YOUR QUESTIONS ANSWERED
Navin's Bio
Leg Extension Machines: Not a Big Fan
Alexander Technique
Kinesio Tape
Vitamin D and Athletes
Keys to Preventing Arthritis
Rolling Patterns
Five Foods that Fight Inflammation
Kale
Tylenol (acetaminophen) vs. Motrin/Advil (ibuprofen)
Omega-3 Fatty Acids
Foot Fungus
Empty Calories
Sit-Ups...Are They Worth the Pain and Effort?
Jumping Higher
Exercise In All Directions!
Running Barefoot
Ankle Sprains: It’s Not the Shoe!
One Exercise?

Welcome to the Ask the Athletic Trainer blog where Mystics Athletic Trainer Navin Hettiarachchi answers fitness questions from the WNBA’s best fans. If you have a question for Navin, just tweet it to @WashMystics with the hashtag #AskNavin and you could see your question answered here!

Navin Hettiarachchi is entering his eight season with the Washington Mystics as the team's certified Head Athletic Trainer. His responsibilities cover all aspects of medical care, rehabilitation and sports performance for the team.

Navin earned a B.S in Sports Medicine from West Virginia Wesleyan College and a Master’s degree in Sports Medicine from The United States Sports Academy. He has learned and trained under world renowned physical therapists, chiropractors and osteopaths and earned multiple certifications in rehabilitation of musculoskeletal injuries, including: A Graduate Diploma in Manipulative Therapy (Dip MT), Certificate in Advanced Sports Rehabilitation (CASR), Performance Enhancement Specialist (PES) and Corrective Exercise Specialist (CES). Instead of relying on one technique, Navin combines his knowledge from a variety of disciplines to create a unique and innovative treatment approach enabling an athlete to get the best treatment. Navin’s approach is a combination of skillful manual therapy and therapeutic exercises using evidence-based best practices and scientific literature.

Navin’s main goals for the Mystics (and their fans) are injury prevention, rehabilitation and the treatment of movement dysfunctions. He bridges the gap between rehabilitation and performance by enhancing the physical health and functional abilities of the athletes. Learn more about Navin here.

Please remember that "Ask the Athletic Trainer” does not provide medical advice, diagnosis or treatment. See additional information.


Leg Extension Machines: Not a Big Fan

When exercising, it is tempting to take the easy way out. Machines make exercise simple by allowing users to sit and follow simple steps that are supposed to help specific muscles. Unfortunately, the easiest way is not always the most effective way. The leg extension machine is a simple machine that is designed to strengthen the quadriceps, but does it actually work?

Don’t get me wrong, the leg extension machine is effective at isolating muscles of the leg and may have a role in early phases of rehabilitation. But, I am definitely not a fan of placing resistance on the leg beneath the knee because of the increased amount of joint torque. In sports or daily activities, there is no load below the knee; it’s always above the hip. When you are sitting on a leg extension machine, you disrupt normal kinematic sequencing of the lower kinetic chain and the movement/mechanics are not functional or fundamental. Also, when the foot is off the ground, we lose the feedback loop from the foot to the nervous system. Thus, while there are some studies that demonstrate short-term gain in strength with the leg extension machine, it will not help us in a real-world situation.

Leg extension machines can be useful. According to a study done by the University of Campinas in Brazil, the machine does strengthen muscles like the rectus, in particular. However, it is not the be-all and end-all to quadriceps growth. Doing leg extension machine training alone will not get you very far. No long-term studies are available to substantiate the impact of this machine over other lower body exercises.

If you are a typical bodybuilder or someone interested in building muscle, the leg extension machine is a good fit for you. It might be a good supplement to traditional exercises as a way to build up the quadriceps. However, you must remember that it is just that: a supplemental exercise. The main focus of your athletic performance workouts should be single leg squats, kettlebell swings and lunge variations.

There is no doubt that leg machines improve strength and muscle mass that will benefit athletic performance. But it is very limited in improving fundamental and athletic movements. For that, there’s no easy way out.


Alexander Technique

The Alexander Technique is an educational method that teaches people how to utilize optimal technique and proper postural mechanics with daily activities. It is not a form of exercise or relaxation technique but a form of correct movement pattern or reeducation that allows the body to return to normal optimal function by improving breathing, balance and coordination. The technique teaches people to unlearn bad physical habits, returning to a more balanced state of best posture. This allows the body to move with less effort and efficiently.

The Alexander technique is demonstrated through a light, non-invasive touch that allows the student to learn to change the way they move. Typically, a student works together with an instructor in order to achieve the goals that are important to the individual with instruction tailored to the student based on their unique abilities and learning style. Simple, basic movements are practiced including walking, sitting and standing. Lessons may also be given according to the student’s occupation or hobbies from working at the computer, speaking in front of an audience and lifting in order to incorporate instruction into their daily lives.

The practice involves becoming aware of conscious movements as well as thoughts, learning how to stop tensing the body, interfering with its natural alignment.

How can the Alexander Technique help? Increases the ability to better handle stress

  • Reduces tension
  • Allows better range of movement and quality of motion
  • Improves balance
  • Enhances breathing
  • Prevents injury and improves body mechanics to better perform daily responsibilities
  • Allows a better sense of control of the body
  • Can enhance performance and reduce anxiety for stage performers including actors, dancers and musicians as well as to boost an athlete’s performance.

    For more in-depth information on Alexander Technique visit http://www.alexandertechnique.com/


    Kinesio Tape

    Developed 35 years ago by Dr. Kenso Kase and used by many physical therapists, chiropractors and athletic trainers. Kinesio tape is an elastic tape with therapeutic properties. It is used for treatment of swelling, edema and pain. It contains no medicinal properties. The Kinesio taping provides support and stability to joints and muscles without distressing one’s range of motion or circulation. Kinesio tape can be used for a wide variety of situations and conditions, such as tennis elbow, rotator cuff injury, low back strains, hamstring and groin injuries as well as preventive injury measures.

    What Does Science Say?

    Many athletes and fitness enthusiasts swear by Kinesio tape, while others say it doesn’t do anything for them. But, what does science say about Kinesio tape and the Kinesio taping method?

    Sports medicine (Auckland, N.Z.). 2012
    There was very little quality evidence to support the use of Kinesio tape over other elastic taping. However, it does state that Kinesio tape has been shown to improve strength and range of motion, although more scientific research and clinical studies are needed to confirm this. This meta-analysis does state that Kinesio tape has plenty of quality experimental research to back it up and practitioners and physicians can feel confident that their athletes will benefit from the use of Kinesio tape.

    European Journal of Physical and Rehabilitation Medicine Med. 2013
    This systematic review assessed 12 articles that targeted the effects of Kinesio tape in regards to three disorders: lymphatic, neurological and musculoskeletal. The evidence for lymphatic disorders was inconclusive and there was no evidence to support the fact that Kinesio taping is effective for treating neurological disorders. For musculoskeletal, there was limited evidence to support the effectiveness in pain reduction, although in three of the six studies, there was superior pain reduction. While Kinesio tape has been shown to relieve short-term pain effectively, more research is necessary to determine the tape’s true effectiveness with movement and pathologic disorders and disabilities.

    The Physician and Sports medicine journal. 2012 Nov
    Two studies that observed lower extremity musculoskeletal injuries did not have any better, nor any worse, outcome when Kineso tape was used. With musculoskeletal injuries of the spine, two studies showed that patients saw a significant improvement in pain as well as range of motion with the use of Kinesio tape immediately and a full 24 hours following injury, although the long-term results were the same. The final two studies examined shoulder musculoskeletal injuries, one of which had insufficient evidence and the second of which showed that Kinesio tape may in fact help with short-term pain relief.

    Although there is not enough evidence to support Kinesio tape being effective following musculoskeletal injuries, it can definitely be said that it is beneficial. While these studies show that evidence is limited to support the effectiveness of Kinesio tape, there is plenty of confirmation from our players that the taping does provide benefits to those who use it.

    My co-worker, head athletic trainer for the Washington Wizards state that “Kinesio tape gives the player a reminder (neuromuscularly) of where their limb or trunk is in space. In doing so, this allows a fuller use of the muscles surrounding the joint when they may not be functioning properly”


    Vitamin D and Athletes

    The essential role that Vitamin D plays in athletes has been published in numerous research studies. The findings show that Vitamin D is important not just for peak performance and to prevent fractures; it’s important for reducing joint swelling and balance.

    The sun's ultraviolet rays are the major natural source of Vitamin D; in winter it can be a challenge to maintain the body's vitamin D storage, as well as replacing loss of Vitamin D during athletic activities. Athletes who train indoors may have a year-round deficit of Vitamin D.

    An essential component in athletic performance is balance. Research at the University of Maryland Medical Center showed that vitamin D deficiency can impair balance. The research showed that increasing vitamin D intake lowers the incidence of falls by a substantial 22 percent.

    Vitamin D is also essential to regulate bone strength. It helps the body absorb calcium and phosphorus, the two minerals with the greatest importance to bone strength. According to the International Journal of Sports Nutrition and Exercise Metabolism, vitamin D deficiency can potentially cause swollen joints, autoimmune diseases, and contribute to temporary and chronic illnesses. If you are experiencing stumbling while running/walking or having difficulty in performing movements that emphasize balance such as yoga, check for vitamin D deficiency with your physician.

    In winter, when there is less exposure to ultraviolet rays, people suffer from "Seasonal Affective Disorder" (SAD). SAD causes depression, loss of motivation and decreased energy. Light therapy or vitamin D supplements may help athletes increase overall energy and motivation when the number of hours of daylight are at a seasonal low.


    Keys to Fighting Arthritis

    Keys to fighting arthritis
    Arthritis is one of the most common chronic ailments as well as one of the most debilitating. In fact, Arthritis Foundation believes that an epidemic of osteoarthritis will be seen over the next 20 years as the Baby Boomer generation continues to age. Arthritis is much more than a painful annoyance with symptoms that can be eliminated by popping a pill. It has, and will, ruin many lives. If you hope to avoid developing this horrific chronic illness, prevention is key. Even if you’ve already been diagnosed with arthritis, by heeding the following advice, you can relieve your symptoms.

    Regular exercise
    Regular exercise from an early age can prevent arthritis. Researchers at Hobart, Australia’s Menzies Research Institute found that physical activity during childhood increases the amount of cartilage in the knee and helps to prevent the onset of osteoarthritis in later years. Professor Graeme Jones from the institute noted that “the bones adapt to that extra physical load and because cartilage basically covers the end of the bone, if your bone gets larger, you’ll grow more cartilage over the end of the bone.

    Exercise at any age can help prevent arthritis and reduce symptoms for those who’ve developed it. Experts from Northwestern University studied over 3,500 people in their 50s and 60s with arthritis and found that those who reported getting at least 30 minutes of exercise per day for five days per week were the least likely to become disabled by arthritis. If you have arthritis, low-impact exercises are best such as swimming, walking and yoga according to researchers at the University of California, San Francisco.

    Anti-inflammatory Diet
    It’s important to maintain close to an ideal weight to prevent arthritis; being overweight puts extra stress on the joints. It also increases the level of inflammation in the body which can lead to arthritis and just about every chronic illness and disease. The Arthritis Foundation reports that there have been numerous studies showing that following an anti-inflammatory diet and lifestyle can greatly reduce your chances of developing arthritis as well as reduce symptoms if you’ve already been diagnosed. See the previous article for suggestions on anti-inflammatory food.


    Rolling Patterns

    What Are Rolling Patterns?

    The reason that we use rolling patterns is because of developmental Kinesiology. Babies first develop rolling patterns when they learn to turn and roll over. Rolling patterns work to create stability. It all centers around the core, though you have two cores: inner and outer. Dr. Perry Nickelston stated that the inner core ultimately improves stabilization and assists in sustaining continence and respiration. The outer core offers stability with your posture, assists in proper movement and resists loads. Rolling patterns target both the inner and outer core.

    Here are five rolling patterns that you can do on either side:

    • Targeting the upper-extremity, roll supine to prone.
    • Targeting the upper extremity, roll prone to supine.
    • Targeting the lower extremity, roll supine to prone.
    • Targeting the lower extremity, roll prone to supine.
    • From knee to opposite elbow, do a hard roll.

    When performing these rolls, make sure that you stay long, reach and look with your head and eyes. You want to reach and lift your arm, then look into your shoulder before you roll. Keep in mind that using your head is essential in a successful pattern roll. Remember that you want to perform these rolls using your core, not your extremities. Your strength and mobility cannot be improved if you are unable to gain stability. Incorporate rolling patterns to your next workout. You will eliminate your movement pattern dysfunctions and improve mobility and stability.


    Five Foods that Fight Inflammation

    Leafy Greens
    Fresh kale and spinach are rich in nutrients. Leafy greens are also high in alkalizing minerals. The calcium and magnesium content in these greens help alleviate inflammatory responses in the body.

    Berries
    Berries are perhaps the most delicious way of deflating inflammation. Each type of berry holds a different phytochemical which aids in overall health, as well as reducing inflammation. Choose blueberries, strawberries, cherries and raspberries as a regular part of your diet. Acai berries are said to be one of nature's most effective anti-inflammatory agents.

    Cayenne Pepper
    This spice is a very effective anti-inflammatory. Other spices that benefit your health are cinnamon, turmeric and garlic.

    Salmon
    The omega-3s found in oily fish (such as mackerel, salmon and sardines) have powerful anti-inflammatory agents. These are said to be nature's best anti-inflammatory agent. According to research, dietary omega-3 may play an important role in the inflammatory process.

    Green tea
    Studies have shown that green tea, when consumed regularly, decreases chronic inflammation. It may have a role in fighting cancer and heart disease as well.


    Kale

    There are foods which can help eliminate or limit the severity of inflammation. Kale is one of the most powerful anti-inflammatory foods. It is a vegetable similar to cabbage but is in the mustard family. Kale is low in calories and only contains 34 calories per cup, zero fat, and contains 5 grams of fiber, and 15% of the daily requirement of calcium and vitamin B6, 40% of magnesium, 180% of vitamin A, 200% of vitamin C, and 1,020% of vitamin K.

    There are many health benefits, some of which are:

    • It is high in calcium and in vitamin K, which is important for blood clotting.
    • Kale is rich in iron needed for healthy red blood cells.
    • Kale is also rich in the eye-health promoting lutein and zeaxanthin compounds.
    • Kale contains more than 45 "flavonoids" of which at least two types are known to fight and destroy precancerous cells, specifically cancers of the colon, breast, bladder, prostate and ovary.

    There's a need for much more research on the risks and benefits of consuming kale. Check with your doctor before making radical changes in diet and lifestyle, especially if you use prescribed or over-the-counter drugs.


    Tylenol (acetaminophen) vs. Motrin/Advil (ibuprofen)

    Acetaminophen and ibuprofen are the drugs most recommended for headache relief and pain relief. They have very different methods of action, but much the same results. Both are generally safe when used as recommended. It depends on the condition of the patient as to which drug is the better option. Both have risks and benefits.

    Acetaminophen reduces fever and relieves pain. It works directly on nerves and receptors in the brain to relieve pain. It has no anti-inflammatory activity, so it's less effective for relieving pain associated with swelling and injury. Acetaminophen can be safely used with other medications, such as antibiotics. It will not damage healthy tissue.

    Ibuprofen belongs to a class of medications called NSAIDS, non steroidal anti-inflammatory drugs. NSAIDS are used for the treatment of acute or chronic conditions where pain and inflammation are present. That makes ibuprofen the more effective drug for muscle soreness and tissue injury. Washington Mystics internal medicine physician and a US News & World Report ‘Top Doctor’ Dr. April Barbour generally recommends Tylenol for general pain and fevers but ibuprofen for pain due to an injury or inflammation. Dr. Barbour emphasizes that people should not use pain relievers for more than 5-7 days without discussing with their physician to make sure nothing else is going on. One should never take more pills than advised in a 24 hour period as these medications do have potentially serious side effects if taken improperly. In summary, both drugs relieve pain and reduce fever. Ibuprophen works slightly faster and reduces inflammation; Acetaminophen does not. Acetaminophen has, however, fewer side effects, especially with stomach problems.


    Omega-3 Fatty Acids

    Omega-3 fatty acids are healthy fatty acids that must be consumed because the body does not naturally produce them. These unsaturated, essential fatty acids play a significant role in body functions like regulate blood clotting, reduce heart disease and heart attacks, and aid in cellular reproduction.

    Fatty acids, such as omega-3 can be ingested through supplements or by consuming foods rich in omega-3 fatty acids such as salmon, trout, and/or herring. They can also be found in leafy green vegetables and beans.

    Omega-3 fatty acids have been known to reduce inflammation in the body. Inflammation increases the risk of hypertension and heart disease. It is important to remember that supplements can cause serious side-effects when used in conjunction with prescription medication, taken without a physician’s supervision and/or ingested in large amounts.

    References:
    Philibert, A. (2006). Fish intake and serum fatty acid profiles from freshwater fish. American Journal of Clinical Nutrition, 84,1290-1299.
    Wilson, J.F. (2004). Balancing the risks and benefits of fish consumption. Annals of Internal Medicine, 141, 977-80.


    What Do You Do For Foot Fungus?

    Foot fungus, also known as athlete’s foot, can be difficult to get rid of. The best defense is prevention. Athlete’s foot can generally be treated with over-the-counter, topical medications (anti-fungal). These usually come in the form of ointments, lotions, or aerosol sprays. Common types of anti-fungal include: Lotrimin, Lamisil and Tinactin.

    Athlete’s foot is a persistent infection and is known for frequent re-occurrence. Sometimes it is necessary to be treated by a physician. If you are not successful in treating it yourself, you may need a prescription-strength medication.

    However you choose to treat athlete’s foot, it is important to follow these recommendations once your infection has cleared up:

    • Keep bathtubs and showers clean; when using public showers, wear shower shoes. Foot fungus is highly contagious!
    • Use foot powder.
    • After bathing, dry feet completely, paying attention to in between the toes.
    • Allow shoes to air out and dry completely before wearing them again.
    • Wear shoes that allow your feet to breathe and frequently changing socks.

    Washington Mystic Team podiatrist and Diplomate of the American Association of Podiatric Sports Medicine adds, 'Most people have a genetic pre-disposition to getting it. The fungi grow in dark moist areas, like between toes, groin and under armpits.' Using a separate towel to dry feet and not use on rest of body after bathing.

    Allow shoes to air out and dry sufficiently. The sock liners in most shoes, esp exercise shoes, can be removed and washed and air dried. They can even be replaced by charcoal-based products like Odor Eaters. The charcoal eliminates moisture and odor. Do not forget about appropriate socks. Materials like CoolMax and Ultramax wick moisture away from skin and keep feet drier. Similar to a disposable diaper used in kids. Thorlo and Wigwam are companies that often use these materials.


    If you have to pick one exercise to do, what would it be?

    I believe that Turkish Get-Up (TGU) is one of, if not the best, single exercise you can do. TGU works on mobility, stability, overall strength, conditioning, and endurance at the same time.

    I use TGU as a basic screen to find movement problems/patterns. It is a useful tool to both detect and address movement pattern asymmetries and weaknesses. I use this exercise with all with all my patients, clients, and athletes to help them with proper functional centration. Sometimes, I just break this exercise in to segments and make my patients do only specific segments of TGU – this is exercising according to kinesiology development and methodology.

    Before you began TGU, make sure that your health care provider assesses you for basic mobility and stability to perform this movement. Make sure you have a qualified healthcare professional show and asses how you do this complex movement pattern exercise. Be sure to keep the repetitions low in the beginning. Just as with any program, remember to warm-up to prime your body.


    Empty Calories

    “Empty calories" have the same energy content as any other calories but lacks any nutrient value. Typical food with empty calories includes soda, potato chips, cakes, muffins, candy, donuts, beer, wine, and juice. These foods contain a lot of calories from sugar and not much else. Empty calories are typical of ‘junk’ or snack food. They have solid fats and added sugars - these add calories to the food but few or no nutrients. Solid fats are butter in many desserts and baked goods or oil in fried chicken and other meat dishes with the skin.

    These junk food is easily accessible, has addictive tastes, cheap, and easy to prepare. So, people are always tempted to choose this non-nutritious food over something healthy. A small amount of empty calories is okay, but most people eat far more than what is healthy. It is important to limit empty calories to the amount that fits your calorie and nutrient needs. Eat these types of food less often or decrease the amount you consume. Empty calories can quickly lead to weight gain and cannot provide the fuel you need for performance.

    Remember, just because you cut out empty calories, it doesn’t mean you have to cut out the taste – or fun – in your diet. With a few creative swaps and a little moderation, you can significantly reduce your caloric intake. Drinks skim milk instead of whole milk to reduce solid fats; use extra lean ground beef instead of ground beef and you'll cut out a lot of fat. Eat a fruit or drink some water when you feel like having a donut. Put a slice of lemon or cucumber to your drinking water to give it some taste so you are not tempted by soda. These are small adjustments you could make that will help you perform better and lead a healthier lifestyle.


    Sit-Ups...Are They Worth the Pain and Effort?

    In my personal opinion and based on research, evidence show that sit-ups are an expensive exercise. Let me first define the exercise that is called “sit-ups” or “crunches”. The Merriam-Webster Online Dictionary defines a sit-up as: a conditioning exercise performed from a supine position by raising the torso to a sitting position and returning to the original position without using the arms or lifting the feet.

    What do we get out of doing sit-ups/crunches? During a sit-up the intervertebral disc is compressed anteriorly causing the anterior annular fibres to bulge and double the intradiscal pressure.

    Yes, stronger abdominals are a part of the core and are necessary to prevent back injuries. However, I feel that sit-ups are more unsafe than beneficial because it’s not a functional exercise or sport specific exercise. Sit-ups promote poor postural behavior and unnecessary loading to the spine.

    Can we do some other exercise with that time to benefit more?

    Our muscles are constantly flexed while we are sitting down at a computer at work. So do we really need to do more flexion exercises? According to literature, the number one reason for disc herniation is repeated lumbar flexion (sit-up motion). St-ups could also cause side-effects or contribute to degenerative changes of the lumbar disk.

    As you do sit-ups, you fatigue your rectus abdominis muscle (front of the stomach) and start using your hip flexors (illopsoas muscle group) to come up on a sit-up. This high activation on the hip flexor muscle causes these muscles to tighten and result in a poor pelvic position which can lead to imbalance and stress to the back and pelvis.

    The common thinking, especially among people who want to lose weight, is that doing sit-ups will result in a flat mid section or a six-pack. That is not the case! Lie horizontally and place a book or magazine on your bellybutton. This is the adipose (fat) layer of your stomach. In order to see you bellybutton you have to take out the book. Similarly, you have to take that adipose layer out of your body somehow to see your six-pack. You do not lose your adipose layer from doing crunches; you lose it by burning the fat off.

    A recurring error I see in athletes playing sports such as golf or basketball is the over flexion of their stomach/spine and not using their hips to hinge. Therefore, if an athlete is constantly performing sit-ups/flexion exercises they are prone to over flexion while playing the sport.

    Electromyographic studies show there is no single exercise that best recruits all of the abdominal muscles simultaneously. Try a more sports specific exercise such as a plank. The plank or bridging is a great exercise that stabilizes the trunk, while activating the abdominal obliques and rectus abdominis in a safe manner without stressing the spine.

    George Sibel, the Physical therapist of the Cleveland Cavaliers says that he prefers to train athletes’ abdominals in standing positions with functional movement exercises. He recommends an exercise such as the Med ball wall throws which replicates the demand that these individuals will place upon their core during a particular athletic event.

    As with any exercise that you do, before you do you sit-ups, think about what you are trying to achieve with this exercise. Is it s a functional movement?

    Ask your healthcare provider for more suggestions for more advanced and safer exercises that you could perform. Good luck!


    I want to be able to jump higher. What are some good exercises or stretches that can help?

    To jump higher in a track and field event such as long jump/ high jump or in basketball/ volleyball you need to work on strength and explosiveness.

    For strength, athletes need to work on overall lower body strength with core stabilizing exercises such as power cleans. All the exercises should have a hip dominance focus with explosiveness such as kettlebell swings and dead lifts. For direct explosiveness, athletes should work on Plyometric drills such as box jumps or hurdle jumps.

    My friend Jamie Nieto, a two- time Olympian, 2012 American National high jump champion with a personal best of 7 feet 8 inches, agrees that to jump higher he works on strength and speed. According to Jamie, he uses Olympic lifts (i.e., power cleans, dead lifts, and snatches) to generate a good combination of speed and strength.

    As with any workout, make sure you workout with proper weight lifting techniques and preparing yourself for the workout with a good warm up. Work on correcting your movement impairments and restoring your normal mobility and stability of joints. Olympic lifts and plyometric exercises are very technical exercises so consult your doctor before beginning any new exercise regimen. I highly recommend using a strength and conditioning coach or a personal trainer to learn proper lifting techniques and to progress to the next level.


    Exercise In All Directions!

    I see people at the gym everyday training only in one planer motion. There are three types of planer motions. Sagittal plane is where you have front and back motion. A Sagittal plane is an imaginary vertical line that divides your body as left and right from the top of your head to the feet. It is true that we do most of our daily actives like walking, sit-ups, knee extension in Sagittal plane. However, we perform many daily activities in multiple planer motion such as putting on a jacket, dance, or cleaning a counter top. Therefore, we should strength and condition our bodies to be able to carry out multi planer movements.

    The other two planer movements consist of frontal plane (where you have an imaginary line dividing your body into front and back) movements such as jumping jacks. Transverse plane is (where you have an imaginary line dividing the body into halves) is generally rotational movements.

    Research has shown that injuries such as Anterior cruciate ligament injury very rarely occur when a person is doing a one plane motion activity. I recommend you adopt exercises in all planer motion to help prevent injury and improve performance. Here are some examples of exercises you can perform to ensure all your planers are exercised:

    Sagittal plane exercises:

    • Inverted hamstring
    • Pushups or lat pull-down

    Transverse plane exercises:

    • Reverse flys
    • Medicine ball wall throw

    Frontal plane exercises:

    • Lateral lunges
    • Shoulder press

    So, next time you workout, try your best to be creative with your workouts and have movement variations. Have fun!


    Barefoot

    Lately, many people having been asking me what I think about running barefoot.

    Growing up, we ran barefoot all the time from the gravel roads to the paved hot asphalt. Now, as a clinician, I have a different perspective: all of us are might not be mechanically built to run barefoot. However, I believe that it is still possible to gradually progress from walking barefoot to barefoot running given the fact that millions of people around the world and our ancestors walk and run barefoot everyday and are not predisposed to foot, ankle, knee, hip, and back pain. An article in the Journal of Applied Biomechanics (2010) featured a study of people wearing shoes versus going barefoot. This study concluded that there were no significant differences between the two groups in mechanical changes in the foot that would lead to injuries. So, you may be a person who is mechanically able to run barefoot or you may need to wear more supportive shoes because of bodyweight or hyperpornoate feet.

    Before you start running barefoot, please consult your physician and please be careful of hazardous and sharp objects on the ground


    Ankle Sprains: It’s Not the Shoe!

    Can a shoe prevent ankle sprains or cause ankle sprains? Yes, it can prevent ankle sprains and cause ankle sprains as well. These days shoe designers design shoes with specific goals such as providing stability, injury prevention and energy efficiency. Shoes with a deep heel cup and a stable wide rear foot base help to reduce ankle sprain. Shoes without these features and poor mid foot support are most likely to cause foot and ankle injuries.

    You can prevent ankle sprains by having good hip, knee and ankle mobility, stability and strength. If one of the three main components is missing, you are predisposing yourself to injuries, it does not matter how good the shoe is!

    Lateral ankle sprains are one of the most common injuries in basketball. According to an article published in the Journal of Rehabilitation, the primary reason for ankle sprains is neuromuscular fatigue. I am a firm believer of this reasoning as well. Fatigue in the foot/ankle muscles cause decreased activation and muscle firing patterns. This leads to ankle sprains when running and jumping. Unfortunately, athletes very rarely proactively work on their balance or ankle strength training unless they get injured.

    I believe in injury prevention programs that consist of single leg balance and single leg strength training as part of a daily exercise routine. For basketball players, the feet and ankles are like wheels on a car. It does not matter how powerful the engine is if the wheel alignment is off, the car wouldn’t perform to its potential. So, make sure you are taking care of the wheels of your body -the foot and ankle.