March 2020

A very popular concept that has been bandied about in the mainstream fitness world over the past couple of decades is that of the importance of core strength. What exactly is your core, and why is strengthening it considered so important? According to the Mayo Clinic, the core muscles include, "...Your abdominal muscles, back muscles, and the muscles around the pelvis." Although the Mayo Clinic mentions the muscles of the back and those that surround the pelvis, my experience is that most people associate "core" solely with the abdominal muscles. How important is it to strengthen these muscles, and should we make them a higher priority than other muscles of the body? What is the best way to strengthen these muscles? These are questions that we often answer during initial consultations at Total Results.

The muscles surrounding the spinal column can perform four movements: flexion (bending forward at the waist), extension (leaning backward), lateral flexion (bending to the side), and rotation (as in turning to check your blind spot when driving a car). All of these actions are things that we do in everyday life. There are many muscles, both superficial and deep, that work in concert to perform these functions. Trunk flexion is performed by the Rectus Abdominus muscles, which are superficial and most visible to the surface. Trunk extension is performed by several groups of muscles. The most superficial group is called the Erector Spinae (sacrospinalis), which is made up of the Iliocostalis, Longissimus, and Spinalis. If we go a little deeper, we find the Transversospinalis group of muscles, which include the Semispinalis, Rotatores, Multifidus muscles (the Multifidus runs nearly the entire length of the spinal column). Also contributing to the performance of trunk extension are the Interspinalis, as well as the Internal and External Intercostal muscles. Lateral trunk flexion is performed primarily by the Internal and External Obliques, Quadratus Lumborum, and Erector Spinae, with some assistance by the Rectus Abdominus, Semispinalis, and Iliopsoas. Finally, trunk rotation is performed by the Internal and External Obliques, Multifidus, and Rectus Abdominus muscles.

Now that we have a better understanding of which muscles perform which functions, we should ask if certain muscles are more important to strengthen than others. Your body is not just a collection of different muscles and body parts; rather, it functions as a unit. You are only as strong as the weakest link in the chain, and muscular imbalances can lead to an increased risk for injury, whether you are a professional athlete, weekend warrior, or just a regular person trying to function every day. While most people place a higher level of importance on the abdominal muscles (partly because they are more visible in a mirror, and many of us romanticize the idea of the so-called "six pack"), lower back pain is still the leading cause of missed days from work. Most of us have seen in fitness and bodybuilding magazines exercises that will target the abdominal muscles, but there are very few exercises that can adequately address the spinal erector muscles, and even fewer properly designed exercise machines that can safely build strength in that area. Unlike many, I am not a believer in the concept that you strengthen your lower back by performing abdominal exercises. In my opinion, the best way to reduce lower back pain and improve function is to directly address the spinal erectors.

What is the best way to improve core strength? In my experience, it is important to perform an overall balanced exercise routine, with an equal emphasis on the upper and lower body musculature and equal amount of pushing and pulling movements. Your abdominal muscles are certainly important (ask any woman that has had a Caesarian section), but they are involved in every exercise that is performed in a Total Results workout, as you can tell by performing the torso slump on exercises like the Pulldown, Chest Press, and Overhead Press. We do perform direct exercise for the abdominals, such as the Floor Crunch and Linear Spine Flexion, but performing a lot of specific exercises for this muscle group is neither necessary nor optimal. In order to address the trunk extensor muscles, especially the deep muscles, we use the MedX Lumbar Extension (low back) machine. By immobilizing the pelvis, using knee restraints, and properly positioning the legs, we can effectively target the spinal erectors while minimizing the involvement of the hip and leg muscles. This translates into a more effective exercise stimulus for these difficult to address muscles. I have seen no other machine that accomplishes this as effectively as our machines do.

Increasing strength in the core muscles of the trunk will lead to greater stability, as well as an increased resistance to injury. In addition to working to strengthen these muscles, it's important to be conscious of and try to practice good posture and avoid sitting too long at one time. If you are an athlete or weekend warrior, it's important to practice the skills specific to the nature of your sport or activity; this will also enhance stability. Regular Total Results exercise performed on properly-engineered equipment will keep you strong, fit, stable, and resistant to injury. We look forward to working with you!

The strength of your body starts with your hands so grip strength is very important. It affects most muscle groups you use and most exercises you do. There are 35 muscles involved in movement of the forearm and hand, with many of these involved in gripping activities. During gripping activities, the muscles of the flexor mechanism in the hand and forearm create grip strength while the extensors of the forearm stabilize the wrist.

Our fingers don't have any muscles of their own. They move through the pulling of tendons attached to the bones that are controlled by the muscles in the hand and forearm. This is one of the main reasons that strength training is so important for lower arm health; as we age our muscles begin to lose tone and strength and this can lead to problems in finger strength and coordination.

Last year I was diagnosed with rheumatoid arthritis (RA) which developed in two fingers in my right hand. RA is symmetrical; however, it did not develop in my left hand. My X-rays and bloodwork showed I had RA even though it wasn't in both hands. My fingers are swollen constantly and the pain is very intense.

My weekly workouts at Total Results helps immensely to retain and build the strength in my hands but I found it's too long between workouts. So I purchased a set of hand grips which are two handles joined by springs. These devices isolate your forearm muscles when squeezed helping build your grip strength.

I do one set of 35 to 40 reps every morning. It helps my blood circulation and relieves the pain. The COVID-19 pandemic has temporarily shut down Total Results and we are encouraged to exercise at home during this period. Hand grips are very inexpensive and should be a part of your home routine. Should you not want to purchase them a tennis ball will suffice. Simply squeeze very slowly.

Keeping your fingers, hands, wrists, and forearms strong and healthy is critical to your quality of life. Without these body parts capable of functioning fully, you can lose not just your mobility but your independence as well.

The ostensible purpose of performing regular Total Results exercise is to increase muscular strength. As we have learned, building strength leads to a number of other physical improvements, such as increased insulin sensitivity, improved metabolic and cardiovascular conditioning, resistance to injury, and even facilitation of fat loss. Each exercise that is performed in the course of a workout will have an effect on the muscle or muscles that are involved in that particular exercise ( e.g.- the biceps muscles during a bicep curl). This is referred to as a local effect. Exercise also leads to what is called a systemic effect, which is the impact that the entire exercise session has on the whole body in terms of stimulus. What does this mean, and is one or the other more effective for producing physical improvements? Let's take a closer look.

I have stated in previous articles that there is a dose-response relationship to exercise, and that according to Dr. Doug McGuff, exercise has a narrow therapeutic window. This means that too much exercise can have a toxic effect on the body, and that not enough exercise will not stimulate any physical improvements. We want to perform the minimal amount of exercise necessary to elicit the stimulus; too much exercise and/or too much activity between exercise sessions will prevent the body from making adaptations, and can increase the risk for injury or illness. In order to stimulate the greatest overall exercise effect, you need to exercise briefly and intensely, and cover all of the major musculature of the body.

To achieve optimum benefit, workouts should last no more than 30 minutes, preferably 20 minutes or less. The longer an exercise session lasts, the more the body releases the stress hormone cortisol. This is problematic because cortisol can impede your body's most important functions, such as sleep and digestion, and it can also contribute to weight gain. Advocates of split training routines train way too long and too frequently. They generally subscribe to performing multiple sets of each exercise, and as a result, rarely train with anything resembling high intensity (effort). Bodybuilders that utilize this approach fail to understand that the body is far more than the sum of its parts. The body functions as a unit and should be exercised as a unit. One properly performed set of each exercise is all that is required to elicit the stimulus; multiple sets just reintroduce the same stimulus more than once and consume valuable recovery resources, but do not provide additional benefit.

Weight training exercises can be classified as either simple or compound movements. Simple movements generally involve one joint and smaller muscle groups, while compound movements involve multiple joints and larger muscle groups. Both movements have their benefits. Compound movements involve a greater amount of muscle in a shorter period of time, which will lead to shorter and more intense workouts. On the other hand, simple movements effectively target smaller muscles more directly, such as in the Cervical Extension exercise for the posterior neck, and in the External Rotation exercise for the muscles of the rotator cuff. This is certainly beneficial from a rehabilitation standpoint.

Both a local and systemic exercise effect are important for us to achieve maximum health. Someone suffering from lower back pain due to a herniated disc will need to perform direct (local) exercise for the spinal erector muscles in order to strengthen the spinal column and reduce pain. By the same token, if our workouts consist only of simple movements to cover the body's major musculature, the workouts will be far less efficient. This is why much of the workout should consist of compound movements, so that we can cover more ground in less time. Larger exercises like the Leg Press and Pulldown will stimulate growth in muscles that are not directly involved in those exercises. Arthur Jones (founder of Nautilus and MedX) referred to this as the indirect effect. I have often told clients that if they were in a time crunch and only had time to perform two exercises, the Leg Press and Pulldown exercises would cover all of the body's musculature with the exception of the neck. Conversely, a simple exercise like a Triceps Extension will do very little to stimulate musculature outside of the triceps.

Reaching momentary muscular failure on each exercise creates microtrauma, which are microscopic tears in the individual muscle fibers. Between this event and your next exercise session, the body produces an inflammatory response, which stimulates the release of growth hormone. This growth hormone is released in proportion to the amount of muscle inroaded during an exercise session. In the interim, the body must (through proper diet) replenish its glycogen stores (the primary fuel source for intense exercise). Now the body goes about the process of repairing the muscle tissue that has been damaged during the intense workout. If the exercise session takes too long or uses up too many recovery resources along the way to the stimulus, the repair and recovery process will take longer (if the variables of exercise frequency, duration, and intensity are properly regulated by your instructor, you should recover within 3-7 days). When the above requirements have been met, your body will adapt and you will then be ready for your next exercise session.

We want to achieve both a local and systemic exercise effect in order to optimize physical improvements. Our goal is to strengthen any problem areas (joints) you might have, while giving you the best overall metabolic effect possible. We will use both simple and compound exercises to get the job done. Less than one hour of exercise per week is all that it takes. We are here to serve you. Stop putting it off and start today.

Total Results Clients,

Due to concerns about the COVID-19 Virus, On March 23^rd Virginia Governor Northam issued Executive Order 53 which calls for certain businesses to close down from midnight March 24th until April 23^rd. Total Results is included in the list of closures under the category "Indoor Exercise Facilities".

Links:

Executive Order 53

governor.virginia.gov/media/governorvirginiagov/executive-actions/EO-53-Temporary-Restrictions-Due-To-Novel-Coronavirus-(COVID-19).pdf

https://www.governor.virginia.gov/newsroom/all-releases/2020/march/headline-855292-en.html

We will be contacting each of our current clients individually over the next several days in order to update you on the details of our work together going forward.

Total Results has been operating continuously since 2001 and we plan to continue going strong as soon as this Executive Order is rescinded.

I would personally like to thank all clients who have supported Total Results over the years, and especially those clients who are continuing to support our business through this extraordinary time.

We very much look forward to continuing our work with you as soon as circumstances allow. In the meantime, be on the lookout for Total Results Blog Posts, Facebook posts, Linked-in discussions, and more. We will be giving you tips for home fitness options, inspiration for healthy living during this difficult time, as well as our usual information on the science of fitness and nutrition.

Thanks again,

Tim Rankin - Owner, Total Results

The knee joint is an essential joint for humans. When that joint is compromised, we cannot easily walk, run, climb stairs, stand, or support our own body weight. When most people think about strengthening the knee joint, they tend to think about the quadriceps muscles, which primarily function to extend (straighten) the knee. Often an afterthought are the hamstring muscles, which work to flex (bend) the knee. Many trainers and physical therapists tend to focus almost exclusively on performing leg extension exercises to strengthen the muscles surrounding the knee, but they very rarely incorporate the leg curl exercise for the hamstrings. This could be for two reasons. The most common reason is that they do not have access to a properly designed machine in their studio or clinic. The other reason is that they believe this exercise is contraindicated for their patients or clients; in my experience, this is very rarely the case.

To get a better understanding of the knee joint, we need to discuss its anatomy. The knee is a hinge joint that involves three bones: the femur (upper leg), tibia (lower leg), and patella (knee cap). There are four ligaments that connect the upper and lower leg bones, as well as tendons that connect the bones to the muscles that extend and flex the knee. In between the bones are pieces of cartilage which act as cushions. There are also bursa sacs located in the joint which secrete synovial fluid that helps to lubricate the joint (much like motor oil in your car's engine). While the knee is a fairly mobile joint, it can be susceptible to injury, either due to overuse or one traumatic event. A tear of the anterior cruciate ligament (ACL) is a single event injury that is very common in sports, while a gradual wearing of cartilage due to being a distance runner would be considered an overuse injury. The overuse injury could likely have been prevented (by not pounding your feet on the pavement day after day), while the ACL tear can often come down simply to bad luck. Sports injuries can never be completely prevented, due to the high force nature of sports and improper training techniques. One thing is certain: in order to strengthen the knee joint and reduce your risk for injury it is critical to strengthen all the muscles that surround the knee joint.

We talked earlier about the opposing muscle groups that surround the knee joint: the quadriceps and the hamstrings. As you probably guessed, there are four muscles that make up the quadriceps (vastus medialis, vastus lateralis, vastus intermedius, and rectus femoris). Conversely, there are only three muscles in the hamstring group (semitendinosus, semimembranosus, and biceps femoris), which means there is a natural imbalance between the two muscle groups. While it's important to perform regular knee extension exercises like the Leg Press for the knee, it's also important to balance that out with regular knee flexion exercises as well. This is why the Leg Curl exercise is so critically important.

In my opinion, no other exercise can engage the hamstrings as effectively as the Leg Curl. While the hamstrings are involved in the Leg Press exercise from a standpoint of hip extension, their involvement is sigificantly less than that of the glutes and quadriceps. In the Leg Curl, the hamstrings are the primary mover, with some assistance provided by the muscles of the calf (the gastrocnemius and soleus). Unfortunately, most Leg Curl machines are poorly designed, whether they are performed in a prone (when the client lies face down) or seated position. Most prone Leg Curl machines do not have a properly engineered cam to adequately vary the resistance. This results in the knees sliding forward and out of proper alignment with the axis of rotation, and it can also cause irritation to the lower back. Most seated Leg Curl machines in traditional gyms also do not have a properly designed cam, and have neither proper seat belts nor a coupled movement arm to prevent sliding forward of the knee joints or the pelvis during the exercise.

The Leg Curl machines at Total Results are engineered based on our exercise protocol's slow speed of movement, and they have a seat belt to properly restrain the pelvis and a coupled movement arm to keep the knees in proper alignment with the axis of rotation. Our machines are also designed with a floating seat to minimize knee irritation. There is a slight incongruity between the ovoid knee joint and the circular arc in which the movement arm travels. The floating seat helps to bridge that gap (so to speak) so that the client may move in a safe and pain-free range of motion.

The Leg Curl can be a challenging exercise to perform. Unlike the Chest Press, which most people can relate to from having done some variety of a push-up, the Leg Curl can seem like a slightly unnatural movement, since it isn't something most of us do in everyday life. It is also a blind movement, meaning that everything develops behind you during the positive phase of the movement. However, just because it creates some challenges doesn't mean that it shouldn't be performed in your exercise routine. We often have clients perform this exercise at the very beginning of a workout, just prior to the Leg Press. Performing a knee flexion exercise (Leg Curl) prior to a knee extension exercise (Leg Press) serves to properly warm up the knee joint and release synovial fluid, which helps to lubricate the knee. This will allow you to work intensely and further reduce your risk for injury, particularly if you already have knee issues. We can also modify how we perform the Leg Curl exercise if a client experiences pain during a dynamic movement. We can adjust the range of motion, perform a Timed Static Contraction, or even use negative-only protocol to strengthen the hamstrings without inflaming the joint.

Remember, the best way to strengthen your joints and be more resistant to injury is to strengthen the muscles surrounding the joints. Increased strength leads to improved function and a decrease in pain. The Leg Curl exercise is a vital one for overall knee health. The combination of Total Results exercise protocol, equipment, and instructors will safely maximize your benefits in minimum time. Experience the difference today.