Shamona Harnett

With a foam block lodged under the front of his wheelchair to keep it from rolling, Regan Block leaned forward to stretch himself carefully.

For a fleeting second, he imagined that he might fall out of his chair.  He knew that in reality, however, that he was safe.

“I didn’t feel like I could hurt myself,” says the 43-year-old Winnipegger.  “[Instructors] were always there when I needed it.  You can’t go into yoga if you’re by yourself, on an island.”

For years, Block longed to try yoga but never thought that was feasible.  The St.James resident has been in a wheelchair for 22 years following a spinal-cord injury.

Recently, his yoga dream came to life when his massage therapist handed him a brochure promoting something called “adapted yoga”–a type of yoga designed for people with mobility issues, including those in wheelchairs.  Block was thrilled.

He’s tried about six classes so far and describes them as busy.  “It’s exhausting.  After a few minutes of stretching, going from one side to the other side and then holding it and looking ahead to see what the next pose is, it’s confusing to someone who’s never tried it,” says Block.

” But by the third or fourth class I was moving along pretty fast and could tell that things were changing for me.”

Among Block’s health improvements: the muscle spasms in his legs–a result of his spinal-cord injury–have lessened.  “They don’t jump as much,’ he says.  “I take less medication 

Block a rehabilitation cousellor who spends a lot of time working at a desk, says he also noticed that following classes he felt more relaxed and limber.

His class instructors assisted him constantly and even used a special cord to help him raise and bend his legs.  His digestion improved, he says, thanks to moving and stretching his torso–something he never did before.

Adapted yoga is the brainchild of Winnipeg occuipational therapist, Marnie Courage, who launcher the program in April 2010.  Courage, 36, owns Enabling Access (www.ea-solutions.ca), a business through which she rehabilitates Winnipegers using movement.

After taking some yoga classes herself for the first time, Courage realized that her clients–particularly the ones with mobility issues–could truly benefit form them as well.

“I did a bid of research and there wasn’t, really, anything out there that I could find in terms of a class for people who couldn’t get down to the floor,” says Courage.

She says that yoga not only improves flexibility, but also helps digestion, blood circulation, increases lymphatic-system flow and creates positive thinking.  She says people with limited mobility often have problems in these areas.

Courage hired a yoga instructor and the pair examined traditional yoga postural poses.

“We adapted each one for poeple suffering disabilities.  So I would say, “if someone was in a wheelchair, how could they get the benefits of this pose?”

Courage says her adapted yoga classes are perfect for people with multiple sclerosis, fibromyalgia and other conditions in which mobility is limited.

“A lot of poeple who are spinal injuries, even MS, have alot of trouble using their muscles to expand their lunmgs and get in as much oxygen as they need, says Courage, who teachers all her yoga participants the importance of breathing properly.

Don’t have a mobility issue? Courage syas her adpated yoga can even help people who aren’t as flexibile as they wish–those who need extra help in a pose and maintaining yoga positions.

“It’s nice to see a class where you can see a whole variety of different abilities”, says Courage, who plans to offer classes at assisted-living facilities around as well as in community centres.

Canwest News Service

by Jill BarkerThe reasons to stop doing sit-ups continue to mount.

First, Stuart McGill, professor of spine biomechanics at the University of Waterloo, declared the sit-up more harmful than helpful. And now a study out of Youngstown State University in Ohio says sit-ups don’t build strong abs.

The goal of the study was to find the most effective method to strengthen the rectus abdominus, the long flat muscle that runs between the sternum to the pubic bone and forms the much-coveted “six-pack.”

Despite the fact we have been doing sit-ups for years, there’s a shortage of definitive research stating the optimum training protocol necessary to maximize stength gains.

Some experts suggest that the abs, like any other muscle, benefit from an every-other-day training routine.  Others maintain that a daily diet of sit-ups yields the best results.

Then there’s the question of whether a traditional sit-up done without any added resistance (beyond body weight) provides the necessary training stimulus to strengthen the abs.

The Youngstown State University study, published in the October, 2009  edition of the Journal of Strength and Conditioning Research, separated 71 men and women into three groups.  The control group did no sit-ups.  The other two groups performed three sets of 20 repetitions (30 seconds” rest between sets) of three distinct abs exercises for 11 weeks.  Group One performed the sit-ups three times a week on non-consecutive days and Group Two trained the abs six days per week.  The ab exercises increased in difficulty every four weeks and speed was regulated by a metronome.

The results surprised even the researchers.  None of the three groups of exercisers demonstrated any strength gains. Nor did they reduce their waist circumference or percentage of  body  fat.

“This finding suggests that training the abdominals with resistance levels short of fatigue is inadequate to produce strength gains, and may be consistent with findings suggesting that pushing a muscle to repetition failure is more effective in producing strength gains,” said the study’s authors, Jennifer Pinter, Ken Learman and Renee Rogers.

The authors did acknowledge that the exercise regime may have improved muscular endurance, but it was not measured in the study.

What does that mean for anyone who wants a stronger set of abs?

The message is clear:  Sit-ups aren’t going to get the job done.

Muscles need to be sufficiently fatigued before they can build strength.  That fatigue is notable only when the muscle has reached its repetition limit, at which point  your abs are so fatigued, you can’t perform even one more sit-up.

That being said, when it comes to well-conditioned abs, strength may not be your ultimate goal.  McGill suggests that building muscular endurance is more important than building muscular strength–at least initially.

Which means training the abs to work harder, longer is better than developing strength without endurance.  He also says repeated bending of the spine (similar to the action that occurs during a sit-up) increases the risk of back pain.

If you want a better-conditioned set of abs,  substitute curl-ups for stability exercises such as the plank, or try McGill’s modified curl-up.

Time in the gym is too precious to waste on exercises that fail to live up to their billings.

Canwest News Service

Breaking News: VancouverSun.com/ Monday, March 29, 2010

[The use of the Mastermoves Core Training Program "Masterdisc" to tone up the abdominal muscles follows the principle of exercising the "abs" to fatigue when following a comprehensive Core Training program. This is a major reason that Fred Samorodin, RPT recommends this program instead of ineffective sit-ups! http://mastermoves.com/fred.html ]

One of the major symptoms of patellofemoral pain syndrome (chondromalacia patellae)  is difficulty climbing or descending stairs, or walking down a hill (Malek & Malgine, 1981).   While stair-climbing may be difficult, due to pain, controlled retraining of the quadriceps muscle will help restore the full ability to climb and descend stairs, plus help stimulate the regeneration of normal cartilage on the patella (Palmoski, et al, 1980).  A training routine for increasing muscle endurance to the knee must be accomplished without provoking sharp pains, as this would negate any strengthening effect.   Traditionally knee muscle strengthening programs suggest using ankle weights to stress the quadriceps, the following program aims at using a more functional activity for increasing the endurance and, not necessarily the size or bulk of the muscles.  The following routine consists of doing isotonic concentric and eccentric step-up/step-down exercises for the knees. This activity also positively  stresses the hamstrings and buttock muscles.  Research by McKenzie, et al indicate that good foot alignment such as what foot orthotics provide, plus core stability training for the buttock muscles improves the effects of muscle endurance training programs.   Lower extremity kinematics of females with patellofemoral pain syndrome while stair stepping. J Orthop Sports Phys Ther. 2010 Oct;40(10):625-32.

To begin:

1. Get a 4 to 6 inch (10–15 cm) thick block of wood (or other firm material, such as a phone book).  A taller person will require a thicker block, while a shorter person should use a thinner block.  The knee should be at an angle of 30 degrees or less when one foot is on the block while the other heel touches the floor.
2. On the first day, do a continuous series of step-ups on both the normal and affected legs to determine the maximum number of step-ups you can accomplish per leg.  the Maximum number on the weaker leg will be called MAX.
3. The PLAN is to do this exercise routine on ALTERNATE days.
4. ENDURANCE = 60-80 % of MAX for any muscle tested.

The AIM of this particular program is to do three sets of 70% MAX per exercise session.  When starting program, completing three full sets of 70% may be difficult, therefore, do as many repetitions as are comfortable during any given set.

Because a muscle responds to strengthening based on the speed and the degree of joint bending/unbending, it is advisable to do each exercise set at a different speed (rate).

If there is increased discomfort upon completion of an exercise session, apply an ice pack over the knee, using a package of frozen peas, for no more than 10-15 minutes.

PROGESSION

1. Increase the routine to a daily session.
2. Increase the block height, eventually using a standard stair height.
3. Increase your 70% MAX, remembering that too many repetitions can lead to further overuse.

ADJUNCT EXERCISES

1. 5-10 minutes of stationary bicycling at a constant speed.
2. Rotational core training on pivoting disc using the Mastermoves Core Training Program (http://mastermoves.com/fred.html)
3. Swimming with a paddleboard.
4. Elliptical trainer in “Hill climbing” mode
5. Physio Ball core stability exercises for the hips and pelvis.
6. Variations on the yoga “plank” exercises for core training of the lower body.

Fred Samorodin, RPT

Fred Samorodin,RPT

http://www.youtube.com/watch?v=vQ_RvGB3TFU