to a potentially injury-causing stress. Twisting your ankle may or may not hurt depending upon how well you alter the way you walk and carry your body weight differently over knees and hips.

A body will fix a problem by itself — healing a torn muscle, for example — if it has the resources to do so. It will otherwise adapt its function so that that particular muscle is utilized minimally.

Fixing the problem thus depends on isolating the part that isn’t performing normally. That is, find out how function is impaired, and then address the condition that is preventing its restoration.

This is very much like the circuit breaker in your house tripping when you try to flip the switch to turn on the lights in the bedroom. The circuit for the bedroom lights could have blown due to a number of reasons. Faulty wiring, electrical overload, or a short in a particular appliance, to name a few.

Getting the lights back on then requires two things. First, address the problem. Remove the appliance that’s causing a short, for example. Second, reset the circuit. Only by performing both actions will you get the lights back on.

Bodies work similarly, but the circuits are a lot more complex. When seeing patients, the “circuits” I fix every day can require the restoration of alignment with an adjustment to the joint, fascial work around an impaired muscle, or the aid of supplemental nutritional enzymes to help clear out debris and damaged tissue.

As we are indeed holistic individuals, the restoration of function can require that we address the entire spectrum of chemical, structural, and psychological stresses that each of us encounters every day.

For lasting change, however, we must both address the cause of the problem and do whatever is necessary to “reset the circuit”. Anything less is a disservice to you as an athlete in the game of life!