It’s Pronounced ab DO men

Patrick Helm - SnootyFoxImages

You are told, strengthen your abdomen and you think, no problem, I am toned.  Or you are one of those who feels hopeless, knowing that no matter what you try, that area will never respond to your efforts.   You know, you have tried.  Or maybe you are not quite hopeless, you could build strength and develop great muscle tone, if only you would do the work.  What should you do to strengthen the abdomen?  When did you learn what works most effectively?  What do you know about your belly? 

      The rectus abdominus flexes the trunk (bends it forward).  The internal and external abdominal obliques and transversus abdominis muscles flex the trunk and bend the trunk laterally (sideways).  These muscles are innervated by intercostal nerves 7-11, subcostal, iliohypogastric and ilioinguinal nerves (the rectus receives innervation from the intercostals and the subcostal alone).  When you contract these muscles, it is the obliques and transverus muscles that flatten the abdomen (bring your front toward your back).  The rectus muscle brings the top toward the bottom (the chest toward the pelvis).

        Crunches are popular, portable, affordable and accessible but are they effective?  If done correctly, they can be.  Yet there are limitations.  It is difficult to exercise all the fibers of each abdominal muscle doing only crunches.  The abdominal muscles are large and cover a lot of body surface area.  To exercise them efficiently, one has to accomplish full extension and contraction at some point during the motion to actually strengthen the fibers of the target muscle.  When lying on the floor, the floor itself limits your extension to zero degrees when you might benefit from a starting point of a bit more (slight trunk hyperextension).    One cannot bend back past the floor.   And crunches are not a true functional motion, unless you are a wrestler, or unless you spend an unusual amount of time getting out of bed or up off a floor.  More effective are exercises that work the muscles through longer ranges of motion, against gravity, in more functional positions, such as standing or sitting.  Motion in all planes around a central axis will assure development of all the abdominal muscles as well as the accessory muscles.   The best way to exercise the abdominal muscles is to combine simple single or multiple plane exercises during your normal routine.  You can do the crunches on a stability ball increasing your range of motion beyond that possible on the floor, but you must be aware of your body form!  Then changing your plane of motion, and performing a torso twist will also work the obliques (as well as a few leg muscles).   

     Simple side bending can be done with or without weights (free weights, or at a cable apparatus) to work the internal and external oblique muscles. 

You can use a cable apparatus to perform the torso twist move as well.  There are benefits to varying the way you work the muscles since in life you use the muscles for so many different functions (for motion and for stability). 

     The list of existing known abdominal exercises is long, and most are reasonably effective.  The key is performing any exercise correctly.  Most people do not use their abdominal muscles as well as they should when doing crunches or other “abdominal” exercises, wasting a lot of time and energy and sometimes doing some real harm.  You have to learn to use the muscle you are targeting in isolation when you exercise (when you are weight or strength training, anyway).  This is extremely important when targeting the abdominal muscles.  Otherwise you use the neck, back or legs instead.  If you are unsure if you can isolate your abdominal muscles during a crunch try this exercise.  I call it “Belly, Butt, Back of the Legs” (it is my own creation and could use a better name, I know).  The starting position has you lying on the floor, knees bent, feet flat on the floor with arms at your side.  Take a deep breath, and as you exhale, squeeze your belly, and only your belly sucking it in as deeply as you can toward the floor (nothing else moves), then relax.  Next take a deep breath and as you exhale, contract your buttocks, as tightly as you can (but nothing else moves-keep your legs and belly soft) and then relax.  Finally take another deep breath, and as you exhale, contract the back of the legs (the hamstrings, keeping the buttocks and belly soft) and then relax.  This usually takes some practice, if you have never thought about using these body parts in isolation before.  And if you are having a hard time doing this, you are probably contracting both the buttocks and the back of the legs every time you do a crunch, and this is wrong.  And, you are also probably using the low back muscles for part if not most of the motion of your crunch.    If you are, this would mean that for every crunch you do, you are working your abdominal muscles a lot less than 50% of your effort.    Ok, I am making a lot of presumptions here but this is a general statement and I get no individual feedback through this venue, but I think you get the point I am making?! 

           When starting a crunch, or any abdominal exercise from a supine position (lying on your back), you should start by first inhaling, and as you exhale, before you move anything, start contracting the abdomen.          

                Once the abdominal muscles have begun to contract (we in “the biz” refer to this as the muscles being engaged) start moving. In the case of a crunch, the head, neck, shoulders and upper trunk should all fold up off the floor in one piece.  Yes, I said fold, not roll.  The motion is a simple lift upwards.  Okay, I think I have exhausted the crunch in words.  Need anything more and I will just have to show you.  There is more to know but I cannot imagine you wish to read anything more on this subject right now. Come back again!

     

Rolling Along

          Nearly every athletic training room and most physical therapy facilities contain an array foam rollers of different lengths and consistencies.  These serve as tools for hands-on soft tissue care as part of massage therapy in caring for injury.  Techniques like massage, Muscle Activation (MAT), and Active Release Therapy (ART) can work wonders for sore or injured patients.  The foam roller enables one to self treat, manipulating soft tissue yourself in ways a therapist might.  A foam roller is simply a cylindrical piece of extruded hard-celled foam.  They usually come in one-foot or three-foot lengths.  They are also now available in a number of densities from relatively soft foam, to newer high-density rollers that feel much more solid.  The denser the user, the more dense the roller should be.  Large, heavily-muscled users will do better with a very high density roller whereas a smaller, younger user should begin with a less dense product. 



Basic foam roll



The application techniques are simple.  Pressure can be applied to tender areas.  Or the user can roll the injured area over the roller in a sweeping stroke for a massage effect.  The sweeping stroke can act to stretch the soft tissue.  Users are instructed to let the roller search for tender areas or trigger points and to roll these areas to decrease density and over-activity of the muscle (cramping).  Most users, however, require instruction on where to find the tender spots and on the positioning of the roller, such as parallel, perpendicular, or 45 degree angles, depending on the muscle.  There is no universal agreement on when to roll, how often to roll, or how long to roll, but generally, techniques are used both before and after exercise.  Foam rolling prior to exercise can help decrease muscle cramping and promote a better warm-up.  Rolling after exercise may help muscles recover from strenuous exercise.   Foam rolling is hard work that can border on being painful.  It is important that one learn to distinguish between a moderate level of discomfort related to working a trigger point and a discomfort that can lead to tissue injury.  When someone has completed foam rolling, he or she should feel better, not worse.  Rollers should never cause bruising.  Massage therapy remains a better therapeutic option but foam rollers do offer a cost effective alternative.  If you do not have the strength to manipulate your full body weight over a foam roll, consider other manual tools like “The Stick” or “Body Balls”.  These offer the same myofascial release with much less exertion.   Foam rollers can be a very useful tool specifically when treating the spine instead of the soft tissue.   One can achieve gentle spine segmental mobilization by rolling over a medium density roll with no significant adverse effects and good benefits.

Good use - simple spine mobilization

The Dancer's Injury

     Technically, by definition, we recognize Art as the quality, production, expression, or realm, according to aesthetic principles, of what is beautiful, appealing, or of more than ordinary significance¹ , and Sport as an athletic activity requiring skill or physical prowess and often of a competitive nature¹.  Artists and athletes are viewed as being from two distinct subspecies.  Today Dancers perform and compete quite regularly so that boundary between artist and athlete has distinctly blurred.  Professional dancers get hurt just as often and suffer just as serious injuries as athletes in contact sports.  The practices, so often segregate, as performing arts medicine or sports medicine must coalesce when considering a dancer’s care.    For the last twenty years a special group of dedicated clinicians have worked targeting the special needs of the performing artist (See PAMA - Performing Arts Medical Association).

 What is it really that makes the dancer prone to injury?  Their bodies are conditioned so perfectly to their craft.  Their endurance is profound.    In part it is the need for repetition, the essential mandatory rehearsal of a set of moves performed until the sequence flows from their bodies without requiring thought.  Simultaneously they concentrate on sequence as well as form and music not to mention expression though this is more a feeling than a thought but still, it is part of the dancer’s awareness as they move.  Each element contributes to the motion they produce, to the energy being transferred through the trunk and limb and this is what a dancer must master.  It is so common to hear them say “it was silly really, how I hurt myself” and one will almost always be able to trace a dancer’s injury to a moment of distraction.  The moves themselves are obvious.  The injuries themselves fairly predictable. 

     The statistics do not seem to change over time.  A dancer sprains ligaments and strains muscles. Partners will see disc injuries and more traumatic ligament and muscular damage.   Degenerative changes will plague older dancers, with joint diseases affecting the spine, ankles, knees, hips, feet and shoulders.  In approximately this order one sees clicking hips, hallux valgus (bunion), patella disorders,  stress fractures, scoliosis, coxarthrosis, and spondylolysis as the usual leaders. Competent clinicians know how to treat these.  The trick is realizing that successful treatment of a dancer requires acknowledging more than just the injury as part of the problem to be overcome.  The successful treatment of a dancer involves artful negotiation between the clinician and patient, compromise that will allow adequate healing as well as continuation of their performance.

1.       Dictionary.Com

Workout Basics

     The potential variations are endless, but here are the underlying principles.

Aerobic exercise increases metabolic rate, burns fat and improves cardiac function.

Anaerobic exercise pushes beyond pure aerobics increasing metabolic rate, building endurance, enhancing power and further improving cardiac health (in those who are healthy enough to tolerate this).

    When one performs aerobic exercise for up to about 30 minutes, one taps into purely aerobic mechanisms (as a generalization).  Beyond the 30 minutes one starts tapping into anaerobic metabolism which is a more efficient calorie burner.

Weight training: as a topic can be overwhelming. In an oversimplified summary:

 Lower weight/more repetition:  builds some muscle, builds endurance, burns calories to a lesser degree, increases muscle metabolism.

 Higher weight/few repetition: builds muscle, builds strength, builds power, ultimately enhances the long term metabolic rate.

          Aerobic sessions should be at least 30 minutes long, but 45 – 60 minutes will allow one to accomplish more.

          Weight training sessions should include enough work to fatigue at least 4 major muscle groups.

          You can combine aerobics and weight training through calisthenics…. Call these mixed sessions.  I call them boot camp exercises.

          Abdominal strengthening should be viewed as its own category and should (my opinion) done at every workout.

Aerobic workouts should be vigorous enough to get the heartrate up to at least 130 and no more than 160 for 25 minutes or longer.  You get more cardiac and metabolic benefit from an aerobic workout if the intensity is varied throughout the session (It also makes them less boring). Straining for a few minutes at a higher intensity makes a lower level exertion seem easier.  In this way a medium intensity that seemed hard, done after a few minutes of a really hard exertion, now seems easier…. You end up tolerating a higher average intensity by the end of the session.  Not a bad way to progress your workouts. 

Aerobics:  At least three sessions a week, though 4 – 5 are the ultimate goal.

Walking: Walk for 30 minutes at a medium pace (2.5 miles/hour).

          When this gets too easy, add two to five minute intervals of walking as fast as you can.  Once you can do 3 five minute intervals at a speed pace in a 30 minute walk, increase the length of the walk.  You can also use three levels of intensity, in the same way ( for example: 3 minutes warm up, slow pace, 5 minutes medium pace, 2  minutes fast pace, 3 minutes medium pace, 2 minutes slow pace, 5 minutes fast pace 3 minutes medium pace, 2 minutes slow pace).

          A 30 minute speed walk with no slow intervals is a good “medium to hard” aerobic workout when you don’t have a lot of time.  This would be a session where you do not vary the intensity, but keep it high the whole time, but for a shorter workout time.  This is a good thing to do at least once a week.  When 30 minutes at your highest intensity gets too easy, you’ll need to find something to do that is harder than walking ( ie run, bike, swim or join a gym to have access to other aerobic equipment)

For any other type of aerobic workout, the same system of varying intensity can be applied.

Add calisthenics to a walk:  Add 30 second to 2 minute intervals of lunging steps, or broad jumps or skips.  Walk backwards for segments, jog, or sprint.

An excellent way to build functional power and endurance is to interrupt an aerobic walk with 2-3 minutes of abdominal crunches, pushups, or other stationary calisthenics.