Thoracic mobilization and shoulder range of motion

When shoulder range of motion is impaired, the most common response is to address the shoulder joint. While this seems to make sense, it is not usually the best solution.

Shoulder range of motion is intimately related to thoracic mobility, or the mobility of the middle of your back. Full shoulder range of motion is possible only if there is adequate thoracic extension. Accordingly, in many cases thoracic mobility is a significant contributor to a lack of shoulder range of motion.

Most people have stiff thoracic spines because of poor training habits and poor posture. The best way to improve thoracic mobility is through manual mobilization at the hands of a skilled therapist. However, another great, simple option is to use a foam roll.

While this is commonly suggested, I think the way most people are instructed to do it poorly addresses thoracic joint mobility into extension, and instead focuses on mobilizing the muscles of the thoracic region. And this is a big difference. The goal of mobilizing the thoracic spine to improve shoulder motion is to specifically increase gliding of the joint surfaces to allow for increased thoracic extension. Accordingly, we need to as best as possible stabilize one region so the other can glide in a manner to increase extension.

However most people are rolling back and forth on the roll to reduce the soft tissue density of the muscles, thereby increasing extensibility. The only range of motion this will improve is flexion, or bending forward, which is the opposite direction you want your spine to go to improve shoulder mobility.

Spectrum trainer Tom Biggart, ATC, CSCS, demonstrates a great way to increase thoracic extension mobility with a foam roller below.







Most of us should be mobilizing our thoracic spines daily to counteract poor postutre habits. This should be certainly something you are doing if you need to improve shoulder range of motion.

The Truth About Abdominal Exercises

Many people spend inordinate amounts of time doing ab exercises, with the misguided notion that they will flatten their belly and protect their back.

Training the abdominals is one of the most misunderstood component of fitness. I'll cut to the chase and list 5 cold hard facts about the core:

1. Training the abs won't lead to a ripped or flat midsection. It will do nothing to get rid of that "stubborn body fat". These muscles are small. Small muscles have a limited capacity to oxidize (burn) fat. These muscles also don't grow well, so they won't become big muscles.

2. Doing several abdominal exercises makes fat loss more difficult. The most common reason why people say they have problems getting results with weight loss is that they don't have enough time to exercise. You need to exercise to lose fat. So if you spend the limited amount of time that you have doing several abdominal exercises, then you are spending less time doing exercises that actually work big muscles and burn fat. Take away the 321 versions of the crunch, focus on proven fat burning exercises, and watch the fat come off.

3. Doing many ab exercises will increase your risk of back pain. Ever see the research in (pick your favorite fitness magazine) that shows the "best ab exercises"? They are all missing a key point, big time.

You see, most research on the abdominal exercises focuses on how much muscle is working. They conclude that the higher the activation of the abs, the better the exercise.

Wrong. A brilliant researcher from Canada, Stuart Mc Gill, and several others, have studied ab exercises in depth, with a different perspective. Rather than focusing only on how much the muscles were activated, they also measured the stress imposed upon the discs, ligaments, and joints of the spine. These are the structures that are involved in back pain.

The results were amazing. Many of the exercises purported to be the "best ab exercises" imposed stress on spinal structures far beyond levels known to cause spinal damage.

Ironic how people are advised to do "protective" exercises that have actually been shown to damage the very structures causing back pain!

4. Strong abdominals do not reduce your risk of back pain.

If they did, then why do so many weightlifters, gymnasts, and football players have back pain? They have abs of steel! The research shows that motor control and endurance of the trunk muscles is correlated with reduced back injury, but strength is not.

5. Sit-ups, crunches, and ab machines are horrible exercises.

Do you know what movements are essential to allow a disc to herniate? Bending and twisting of the spine. Add excessive compression (via muscle force, additional weight, etc) and you have a great shot at damaging your back.

Guess what crunches, sit-ups, and ab machines have in common? Bending and twisting under high compressive loads. No wonder why low back pain is so common.

I could go on and on about this topic, but these points should hopefully shed some light regarding the truths about abdominals.

So what exercises should you do for your core? It depends on your goals.

If you want to lose fat, focus on working big muscles that have a high capacity for calorie burn. This usually involves multi-joint body weight and free weight exercises that use multiple muscles, including your abs! Of course, nutrition is a huge factor as well, and some energy system work in most cases.

If you want to protect your back, focus on adopting proper ergonomic in daily life, learning how to use your torso muscles, and choosing exercises that focus on proper body mechanics, controlling movement of your back and pelvis, and challenging the torso muscles that stabilize your low back without mimicking the very forces known to cause back injury. These things can be challenging to learn initially, but become ingrained habits, like riding a bike, with sufficient practice and instruction. For starters, check out some other examples here.

Sunshine and Vitamin D

We’ve certainly had some beautiful weather around here in New England; lots of sun, and some great beach days already.

All of this sun sparked a question I received about vitamin D, so I thought I’d share my response based on the latest research.

Do we need to supplement with Vitamin D?

There are several studies showing Vit D deficiencies are common, and are

associated with many diseases and disorders.

What is considered a Vit D deficiency?

Deficiencies are determined by blood tests. Testing blood levels (25 hydroxy vit D) are not usually covered by most insurances for a typical blood panel (unless you complain of fatigue or are elderly) so some PCPs will either not test and not advise supplementation, where as others will advise supplementation without testing assuming that most could benefit, and risks are low. It would not hurt to ask your PCP to test you though.

There is much debate about what is considered deficiency, as measured by 25 hydroxy vit D blood levels, and what is optimal. Minimum is usually defined as 37.5 nmol/L, where optimal is considered between 75 and 100

nmol/L.

Can you take too much?

Toxicity levels are > 375 nmol/L measured by 25 hydroxy vit D blood levels

Toxicity is very rare. Very conservative estimates states that the safe upper limit for intake is 2000IU per day, while many believe it is more like 20,000. Studies show toxicity with levels exceeding 50,000IU/day for months.

I know I can get Vit D from the sun. Does sunscreen impair this?

Sunscreen can limit vitamin D production by the skin. However, studies suggest that it only takes 10 minutes of daily sun exposure to produce adequate levels of Vit D. This can be impaired for those who are dark skinned or elderly. Interestingly, studies have shown that even Hawaiian surfers can have vit D insufficiencies, so there’s more to this than simply sun exposure.

So should I supplement with Vit D? How much?

Those with a history of inflammatory issues (crohns, IBS, OA, asthma, acne), autoimmune issues, significant dietary restrictions (no dairy, picky eater, no fish), risk of heart disease, elderly, or infants exclusively breast fed, I tend to think supplementing vit D is a good idea- no risk, and possibly a benefit. More studies are needed for sure. These people should get a 25 hydroxy vit D test from their PCP to know for sure.

For those on low carb diets who are over weight, I would definitely advise Vit D supplementation, as body fat is inversely related to 25 hydroxyl vit D levels and the dietary restriction can be an issue.

As far as how much, conservatively, for both kids and adults 2000IU is the level I would use if I were to supplement.

For everyone else, considering that it only takes 10 minutes of sun exposure to produce adequate levels of Vit D, and that most breads, cereals, and milk are vitamin D fortified, not to mention eggs, fish, and tuna serving as good sources, I not 100% sure that Vit D supplementation is necessary.

Hope this helps clear up the vitamin D issue. As always, feel free to contact me at mike@spectrumfit.net with any questions.

For all the New Englanders, enjoy this great weather, and go Celtics!