Norway on Foot Back Pain

NO TO NORWAY ON FOOT BACK PAIN

THE AIR IS FRESH; THE VIEWS ARE this is a rocky ledge 604 metres above with his left knee as a result of inten- In most cases, our doctor-led Medical FANTASTIC AND THE COLOURS the Lysefjord. From here they walked sive football training over many years. Strengthening Therapy accompanied VIBRANT! THE NORWEGIAN FJORDS to the Trolltunga – the troll’s tongue – on a 1:1 basis quickly alleviates or ARE A SPLENDID BACKDROP FOR a piece of rock that projects horizon- In order to relieve the structures of eliminates back pain. We know this WALKING. ERIK SCHMIDTKE, KIESER tally out of the mountain some 700 the knee and as preparation for the not only from our own experience TRAINING INSTRUCTOR FROM metres above a water reservoir. Next trip, his doctor and physiotherapist but also the findings of scientific ROSTOCK WALKED IN NORWAY on the itinerary were the so-called both recommended training on the research. In addition, it is often possi- FOR SEVEN DAYS – DESPITE KNEE Monks’ Steps. Erik was really im- B3, B4, B5, B1, B8 and J1 machines. ble to avoid surgery. We are not alone PROBLEMS. pressed and not just with the land- A colleague also recommended the in being convinced of its benefits. The scape and the spectacular views. use of barefoot shoes for everyday Allianz Private Krankenversicherung, “In August 2014, I spent a week in He was thrilled that his knee held walking. Erik followed their advice one of Germany’s largest private Norway walking with my father,” out. Shortly before the holiday the and is so glad that he did. “My knee health insurers is as well and since explains Erik. For their first trip, the 24-year-old had experienced problems pain disappeared: Something that I 2012 has been collaborating with two of them tackled the would not have thought possible.” Kieser Training. Kjerag – a high rocky plateau overlooking Lysefjord Erik remained fit and well during the Allianz rewards exercise: Depend- in the southwest of the entire trip, walking in barefoot walking on the medical indications and country. The high point is ing shoes throughout. “The flexible the premium paid by an insured, the Kjeragbolten; a large soles make you much more aware of Allianz pays up to 100 % of the boulder wedged in a crev- the ground beneath you. This means cost of the Medical Strengthening ice some 1,000 metres you are less likely to slip,” explains Therapy offered as part of our Back above the ground. “Un- Erik. “Although the shoes do not Programme. To date, more than 3,200 fortunately, the weather support the feet, the training had policyholders have benefited from that day was not good. strengthened my ankle muscles. a programme that is good for both The path was damp and Stability had improved as had my sense their back and wallet. the stones were slippery of balance. Even on extremely rough and so we did not venture terrain, I did not go over on my ankle Innovative: Allianz also reimburses onto the boulder.” Despite and remained free from injury.” up to 50 % of the cost of independ- that, the walk along the ent Kieser Training – depending on high plateau remains one training frequency. After all, regular of the highlights of their training is essential for a long-term week-long trip. solution to back pain.

Instructor Erik Schmidtke (top) from the Kieser On their next walk, father Training Studio in Rostock had knee problems. and son ascended the To control it, he did strength training. This allowed him to enjoy in full his walking trip to Preikestolen. Known in the Kjeragbolten (Norway). English as the Pulpit Rock, INTENSIVE: EFFECTIVE TRAINING NEGATIVE TRAINING FOR WALKERS AND SUMMITEERS HAS YOUR TRAINING STAGNATED? ARE YOU NO LONGER MAKING PROGRESS? IF SO, TRY NEGATIVE TRAINING.

Negative training emphasises the eccentric phase of an exercise, i.e. the phase in which you lengthen the muscle and return the weight to the start position. This is why it is often referred to as “eccentric training”. Although we don’t know the precise reasons, we do know that muscles or individual muscle fibres are stronger during the eccentric phase of an exercise than during the concentric or isometric phase when the muscle is shortened or its length remains the same.

What to do Pull-ups on the J2/J3, for example, can be done with negative movements only. You simply climb the steps of the J-tower and grab the bar with bent arms, shoulder-width apart. Your chin should be above the bar. Now try to slowly lower your body (negative/eccentric phase). With this exercise, Would you like to increase negative training intensity and try the training is negative method? achieved Ask your studio only for advice through the slow and steady lower- PLAY IT SAFE AND STRENGTHEN Without muscles nothing works everything that little bit easier – even ing of the body YOUR MUSCLES: THIS WILL IMPROVE If you fail to prepare the muscles, you if the climbs are long and steep. The (about ten seconds). PERFORMANCE AND REDUCE THE IN- fatigue more quickly. Tough luck! After programme should consist primarily of The exercise should be CIDENCE OF STRAINS AND BACK OR all, you can’t simply stop in the middle exercises that strengthen the buttock, repeated until the muscle stops work- KNEE PAIN, MAKING YOUR NEXT TRIP of nowhere. You have to continue thigh and calf muscles. Each step will ing (within a time span of 60 to 90 EVEN MORE ENJOYABLE. walking. If muscles are fatigued, you then be stronger; you will be more seconds). become less sure-footed and more sure-footed and more resistant to fa- Walking in the Alps or other steep likely to slip, turn your ankle, fall or in- tigue. Strength training also helps What it achieves challenging terrain puts an enormous jury yourself in some other way. In ad- strengthen the muscles that stabilise Emphasising the eccentric phase in- strain on the body. The entire day is dition, you will probably develop very the joints. It also strengthens the liga- creases the mechanical tension. The spent climbing or descending and of sore muscles and this can seriously ments and tendons – although this training stimulus is normally higher course there is the little matter of less screw up the tour. Similarly, back or takes a little longer. than if the emphasis is more on the oxygen at high altitudes. All in all, it knee pain during a trip can seriously concentric phase. This can help kick- saps your energy, making a certain re- reduce your enjoyment; this is often Don’t forget to train the arms and start progress if training has stagnat- sistance to fatigue essential. Before the result of muscle strain. shoulders. They are an essential for ed. In some cases, it may be sensible you depart, you need more than just walking, e.g. when using poles for to reduce the weight. careful tour planning, the right cloth- Benefits of stronger muscles support, roped up for safety reasons or ing, equipment and enough provisions. To enjoy your walking trip to the full, when scrambling is required. In addi- You also need to train the muscles. strengthen the muscles before you go. tion, if you are also carrying a heavy A special training programme will in- rucksack, you will be glad of strong crease performance and make trunk muscles.

PROGRAMME FOR WALKERS*

A1 HIP EXTENSION B6 LEG PRESS C1 PULLOVERS Strengthens the lower back and The front and rear thigh muscles The latissimus dorsi muscle allows gluteal muscles and so helps with give you the strength you need effective use of arms when walking. walking. to walk.

A2 TORSO FLEXION F3/F3.1 LOWER BACK E2 LATERAL RAISE This exercise improves posture and Walking puts a constant strain on Strong shoulder muscles are ensures an optimum load on the the lower back as it works to keep essential when carrying a heavy joints when walking. the body upright. load on your back.

A3 ABDUCTORS F1/F1.1 ROTARY TORSO B3/B4 FOOT/CALF The lateral gluteal muscles stabilise Walking uses every trunk muscle. Strong ankle pronator and the hips when the weight of the They stabilise the trunk and ensure supinator muscles provide additional body is unevenly distributed, e.g. an optimum axial load. support and keep you stable on on uneven terrain. uneven ground.

*Selection SHOW ME YOUR FEET! INTERVIEW WITH BAREFOOT TRAINER MARCO MONTANEZ

Marco Montanez is a barefoot expert. He is What does your training include? offering workshops in many Kieser Training I aim to create an awareness of our Studios where he shows us how to develop a new awareness of our foundations, i.e. our feet. foundations. I use a foot pressure plate to analyse how pressure is distributed when we stand. In most Cracks will develop in the walls. Similar- cases, I find that pressure on the big ly if the feet are not working properly, toe is almost non-existent whereas the body becomes unstable and sooner functionally, it should be the final link or later the resultant forces will cause in the muscle chain. When we stand, problems. I see this daily in my work. the big toe should be the anchor that People come to me with back, knee, claws itself into the ground and when hip and neck pain. The first thing I do we move, it should allow the foot to is to make sure that they are standing roll from toe to heel. If we activate the correctly, i.e. I start with the founda- muscles of the big toe, this realigns tions. the arch of the foot and strengthens overall leg-muscle function. You say that most people have to learn how to stand properly? How do you achieve that? For most people, standing is a problem. In principle, I keep giving the feet Shoes with heels – whether low or new tasks to complete. I seek to raise 6 inches high – are a massive problem; awareness by using balance boards at they change the statics of the body. To different angles. I use the B3/B4, B8 avoid falling over, you have to adjust and the J Tower to replicate and train the knee, hips and lumbar spine. This the four separate movements of the not only affects the strength of individ- foot, i.e. pronation, supination, dorsal ual muscle chains but also joint align- flexion and plantar flexion. Finally, the ment. The result is pain. That is why I training moves outside – barefoot of start off by asking people to stand so course. Running barefoot is the right that they can feel the forces at work in way for humans to move. their feet.

IN ORDER TO STAND WALK AND RUN causes foot deformities such as flat You also offer barefoot workshops in PROPERLY WE NEED TO USE THE 26 feet, fallen or high arches or heel many Kieser Training Studios …? BONES IN OUR FEET, THE 33 JOINTS, spurs. More than 80 % of us have I consider Kieser Training an excellent 60 MUSCLES, MORE THAN 100 a lateral deviation of the big toe, partner. It introduces customers grad- LIGAMENTS AND INNUMERABLE known as hallux valgus. However, ually to training and does not overload 5 TENDONS. HOWEVER, MANY OF our feet underpin each and every them. It is also the only provider offer- 4 US HAVE FORGOTTEN THAT, SAYS movement. They act as a sensory ing special training for the feet. I value SPORTS SCIENTIST MARCO MON- organ and tell us where we are in its focus on the essential as it accords 3 TANEZ. THE REASON: POOR SHOES. space and how we interface with with my priority which is to concentrate IN OUR INTERVIEW, THE BAREFOOT the ground. If the foundations are on the fundamentals. TRAINER EXPLAINS THE ROOT OF restricted or deformed in some way, THE PROBLEM AND WHY WE NEED this has a detrimental effect on the TO RELEARN THE ART OF WALKING. statics of the body.

Marco, most of us are born with In other words, things start to 2 1) Flexor hallucis brevis muscle healthy feet but develop foot prob- fall apart? 2) Tendon of tibialis posterior muscle lems later on. Why? It’s like building a house. If the founda- 3) Flexor digitorium longus muscle 4) Tibialis anterior muscle Our feet have to fit the shape of our tions are wrong we cannot expect the 5) Flexor hallucis longus muscle shoes rather than vice versa. This upper floors of the building to be OK.

WHY WE GET SORE MUSCLES

THE WORD MUSCLE COMES FROM dence of a micro inflammation. If you fore, to give the muscle sufficient of degeneration.” If that happens, THE LATIN “MUSCULUS” AND do a physical workout that is more time to regenerate.” muscle tissue disappears and is re- MEANS LITTLE MOUSE. PERHAPS THE strenuous than usual, this can cause placed by fat and connective tissue. PERSON WHO GAVE THEM THE NAME microscopic damage to muscle fibres As a rule, the muscle soreness disap- It is far better to put a light load on “MUSCLES” THOUGHT THEY LOOKED and the muscles becomes sore within pears within four days. However, this LIKE LITTLE MICE RUNNING AROUND 24-48 hours of the workout. In con- does not mean that muscle regenera- those muscles or to train different UNDER THE SKIN WHEN FLEXED. trast, lactic acid merely reduces pH lev- tion is complete. The regeneration muscles and muscle groups. TRY CONTRACTING YOUR BICEPS els in the cell. This can restrict the abili- period can take several weeks. As a AND YOU MAY UNDERSTAND THE ty of muscle fibres to generate strength result, our expert recommends that if Does stretching prevent sore ANALOGY. SO WHY DO MUSCLES but does not cause sore muscles.” muscles are extremely sore, you muscles? BECOME SORE AFTER EXERCISE? should avoiding working those mus- Does muscle stretching before or Sore muscles – are they essential cles at the same high intensity. during training help prevent sore Sore muscles – the result of lactic for muscle build-up? muscles? “We now know that this is acid? “From a physiological perspective, “There needs to be a balance be- not the case,” says Dr Aguayo. “Definitely not,” says Dr David there is no direct linkage between tween exertion and regeneration,” “Admittedly, stretching can help Aguayo, a muscle physiologist who muscle build-up and sore muscles,” says Aguayo. “If you interrupt the reduce the perception of pain if works in the Kieser Training Research stresses Dr Aguayo. “Rather, it is evi- repair process and train at an intensity muscles are already sore.” Department. “The pain is caused not dence that you have put undue strain that triggers further muscle damage, by a build-up of lactic acid but is evi- on a muscle. It is important, there- you can change the balance in favour business man seeking to get custom- what I had written but – and this ers in and out of the door quickly. surprised even me – have gone even Even if that had been the case, it still further. These extremely interesting does not mean that athletes should findings are the subject of a medical WERNER be wasting their time. congress, “The Powerhouse of Life – Muscle Training 2015”, to be held at KIESER’S A new generation of scientists, work- the Hygiene-Museum in Dresden, ing internationally and independently Germany on 25-26 September 2015. CORNER of one another, has now examined the content. They have not only confirmed Werner Kieser

THE POWERHOUSE OF LIFE – THE WHEELS OF MUSCLE TRAINING 2015: SCIENCE TURN PRESENTATIONS HELD IN ENGLISH SLOWLY – BUT THEY James Fisher Dr Doug McGuff DO TURN School of Sport, Health and Social USA Sciences, Southampton Solent “12 Minutes HIT Per Week – Is This University, United Kingdom Enough?” “Advanced Resistance Training Techniques” Dr Patrick O’Connor Professor Dr Bente Klarlund Pedersen Department of Kinesiology, University Just under 50 years ago I said in pub- They wrote enthusiastically saying Centre of Inflammation and Metabo- of Georgia, USA lic that you could achieve everything that they had confirmed what I had lism and Centre for Physical Activity “Strength Training and Mental Health” there was to achieve from strength written. However, there were also let- Research, Rigshospitalet and University training with just one set. How did ters from those who represented the of Copenhagen, Denmark Dr James Steele the experts respond? At best with prevailing doctrine – three sets or “Muscle as a Secretory Organ – the Centre for Health, Exercise and Sport laughter but more seriously there more per exercise. They were under Role of Myokines Mediating Muscle- Science, Southampton Solent Universi- were those who asked why I lied. pressure to justify their approach. Organ Crosstalk” ty, United Kingdom Same “pay” for three times the “Questioning the Aerobic/Resistance In 1998, I wrote an article in “work”? That could not be possible! Dr Jeppe Bo Lauersen Training Dichotomy – Does Exercise “Leistungssport”, a German-language Department of Cardiology, Mode Impact Adaptations?” journal of sports science. Its title was One particular person adopted an Endocrinology and Nephrology, “How many sets with strength train- ad hominem approach, attacking me Frederikssund Hospital, Denmark ing?” Several of the trainers who as a person rather than the content “Exercise Interventions to Prevent read the article then tried my method. of the article. I was merely a good Sports Injuries”

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Reflex is published three times a year, THE POWERHOUSE OF LIFE – MUSCLE TRAINING 2015 including online. Stay informed! To subscribe to Reflex visit Kieser Training, in conjunction with kieser-training.com GMKT (German Association for Med- PUBLISHER / COPYRIGHT ical Strengthening Therapy) Kieser Training AG and the Association for Hardstrasse 223 Sports Medicine in CH-8005 Zürich Saxony (a member of DGSP, the German CEO Information and registration at: Michael Antonopoulos Association for Sports Medicine kieser-training.de/ EDITOR and Prevention), fachkongress-dresden Claudia Pfülb is organising an [email protected] international medical EDITORIAL OFFICE congress, “The Power- Tania Schneider house of Life – Muscle prschneiderei.de Training 2015”, to be held at the Hygiene-Museum in Dresden, TRANSLATIONS Sue Coles Germany on 25 & 26 September.

PROOFREADING In recent years, scientific research has Dr Philippa Söldenwagner-Koch produced consistent evidence of the importance of muscles for our organ- LAYOUT Kunde & Co ism and our physical and mental kunde-co.de health. During the Congress, internationally renowned experts from PICTURE CREDITS Denmark, Germany, England, Switzer- Professor Dr Patrick O’Connor, • Muscle training for cancer patients P. 1, cover image: © Eric Schmidtke land and the United States will give an Dr Marco Toigo, Bernd Sigl, Dr James • Epigenetics and sport P. 1, image: © iStock P. 2, image: © iStock insight into recent findings and the Steele and Dr Joachim Wiskemann. • Psyche, thought and the sensation P. 3, image: © Macamoca value of High Intensity Training (HIT). of pain P. 3, illustration: Holger Vanselow Topics include: P. 4, image: © iStock Speakers: • Myokines – the muscle messengers Join us on an exciting trip through the Professor Dr Wilhelm Bloch, James • Muscle training for the fascinating world of muscles. Fischer, Professor Dr Dr Jürgen Gießing, cardiovascular system Professor Dr Wolfgang Kemmler, • Effective weight reduction The congress is targeted at medical Professor Dr Bente Klarlund Pedersen, • Back pain therapy professionals; two days are worth 13 Dr Jeppe Lauersen, Dr Doug McGuff, • Prevention of sports injuries CME points.

ISSUE NO. 56, QUARTER 2/2015