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Total Results Blog

The Rotator Cuff, by Matthew Romans

The rotator cuff is a group of four small muscles deep within the shoulder joint and below the major muscle of the shoulder joint, the deltoid. The supraspinatus holds the humerus (upper arm bone) in place. It originates above the spine of the scapula (shoulder blade) and inserts on the greater tuberosity of the humerus. The infraspinatus rotates and extends the shoulder. This muscle originates from the infraspinous fossa of the scapula and inserts into the posterior aspect of the greater tuberosity of the humerus. The teres minor rotates the arm away from the body. Its origin is the lateral scapula border and it inserts on the inferior aspect of the greater tuberosity of the humerus. Finally, the subscapularis holds the humerus to the scapula, and helps you to rotate, lower and hold your arm out straight. Its origin is the anterior surface of the scapula, and it inserts into the inferior aspect of the greater tuberosity of the humerus.

The shoulder joint (also known as the glenohumeral joint) is a ball-and-socket joint. As movement occurs, the "ball", or head of the humerus glides along the groove of the scapula (known as the glenoid fossa). The shoulder joint is very mobile, which is why you can move your arms in a number of different ways. Unfortunately this leaves the joint very unstable, and it can easily be injured. While acute injuries can occur as a result of a fall or some other trauma, the most common injuries to the rotator cuff are overuse injuries. Painters, cosmetologists, and athletes who throw (pitchers, quarterbacks, or javelin throwers) are particularly susceptible to overuse injuries of the rotator cuff. This could be something relatively minor like tendonitis and bursitis, or something more serious like impingement or a tear.

Another fact to keep in mind is that there is a natural imbalance between the functions of internal and external rotation of the humerus (rotating the upper arm toward and away from the midline of the body). While four muscles work to perform internal rotation (latissimus dorsi, teres major, pectoralis major, and anterior deltoid), only the infraspinatus and teres minor perform external rotation of the humerus. This natural muscular imbalance can leave the small muscles of the rotator cuff in a vulnerable position.

A complete tear of the rotator cuff will probably require surgery, depending on your age and lifestyle. An incomplete tear, inflammation, and impingement may simply require rest from the activity that is the cause of the problem. To protect your shoulder joint in general, you want to make the muscles surrounding the joint as strong as possible, and do so using an exercise protocol that is safe, slow, and low-force. At Total Results we specifically strengthen the rotator cuff by performing the External Rotation exercise using a Timed Static Contraction for 90 seconds (30 seconds each at 50%, 75%, and 100% effort), and the client provides manual resistance with their opposite hand. As a former college football quarterback who played in adult men's flag football leagues for nearly 20 years, I found that this exercise played a major role in preserving the health of my shoulder joint, and I performed it in every workout. We can also eliminate or modify certain exercises to work around rotator cuff injuries, such as altering the start position of the movement arm on the Chest Press or doing only horizontal exercises for the upper body.

While the rotator cuff makes up a very small percentage of your total muscle mass, these muscles can cause big problems if they are weak or injured. Let Total Results help you restore muscle and joint function, reduce pain, and protect against injury.

Posted July 16, 2019 by Tim Rankin

Death by Food Pyramid - a book recommendation

Note: This review was originally sent out in our In Shape For Life newsletter in January of 2014

Denise Minger is a nutrition blogger (www.deniseminger.com) who first gained notoriety when she critiqued The China Study, a popular book by T. Colin Campbell which advocates a plant based diet. Minger took the figurative magnifying glass to the raw statistics in the study/book and found Campbell's conclusions lacking. The diets and subsequent health effects of various Chinese populations did not, in fact, point to meat and dairy consumption causing heart disease and cancer. Needless to say, advocates of vegetarian and vegan diets, who point to The China Study as justification for their diets, were not happy, so Minger's careful analysis caused an uproar. Interestingly, Minger herself was a practicing vegetarian/vegan for 10 years and still has respect for those who follow that path.

Minger has recently aimed her critical analysis skills at the USDA and its Food Pyramid. Although officially no longer in use, the Food Pyramid and its predecessor dietary guidelines influenced several generations of Americans in their eating habits. Minger's book, Death by Food Pyramid: How Shoddy Science, Sketchy Politics, and Shady Special Interests Have Ruined Our Health: link, shows that there is a world of difference between what the government recommends and what additions or deletions to the diet actually promote health and longevity.

In Death by Food Pyramid, Minger reviews how politics and business interests shaped the food pyramid recommendations, as opposed to sound science. Minger also takes in depth looks at the various sacred cows of modern nutrition, including the lipid hypothesis (cholesterol as the cause of heart disease), the Framingham Heart Study, Ancel Keys and the Diet Heart Hypothesis, and more. She shows again and again how statistics have been skewed by researchers and/or governments in order to bend to suggested dietary guidelines (ex. 6-11 servings of grains, using fats and oils sparingly, etc.). Finally, Minger looks at populations that have been remarkably disease free for many generations and what they eat. While there is an amazing range of diets, spanning from almost vegetarian to almost purely animal based, there are some similarities across all these groups. Those similarities include minimal refined flour, minimal refined sugar, minimal vegetable oils, and a definite and substantial source of fat soluble vitamins (A, D, E and K), via either dairy, meat, fish, butter or some combination.

I highly recommend reading Death By Food Pyramid, as well as Minger's various blog articles. The science and statistics being examined can be complex and unexciting, but Minger brings her arguments alive with a great sense of humor, a very balanced approach, as well as a voracious hunger for uncovering the truth.

Posted July 16, 2019 by Tim Rankin

Is Distance Running good for you?

Note: This article originally appeared in the April 2014 Issue of In Shape for Life, our e-newsletter

In the March 2014 issue of In Shape for Life, I wrote about the three pillars of the Superslow training philosophy: Safety, Efficiency, and Effectiveness. I compared Superslow to a host of other exercise methods, all of which failed to meet the standards of Superslow training in one or more of these three pillars.

Now that warmer weather is finally upon us in Virginia, the most popular of these "other" exercise methods seems to be running. Everywhere I go, I see men and women, young and old alike, running along roads and through neighborhoods. These runners may be running anywhere from one to ten or fifteen miles per outing and running anywhere from once per week to every day. Certainly there is a big difference between a casual jogger and a distance runner. I define distance running as any more than a few miles of easy jogging, and any more than a few times per week.

Presumably, most of these runners are trying to improve their fitness. Most people who do any exercise are either trying to lose weight, increase strength, improve cardiovascular efficiency, or enhance flexibility. Runners also may be attempting to improve their resting heart rate, blood pressure, blood sugar, insulin sensitivity, etc. Finally, runners may be trying to relieve stress and improve their mental outlook. All of these goals are noteworthy. The question is: is running the smartest way to achieve these goals? Moreover, is running even good for you? Do the negative outcomes outweigh the potential benefits?

Let's look at a few of the major goals of runners:

-Losing weight - Runners hope to burn enough calories to lose excess fat from their bodies. However, a runner would have to run approximately 5 miles per day, 7 days per week, in order to burn the calories stored in 1 pound of body fat! To lose 1 pound per week via running, you will have to run 35 miles every single week. However, it is more complex and frustrating than that. All those miles run stimulate appetite and encourage runners to eat more than they did before starting their running program. While it can take an hour or more to run 5 miles, it only takes a few minutes of eating to completely negate the caloric burn achieved by the run.

Bottom line: running is not a great tool for losing weight

- Increase strength and improve muscle tone - Running can and does strengthen the lower body muscles to some degree at first (and does nothing for the upper body), but the moderate gains peak quickly and can even reverse with significant distance running. The muscles actually atrophy with overtraining (daily long distance running of over a few miles). You will notice that many marathon runners look emaciated - that is because they have lost most of their lean muscle mass due to their body's reaction to running.

Bottom line: running is not a good tool for improving strength and muscle mass.

- Cardiovascular fitness - This is supposedly the holy grail of distance running - the belief that running is the best thing you can do for cardiovascular health. However, the facts do not bear this out. Two primary aspects of cardiovascular fitness improvement are direct (stronger heart muscle, higher lung capacity, etc.) and indirect (ex. increased venous pathways leading to lower blood pressure, lower resting heart rate, etc.). Running does nothing for the lungs, and only moderately affects the heart muscle. As for the indirect aspects, distance running is not intense enough to stimulate an increase in the number of venous pathways in the body the way a high intensity exercise like Superslow does. Steady state activity like running primarily serves to strengthen the leg muscles, and only moderately at that.

Bottom line: running is a poor method for improving cardiovascular fitness.

So, running is an inefficient method of achieving most fitness goals. To make it even worse, distance running is rife with risk. A large percentage of distance runners get injured every year, with injuries running the gamut from ankles, to knees, to back issues and more. Additionally, distance running can weaken the runner's immune system, making them susceptible to all manner of viral and bacterial infections.

There is one benefit I think running can achieve - stress relief. Many people run, at least in part, for this benefit, and it is a worthy goal. However, stress relief can be achieved in a variety of safer ways, including walking, meditating, listening to music, etc. Even shorter distance and duration running can give the same stress relief benefit as can distance running with much less risk.

In conclusion, before you strap on your new Nike's and go for a run, consider the risks and rewards. Instead of running all those miles, it would be more beneficial to your health and wellbeing to take a walk with a loved one, lift weights intensely once or twice a week, eat well, and get plenty of rest.

Posted July 16, 2019 by Tim Rankin

Understanding the Cam Effect - by Matthew Romans

In previous blog posts I have written about some of the exercise machines we have in our Total Results studio. If you take a closer look at these machines, you will likely see an oddly-shaped plastic or aluminum structure over which a kevlar belt runs around its perimeter and attaches to a movement arm. This structure is called a cam, and it is what provides variable resistance throughout the range of motion of the exercise. Why is this important? The cam is a critically important component of exercise equipment design and is one of the foundations of our exercise protocol. Having an understanding of the cam effect sets the Total Results exercise philosophy apart from the rest of the industry.

Prior to the 1950s, the only tools available for weight training were barbells and dumbbells. You could certainly get stronger using barbells and dumbbells, but there were inherent limitations; you most likely needed a spotter for many exercises (like a bench press or squat), and it was harder to progressively add small increments of weight. Two exercise machine companies emerged in the late 1950s: Universal (1957), and Marcy (1959) each came out with their own version of all-in-one exercise stations. Universal was the more recognizable brand. Their machines tracked on a round pulley that did not vary the resistance at all. From a convenience standpoint it was an improvement upon the barbell (my high school weight room contained a Universal multi-exercise station). Arthur Jones, who had been a filmmaker and animal trader, created the first Nautilus exercise machine in 1970, largely because he saw a way to improve upon the limitations of the barbell and Universal machines. Jones inherently understood that human muscles are stronger in some positions and weaker in others, so there was a need for variable resistance. In his memoir, Jones credited his oldest son Gary (who later went on to create Hammer Strength exercise machines) with solving the problem of how to provide variable resistance with the cam. Since the cam was eccentrically-shaped and looked like a nautilus shell, that was how the company got its name. After selling Nautilus in 1986, Jones formed the MedX corporation, initially to produce medical-grade testing machines before making general exercise equipment. MedX machines (we have several of them) are leverage-driven and do not have a cam like Nautilus machines do and are not connected to a belt (since their weight stacks have no guide rods), but are very well-designed.

Ken Hutchins (the founder of our exercise protocol) was an employee at Nautilus during the 1970s and 1980s, and held a variety of responsibilities for the company. In addition to supervising (with his wife Brenda) the Nautilus Osteoporosis Project at the University of Florida, he also worked very closely with Jones in equipment prototype design. Hutchins eventually understood that most of the older generation of Nautilus machines were engineered based on a relatively fast speed of movement (2 seconds raising the weight, 4 seconds lowering the weight), and in some cases (such as the vintage Leg Curl machine), the cam effect was backward, meaning that the resistance was too heavy in the most contracted position and too light at the starting position. After leaving Nautilus in the late 1980s, Ken began manufacturing his own equipment (and many of his machines can be found in our studio) under the moniker of Super Slow Systems. These machines are an intellectual leap forward from the Nautilus cams; they were designed for a much slower speed of movement (10 seconds lifting, 10 seconds lowering) and with much less friction between the guide rods and weight stacks. The cam effect on these machines can and should vary from one exercise to the next, based on the involved musculature. While the Leg Curl has a fairly radical cam fall-off, the Chest Press feels less radical.

What does this mean for your workout? The inherent mechanical limitation of the barbell is that there is no way to achieve variable resistance, so the weight will be too heavy in some positions and too light in others. We want to be consistent with timing, which is the matching strength with resistance. The resistance should be heaviest when your muscles are in their strongest position (usually the start of the positive phase of the movement), and lightest in their weakest position (usually the most-contracted position). This results in your muscles being loaded/targeted more effectively, and translates into a more thorough inroad and stimulus. Theoretically, if the cam is properly designed, you should reach momentary muscular failure at random positions in the range of motion from one workout to the next (although I usually find myself hitting failure on the Leg Press in the bottom out position). Further, any movement faster than approximately 5 seconds renders the cam effect virtually meaningless, which is one reason we emphasize a very slow speed of movement (approximately 10 seconds in each direction).

At Total Results, our exercise protocol is centered around our equipment design, and while you can use our protocol on regular gym equipment, the effect doesn't come close to what you get working one on one with us in our ideal exercise environment. Come experience the difference today!

Posted July 11, 2019 by Tim Rankin

The Neck Machines and Exercises at Total Results - by Matthew Romans

An often overlooked and under-addressed group of muscles in the human body is that of the neck. Your neck muscles are responsible for holding up your head (which weighs ten to eleven pounds), and greatly influence your posture. Weak neck musculature (combined with excessive sitting and looking down at electronic devices) can cause the head to drop lower, which can eventually lead a lordotic curve in the thoracic region of your spine, and can be responsible for recurring tension and migraine headaches. Working to strengthen your neck musculature is absolutely critical to maintain good posture and protect against injury; this is important for everyone, but especially for people participating in combat sports (football, boxing, wrestling, martial arts), the elderly population, and those with a history of neck injuries.

The two major muscles of the neck are the sternocleidomastoid, which originates on your sternum and inserts on the mastoid process of the temporal bone of the skull, and the trapezius, which is a kite-shaped muscle that originates on the occipital bone of your skull and inserts into the clavicle (collarbone), acromion process, and the spine of the scapula (shoulder blade). These two muscles perform all of the gross motor functions of the neck, which include lateral flexion (tilting your head from side to side), rotation of the head (as in looking over your shoulder), cervical flexion (tilting your chin towards your chest), and cervical extension (as in looking straight up).

Most "trainers" and exercise enthusiasts simply ignore the neck musculature. It's probably best that they do, because most exercise protocols seem to make matters worse. The neck muscles are collectively very strong, but they are delicate and can easily be injured. At Total Results, we pride ourselves on being able to improve function and strengthen the muscles of the lumbar, thoracic, and cervical spine, and we have worked with clients that have a variety of spinal issues. Our exercise protocol is the only one that is safe enough to address the musculature of the neck, and we have a few different ways to do that.

We have two different four-way neck machines. One is made by Super Slow Systems (located in our front exercise room) and has a fixed head pad, no back pad, and has a timing crank to customize the resistance curve for each client (just like we have on the Super Slow Systems Leg Curl machine). Our other neck machine (located in the back exercise room) is manufactured by MedX, which features a horseshoe-shaped swivel head pad and has an adjustable back pad. It also comes with a footrest to minimize tension and unnecessary involvement of the lower body. While both of these machines allow us to perform lateral and cervical flexion, we almost exclusively use them for cervical extension, as that area of the neck needs to be addressed the most.

The seat height is adjustable, and we can even use an additional elevation pad if necessary. The seat should be set so that the base of the neck is aligned with the axis of rotation, and the back pad setting should allow your arms to be extended with the heels of your hands in contact with the handlebars. This ensures that your pelvis is contained in the seat. If the head pad slides on your head during the movement, you are not properly aligned. The exercise begins when the client gently increases the pressure on the head pad through the back of the head to initiate movement. The client should visualize trying to press the back of their head down towards their butt, pause in the most contracted position, and then change directions. The lower turnaround should be performed so that the plates gently touch, but the musculature should not be unloaded. A squeeze technique will be performed on all repetitions beginning with the third. Once muscular failure has been achieved, a thorough inroad should be performed for an additional five to ten seconds. After the exercise is completed, the client should ease off the effort and stand cautiously to avoid getting dizzy or light headed.

If performing a regular dynamic movement is contraindicated due to a previous injury, we can also perform the cervical extension exercise as a Timed Static Contraction. This can be done on either of the machines, or with manual resistance provided by your instructor. For clients that tend to suffer from exercise-induced headaches (EIH), we often perform the cervical extension exercise early in the routine to both strengthen and relax the neck muscles. This is an effective strategy to prevent EIH. As mentioned earlier, strengthening your neck in general, and specifically performing cervical extension will go a long way toward minimizing tension headaches, improving posture, and alleviating impingement in the cervical vertebrae. Start reaping the benefits today with Total Results!

Posted June 28, 2019 by Tim Rankin