With the holiday season upon us there is no better time to be thankful for the people in our lives. I feel so fortunate to have all of you in my life, and for the opportunity to work with each and every one of you. Whether it be for symptom relief or performance enhancement, I am grateful each day to be able to interact with so many different and dynamic individuals. I would like to thank each one of you again for your enthusiasm, inspiration, support, and the ideas you have given me to better myself and my practice.

Enjoy the holidays and cherish the time with those close to you. Take several moments to celebrate your success and have fun while living with an attitude of gratitude.

                
       "We make a living by what we get; we make a life by what we give."
                                                                                       - Winston Churchill

In my last newsletter I wrote a bit about current research findings showing that low vitamin D levels may contribute to many disorders and disease processes. In this installment I would like to write some about the role of calcium in our bodies and again what the latest research is telling us. This will be especially relevant to many of you readers with teenage daughters.

The Osteoporosis Society tells us that one in four women over the age of 50 develops osteoporosis, which leads many to to believe it is a condition which requires attention once we are in our 40s or 50s. We couldn't be more wrong. The reality is that the nutrition, supplementation, exercise, and other lifestyle habits of young women betweent the ages of 13 and 20 are the most important factors that determine risk of developing osteoporosis in later years.  

Between the ages of 11-24 years, our bodies have the ability to absorb calcium from the intestinal tract with a very high degree of efficiency, but this absorption capacity declines with age.  As such, teenagers provided with ideal amounts of calcium are known to drive calcium into their bones at a rate of 400-500 mg per day. If they do this day after day, year after year, throughout their teenage years, they end up with optimal bone density by age 20-24.

This is important because later in life, when estrogen and other hormones decline (this is the reason why more women than men get osteoporosis), calcium leaks out of bone into the bloodstream, is filtered by the kidneys, and excreted in the urine. Sure, one can take extra calcium later in life to slow down the rate of calcium loss from bone. Resistance exercise coupled with 1,200-2,000 IU of vitamin D on a daily basis may even help stabilize their bone density. Many women, however, simply did not get enough calcium when they were younger and end up paying for it as early as age 45, when osteopenia or osteoporosis is often discovered upon bone density testing. 

While it can be difficult to convince teenagers to subscribe to healthy habits for preventative purposes, research has shown that the teenage version of an osteoporosis prevention program is relatively simple and very effective. Recent studies have shown that teenage girls achieve optimal calcium accumulation in bone at a daily calcium intake of 1,200 mg a day. As the average teenage girl consumes only 500 mg of calcium from her diet each day, researchers found that providing an additional 500-700 mg per day of calcium from a calcium supplement worked well to maximize total body bone density during the important teenage years (Rozen, Lambert; 2008).

So, what would be the ideal scenario for the teenage girl? Well, for starters she would consume 1,200-1,500 mg of calcium a day from food, go to the gym and lift weights three times a week, perform aerobic/anaerobic exercise regularly, and avoid foods, beverages, and behaviors that rob the body of calcium (salty foods, soda pop, caffeine, cigarettes). Again, for many teenage girls this may be asking a lot. What can we perhaps more easily implement?

For starters, based on the research, teenage girls should consider a high-potency multi-vitamin and mineral that contains 500 mg of elemental calcium and 400 IU of vitamin D, along with some zinc, copper, and magnesium.

One last note of interest: One in eight men over the age of 50 now develops osteoporosis, and thus, the same prevention program is suitable for teenage boys.

Did you know that if an injury is not corrected within six weeks, the central nervous system is forced to adapt into other areas of the body? In the adaptive process, other tissues or system are forced to take on more of the load. Without bombarding you with the details of proprioception, muscle motor units, tension and stretch relationships, agonist / antagonist function, and Sherrington's Law, I will get straight to what you need to know.

When a muscle or tissue is overloaded beyond its ability to handle the load, one or two things happen. Either the muscle/tissue tears and/or the proprioceptors inhibit the contracting muscle to cause it to "give way". The latter occurs in order to reduce the amount of damage to the tissue. This process is similar to a circuit breaker in an electrical unit. Once this occurs, the injured muscle stays inhibited and other tissues take on the added load in an adaptive process. This is a form of compensation. With each compensation, the body loses a degree of efficiency.

If the adaptation / compensation is successful, the symptoms disappear. This would explain why some think they can "work", "play", or "run" through an injury. However, this way of thinking is not only wrong, but also leaves one more susceptible to further, more serious injury. You see now the compensatory tissues are in an overload situation which create an overuse syndrome, such as iliotibial band syndrome or carpal tunnel syndrome.

If the compensatory tissue is injured, the system can no longer adapt at the local site. If the inhibited muscles are continually stressed they will inflame at the attachment sites, significantly reducing the muscles ability to contract under load.
 
Now the connective tissue; i.e. tendons, ligaments, cartilage, bursa, bone are forced to take on more of the burden of support. These tissues are not designed for this, prompting the proprioceptive centers to create pain (think of this as an alarm reaction) in an effort to force you to reduce the amount of stress placed on the tissue or restrict movement in the joint. This is your body doing its job to protect you from further damage. Bigger problems then arise when  the protective mechanism is removed through the use of medication. Now the body can no longer monitor or feel the pain. 

Truth is, to suppress the symptoms is to set the body up for more serious problems in the future. Instead we should accurately assess and translate what the body is communicating to us.  Follow this with efficient strategies to correct the movement impairments and inhibitions. This leads to higher function and the alarm reaction is no longer needed.

Remember the movie, "Ghostbusters"? You know, the one with Bill Murray, Dan Aykroyd and their gang ridding the city of ghosts and ghouls. Well, if there was such thing as an Exercisebuster, I would sign up for the job. 

Even in the most expansive of exercise libraries, there are relatively very few "bad" ones. However, there still remains several of which should not be performed by certain individuals presenting with certain conditions or limitations. In fact, it could be argued that there is no one exercise suitable for every single one of us. Whether it be a doctor, therapist, or personal trainer working with an individual, there needs to be consideration of risk versus benefit.

With that being said, in my humble opinion there are a few exercises that should probably never be performed due to the high levels of stress placed upon the spine. Cue the entrance of  Josh - the Exercisebuster!

This month I would like to bust up - and provide the rationale for doing so - the seated crunch. This is an exercise commonly done in gyms and fitness clubs across the country, and is at least partly responsible for some of the low back pain that afflicts so many people. 

Performing the seated crunch against resistance does not fair well with the low back. Generally speaking, some of the highest levels of stress to the low back, and in particular, the intervertebral disks occur in the seated posture. The pressure in the lumbar disks is then significantly increased with forward bending and yet further increased by performing this motion against resistance. To add insult to injury, most individuals will perform the motion with a jerking motion to generate a starting momentum. Yes indeed, this is a recipe for disaster to one's low back and lumbar disks.

A better alternative is a standing medicine ball chop while avoiding end range loading.