Wednesday, February 26, 2014

Adult Nationals Weekly Series #1: Introduction

Cape Cod Rehab has been announced as the Official Sports Medicine Provider at the 2014 U.S. Adult Figure Skating Championships.  The competition hosted by the Yarmouth Ice Club will take place April 8-12 at the Hyannis Youth and Community Center.

What is Adult Figure Skating?

Competitive adult figure skating is relatively new to the skating world.  It has really blossomed over the past decade and this year marks the 20th anniversary of the competition.  (The U.S. Figure Skating Championships held in Boston this year to determine the Sochi Olympic Team was celebrating 100 years!)

To be eligible to compete as an adult, skaters must be over the age of 21 and current members of U.S. Figure Skating.  Some skaters will qualify for the Championships at one of three sectional qualifying competitions whereas some events do not require a skater to qualify via sectionals.

Yarmouth Ice Club & Cape Cod Rehab

The relationship between the Yarmouth Ice Club and Cape Cod Rehab is very unique.  Physical Therapist and Coach Briana Lackenby appears to be the glue that holds everything together.  Briana’s knowledge of both figure skating and sport specific injuries created a very trusting relationship both on and off the ice.  As the ice club grew and began hosting events, Cape Cod Rehab’s physical therapists and athletic trainers stepped in as the medical providers at these events.  Most recent competitions include the Eastern Sectional Figure Skating Championships in 2012 and the Nations Cup and U.S. National Theater on Ice in 2011.  This is the first year that Adult Nationals will be held on Cape Cod and a few of our local skaters will be competing.

U.S. Adult Figure Skating Championships

For some figure skaters, Adult Nationals is about picking up where they left off.  For others it’s about the personal challenge and setting goals.  One thing they can all agree on is that it’s their love for the sport that keeps them coming back!

For the next few weeks, the Mashpee Fitness blog will highlight some of the local figure skaters, coaches, and officials leading up to competition weekend.  We will share with you their passion for the sport and the obstacles they have faced along the way.

Stay tuned for next week’s post featuring Briana Lackenby!

Blog post by Jen Skiba.

Monday, February 24, 2014

Make Interval Training Work for You

High Intensity Interval Training (HIIT), and other acronyms/names for interval workouts (tabatas, anyone?), have become de rigueur among fitness enthusiasts and trainers lately, and no wonder. The workouts, which include brief periods of a burst of high intensity exercise, followed by a set period of lower intensity “recovery” exercise, or even complete rest, are shown to be quick, efficient, and they leave those doing the workouts feeling like they’ve really killed themselves (in that way that fitness fiends and athletes love).

The benefits of interval training are pretty attractive, too. The high intensities push your heart rate up, helping to improve your cardiovascular fitness (in some cases, even doubling your aerobic endurance capacity); you can accomplish higher training levels (i.e. run farther at higher intensities) because you allow your body to recover a bit in between bouts; and it’s been shown in studies to improve time-trial performances (in other words, can help you hit that PR you’re aiming for in a race). 
Chemically/metabolically, it’s helped improve muscle oxidative potential, muscle buffering capacity, and muscle glycogen content–fancy ways of saying it helps delay fatigue by getting the muscles to store/use energy more efficiently.

The trick to intervals is knowing what you're training for, since the intensity/rest ratios can be manipulated to target very specific energy systems. Are you a 100-m dash specialist looking to gain an edge (in the form of maybe a tenth of a second shaved off your time) for your upcoming meet? Are you looking to improve your endurance for your next soccer season? Or are you looking to improve your time in an upcoming marathon? Knowing your goals is the first step. The next is knowing how intervals impact the energy systems in the body. There are three major energy systems that we use:
  1. Phosphagen System
  2. Glycolysis
  3. Oxidative System
Knowing how long to let the body recover so that the energy sources being used can “re-up” and be fully taxed again means the difference between training that particular system and having another energy source “step in." (All three systems are at work at any given point in time, but one is more dominant depending on the energy sources available).

So what are some good interval-to-rest ratios?

If you want to increase power/strength--needed in short sprints and Olympic/heavy lifting--tax the phosphagen system. The phosphagen system is mainly responsible for very short-duration, high-intensity exercise. You'll want a 1:12 or even a 1:20 work interval to rest interval ratio. That means 10 seconds of hard, very high intensity work to 120 seconds of rest. This kind of interval is best used by elite athletes training for a very specific power improvement, and typically done under supervision of a trainer.

For more moderate intensities--good for improving performances in sports, like soccer, where you need short bursts of speed and power (a sprint down the field) followed by longer duration exercise (field positioning)--try working on the glycolytic system. Those intervals, which can last from 15 seconds to three minutes, are best targeted by intervals with a 1:3 or 1:5 ratio...a minute of moderate-to-high intensity work and three to five minutes of lower intensity recovery. If you have a solid aerobic base already, this is a good interval system to try, but it's suggested to have a fitness test done before you start doing these.

If you're looking to improve your time for long races and endurance levels in general--good for beginners, and for endurance athletes like marathoners--working with your oxidative system is your best bet. Use 1:1 or 1:3 low-to-moderate intervals of work, followed by low intensity recovery intervals. If you're new to running, try jogging for a minute and then walking for a minute.

Blog post by Ashley Crosby.

Thursday, February 20, 2014

Kinesiology Tape at the Olympics

Did anyone see the historic two-man bobsled final race on Monday night when American bobsledder Steve Holcomb broke a 62 year drought to capture the Olympic bronze medal?

What Cape Cod Rehab Physical Therapist Briana Lackenby PT DPT saw at the start of the race was the black tape that Holcomb was donning on his left calf.

This type of sports tape has many names: Rock Tape, Kinesio Tape, KT Tape etc.  Unlike the old white athletic tape that only stabilized, this athletic tape has a stretch gradient and can be used for a number of injuries. 

“The tape can be applied depending on the direction of pull to support a weak or injured muscle.  It can be used to stretch a tight muscle and the tape can even be braided over swollen regions to help with fluid removal,” says Lackenby who has seen tremendous personal and professional success over the past year with its use.

“Tape can help you stay lose and reduce pain between your physical therapy and training sessions,” added Lackenby.  The tape can be worn up to five days and can even be worn in the pool.

For Holcomb, the calf strain came while pushing off during the second heat on the first day of competition.

The start is super important in bobsled.  To push off with a weak or injured leg could have potentially ruined Holcomb’s chances at a medal.  After night one of competition, Holcomb met with trainers to receive treatments and to keep his strained calf loose.  A combination of massage, electrical stimulation, acupuncture, and kinesiology tape got him ready for the final two runs.

When asked if he should drop out of the race, Holcomb said, “It’s four years to get to this point.  I’m not going to be stopped by a little calf muscle.”

Braided pattern used by Lackenby to reduce swelling

Kinesiology tape can be used to treat a number of injuries and to enhance sports performance.  Interested in learning more?  Talk to your physical therapist or athletic trainer today!

Blog post by Jen Skiba.

Monday, February 17, 2014

Are you ready to take on the Battle Ropes?

Have you ever wondered about the ropes coiled under the LifeFitness Synrgy360?  Here is your chance to learn all about them…

First off don't be intimidated!  They may look threatening or difficult to use but that’s only because they are new to you.  The ropes are actually a relatively simple piece of equipment to use if you know what to do. They come with a variety of different exercises and are a great tool to shake up your current program. Not to mention all the benefits you will by adding a few simple exercises to your routine.

The ropes give you a total body workout building muscular strength, power, and endurance. It is a great way to develop grip and forearm strength while working on core stabilization. And to top it off, it can be a great cardiovascular and fat burning workout!

The intensity of these exercises can easily be manipulated in a couple different ways.  First would be by your choice of rope. Most gyms feature different sized ropes of different weights. You can also increase or decrease the speed and size of the movements.

Slams and Waves are two basic exercises performed with the ropes and the best place to start for beginners.

Rope slams

Begin in a squat position with both hands together. As you come out of the squat position, lift the ropes as high as you can and move back into your squat as you slam the ropes down to the ground as hard as you can. Remember to keep you back straight and heels on the ground.


Rope waves

Start by standing straight with a slight bend in your knees. Move both arms up and down together (or alternate left and right arms) in small, fast, controlled movements. The ropes should create a smooth wave pattern as you do this exercise. 

Incorporate these exercises in a circuit or interval training session.  Start small and gradually build up your endurance and strength.  Once they become easy you can start to challenge yourself more by incorporating different movements (li.e squats, lunges, or jumps) or pieces of equipment (i.e physioball, or the BOSU) to these two exercises.

Blog post by Catie Furbush CSCS.

Thursday, February 13, 2014

Stress Fractures in Female Athletes

Stress fractures are very common to female athletes, especially runners.  They are essentially an overuse injury that worsens over time.  Bone structure, running mechanics, and the Female Athlete Triad all make women more susceptible to stress fractures than men.

What is a stress fracture?

According to the American Academy of Orthopaedic Surgeons, a stress fracture occurs “when muscles become fatigued and are unable to absorb added shock. Eventually, the fatigued muscle transfers the overload of stress to the bone causing a tiny crack called a stress fracture.”

Typically a stress fracture begins with pain that occurs toward the end of a physical activity or after the activity is through.  It can progress to a constant pain while walking or standing.  In most cases, pain can be pinpointed and there is also some local swelling or tenderness.

Return to play time is typically 12 weeks, depending on the risk classification.  If an athlete begins activity before the stress fracture is fully healed, they are at a higher risk of re-fracturing that bone.

Factors that can contribute to a stress fracture: previous stress fractures, the Female Athlete Triad and the FIIT (frequency, intensity, time, and type of physical activity).

The Female Athlete Triad

The Female Athlete Triad is made up of 3 health problems common to female athletes:
    • Energy Deficiency/Eating Disorders
    • Low Bone Mass/Osteoporosis
    • Menstrual Irregularity/Amenorrhea

Energy deficiency is another term for “under-fueling.”  We get our energy though our diets and if your body is not getting enough nutrients, it will not be able to perform and you will feel tired and weak.  It can lead to injury, illness, menstrual changes, and changes in energy levels.

Low bone mass can be a result of many risk factors: not enough calcium and vitamin D, cigarette smoking and alcohol consumption, a sedentary lifestyle, gender, and genetic predisposition.  Osteopenia and osteoporosis are advanced cases of bone loss and can be diagnosed through dual energy x-ray absorptiometry (DXA).

Energy deficiency can also lead to menstrual irregularity.  A cessation of the menstrual cycle is termed amenorrhea.  Low body weight, hormonal imbalances, stress, eating disorders, or over-exercising can cause amenorrhea.  When periods are missed, the female body produces less estrogen, a hormone essential to building strong bones.

The Female Athlete Triad is not something to be taken lightly.  Stress fractures are just one of the potential side effects of the Female Athlete Triad.

How can stress fractures be prevented?

There is no way to completely prevent stress fractures but here are some tips to help keep those bones strong and decrease the probability of injury:

  • Drink your milk!  Calcium and vitamin D are essential bone building nutrients.  They work together as vitamin D helps the body absorb calcium.  The latest guidelines recommend 1,000-1,200mg per day of calcium and 600IU per day (800IU for 70+ years old) of vitamin D.  Peak bone mass is reached in your 20s but consuming enough calcium and vitamin D can help slow down bone mass loss as you age.

  • If you are just beginning an exercise program or just getting back into it, start slow.  Increase your mileage gradually to avoid injuries.  Impact and weight bearing activities help to preserve bone mass but if you get too ambitious too quickly, it can add extra stress to your body.

  • It’s important to incorporate a good strength training program into your routine.  Functional training, the Burdenko Method (on land), free weights, and resistance tubing are all great ways to maintain your bone mass and gain muscle strength and endurance.  Fatigue and weakness can lead to a change in your running form, which can then lead to injuries.  Build strong bones and muscles to keep from losing your stride.

  • Get screened!  The Functional Movement Screen (FMS) is a good tool to discover any physical limitations or asymmetries in different patterns of movement.  Finding these areas of weakness and working to correct them will help to help to keep you injury free. 

  • Change your shoes often.  A good pair of running will typically last 300-400 miles.  Pay attention to the wear patterns on your shoes.  Over-pronators or over-supinators may go through shoes quicker than someone with a more neutral stride.  If you start to see the bottoms of your soles wear off, its time for new shoes!  Running shoes will cost you around $90-110 but new shoes are cheaper than Physical Therapy and your feet, knees, and hips will thank you in the long run!
Blog post by Jen Skiba.

Tuesday, February 11, 2014

Calories: Why do I need them?

When we talk about how much energy our bodies need throughout our day, we first need to understand what energy is. We gain energy from our diets through the consumption of carbohydrates, fats, proteins, and alcohol (in moderation). When these nutrients are consumed, our bodies digest, absorb, metabolize and either use the energy immediately or store it until it is needed for movement or exercise. A more commonly known word for energy measurement within the body is Calorie (or kilocalorie).

Although Calories often get a bad reputation for being the cause of weight gain, it is important to remember that we need Calories to live and function. It is however more important that we find ways to balance how many Calories that we consume a day to that in which we need per day in order to control fluctuations in weight and energy levels. As healthy active individuals we should think of Calories as our energy needed for our daily living tasks and energy necessary for optimal performance during exercise.

So you may be wondering, “How many Calories do I need then?” This is a tough question to answer because there are many different factors that influence energy balance for each individual. Some common factors that affect energy balance are:
  • Age
  • Gender
  • Body Composition
  • Metabolic Rate
  • Tissue Growth
  • Intensity and Duration of Activity
Some general recommendations for Caloric intake have been made and consensus among researchers show that the amounts needed can be categorized into four separate groups of individuals and their requirements. Below is a table that shows the different groups and the recommendations that have been given to each.

Sedentary Men and Non-Pregnant Women
Approximately 31 Calories / kg* of Body Weight                          
60kg x 31= 1860 kcal
Male and Non-Pregnant Female Recreational Athletes
Approximately 33-38 Calories / kg* of Body Weight
(Low End) 60kg x 33= 1980 kcal

(High End) 60kg x 38= 2280 kcal
Endurance-Trained Athletes
Approximately 35-50+ Calories / kg* of Body Weight. Needs vary depending on specific sport and training regime.
(Low End) 60kg x 35=  2100

(High End) 60kg x 50= 3000 kcal
Strength-Trained Athletes
Approximately 30-60 Calories / kg* of Body Weight. Needs vary depending on specific sport and training regime.
(Low End) 60kg x 30= 1800 kcal

(High End) 60kg x 60= 3600 kcal
*  To convert weight from pounds to kilograms, divide weight by 2.2.
**Example 132lbs / 2.2 = 60kg

Individuals who continually consume too little Calories often do not consume enough nutrients which in turn can cause a decrease in performance and overall energy levels. If low-Caloric, low-nutrient diets put the individual at risk for muscle and bone mass loss, inability to gain muscle or bone mass, fatigue, illness, menstrual changes, and injury. For those who need to maintain a restricted Calorie diet should work closely with a professional dietician to plan nutrient-rich, low Calorie diets that will enhance their training performance while achieving training goals.

Blog post by Craig Moody.

Sunday, February 9, 2014

Aqua Jogging & the Benefits of H20

In the cold winter months when we can’t get outside to exercise, the pool can be the place to turn. Whether you’re rehabbing an injury or trying to prevent one, the water can be an effective tool.

Exercising and running in deep water provides resistance in all directions challenging opposing muscles to work equally and can also improve cardiovascular endurance, strength & flexibility. The hydrostatic pressure of water is great for reducing swelling by promoting circulation and blood flow.

When running outside or even on a treadmill, our joints take on stress by constant pounding on a hard surface. Wearing a floatation belt in the deep water at neck level, we are about 10% weight bearing. This may sound like deep water running would be easy but think again- water has more resistance than air and there are plenty of ways to increase that resistance. Different forms include: ankle cuffs (flotation), gloves, barbells, and tethered running.

Aqua jogging in deep water draws similarities to over-ground running in regards to body positioning, form and stride -keep in mind these are key elements when in the water.  Maintaining a vertical position challenges the core muscles and the resistance of the water challenges the arms which is one difference from running on land. According to Dr. Robert Wilder, physiologist and director of sports rehabilitation at the University of Virginia in "The Sunday Times," water running burns 11.5 calories per minute. Using this figure, water running for 30 minutes will burn about 345 calories and an entire hour of water jogging will burn about 690 calories! These numbers are just estimates but in any case everyone has something to gain from deep water running, no matter your fitness level.

Blog post by Farran Jalbert.

Wednesday, February 5, 2014

Tips for Safe Snow Cleanup

The forecast is calling for more snow!  Snow can be great for recreational activities such as skiing (downhill and cross country), snow shoeing, sledding and more.  However, it can cause much frustration with walking, clean up and travel.   

Here are some tips for safe snow clean up.


Warm up before shoveling.  Shoveling can be a strenuous activity and just like an athletic event, you should properly warm up.  A simple warm up would be to walk around the house for a couple of minutes before heading outside.  Once you are outside, start by cleaning off your car to help warm up the arms and shoulders.

When possible try and shovel multiple times during a snow storm.   Shoveling 2 inches of snow at a time will be less strenuous than letting the snow build up and doing it all at the end.

Push the snow as you shovel.  This will be easier on your back.  If you do have to lift the snow, bend with your knees, use your legs and do not fill the shovel completely!

Take it slow! Take frequent breaks; do not work to the point of exhaustion.  If you feel tightness in your chest while shoveling, stop immediately.

Dress warmly and pay close attention to extremities.  These are the first areas to develop frost bite (hands and feet, nose and ears).

Clearing your car

Use a brush/ice scraper to remove snow and ice from windshield, side and rear windows, side mirrors, and head lights/tail lights.

Make sure your tailpipe is clear of snow before starting your vehicle.

Also make sure to clear the snow from the roof of your car.  Sliding snow can be dangerous for yourself and other drivers. If you have a taller vehicle such as an SUV or a truck, grab a step stool or invest in a long handle brush.

Don’t force the wipers; you may damage the motor.  If your wipers are stuck to the windshield try pouring some windshield washer/deicer fluid on them.  Do not use hot water to remove ice from your windshield as this could cause your windshield to shatter.

Blog post by Eric Chandler CSCS.

Sunday, February 2, 2014

Mashpee Fitness Super Bowl Challenge

Did you know?

The Super Bowl is ranked as the number two food consumption event of the year, second only to Thanksgiving.                                                                   
(Source: American Institute of Food Distribution)

1,200 calories: Amount the average Super Bowl watcher will consume while snacking.

Most people have already gained an average 6 pounds over the holidays. Don’t compound it by overeating on Super Bowl Sunday!  Instead of sitting around and snacking, are you up for a Mashpee Fitness Super Bowl Challenge?

Pregame Warm Up:

10 Burdenko Catch and Stretch
10 Burdenko Leg Swings
10 Burdenko Skaters

During the Game: 

Perform each of these exercise tasks every time one of the following takes place...

Start of Each Quarter - 10 Burdenko Wake Up Call

First Down - 10 Squats

Time Out - 10 Tricep Dips

Field Goal - Jog in place 30”

Touchdown - 20 Jumping Jacks

Halftime - 4 Planks (hold until fatigue)


Every time Petyon Manning yells Omaha - 2 Push Ups

(During the AFC Championship Game, he yelled Omaha 31 times!)

Good luck!

Blog post by Jen Skiba.

Be Ready to Shred your Snowy Weekend Getaway

3 Exercises to Increase Ski & Snowboard Performance In Season

It is imperative as a winter athlete to develop lower extremity strength & endurance in order to avoid injury, conqueror changes in terrain, and resist muscle fatigue.

Forward & Lateral Lunge onto the Bosu Ball

The lunge is a great choice due to its activation of the large leg muscles (gluteus maximus, quadriceps, hamstrings, hip flexors).

The goal of the exercise is to take a large forward step onto the Bosu ball; lunge by bending the front knee until 90 degrees of flexion is achieved, then explosively pushing off the ball, returning back to the upright position.

When performing the lateral lunge, the goal is to side step one foot onto the Bosu Ball, bending that knee while keeping the other leg straight. 

Tips for Both:
·   Knees should never go over the toes.
·   When performing laterally, try to sit back and stick out the butt into a squat.

Increasing the repetitions and alternating the legs enhances muscular endurance and eliminates the ability for one leg to over compensation for the other.

The addition of the Bosu Ball challenges balance making the ankle stabilizing muscles work harder to maintain proper posture.

This exercise can be performed with or without weight (dumbbells, medicine ball over head, etc.)

Depth Jump

Improper lower body mechanics is one of the leading causes for ski & snowboard knee injuries.

The depth jump focuses on the proper landing phase from a predetermined height.

The goal of this exercise is:
·    To land softly, receiving the weight through the balls of the feet.
·   Then distributing it into the heels.
·   While carrying that downward momentum into a Perfect Squat (Sit the butt back, knees don’t go over toes, and maintain proper foot and knee alignment)

This exercise focuses on the deceleration of one’s own body weight by forcing the large leg muscles receive the weight, slow then stop that momentum. 

Russian Twists

Core development is vital in order to maintain strong posture, form, and the ability to turn rapidly from the waist or trunk.

The Russian twist is performed with only the lower back in contact with ground, while the body is positioned in a “V” shape.

Goal of this exercise is to;
·   Rotate the torso and arms side to side
·   Both hands should make contact with the ground or mat, clasp hands together.

To progress this exercise a medicine ball should be added and held so each twist involves contact of the medicine ball to the ground instead of hands.

Recommendations for Intensity & Frequency

First step is to master perfect form and correct range of motion before using any weight or large heights.
Second step is to increase your repetitions per set until you can achieve 12 great reps per set.
Step three is to then incorporate weight or increase height by small increments to ensure safety and correct form.

Incorporating these exercises into your fitness routine 2-3 times/week will help prevent injury, increase performance, and keep you feeling strong. You’ll be ready to hit the slopes all winter long!

Blog post by Drew Sifflard CSCS.