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The Functional Movement Screen (FMS)™

“No pain, no gain” – that’s the mantra of many people dedicated to fitness. However, exercising through pain may mean that you are ignoring an underlying issue, a risk that can make the problem worse and result in having to take more time off later on while you heal from an exacerbated injury.

While some discomfort during activity – for example, when you would rather be sitting on the couch watching TV instead of lifting weights – is normal and necessary for growth, pain is an indication that something is wrong and needs to be corrected. You may simply have incorrect form or technique, or you may have an injury.

FMS Screen at BJJHere, Dr. Spillman is performing FMS screening at a local martial arts school. A Functional Movement Screen (FMS)™ can help determine which it is and how to fix it. One recent study, noting that “[e]stablishing a valid method of identifying athletes at elevated risk for injury could lead to intervention programs that lower injury rates and improve overall athlete performance,” concluded, “The Functional Movement Screen (FMS)™ is an efficient and reliable method to screen movement patterns during the performance of specific tasks.” The study echoes an earlier one that confirmed (FMS)™ is “able to predict injury in female athletes.”

During an FMS™, you are guided through a series of basic exercises. The screener then assigns a score based on your ability to perform the full range of motions with proper form and without pain.

The lower your FMS™ score, the greater your risk for injury. For example, a large study in California demonstrated that firefighters with an FMS™ score of less than 14 (on a scale of 1-24) were injured at a much higher rate and more severely than firefighters that scored above 14.

If you have a low FMS™ score – or if any part of the test causes pain – then it is likely that you already have an injury and should see a healthcare provider such as a chiropractor or physical therapist for further evaluation and to develop a treatment plan before engaging in physical activity.

A score below a 14 represents an elevated risk of injury. If you score in the mid-range, you could also benefit from developing a plan with a chiropractor or physical therapist to improve your mobility and stability. In the meantime, you would want to avoid situations that could aggravate an existing issue, such as large group classes at the gym, where you receive little personal attention and correction for improper form. At 14 and above you are likely to be able to perform any exercise without elevated risk of injury, but this is where the performance enhancing comes in. Increasing your score will likely result in improved performance in your sport, in and above any necessary skill training.

A good score means that you can feel free to engage in any activity, knowing you are at low risk for injury.

During a post-FMS™ visit, a chiropractor or physical therapist will perform an assessment (based on a Selective Functional Movement Assessment and a neurological and orthopedic history) to diagnose your injury and create a specialized plan to help you recover.

In addition to assisting with injury recovery, a chiropractor or physical therapist can use post-FMS™ assessments to identify ways an injury-free athlete can improve their strength and speed.

If you have reached a plateau in your training and aren’t getting faster or stronger no matter how much effort you put in, there could be a functional reason – a relative weakness that could be improved with the right exercises. An FMS™ can help identify specific areas for improvement, allowing you to focus your hard work on what will make the biggest difference in your performance.

Make an appointment today for a Functional Movement Screen! Dr. Sam Spillman is one of only a few people in Charlottesville to be certified by Functional Movement Systems and is the only FMS™ certified chiropractor in the area – remember, if you have a low FMS™ score, you should see a healthcare provider for an assessment. Dr. Spillman can provide both the FMS™ and the assessment, if needed. He regularly receives training on using the most up-to-date techniques for evaluating functional movement and creating treatment plans. He will also perform a functional evaluation at the end of your treatment to confirm that you can safely return to activity.

In addition to appointments at his clinic, Dr. Spillman is available to provide on-location screenings at offices and other facilities, including gyms, martial arts schools, sports teams, running clubs, or other fitness studios. Call Dr. Spillman at Balance Chiropractic and Physical Therapy at (434) 293-3800 or email [email protected]

The Last Diet You’ll Ever Go On

dieting“Eat less, move more” is supposed to be the one-size-fits-all prescription for losing excess weight. But our ability to follow the prescription varies greatly as we are seemingly sabotaged by stress in our lives or by simply being too busy, contributing to a yo-yo dieting pattern of weight loss and gain. Can a healthy weight become a long-term habit, despite the challenges we experience over a lifetime? Yes, if we take advantage of two powerful tools: plasticity and precommitment.

Scientific research confirms what many of us already know, that our impulse control, or lack thereof, affects our ability to lose weight and keep it off. How we set ourselves up for failure is to respond, “So all I have to do is control my impulses to overeat.” Not so fast. When that oversimplified approach fails, we beat ourselves up, resulting in even less energy to make good choices next time.

Instead, we need to understand that the degree to which we can exert effort to change behaviors (say, to eat sensible portions instead of overfilling our plates) is governed by the current state of our brains – which is a result of both genetics and the social environments we have lived in. It is also the result of the immediate situations we face. We know that stress seems to lower our self control, but numerous studies have also shown that making decisions – even decisions as seemingly innocuous as completing your wedding registry or ordering a new computer! – lowers one’s impulse control (a.k.a. “willpower,” “self control,” and “the way you stop after one doughnut”). Pretty much anything that requires mental energy is tapping into the same reserves that willpower needs.

In a cruel twist for anyone trying to lose weight, glucose will restore willpower in the moment. When you reach for the brownies after a hard day of work, with a long To Do list still waiting for you at home, you’re not a failure. Your body is doing what it knows to do to make sure you have mental energy.

The good news is that our brains also have an amazing feature called plasticity. Scientists used to think that the brains we were born with were the ones that we had for life. In recent years, however, we’ve learned that’s not true – our brains can grow new neurons! We have the ability to begin to think differently.

The question, then, is how to cultivate higher behavioral impulse control, and the answer is to practice precommitment.

Precommitment is defined by researchers as “the voluntary restriction of access to temptations.” Precommitment means taking steps before an event occurs to ensure that you will stay on track to meet your goals. Images of the brain have shown that precommitment changes the way the brain responds to the need for willpower, increasing its ability to delay gratification, especially in individuals who tend to be more impulsive.

In addition to limiting factors that might derail your weight loss goals, another key component of precommitment is self-care – knowing what you need to feel well and actively incorporating it in your life. This will help keep your emotional and mental bank account full, allowing you to make withdrawals later when you need strength for impulse control.

There are numerous ways to incorporate precommitment.

  • When you go to dinner at a restaurant, ask the waiter not to bring out the bread bowl before the meal, so that you won’t have the chance to spend all your calories on carbohydrates and throw off your blood sugar levels.
  • If you know you will be hungry waiting for your dinner out or at a party, eat a small snack full of fiber, protein, and fat – nuts are ideal – before you leave home. The snack will keep your blood sugar stable and help prevent you from glutting on calories later on, out of ravenous hunger and lowered self-control.
  • Cut up servings of veggies and fruit at the beginning of the week that you can easily grab for lunches and dinners later. If you have older children who can help, make it a family project on Sunday afternoons. (Bonus: hands-on activities are the best ways for kids to learn new skills!) Order pretty, reusable storage packs. In my case, I like to make green smoothies for lunch. They taste good, are quick and are a good way for me to make sure I’ve got a healthy lunch.
  • Devise ways around the obstacles that keep you from exercising. Turn off your phone and computer at a set time each night so you get to bed earlier and are able to stop hitting snooze instead of lacing up your sneakers the next morning. Load your iPod with new songs to keep your runs from being boring. Download an app that helps you keep track of your workouts.
  • Schedule time with friends every week (or as frequently as you need). Conversation and fun with friends aren’t superfluous activities. People who have meaningful relationships with others are not just happier, they are healthier. Even the Mayo Clinic says so.
  • Schedule alone time, especially if you are an introvert. Introverts are re-charged when they have time to themselves. Like time with friends, quiet time is important, not just something that should be tacked onto our lives if we are not too busy. One great way to achieve this quiet time of reflection is to…..
  • You don’t have to sit a certain way for an hour and chant Om. You can start with just a few minutes, anywhere you find comfortable. You can even practice walking meditation. Meditation will make you feel better, and it will make those important brain changes mentioned earlier. In a study that took MRIs of people’s brains after meditating, “participant-reported reductions in stress also were correlated with decreased gray-matter density in the amygdala, which is known to play an important role in anxiety and stress.” And of course, there’s an app for that.
  • Think about the life you want. A recent study indicated that overweight women are capable of demonstrating greater impulse control if they imagined themselves “in enjoyable future scenarios.”
  • Make a chiropractic appointment. Don’t live with energy-taxing pain. Chiropractic care can relieve painful body conditions and prevent them from returning. A chiropractor can also support weight loss by providing diet and activity recommendations and managing any injuries that occur, so you can keep your momentum going.

 

If you’re like many of us, at least one of the above tips feels like an indictment.
“I could never convince my kids to help with kitchen chores!”
“How am I supposed to find time to meet up with friends? I brush my teeth in the shower and eat standing up!”

Fortunately, making changes isn’t a one-chance deal. Plasticity is achieved over time. If you didn’t reach your goals this week, you have another opportunity to practice precommitment by figuring out why it didn’t work and how to make it work next week. You can also change your goals if you continue to miss them, which can be a sign that they aren’t realistic, or at least not realistic for now. Your goal is to cultivate habits you can enjoy over a lifetime.

What many weight loss plans are missing – and what keeps us hopping from one fad diet to another – is that we are not machines, where you plug in a specific formula and an ideal weight pops out. We are humans, with rich lives and living brains, which respond to the choices we make over time.

That’s the secret. That’s the last diet you will ever go on.

8 Tips for a Healthy Weight and Active Life

Need inspiration for how to achieve a healthy weight and improve your fitness? We’ve put together top tips, based on the latest research.

high intensity training1. Use High Intensity Interval Training (HIIT) to get the most out of your workout.
HIIT is exercising at a low to moderate pace followed by a short but very intense burst (or sprint) of exertion. Repeat.

The effectiveness of HIIT has been confirmed in numerous studies over the past few years, with Science Daily summarizing the results of a 2013 clinical study of HIIT: “Inactive people can achieve major health and fitness gains in a fraction of the time.”

One of the ways HIIT increases fitness levels is by promoting post-exercise oxygen consumption, which means you burn more calories, even after your workout is over.

There are numerous interval workouts online to try out.

2. Don’t forget to strength train.
Too often, we focus on aerobic exercise – think jogging, cycling, and using the elliptical machine at the gym – and neglect strength training (also called resistance training). This is a huge mistake, as strength training has been shown to control belly fat; ease lower back pain; improve glucose control; improve cognitive function, including memory; and decrease the risk of osteoporosis. Scientists have yet to determine whether it will make your mother-in-law like you, but it probably won’t hurt.

Lifting weights is a method of strength training, as is using the resistance of your own body, such as when you do certain yoga poses.

3. Eat the rainbow.
Include lots of colorful vegetables and fruit in your meals and snacks. Michael Pollan encapsulates this idea in one of the shortest diet plans ever: “Eat food. Not too much. Mostly plants.”

The “eat food” part means eating real food, not the stuff we’ve created in the last century (ahem, Twinkies). Highly processed food should be avoided – the longer the list of ingredients, the more processed the food is.

Fill out your diet with lean protein and going easy on the carbohydrates, especially simple (and often highly processed) ones like bread.

4. Go to bed.

In research studies, people who had not had enough sleep ate 260550 extra calories a day! Sleep deprivation may increase your risk for obesity and diabetes. Adults should sleep for 7-8 hours every night.

5. Practice a technique known as precommitment to avoid overtaxing your ability to make good choices.
Impulse control, the skill that keeps you from eating an entire box of Girl Scout cookies in one sitting, requires mental energy. You know what else requires mental energy? Pretty much any decision, from picking out what shoes to wear to whether to ask for a raise at work. (Many highly successful people are noted for wearing similar clothes every day – Steve Jobs’ iconic black mock turtleneck shirt is one example – so they can focus on decisions that are more important.)

Precommitment is planning beforehand (like Steve Jobs) how to minimize energy-tapping decisions and preserve impulse control. Make it easier for yourself to make good choices by practicing precommitment, especially during times like the evening when you are fatigued from a long day. On the weekend, cut up veggies to have on hand for dinners. Tell the waiter not to bring out the bread basket when you go to a restaurant after work.

And a tip you can really enjoy: eat your Girl Scout cookies with breakfast. Seriously. In one study, participants who ate dessert with their high carbohydrate, high protein breakfast lost more weight than those who ate smaller breakfasts and larger dinners. Having a slice of cake in the morning may take away the temptation to eat half a cake at night after a day of eating yogurt and fruit.

Read more here about precommitment.

6. Find an app for that.

It can be difficult to keep track of our wellness progress during the day. Plus, tallying calories uses valuable mental energy (see above!). Let an app do the hard work for you. MyFitness Pal will track both your diet and exercise. Other helpful apps include SparkPeople and Noom.

You can also download apps that monitor your heart rate while you exercise. Instant Heart Rate by Azumio is a good one. Remember that exercise intensity is important. A good goal is to keep your heart rate between 70-85% of your maximum rate. A rule of thumb for determining your maximum heartbeats per minute is subtracting your age from 220. (Click here to learn more about gauging your target heart rate during exercise.)

7. Identify your goals and make a realistic timeline.

The Mayo Clinic helpfully points out that we need to make two types of goals for successful weight loss: a process goal and an outcome goal. “Lose 30 pounds” is an outcome goal – the result you want. “Exercise every day” is a process goal – what you are going to do to achieve results.

Determine the results you want, then identify changes in your habits that can make them possible.

Here’s an obvious truth that we often ignore: if you consistently fall short of your goals, you need to set a new goal, one you can accomplish! If you’ve spent two weeks trying and failing to exercise every day, make exercising twice a week your new goal. When that becomes a habit, make a new goal of three times a week, and so on until you are able to exercise every day. Your timeline for reaching your goal may become longer, but your results will be sustainable and your overall health better as you work with yourself, not against yourself.

Or maybe you need to change your definition of what counts. Thirty continuous minutes of exercise may not be doable at first, but three 10 minute walks at different times throughout the day might be perfect for your current health level and schedule, and something you can manage every day.

8. Make a chiropractic appointment.
Our providers at Balance Chiropractic and Physical Therapy can support weight loss by providing diet and exercise recommendations and managing any injuries that occur, so you can keep your momentum going.

What tips have you found that help you achieve your health and fitness goals? Please share them in the comments or join us on Facebook to discuss with others interested in lifelong wellness!

Rest! Recover!

lazy dogI am guilty – guilty of not practicing what I’ve preached. I have always prided myself on strictly following the advice I give my patients. A patient taught me how important this was in my very first year of practice; I was scolding him for not having had a check-up in several years, and he asked me when was the last time I had been to MY family doctor… and it had been years. I found a doctor and went. It turned out that I had some health issues to work on. Ever since then, I’ve made a point of following the advice that I give patients: I exercise, I eat right, I have an ergonomic workstation… How can I possibly expect my patients to do it if I’m not willing to do it?

rest and recoverExcept it turns out that even I don’t follow my own advice all the time. Over the last year, the active lifestyle I pride myself on led to some bumps and bruises and eventually, low back pain (the irony!). And I ignored it. I thought I was strong enough to work through it while I healed. I didn’t want to disrupt my workout schedule, my jujitsu training, my active lifestyle. Every now and then I’d make time to get some treatment, but the only thing I did consistently was complain about it. And it came and went, and came and went.

So it should be no big surprise to you to learn that my back has gradually gotten worse. That’s what happens when my patients don’t follow my advice, and that’s what happens when I don’t follow my own advice. I finally made an appointment to get it looked at, and the prescription is REST. And finally the gears turned and clicked and I understood: I should have taken some time off when my back first began to hurt. I should have stopped that cycle of chronic inflammation before it started. I’ve often warned, “if you don’t slow down when you need to, your body has a way of slowing you down.” True story. I could have been pain free this year if I’d listened to my own advice.

So please, friends, learn from my mistakes. rest and recoverEven for a mild injury, take some time off. Don’t underestimate the importance of rest and recovery.

Reach Your Goals!

reaching goalsIt feels so good to reach your goals!!

I admit that lately, I don’t always have the energy to do an intense workout. But I like to set goals and try my best to achieve those goals! If you’re not used to doing this in your exercises routine, start with something easily attainable then work your way up to some more challenging goals. You may be surprised at what you can achieve! Hope you’re having a wonderful week!
~Dr. Eng

Trying New Things

Trying new things…

 

Most of us don’t like change.  Oh, sure, we want to improve, to do it better, faster, and have more fun doing it.  Tomorrow.  Today, we creatures of habit are most likely going to do what we did yesterday.  We liked it then and we’ll like it tomorrow, and it’s easy to keep doing it.  It’s pretty easy, too, to limit our ideas about self-improvement to the things we already enjoy doing.  Maybe I’m a runner, and I want to run farther or faster.  Maybe I like getting stronger, and in pursuit of that improvement I’ll do more reps, more of the same thing.  You get the idea.

Last night I tried something I’ve never done before: Hot Yoga.  I’ve always been a fan of balance, in theory.  Strength should be balanced by flexibility, and flexibility should be tempered with strength.

Hot Yoga

Hot Yoga

In theory.  But I hadn’t done much about flexibility in my own training.  I didn’t know what yoga would be like.  I didn’t know if I’d like it.  But I spent an hour putting myself in new positions, and breathing, and paying attention to exactly how my body felt… and I liked it.

So let me encourage you to move in a new direction by trying something new.  If you’re like me and you’ve focused on strength or speed, try a yoga or stretch class.  If you do yoga, some strength training will help you hold your poses longer.  If you play a sport focused on a skill, like golf, try exercising a different skill set.  And if you are an all-round athlete, try sitting still and meditating.  Get out of your comfort zone.  Stretch yourself. Grow.

I Never Lose

losing“I never lose. I either win or I learn.” This quote was a Facebook post from the folks at Spartan (an obstacle race course and fitness group), and it has been widely reposted, likely because others seem to be as struck by it as I am. Those words are probably as close as anything I have seen to a real credo by which to live: embrace setbacks as opportunities to learn, instead of rejecting them as personal failures. Setbacks happen to everyone on the roads to our successes. It is okay to make mistakes and it is okay to miss the mark and to fall down and to be hurt. Japanese proverb expresses a similar sentiment: “Fall down seven times. Get up eight.” We heard this a lot in Aikido and Judo practice. Accept that you will make mistakes, you will fall, you will fail before you can succeed. You will only learn if you are willing to also fail. “I either win or I learn” takes that important acceptance one step further: you can turn that fall or that fail into something valuable if you are open to learning from it. It is a great thing to persevere and never give up, but that single-mindedness can leave you banging your head against the same wall over and over again. Don’t do that, it hurts  It is an even better thing to learn from both successes and failures. That has been true for me in all manner of endeavors. It was true when I was trying to lose weight, it was true when I was training for a black belt exam, it was true when training for a Spartan race, it was true in graduate school, and it has been true in my professional life as well. chiropractic care
So, don’t keep repeating what’s not working for you: learn why it’s not working, and change it. Don’t kick yourself because your diet isn’t showing results; think about where and how it’s not working for you. Don’t scold a child who did not meet your expectations; ask yourself how you failed to communicate and in doing so, teach the child it is ok to fail while you also learn to express yourself more effectively. Don’t hurt your back the same way twice!
Don’t give up because you have tried and failed. Think. Do things differently. Fail differently. Win or Learn…words to live by.

SNOW Safety!

Shoveling snow can really do a number on your back!

Here are some things to keep in mind when shoveling.
Pick the Right Snow Shovel
Pick a light shovel so it doesn’t add to the weight of the snow. Make sure the handle is adjustable or long enough so you don’t have to bend over more than absolutely necessary.

Warm Up!
Shoveling snow is strenuous exercise. You should warm up beforehand just like you would before working out in the gym or playing basketball. Do some light calisthenics (arm circles and raises, spinal twists, body weight squats) to warm up your muscles. You’ll know you are warmed up when you feel warm, start to sweat and are a little out of breath. Avoid stretching before you exercise…stretch after.
Use Good Form
Whenever possible, push the snow to one side rather than lifting it. Many shovels are designed to let you push snow.  When lifting the snow shovel is necessary, make sure to use ergonomic lifting techniques:
Always face towards the object you intend to lift – have your shoulders and hips both squarely facing it.
Bend or HINGE at the hips, not the low back, and push the chest out, pointing forward. Tighten or flex your abs (think bracing) and your buttocks. Then, bend your knees and lift with your leg muscles, keeping your back straight and keep your face looking straight ahead or up. Just like you would doing an exercise in the gym.
Keep your loads light…work smarter, not harder.
If you must lift a full shovel, grip the shovel with one hand as close to the blade as comfortably possible and the other hand on the handle (handle and arm length will vary the technique). Keep your body as close to the blade as possible… the longer the lever arm, the more pressure on your back.
Turn to the side to dump your snow, avoid twisting your back (I know, it seems easier but it is much riskier for your back). Resist the urge to throw the snow.
Wear proper footwear to avoid slipping and falling.
Pace Yourself
It is easier to remove small amounts of snow than large amounts. Consider breaking the chore up into several sessions. Also, if possible, it is easier to shovel as the snow falls, rather than waiting for it to accumulate. Usually, you can push a few inches around.

This is also important for your heart. Snow shoveling is strenuous work and as you are bending and lifting, your muscles tighten around your organs, this internal pressure will raise your blood pressure. So it can be an intense workout for your body and your heart. If you start feeling dizzy or light headed, take a break.  Heart attacks are common during snowfalls for this very reason. If you have high blood pressure or a heart condition, you’ll want to be extra careful when going out to shovel snow. If you have any questions, be sure to consult with your doctor or cardiologist before shoveling snow.
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If possible, use a snow blower or borrow one from a friend or neighbor. If you already have back trouble, consider using a service for snow removal.  If you have elderly or infirm neighbors, please help them!

Yoga

Yoga is the poetry of movement. It helps you to push yourself, to slow down and be in the present. I really just do it so that I can polish my toenails. ~ Dr. Eng

yoga for fun and fitness

Exercise Can Be Fun

Everyone knows we should exercise, and reminders are everywhere.

 

Exercise can be fun!

But when a lot of people think of exercise they think of unpleasant things: endless time in the gym on the treadmill, stationary bike or walking around a track. However, exercise comes in many forms:  snowboarding, rock climbing, martial arts, dancing, gymnastics… I like to do a variety of things to keep fit and one of my mantras is that whatever I’m doing, it has to be fun. Charlottesville is a great area with lots of options to keep fit and most of them are well outside the gym. I got a great workout on the slopes this past weekend with my cousins snowboarding. I used my core and worked my legs to stay up right…and to protect myself when I fell 🙂

Another note about exercise, is that it can feed the soul as well as the body. I reconnected with cousins I hadn’t seen in the last year and I got out of the house; out into nature. What could be better than reconnecting with friends and family and getting some exercise while you’re at it?