It is time that our patients understand that it makes good sense to take charge of one's own health. It is time that we help our patients understand that exercise, nutrition and strength conditioning are the most valuable tools which they have to empower them to control their own health.
The chiropractic adjustment is indeed the most powerful adjunct to all physical activities. I have proven this time and again with some of the most elite athletes in the nation. Conversely, your patients must be helped to understand that keeping the body strong, flexible and well nourished also enhances the ability of the body to hold and maximize the chiropractic adjustment.
The best method, bar none, to develop muscular strength is by weight resisted exercise. This does not mean that each person, male and female, must strive to develop a huge, hulking, muscular body. Common sense must be developed as it relates to weightlifting exercises. Today, weightlifting is used in an overall program of fitness for the individual including cardiovascular training and wise nutritional choices.
Weightlifting is the process by which weights, such as barbells and dumbbells, and apparatus such as cables and pulleys, as well as modern day cam and digital machines, are used to put resistance on a muscle or groups of muscles during repetitive exercise. The purpose of this is to tone and strengthen muscles. As a byproduct of lifting weights, muscles hypertrophy and also increase their capacity for endurance. An added bonus is that the skeletal system which supports the muscles becomes thicker and more dense.
Common sense dictates that increased stress on the muscular system is what we need to enhance the skeletal system, including the strengthening of the joints and ligaments (Wolff's Law). It also makes good sense that you instruct your patients to recognize that there are levels of expertise with regard to lifting weights. People should acknowledge beginning, intermediate and advanced levels. It is necessary to develop solid fundamentals to ensure proper results and to stay virtually injury free. The fundamentals of lifting require common sense practicality.
I stated earlier that the chiropractic adjustment is a perfect adjunct to all physical activities. This is true. On a more superficial but pragmatic level, it is also true that proper weightlifting is a perfect adjunct to all other physical activities. It is my contention that not only is the chiropractic adjustment valuable to all physical activity, but consistent physical activity, such as lifting weights, is a perfect complement to the chiropractic adjustment.
To go into the wide variety of specific exercises for each body part with an explanation of methods and how these exercises help to create a more balanced body would make this a very long article. To break it down to a more manageable text, I have decided to make this a series of articles that highlight each of the body parts so that the general ideas of strengthening may be more easily handled.
We will begin with what I call the power muscle groups. The power groups are those muscle complexes which contain the larger and most powerful of the body's muscles. These include the back, chest and legs. Later articles will address exercises emphasizing the shoulders, biceps and triceps.
The first of these power groups is the back. When we read or hear of the back muscles in standard muscle or fitness magazines or in the gym environment, we hear such terms as "lats" (latissimus dorsi), "traps" (trapezius), rhomboids and "erectors" (erector spinae). To clarify, the lats, traps and rhomboids are considered muscles of the shoulder and shoulder girdle. This will explain why you always feel shoulder involvement while doing the vast majority of back exercises.
Instruct your patients that there is a potential for injury while doing any weightlifting exercises. Overtraining can cause muscle spasms, muscle strains and possible joint sprains. Incorrect mechanics may also lead to a segmental dysfunction of the lumbar vertebrae putting the spine out of alignment. Further misalignment may also occur in the pelvic region, specifically the sacroiliac joints. If I have patients or clients with acute or long-standing low-back problems, I strongly suggest they do back exercises that don't directly affect the injured region until such time when these movements can be more beneficial.
Other necessary terminology includes sets and repetitions. A repetition is the amount of times the weights are lifted throughout a specific movement. When I move a weight up and down, that is considered one repetition. A series of repetitions makes up a set. For example, one set may consist of 20 repetitions. Usually, to complete a specific exercise, one would do so many sets at so many repetitions (i.e., 5 sets of 12 repetitions). Repetitions may be abbreviated as "reps."
• Strengthen the back. I will discuss only two of the most common exercises. The template for mechanics and method will be virtually the same. For rehabilitation, do lighter weights and more times per week. For general strengthening and muscle tone, do these exercises no more than twice per week, preferably every fifth or sixth day with a moderate degree of intensity. Choose two or three exercises from the following to cover the entire back. Since the back muscles have supporting muscle groups with regard to exercise, you will notice that the rear deltoids and the biceps will also be called into play with virtually all back exercises.
Exercises:
- Lat pulldowns
- Bent-over rows - barbell
- Supported rows - special bench
- T-bar rows
- Dumbbell rows - one arm, bent-over
- Seated rows - cable
- Dead lifts
- Pullovers
- Standing pulldowns
- Hyperextensions
- Power cleans
- Pull-ups/chin-ups
Lat pulldowns are done using a station constructed for this purpose, usually made with cables and pulleys. There are also a variety of stationary machines that achieve the same kind of motion. All other cable variations are dependent upon the handle or grip used. The most popular are: 1) wide grip behind the neck; 2) wide grip to the chest; and 3) close grip. The different grips change the angle slightly, which, in my view, should all be used at one time or another during the strengthening cycles. The mechanics of movement are the same. (Other upper back exercises include pull-ups, chin-ups, power cleans, dead lifts and pullovers).
To do the basic lat pull down exercise (wide grip to the chest), be seated facing the apparatus. Four to five sets are adequate with the first one being a warmup set. The first set (the warmup set) should be done with relatively lighter weights for 15-20 repetitions. This ensures that the muscles will have an increased blood flow established and the muscle fibers will be prepared for the specific movement. The remaining sets may be performed doing from 8-12 repetitions. With each set, try to add a little more resistance (pyramid up) and make sure the rest period is from 60-90 seconds between each set. One way to increase intensity without increasing the amount of weights is to reduce the time of the rest period. To decrease the intensity, do the opposite (increase the rest period).
• Chest as possible while contracting the muscles before returning to the starting position. The benefit of this strengthening is not just in the upper back. You will notice that, if done properly, there is much "stretch-flexing" for the shoulder girdle, especially the upper lats and the pectoralis majors (pecs).
Seated rows, as in all back exercises, works the entire back, but it tends to emphasize the lower and middle back. Caution should be used with this exercise due to the forces on the lower back. With proper mechanics and common sense, this is very powerful for keeping the lower back muscles very strong, which is great for spinal support. The added tonicity will do much to aid the body in terms of holding an adjustment for a longer period of time. (Other low back exercises include supported rows, bent-over rows, T-bar rows, one arm dumbbell rows, dead lifts, and power cleans.)
Once again, remember that it is important to start your warmup set with lighter weights. Progressively add resistance, if you choose, or establish a working weight, slightly higher than the warmup set, and finish the remainder of the sets and repetitions. Use up to 15-20 repetitions for the warmup set. The next 3-4 sets should be done using from 8-12 repetitions. Each repetition should be performed with the maximum range of motion necessary to encompass the eccentric as well as the concentric contraction of the muscles (this is an example of one method).
This exercise is generally done on a bench built specifically for this movement which has a cable pulley system along with a stack of weights to be raised or lowered by pin placement. Sit on the bench with feet on the platform. This movement is almost always done with a close grip handle, but it is not unusual to use a wider grip if you so choose. Start in the seated position with the knees slightly bent. With the grip in hand, lean forward as far as comfortably possible feeling a stretch as you bend and as you slowly exhale. As you come to a seated position, inhale while pulling the bar toward your body. Contract the back muscles while lifting the chest slightly to exaggerate the back in an upright position.
As you release the arms to a straight position, the body should again be leaning forward toward your feet to get a stretch in the hamstrings and the lower back. Exhale just before you reach end range of motion. This is the end of one repetition. Repeat the motion. Remember, go slowly into the seated position and slower into the forward position. The entire activity gives the appearance of rowing a boat.
Please understand that the basic premise for weight training is to do at least one warm up set followed by 3-4 working sets. This will establish a template that may then be expanded as your understanding of strength training increases.
• Chiropractic works at its best when the patient takes charge of their own health care. Part of that responsibility includes a reasonably consistent routine of strengthening and stretching. This, coupled with cardiovascular exercise and proper nutrition, is the most powerful combination of health care in existence.
Reference
- Leone M. It's Time to Play Weights.
- Mick Leone, DC
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