By Dr. Matt Fontaine

This is the first in a series of articles that will detail a new paradigm in dealing with musculoskeletal injuries.  The first of which will deal with assessing human movement, and highlight the Functional Movement Screen™ and the Selective Functional Movement Assessment (SFMA), developed by Gray Cook and Lee Burton.  The Functional Movement Screen™ is an innovative system used to evaluate movement pattern quality for clients or athletes.

“It has also been recognized that the dysfunctions of muscles and joints are so closely related, the two should be considered a single, inseparable functional unit” Dr. Vladimir Janda

Our nervous system generates normal movement by integrating and orchestrating groups of muscles to produce fundamental movement patterns with an adequate balance of mobility and stability to meet the demands of the task at hand.

The human system will compensate normal patterns of movement in response to pain or in the presence of weakness, tightness, or structural abnormality. Over time, pain alters normal movement patterns, often causing compensation such as limping or guarding to protective injured joints or muscles.   The pain associated with movement often results in as decreased ROM, muscle length changes, and decreased strength.

Gray Cook has said that a limp is visual representation of the body giving up it’s core stability in order to prevent the loading of a painful joint.  Sometimes the body compensates in a less dramatic fashion and the altered movement patterns are more subtle.

The traditional sports medicine model is to look to the pain.  Typical RICE(rest, ice, compression, and elevation) is helpful to control inflammation.  However, using an isolated or regional approach to either evaluation or treatment will not accurately detect the issues that caused the pain, nor restore function. Gray Cook has said repeatedly that functional restoration requires a map of dysfunctional patterns and a working knowledge of functional patterns to gain clinical perspective and design an effective treatment strategy.

Pain-free functional movement for participation in occupation and lifestyle activities is desirable. In order for our body to create proper pain-free functional movements during sport or activities requires adequate posture, full unimpeded range of motion, proper muscle and fascial gliding between soft tissue structures, motor control, and balance reactions.  Impairments in  any of these areas can alter functional movement resulting in or as a consequence of pain.

Utilising the Functional Movement Screen™ and the Selective Functional Movement Assessment (SFMA) allows healthcare professionals to assess key functional movement patterns the body performs and allows the detection of faulty movement, muscle imbalances, and lack of joint mobility and stability.  This information is essential to identify dysfunctional movement. Traditional muscle length, strength, and special tests can be used to help the clinician identify the impairments, which are associated with dysfunctional movement.

By using the Selective Functional Movement Assessment (SFMA) as an approach designed to complement existing exam the practitioner can better detect faulty movement patterns and be much more specific in devising a program therapeutic exercise to help correct the problem or issues. The Functional Movement Screen™ and the Selective Functional Movement Assessment (SFMA) serve as a model to efficiently integrate the concepts of posture, muscle balance and the fundamental patterns of the movement system into musculoskeletal practice. It should also serve as a feedback system for the effectiveness of the therapeutic exercise program, which should target the dysfunctional movement pattern as well as the impairments that have been identified.

Part two will address the approach that should be utilized to properly evaluate and manage muscle and joint pain syndromes.

I have noticed an interesting evolution in my practice. When I was in my 20′s the vast majority of my patients were similar in age, and therefore had questions commonly found in the 25-38 year old crowd. Questions like, “How do I get a six-pack?” used to dominate the discussion.

Now in my 40′s, the tones of vanity have given way to cries for survival!

“Why is this happening to my body?”
“Will I ever be able to do that again?”
“Why is it taking me so long to heal?”

And my personal favorite, “Do you have any secrets for living longer?”

Well luckily, I do advice in the area of longevity, but I have to warn you, be careful for what you wish for, because when pressed on the subject, most honest people are able to admit, its not living longer that we most desire, its living more quality years.

So before I dive into the first lesson for longevity a few Rules We Must All Agree On:

1. Anti Aging is QUACKERY! I will tell you that real scientists agree that they cannot do such a thing, so anyone making those claims is a con artist and a charlatan.
2. Our Goal is more quality years NOT more total years.
3. Longevity is more than just your physical being, it is the health of your mind and spirit.
4. I am not sharing any Rules or hidden secrets, I am sharing lessons learned from the most successful cultures on this planet. Cultures that seem to have fooled the clock, or the science books, about the concept of living a long and happy life. Many of these lessons were taken from studies done in the book “The Blue Zones.”

Without further delay:

RULE NUMBER ONE: Move Naturally

Considering I just completed a marathon, this first rule may surprise you. The research suggests that longevity isn’t about running marathons and triathlons, and it isn’t about being the weekend warrior. Worse still, it isn’t about the 90 day P90x or Insanity workouts, its about making regular, low-itensity physical activity, part of a daily routine. Cultures that spent their lives gardening, or working as shepherds; doing daily yoga or taking regular nature walks, did the best.

Remembering that “LIFE” is the marathon, so don’t approach it as a sprint. All of the longevity cultures studied incorporated some form of regular, low-intensity activity that satisfies each of the following:

-A large emphasis on core strength at least twice a week,
-Daily balance exercises
-Aerobic exercise 5 times a week.

STRATEGIES TO INCORPORATING LESSON ONE

1. Inconvenience Yourself-Use the stairs not the elevator, get up to change the channel, get rid of the electric can opener/snow blower/garage opener.
2. Have Fun. Keep Moving.-Rather than exercising for exercise sake, make your lifestyle active. Take walk breaks instead of coffee breaks, don’t join a gym if you hate it, do things that keep you active that you enjoy.
3. Walk.- Its easier on the joints, always accessible and invites company.
4. Make a Date.-Getting out and about can be more fun with other people. Knowing someone else is counting on you will motivate you to keep at it.
5. Plant a Garden.-Working a garden requires frequent, low-intensity, full Range of Motion activity, and you have the benefit of fresh vegetables!
6. Enroll in a yoga class.-Just be sure to practice it 2 times a week.

Here are five common fitness barriers, along with some tips for making them disappear.

Barrier #1: Too Busy
It’s unlikely that you’re too busy to exercise. You probably just need to use a little creativity to get the most out of your time.

Get up 30 minutes earlier. If your days are packed and the evening hours are just as hectic, get up 30 minutes earlier twice a week to exercise. Once you’ve adjusted to early-morning workouts, you can add another day or two to the routine.

Rethink your weekend rituals. Your Saturday matinee could be reborn as a Saturday bike ride, a trip to the pool or a hike.

Squeeze in a few 10-minute walks throughout the day. If you don’t have time for a full workout, don’t sweat it. Shorter spurts of exercise spaced throughout the day offer benefits as well.

Park in the back row of the parking lot. Or park a few blocks away — and then walk quickly to your destination.

Barrier #2: Boredom
It’s natural to grow weary with a repetitive workout, especially when you’re going it alone. But exercise doesn’t have to be boring.

Exercise with a partner. Enjoy the camaraderie, and offer encouragement to one another when the going gets tough.

Vary the routine. Rotate among several activities — such as swimming, walking and cycling — to make things more interesting.

Check out sports leagues or exercise classes. You’ll learn new skills while getting a great workout.

Barrier #3: Fear
If you’re nervous about injuring yourself, try the following techniques.

Try an exercise class for beginners. Focus on the basics, and don’t worry about the hard stuff.

Consider working with a personal trainer. Get a customized fitness tutorial from a certified expert who can monitor your movements and point you in the right direction.

Keep the exercise simple. Start with a simple walking program. As you become more confident in your abilities, add new activities to your routine.

Barrier #4: Lack of Money
You don’t need a gym membership to get a great workout. Consider these alternatives.

Try the community center. Exercise classes offered through a local recreation department or a community fitness group might fit your budget better than an annual gym membership.

Take the stairs. Skip the elevator when you can. And try to make climbing stairs a workout in itself.

Do strengthening exercises at home. If you can’t afford weights, try inexpensive resistance bands. Or do squats or push-ups using your body weight to gain strength.

Watch exercise videos. Try videos on cardio kickboxing, aerobics, tai chi, yoga or other techniques.

Start a walking group. Round up friends, co-workers or neighbors for regular group walks. Plan routes through your neighborhood, near your workplace, or at local parks.

Barrier #5: Lack of Support
Remind those close to you how beneficial exercise can be — and ask them to join you.

Suggest a new adventure. For example, invite a friend to go to an indoor climbing wall or rent a tandem bicycle.

Exercise and play with your kids. Sign up for a parent-child exercise class. Take your family to the park for a game of tag or kickball. Swim with the kids in the pool instead of watching from your chair.

In the end, there’s no obstacle to fitness that can’t be overcome. Just put your mind to it, take it a step at a time, and you’ll be surprised how easy exercise becomes over time.

If your stomach isn’t as flat as you’d like it to be then you have come to the right place. Exercise alone will not get you a toned stomach – diet is a huge part of the equation. Below are 5 very easy tweaks to your eating habits that will dramatically flatten your abs.

Diet Tweak #1: Don’t eat after 6pm
This is such a simple and effective way to lose fat. Late night eating is the most damaging to your waistline, so cut it out completely.

Brush your teeth immediately following dinner. Once your teeth are brushed, you’ve put a period to the end of your consumption for the day.
Change your evening routine. If you’ve always ended your day watching your favorite shows with your hand in the snack bowl, then now is the time to change things up. Find activities that don’t revolve around food and stick with those.
Make it a habit. The first few weeks will be the hardest, but soon your new no-food-after-6pm routine will feel normal.

Diet Tweak #2: Cut back on carbs
Notice I didn’t say to cut out all carbs, but rather to cut back on carbs. These diet tweaks are meant as lifestyle changes that you stick with long term. Cutting back on carbs is a realistic and very effective way to lose weight.

Always choose whole grain bread and pasta over white. Whole grains are less likely to be stored as fat than processed grains.
Eat half of the carbs you normally do. Eat your sandwich open-faced and reduce the size of your pasta serving.
Avoid carb-filled snacks between meals. Instead of crackers or chips, have fresh fruit and veggies.

Diet Tweak #3: Eat more fiber
Most people simply do not get enough fiber in their diets. Fiber is essential when it comes to getting lean since it is low calorie while filling you up.

Instead of seeing salad just as a side item, make salads into meals. Add protein to a large pile of greens for a guiltless meal. *Try the recipe for Grilled Salmon and Peach Salad below.
Make veggies a part of every meal. The benefits of eating more vegetables are too numerous to list, just know that your body will become healthier and leaner with each fibrous bite.
Fruits are a delicious source of fiber. Incorporate fresh, seasonal fruits into your daily diet.

Diet Tweak #4: Drink tons of water
Drinking plenty of water is another extremely simple way to promote weight loss. Chronic dehydration leads to false hunger signals and unnecessary calorie consumption.

Drink a large glass of water before each meal. This will prevent overeating.
Choose water instead of sugar-filled sodas and juices. Sugar-filled drinks are a huge weight-gain trap.
Carry a water bottle with you throughout your day. Keep water in the car and at your desk for constant hydration.

Diet Tweak #5: Enjoy natural sweets
Traditional sugar-filled sweets will quickly add up around your waistline. Instead of going for sugary sweets, enjoy natural sweets.

Fruit is nature’s candy. Reach for sweet, seasonal fruit for dessert.
Avoid foods that contain white sugar or high fructose corn syrup. Consider these items ‘anti-flat-abs’.
Use wholesome sweeteners such as pure maple syrup, brown rice syrup or dates in your recipes instead of white sugar. Eliminate white sugar from your kitchen.
Eating right, coupled with challenging exercise, is the formula for a toned, lean body.

It’s here—whether you’re ready or not. Retailers like to call it the ‘holiday season’ but let’s be honest its Weight Gain season and it runs straight through New Year’s. The next two months will bring ample opportunity for you to expand your waistline. Of course the choice is yours. Why discuss it now and not mid way through December? Because now is your opportunity to plan for the weeks ahead. Once the craziness begins, you’ll be too busy to put a plan into action. So let’s take this moment of clarity, this calm before the storm, to outline a two-part plan that will save your waist from unwanted holiday inches.

1) Part One: Your Exercise Plan. Exercise is the first thing people cut when they get busy, and the holiday season is notorious for empty gyms. This year do something different—obligate yourself to exercise. Promising to yourself won’t do it, you need to promise to others so that you won’t drop the ball.

Sign up to work with a Personal Trainer.
Join a class – You won’t be as effective exercising on your own during the busy holiday season, so join a class for accountability. Find something challenging that gets your heart rate elevated and uses strength training.
Get a serious exercise buddy – Some friends can be an awesome help while others end up pulling you down. When looking for an exercise buddy consider the following questions:
- Do they share your fitness goals?
- Are they fairly encouraging?
- Do they give up easily?
- Are they at your fitness level?
2) Part Two: Your Diet Plan.The holidays offer ample opportunities to indulge, so you need to hammer down some guidelines before hitting that buffet line. We’re not saying that you shouldn’t indulge in any seasonal treats, but use moderation. Don’t use the holidays as an excuse to eat until the point of being uncomfortable – will you really miss that bloated feeling? Decide which treats to cut out this year.

Don’t bring edible treats to the office or to parties. You know that the leftovers will come home and you’ll end up eating far more than your share. This year do everyone a favor by not gifting fattening treats.
When faced with a buffet line, load your plate first with greens, vegetables and lean meats before breads and heavier foods. Also drink water with your meal and keep alcoholic beverages to a 2-drink maximum.
Beware of holiday drinks – most are brimming with calories. Hot drinks from coffee shops, cocktails at parties and creamy eggnog are all very enjoyable and all filled with empty calories. Stick with hot tea or unsweetened coffee.
Everywhere you go during the holiday season brings you face-to-face with a plate of sweets. To avoid being a bore but without adding inches to your waist, try the one treat rule. Each time you’re in a social situation that involves sweets just eat one, and enjoy your treat slowly.
You don’t have to gain weight this holiday season. The key is your mindset. If you approach the holidays with the mindset of, ‘I deserve to indulge and I shouldn’t have to exercise’ then you’ll enter 2012 a few pounds heavier, a little less healthy, and with lower energy than ever before. We believe that you should enter 2012 in better shape than you are today, healthier than you’ve been in a long time, and with more energy than you thought possible.

As we pass through the “summer midpoint”, I figured some vacation tips might be in order.

Does your upcoming vacation have you worried about your waistline? You should be. The average person gains almost a pound a day while on vacation. (Admittedly, I’m more like 2-3 per day.)
But that doesn’t have to be you. Most of the time extra pounds sneak up on you when you least expect it, so decide right here and now that your vacation will leave you slimmer than when you left. As you embark on your next vacation adventure, use these 7 tips to come home fitter than when you left.

Trick #1: Cut Your Carbs
Vacation days are notorious for carbohydrate rich meals, and it’s a well-known fact that too many carbohydrates will quickly add up to unwanted pounds. Combat this fat-trap by choosing one meal per day to go carb-less.

Breakfast: This may be the most effective meal to use the carb-less trick, since breakfast often involves breads, pastries or pancakes. Skip the toast and fill up on egg whites and lean breakfast meats.
Lunch: A great carb-less lunch is a salad with lean meat. It’s so filling and satisfying that you won’t even miss the bread.
Dinner: Since you’re on vacation, you don’t want to feel deprived, so dinner is the hardest meal to go carb-less. But if you’ve indulged at breakfast and lunch then make it a point to cut the carbs at dinner. Stick with veggies and lean meats.

Trick #2: Be Active
If your travels keep you too busy for a workout, or if your hotel does not have an exercise room, make a conscious effort to be active everyday. Go on a brisk walk after your day’s activities. This is a great way to see a new city, and also a great way to burn off extra calories. Take the stairs instead of elevator in your hotel and any other buildings you visit. Go on a short jog in the mornings or evenings of your stay. If your hotel has a pool, swim a few laps each morning or evening.

Trick #3: Indulge with Control
Eating out is a must while on vacation. Whether you’re visiting 5 star restaurants or fast food diners, you are faced with the same problem: large portions. While the easiest thing to do with a large portioned meal is to simply eat it all – you are on vacation after all…right? – that isn’t the best for your waist.

When you order your meal ask the waiter or waitress to bring you a to-go box. Take half of your meal and place it safely into the box before you even begin to eat. This gives you no choice but to eat a healthy portion. If you would rather not carry around a to-go box then ask that your entrée be made into a smaller portion. If it is dinnertime ask for the lunch-sized entrée.

Trick #4: Don’t Eat Late
One of the easiest tricks for preventing weight loss is to simply stop eating 3 hours before you go to bed. This is especially effective while on vacation. So skip that late night indulgence and wake up looking and feeling great.

Trick #5: Snack Healthy
Have you ever noticed how travel days create the perfect opportunity for snacking? A coffee and muffin before your flight, a snack on the plane and then before you know it – it’s lunch time! Taking a road trip? This opens up even more opportunities for regrettable snacking…rest stop vending machines, gas station quickie marts and of course the never ending string of fast food restaurants along the highway.

This summer cut unhealthy snacking off at the pass by brining along your own healthy options. Dried or fresh fruit, unsalted nuts, health bars, cut veggies and low fat crackers are a good start. By filling up on these healthy snacks between meals you will end up eating less when presented with a less-than-healthy meal.

Trick #6: Avoid Fried Foods
While fast food restaurants are definitely convenient, with their low prices and quick service, this convenience is not worth the additional pounds brought on by chips and fries. As you enjoy your vacation keep this in mind: avoid fried foods. While this is always good advice to follow, it is even more important to abide by while traveling.

While vacationing you will likely burn fewer calories each day than you would burn at home, and you are consuming more calories due to your schedule of eating out. You are walking a fine line, and eating fried foods would throw you right over the edge. A gram of fat contains 9 calories as compared to the 4 calories that proteins and carbohydrates carry – so you can see that consuming fried foods will drastically increase your caloric intake.

Now that you’ve heard about all the benefits of exercise as you age, you’re ready to hit the gym or at least go for a daily walk. There’s only one problem: Your joints don’t seem to want to cooperate. Is it too late to limber up? For most people, the answer is NO!  Flexibility decreases with age and physical inactivity, and this can cause your muscles, tendons and ligaments to grow shorter over time. But regardless of your age, you can increase your flexibility by incorporating stretching into your daily routine. Remember, though, that aerobic fitness and strengthening are also very important for older adults. And exercise can improve your well-being and reduce your risk of falling.

Note: Always consult your doctor before starting a new exercise or stretching routine.

A daily stretching routine can improve the following:

Physical performance. Increased flexibility makes it easier and less tiring to perform daily tasks such as lifting, bending, turning and engaging in other repetitive movements.

Circulation. Stretching raises the temperature of your muscles, increasing the circulation in that area – which helps keep your tissues healthy.

Posture. Short, frequent stretches throughout the day can keep your muscles from getting tight. This helps you maintain proper posture and reduces aches and pains.

• Stretch lightly before engaging in strength and endurance activities, then stretch more thoroughly after your workout.
• If you’re unable to perform strength or endurance exercises but able to do stretching exercises, do them at least three times per week for at least 20 minutes per session.
• Do each stretching exercise three to four times during each session.
• Stretch slowly and as far as possible without pain. Hold the stretch for 10 to 30 seconds. Relax, and then try to stretch further with each repetition.

• Talk to your doctor before engaging in a new exercise program.
• Warm up before you stretch. A little bit of easy walking or arm pumping should be sufficient.
• Mild discomfort or a mild pulling sensation is normal during stretching, but you should never stretch until you feel pain, especially joint pain. If you feel pain, reduce the stretch so that it doesn’t hurt.
• Ease slowly into a stretch – don’t bounce. Jerking into a stretch can cause muscle tightening and increase your risk of injury.
• Don’t lock your joints into place when you straighten them during a stretch. Your arms and legs should be straight when you stretch them, but not tightly so. You should maintain a very small amount of bending in your joints.
• If you’ve had a hip replacement, talk to your surgeon before doing lower-body exercises. When stretching, you shouldn’t cross your legs or bend your hips past a 90-degree angle.

If you work in an office, you probably sit for about six hours per day. That’s a lot of down time! But even if you’re quite busy at work, it’s still possible to find time to exercise. And to avoid gaining weight, you should strive to make good food choices as well.  Each time you eat, think lean and green. If a food contains lean protein and comes from the earth, you’re very likely on the right track (unless the food is fried). Contrary to what some people believe, you should eat breakfast, lunch and dinner every day, as this will stabilize your energy levels and keep your metabolism running high.  When you can’t make it to a gym, don’t let that sideline your exercise. Try these simple techniques while at work:

• Walk during conference calls. Use a cell phone or headset, and get up and pace around. Hold your notes in your hands and keep moving.
• Exercise in your chair. If your chair is wheeled, you can push and pull yourself around. Push away from your desk to increase your upper-body strength. Then walk with your heels toward your desk to work your hamstrings and thighs.
• Stretch. While seated, twist from your waist and reach around the back of your chair. Return to your original position, and then perform the same motion on the other side. You can work your core by holding a laptop or heavy water bottle when you reach back.
• Breathe between e-mails. For every three e-mails that you send, stand up and take three deep breaths. This will reduce stress and work your lower body as well.

You want to be fit. You know how much you should weigh. You know your ideal pant size. You can even picture how great those skinny jeans will look. So why aren’t you living life in your ideal body?
There are many reasons that make weight loss a challenge, reasons that go deeper than simply calories-in versus calories-out. We’re talking about the life issues that get in the way of your success.

Here are 5 obstacles and solutions to unlocking your best body!

1. You don’t want to be bothered.

It’s in your DNA to avoid pain and seek out pleasure. Unfortunately, this works against you when trying to get fit. In your mind, it’s painful (or at least uncomfortable) to deny yourself the tasty food that you crave and to exert yourself with exercise. There’s a simple way to work around this obstacle: Find something painful about being overweight to motivate yourself towards healthy eating and exercise. Focus on the negative impact your current weight has on your health, self-esteem and lifestyle. Convince yourself that the pain of being out of shape is much greater than the discomfort of losing weight.

2. You don’t want to wait for the good stuff.

Just as you wish to avoid pain, you are also an expert in seeking out pleasure – namely food. This served the cavemen well, but these days it ends up as extra pounds around your waist and thighs. There’s good news: extra calories are not your only option to stimulate the pleasure center of your brain. Find an activity or two that make you smile and indulge in those regularly.  You can also retrain your brain to crave the pleasure of exercise-induced endorphins.

• New diet
• New exercise routine
• New friends at the gym
• New clothes
• New self-image

Focus on all of the ways that losing weight will make your life better. Envision that better life everyday so that it goes from being new and scary to familiar and comfortable.