January 2011

Ruling Out Sacroiliac Joint Pain

by Adin on January 26, 2011


Ruling out Sacroiliac Joint Pain

There are several tests that your health care practitioner or educated personal trainer can do to help you determine the source of your low back pain.  As discussed in my prior article about sacroiliac joint pain;  SIJ pain is commonly missed as a potential cause of lower back pain.  With over a dozen SIJ tests, your practitioner can help determine if SIJ plays a role in your low back pain.

In my last article I went over one of my favorite SIJ tests called the Gillet test.  This article will focus in on the active straight leg raise test.

Active Straight Leg Test (see above image):

Your practitioner will have you lie down on your back and have you raise your leg three times on the non affected side (side with no pain).  The reason for starting with the “good leg” is to compare the movement with the other side and to see if there is some back pain associated with raising the non affected leg.

Then your practitioner will ask you to raise the leg on your affected side to see if your pain increases upon lifting.  If your low back pain on the affected side increases on either of the straight leg tests, this may be a sign of sacroiliac joint dysfunction and further testing is needed.

What to do if you fail the straight leg raise test?

If you have failed the straight leg raise test, your practitioner should start experimenting with different angles of pelvic compression and decompression.  Experimenting with different angles of compression and decompression, must be done by a skilled practitioner.  Bilateral compression (applying inward pelvic pressure) is very safe and often gives valuable information about the SIJ.  (see pic below)

Active Straight Leg Raise Test with Bilateral Compresssion

During the straight leg raise test, added bilateral pelvic compression will typically relieve or reduce low back pain.  If you get relief from bilateral compression, you’ll need to strengthen the muscles that work on compressing the pelvis.  Additionally, you may need to stretch any over-tight muscles that are causing decompression of the pelvis.

Which muscles are the common culprits contributing to sacroiliac joint pain?

The hamstrings and abdominal muscles are classically long and weak in most sacroiliac joint dysfunctions.  Have your practitioner perform range of motion and strength tests to determine if these two muscles need to be strengthened and shortened.

Hip flexors, quadratus lumborum, quads, and the lower portion of erector spinae are typically short and tight.  Stretching along with myofascial release of the aforementioned muscles are needed to restore correct postural alignment of the pelvis.

If you are local and have unresolved low back or pelvic pain – Contact us Today at (650-858-1213)

Premier Personal Training: Expert Personal Trainers serving Palo Alto,Los Altos, Mountain View, Menlo Park, Atherton & vicinity.

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Personal Trainer, Silicon ValleyWhy are herbal supplements more effective on American populations?

  • Herbals have been used daily for generations in many Asian cultures
  • Repeated exposure to any herb may decrease the desired effect

In Chinese and other Asian cultures, medicinal herbs will be used daily based on weather conditions and the personal symptoms of the individual.  Many of these herbs are also integrated into everyday cooking for added exposure.  Herbs have been a part of the Chinese cultures that predates the invention of writing!   Through thousands of years and many generations of using medicinal herbals, many Asians have desensitized their systems, resulting in a reduced effect.  For example, if you drink alcohol on a regular basis, you’ve noticed that the “buzz” you got with a couple of brewskis after work when you first started drinking has diminished.   You will either have to increase the dosage of brewskis or switch over to a glass of scotch or whiskey for example.

The importance of rotating your herbs:

Americans, or others who have had minimal to no exposure to herbals, have a chance to get the maximum benefit of herbals throughout their entire lives by simply rotating them.  I personally rotate some herbs weekly, and others every 90 days to prevent a reduced effect.

Supplement companies have over-isolated their herbal product lines:

Many supplement companies sell stand-alone herbs, which can be beneficial in certain cases and conditions for a specific period of time.  For example, if you are experiencing adrenal fatigue and have low morning cortisol levels, you can take pure licorice in tincture form and increase the half life of cortisol in your body.  Increasing the half life of cortisol can support the adrenal glands by allowing them to work less, thus helping the restoration process.  To find out more about adrenal fatigue click here

I experienced a miracle:

Last week I spoke with an herbalist who had been practicing for over 20 years.  I told him how after taking and herbal blend recommended by him, my asthma had mysteriously disappeared at age 34 after having been on inhaled corticosteroids since age 10!  I asked him if he had had anyone else report miracles of this magnitude.  He said, “The only miracles I have witnessed have been from Americans because their bodies are completely new to this kind of medicine.”  After years of working with my clients on nutrition, always preaching a rotation diet, I realized that the same principal applies to herbs!  His words made 110% sense to me!  I asked him about the formulation and about why and how it had eliminated my asthma, and he said that there is no way to tell exactly without doing clinical trials on that particular blend (which is over 400 years old, by the way!).  I have decided to research the blend, so stay tuned for a future post.  In the meantime, if you wish to try out this herbal blend, you may contact me directly.   (650)-858-1213

Premier Personal Training: Expert Personal Trainers serving Palo Alto,Los Altos, Mountain View, Menlo Park, Atherton & vicinity.

Weight Loss, Rehabilitation, Nutrition and Fitness Services.  Lab Testing and BioSignature available through clients only.

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Not All Detox Programs are "Healthy"Juice or Water Fasting Can Cause:

  1. Muscle Wasting
  2. Long Term Increases in body fat
  3. Energy Depletion
  4. Hormonal Upset
  5. Disrupted Detoxification

Muscle Wasting occurs during a juice or water detoxification regime due to a lack or absence of proteins.  Many people detox for weight loss reasons, yet fail to realize that their metabolism will slow down as a result of muscle wasting.  To add insult to injury, a water or juice detox will deprive you of calories and put your body into a starvation mode, forcing your metabolism to slow down even more to conserve energy.

I categorize juice and water fasts alongside the thousands of diets out there.  Diets by definition are supposed to be implemented by those who need to cut back on calories due to eating above and beyond their caloric requirements.   However, most people fail to diet properly and participate in diet programs where they consume less than what their body requires.  The scary thing is, even some medically supervised weight loss programs (MSWP) make the exact same mistake – they starve you!  The first thing that MSWP often do is base the diet on metabolic rate – which does not take into account your activities!  Imagine if took someone who was active in sports or weight training and put them on a diet based on BMR (basal metabolic rate) or RMR (resting metabolic rate)?!  Disaster often results and I end up seeing them after they have failed with these temporary starvation based diets.

Long Term Increase in Body Fat

The more you diet (take fewer calories than required to support your metabolic rate + activities); the more efficient your body becomes at storing fat.  In the book written by Dr. Debra Waterhouse – Outsmarting the female fat cell,

OUTSMARTING THE FEMALE FAT CELL: THE FIRST WEIGHT-CONTROL PROGRAM DESIGNED SPECIFICALLY FOR WOMEN

she explains how “enzymes facilitate the transport of fat in and out of the fat cell.  The enzymes that help store fat are called the lipogenic enzymes, and the enzymes that help release fat are the lipolytic enzymes.”  With every diet you go on, the lipolytic enzymes become less active and the liopgenic enzymes become more active.  Yikes!

Please note:  The science of lipolytic and lipogenic enzymes and dieting also applies to males.

Energy Depletion

Is it really a surprise if your energy gets depleted during one of these diets?  The more brain energy and physical energy you expend, the more calories you will burn.  Imagine someone who participates in daily physical activity and has a high pressure job requiring optimal brain function embarking on one of these 800 calories a day diet plans!  Even if you were to eliminate all activity and eat around 800 calories a day, you would likely have repercussions.  For those who remain active during an 800 calorie diet, they may actually burn 300 to 500 calories a day in physical activity.  The energy expenditure number would then have to be deducted from the estimate metabolic rate (using 800 BMR).  In actuality, the person would only be taking in a net 500 to 300 calories per day.  What a nightmare for the body to have to go through unnecessarily.

Hormonal Upset

If your body is in starvation mode, you’ll be under a great amount of physical and mental stress – increasing your cortisol levels.  Any time cortisol is increased too much over a sustained period, it will affect other hormones in the body, making it work harder to achieve homeostasis.  For example, sustained high cortisol levels will increase blood sugar and affect insulin function.

Disrupted Detoxification

Your body is only able to clear itself of toxins through the aid of proper nutrients during a detox or diet.  In my office, I have helped many of my clients do a safe detox through medical food.  In order for a company to claim the title “medical food”, they need to have done clinical trials supporting it.  Metagenics is the best and largest distributor of medical detox foods and I use them in my practice all the time.

Start off the year with a medically proven detox program and call today!  (650-858-1213)

Premier Personal Training: Expert Personal Trainers serving Palo Alto,Los Altos, Mountain View, Menlo Park, Atherton & vicinity.

Weight Loss, Rehabilitation, Nutrition and Fitness Services.  Lab Testing and BioSignature available through clients only.


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How to Reduce Homocysteine Levels Naturally

If your urine smells after eating asparagus, you have the MTHFR (methylenetetrahydrofolate reductase) gene.  This gene inhibits optimal function of the body’s folate system – increasing your risk of heart disease.

Which populations are at higher risk for carrying the MTHFR gene?

A large majority of the research behind the MTHFR gene has been done on American and French populations.  Notably, only about 2% of the French have this gene, while an estimated 40-50% of the Americans have it.  The lack of the MTHFR gene in the French population contributes to the well known French Paradox theory.  Further cross cultural studies need to be done. However, if you are reading this, simply have an asparagus feast, drink lots of water after your meal and have fun with your experiment.

Common asparagus experiment question:  Some people say to me, “I don’t know if my urine really smells.”  I simply tell them, “either you have a severe sinus infection or you don’t have the gene.”  I might add that you do not need to put your head in the bowl to accurately conclude the results.

The MTHFR gene can raise homocysteine levels, increasing the risk of heart disease.  What can you do about it?

A high homocysteine level is a known risk factor for developing cardiovascular disease.  If you have a family history of heart disease, it is especially important to monitor your homocysteine (tHcy) level.  I recommend that you include tHcy  in your annual blood panel as part of your preventive health program.  Using lab tests as a preventive health measure is absolutely critical to preventing heart disease.  Even if your homocysteine level is within the normal range, you’ll want to know if it is increasing over time.  If you find your level is slowly rising, take action while it is sub-clinical!

There are many lifestyle, diet and exercise changes you can make to keep your level from rising.  However, this article will focus in on a simple supplemental step you can take to prevent your tHcy level from rising (with the assumption you have MTHFR gene).

Oral Supplementation of L-5 MTHF (Methyltetrahydrofolate) is Superior over Folic Acid:

It might interest you to know that “Merck successfully synthesized folic acid into a stable and substantially pure form of L-methylfolate – the body’s preferred form of folate –which is able to cross the blood-brain barrier without further bioconversion by the body.  MERK markets this unique form of L-methylfolate under the trade name Metafolin®. Metafolin® is not folic acid, but rather it is a distinct dietary ingredient achieved through a unique and innovative method that yields L-methylfolate in a stable and substantially pure form.” (Case 2:10-cv-04365-MVL-DEK Document 1)

About 7 years ago, a medical supplement company (Metagenics) had exclusive rights for a couple of years on a specific therapeutic dosage of 1000mg capsules.  Their exclusive rights have since expired and it is now an open market for L-5 methyltetrahydrafolate supplements.

Oral supplementation of L-5 MTHF is one step towards reducing or maintaining your lab scores.  Several studies comparing supplemental L-5 MTHF versus folic acid prove the L-5 form to be more successful at lowering homocysteine levels.  Straight folic acid may help tHcyscores but it can mask B-12 deficiency on a lab test, making L-5 MTHF (methyltetrahydrofolate) supplementation a superior choice.  If you currently take supplemental folic acid and you feel fatigued, please note that it may be due to a B-12 deficiency which the lab isn’t picking up because you are not on the L-5 form.  This is a problem, because if your doctor is unaware of the folic acid masking effect, you may end up wasting time on other tests that may be contributing to your fatigue.  Vitamin B-12 deficiency is one of the most common deficiencies in the U.S., especially among the elderly and those who have the MTHFR (methylenetetrahydrofolate reductase) gene.

If you have the gene, you will want to take a multi-vitamin containing L-5 in it or take it as an add on nutracutical.

I highly recommend the Multi Intense Iron Free vitamin from Charles Poliquin which contains L-5.  If you are content with your multivitamin, you can take L-5 separately by ordering Methylator Plus 3.0.

Those of you who do not have the MTHFR gene need not take L-5 form, because your folate system is functioning properly, giving you enough B-12 and keeping your homocysteine levels low.

If you are a client of ours, you have access to the full Metagenics line as well as Charles Poliquins tarteted supplements used alongside our BioSignatrue Program.

Call our Palo Alto Personal Training facility to schedule an appointment today.  (650-858-1213)

Premier Personal Training: Expert Personal Trainers serving Palo Alto,Los Altos, Mountain View, Menlo Park, Atherton & vicinity.

Weight Loss, Rehabilitation, Nutrition and Fitness Services.  Lab Testing and BioSignature available through clients only.

A large majority of the research behind the MTHFR gene has been done on American and French populations.  Notably, only about 2% of the French have this gene, while an estimated 40-50% of the Americans have it.  The lack of the MTHFR gene in the French population contributes to the well known French Paradox theory.  Further cross cultural studies need to be done. However, if you are reading this, simply have an asparagus feast, drink lots of water after your meal and have fun with your experiment.

Common asparagus experiment question:  Some people say to me, “I don’t know if my urine really smells.”  I simply tell them, “either you have a severe sinus infection or you don’t have the gene.”  I might add that you do not need to put your head in the bowl to accurately conclude the results.

The MTHFR gene can raise homocysteine levels, increasing the risk of heart disease.  What can you do about it?

A high homocysteine level is a known risk factor for developing cardiovascular disease.  If you have a family history of heart disease, it is especially important to monitor your homocysteine (tHcy) level.  I recommend that you include tHcy  in your annual blood panel as part of your preventive health program.  Using lab tests as a preventive health measure is absolutely critical to preventing heart disease.  Even if your homocysteine level is within the normal range, you’ll want to know if it is increasing over time.  If you find your level is slowly rising, take action while it is sub-clinical!

There are many lifestyle, diet and exercise changes you can make to keep your level from rising.  However, this article will focus in on a simple supplemental step you can take to prevent your tHcy level from rising (with the assumption you have MTHFR gene).

Oral Supplementation of L-5 MTHF (Methyltetrahydrofolate) is Superior over Folic Acid:

It might interest you to know that “Merck successfully synthesized folic acid into a stable and substantially pure form of L-methylfolate – the body’s preferred form of folate –which is able to cross the blood-brain barrier without further bioconversion by the body.  MERK markets this unique form of L-methylfolate under the trade name Metafolin®. Metafolin® is not folic acid, but rather it is a distinct dietary ingredient achieved through a unique and innovative method that yields L-methylfolate in a stable and substantially pure form.” (Case 2:10-cv-04365-MVL-DEK Document 1)

Is the material in quotation marks a direct quote from Merk?

About 7 years ago, a medical supplement company (Metagenics) had exclusive rights for a couple of years on a specific therapeutic dosage of 1000mg capsules.  Their exclusive rights have since expired and it is now an open market for L-5 methyltetrahydrafolate supplements.

Oral supplementation of L-5 MTHF is one step towards reducing or maintaining your lab scores.  Several studies comparing supplemental L-5 MTHF versus folic acid prove the L-5 form to be more successful at lowering homocysteine levels.  Straight folic acid may help tHcyscores but it can mask B-12 deficiency on a lab test, making L-5 MTHF (methyltetrahydrofolate) supplementation a superior choice.  If you currently take supplemental folic acid and you feel fatigued, please note that it may be due to a B-12 deficiency which the lab isn’t picking up because you are not on the L-5 form.  This is a problem, because if your doctor is unaware of the folic acid masking effect, you may end up wasting time on other tests that may be contributing to your fatigue.  Vitamin B-12 deficiency is one of the most common deficiencies in the U.S., especially among the elderly and those who have the MTHFR (methylenetetrahydrofolate reductase) gene.

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In order prevent shoulder injury, everyone needs to include rotator cuff exercises in their fitness program.  Shoulder impingement syndrome can be very debilitating, preventing you from performing even the most basic tasks.  The most common sign of impingement is the inability to lift up your arm or to laterally rotate the arm (like opening a car door or reaching back behind the passenger’s seat when backing up).

Aesthetically speaking, rotator cuff exercises will not improve your physique directly.  However, if you have a rotator cuff injury, you might not be able to work out at all.  Having to take a hiatus from the gym due to a shoulder injury will have its negative effects (from this perspective rotator cuff exercises become very aesthetic!).

When working the subscapularis muscle, it is wise to follow my general protocol of 2:1 ratio of work from infraspinatus (external rotation) to subscapularis (internal rotation) exercises.  Most people are strong and tight in the chest muscles and weak in the back and external rotator cuff muscles.  Overworking the subscapularis actually increases the risk of impingement if it is not balanced with the infraspinatus and teres minor, so please refer to my general 2:1 recommendation.  Of course, it is best to see a personal trainer and get assessed to receive proper instruction and protocols specific to your shoulder alignment.

The subscapularis is injury preventative with regards to shoulder impingement due to its humeral head depressing function.  If humeral head depressors are too weak, the humerus will be more likely to glide up and sandwich one of the muscles of the shoulder (most often the supraspinatus gets impinged).

Word to the wise for athletes involved in sports with excessive internal rotation exposure, computer programmers, or software engineers:

Athletes such as baseball pitchers or volleyball players have an excessive work load on the internal rotators and therefore need to perform more external rotation shoulder exercises.

Computer programmers and software engineers often are stuck in a posture that lends itself to excessive internal rotation of the shoulders.  Strengthening the back muscles and external shoulder rotation exercises in this population is a must.

Don’t wait for something to happen to your shoulders, as it is such a commonly injured joint!  Get an assessment today by contacting us at (650) 858-1213 or by email.

Premier Personal Training: Expert Personal Trainers serving Palo Alto,Los Altos, Mountain View, Menlo Park, Atherton & vicinity.

Weight Loss, Rehabilitation, Nutrition and Fitness Services.  Lab Testing and BioSignature available through clients only.

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