Golfers, don’t forget your wrists! By Dr. Stephanie Harris

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Wrists are an often overlooked body part when it comes to golf. People who do stretch before golf will spend time stretching the bigger muscles of their bodies like their back, legs and shoulders, and often don’t even think about their wrists.  Your wrists play an important role during your golf swing and neglecting them (not stretching or strengthening) can lead to poor performance and injury, which can keep you off the course and on your couch!

Here are a few stretches and strengthening exercises to help keep  your wrists strong and to avoid those dreaded wrist injuries!

Wrist Deviation Exercises

• Stand with arms at your side and your elbow bent to 90 degrees.
• Hold your hand out like you are about to shake hands with someone with your thumb up (this is neutral position).
• From this position, move your hand up toward the ceiling and then all the way down to the floor, keeping your forearm locked and only moving from the wrist. Repeat 10 times.
• Next, place a light weight or a water bottle in your hand to provide some resistance.

Ball Squeezes

Wrist Flexor Stretch

• Hold your arm straight out in front of you, keeping the elbow straight and the palm facing up.
• Grasp the involved hand at the knuckles and gently stretch the wrist until a stretch is felt on the inside of the forearm.
• Hold for 15 – 20 seconds. Repeat on the other arm.

Wrist Extensor Stretch

• Hold your arm straight out in front of you, keeping the elbow straight and the palm facing down.
• Push downward on the back of the involved hand until a stretch is felt in the muscles on the outside of the forearm.
• Hold for 15 – 20 seconds. Repeat on the other arm.

An athlete’s key to success…the Off-Season

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A successful season begins with a great off-season!  People often say to me that an athlete must love their off-season because they can just relax and enjoy….that couldn’t be farther from the truth!  The off-season is the most important part of the year for any athlete, at any age, and if the off-season is not productive, their season will follow suit!  It’s the time to get stronger, faster, bigger, leaner, more explosive, more skilled, focused, motivated, and overall healthier! In simple terms, it’s the time to get better!!!!

So here’s the advice and treatment approach I take with the athletes I work with:

(For the purpose of this example, I will talk in reference of hockey, but it applies to all sports)

• Rest and Rejuvenate: Once the season ends, to take a week or 2 or 3 (depending on timing) and remove themselves from the rink and gym…they need to get away from it and let the mind and body unwind
• Evaluate: After they have had some time to unwind, I ask them to evaluate their season that just passed; their performance on and off the ice, and their body’s ability to perform and withstand the rigors of the season.  Be objective and specific as possible in establishing the areas of strength or weakness (skating, strength, endurance, shooting, balance, recovery, mindset, eating habits, routine, etc).
• Assessment:  After I get an understanding of their own evaluation, we move on to a comprehensive assessment to examine what areas are not optimally functioning and address any physical concerns they might have or had on or off the ice.  With hockey players, I place special emphasis on hips/groins, shoulders, and back. In addition to my assessment, each athlete should also undergo an assessment with their personal trainer/training staff, which will help gauge where they are starting from and guide them through their summer of training to reach an eventual goal.
• Treatment Plan: Combining the evaluation, assessment, and an athlete’s goals allows me to come up with a treatment plan for the off-season.  The first few weeks (if necessary) are used to correct any resulting dysfunction from the season.  It’s important this is done before the athlete is submerged into their intensive training schedule….the last thing you want is to build strength on top of dysfunction, which will give you strong dysfunction! Proper functionality of muscles, joints, movement and firing patterns creates a proper base to build upon. After everything is working optimally, the rest of the summer treatments are aimed to: help recovery from rigorous training sessions; help improve areas of concern/weakness (i.e. enhance the functionality of the rotator cuff/shoulder to help the strength of their shot); maximize performance and minimize risk of injury during the season by way of our unique treatment protocols.

Here are some key things that play a factor in a successful off-season:

• Choosing a suitable, sports specific, knowledgeable, adaptable, and comprehensive strength and condition coach/personal trainer that devises the right individualized program with phases/stages to achieve the desired goals (easier said then done!)
• Diet/Nutrition: an athlete’s diet/eating habits are essential to a successful off-season! You can not achieve your fitness goals if your nutrition does not support it! Contrary to common belief, an athlete’s diet should be more disciplined during the off-season than the season!
• Communication: when I am able to communicate with the athlete’s trainer/training staff and vice versa, the benefit to the athlete is enormous.  We can communicate to ensure specific needs are being addressed and that everyone is working to achieve a common goal(s).
• Sleep: get lots of it!
• Stretch: and do lots of it! Flexible muscles have the ability to be stronger, faster, more explosive…and less susceptible to injury!
• Make sure all your training has a purpose! Nothing irks me more than when a pro athlete plays beer league hockey in the off-season- it’s a waste of energy that will negatively impact your training.  They got their retired years to play with their buddies!

Wishing you a successful, productive, and defining off-season!!

Golfers: How flexible are you? By Dr. Stephanie Harris

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Flexibility is an overlooked and undervalued part of fitness, especially when it comes to golf. Golfers are athletes who require great degrees of range of motion in multiple joints (shoulders, torso, hips…) to swing a golf club. If your body does not have the proper range of motion, your distance, consistency, and swing will suffer and will also put you at risk for injury!

No matter what your handicap, every golfer can benefit from a stretching program and they will see the results in both the way they hit the ball and also in the way they feel during and after the round. In today’s post I will talk about the most important things to DO and the things you should AVOID when it comes to golf specific stretching programs.

When discussing stretching, it is important to understand the difference between static and dynamic stretching. Static stretching involves taking a muscle to a point of tension and holding that position for a given period of time. This type of stretching should be used after a work out or sports and helps improve overall muscle flexibility. Dynamic stretching consists of functional based exercises that use sport specific movements to prepare the body for athletic activity. This type of stretching should be used as a warm up before sports.

Dr. Harris’ Tips for a good Pre-Round Warm-up:

• Don’t rush to the first tee! Plan on arriving at the course with enough time to complete a 5-minute warm-up plus time to hit a few balls on the range. This will greatly reduce the tightness/stiffness that is usually felt on the first few holes and reduce your risk for injury.
• Before heading to the range to hit balls, perform a 5-minute dynamic stretching warm up. This will get your muscles loose and ready for your round.
• After your warm up, spend 5 – 10 minutes on the range.
• Don’t warm up swinging more than one club at a time. This can lead to compensatory movements in your arms, altered proprioception (balance), and can lead to over-swinging when you go back to a single club.
• On the range, start with a wedge or an iron to work on your swing sequencing. The driver should be the last club you take out of your bag. Remember, a warm up is about finding your swing rhythm; it’s not about power!
• Don’t forget to breathe! Proper breathing will help you with your tempo.
• After your round, spend another 5-minutes cooling down (static stretching).
• Ensure both your warm up and cool down covers shoulders, elbows, wrists, back, hips, and knees to allow your body to be fully prepared for golf.
• Ask for help. If you are currently are dealing with an injury or experiencing pain, consult a health care practitioner to get a proper diagnosis and a customized stretching program that is tailored to your needs.

Additional Tips:

• If your tee time is in the morning, get to the course a little earlier than usual. Muscles tend to be stiffer and less flexible in the morning.
• If it’s a cold day, spend more time warming-up and wear warmer clothes (layers). Cold weather causes your muscles to stiffen and requires a longer warm-up to achieve the same flexibility as on a warm day.
• Incorporate stretching into your daily practice routine.

Stay Tuned for my next Blog. I will go through a dynamic warm-up that you can perform before your next round of golf!

A Must Read for All Athletes!!

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If you are an athlete (at any level), I am about to tell you something you NEED to know, that few people in the medical community talk about, address, or even think about: The difference between Structural and Functional problems. And more notably the often overlooked importance of functionality!

The reason I am writing this is because all too often I observe first hand (or from afar) athletes being misinformed, misguided, mistreated and incompletely diagnosed.  Ultimately, this has a negative affect on the athlete’s performance level and longevity!  As a functional specialist, I look forward to the day that teams provide their athletes with more complete medical management. But until that day comes, the onus is on the athlete to become more informed and aware of their own health, even if that means that the solutions they are seeking may be outside what is traditionally provided to them!

Simply put:

A Structural problem is when something is broken, missing, or out of place. I.e. a torn muscle, torn tendon, torn ligament, herniated disc, broken bone, dislocated/separated shoulder etc.  A structural problem is most often diagnosed through medical imaging (x-ray, ultrasound, MRI, CT scan, bone scan, etc).

A Functional problem is when a body part or a series of body parts are not working properly, and more specifically, not working properly when the body requires movement/motion.  This can not be seen on an image because there is nothing structurally wrong with their body and it is actually a problem that involves the MOVING parts (remember, images look at things statically, in a stationary position). A functional problem is best diagnosed through a proper examination which involves the practitioner taking a patient’s history AND running the patient through specific orthopaedic tests (see my previous blog in November 2011, “A proper diagnosis: the key to fixing a problem”).

So herein lies the problem with traditional medical management of athletes, and what I often observe within teams’ management of their players’ health….

If a player or athlete sustains an injury or is experiencing pain…. in most cases they are then sent by the overseeing medical doctor for imaging (which is often the correct move). At this point there are 2 possible results:

1) A structural problem is seen, in which case the medical doctors will devise the correct treatment to fix the structural problem (and in most cases they are the right ones to fix it!!). Or…

2) No structural damage is seen on the image, in which case the athlete is typically told that nothing is wrong; that it’s probably just a “strain”, “tweak”, “bruise” or something minor, and to just rest it or work through it; that it will resolve… NO IT WON’T!!!! This is exactly why you see the same players experiencing the same injuries over and over and over again!! (I will address functional problems in greater detail in my next blog).

So lets say you are diagnosed with a structural problem and the doctors tell you what is needed to correct it; surgery, cast, rehab, injections, etc. In most cases, the suggested treatment is the answer to the structural problem…but they missed something crucial to full recovery – the functional problem!!!  Although you can have a functional problem without having a structural problem, you can’t have a structural problem without having a functional problem!  For example, if you have a tear (structural problem) of a tendon, you will have a deficit in the way the adjoining muscle functions (contracts, relaxes, range of motion, strength, endurance, etc).  Simply repairing the torn tendon (structure) will only get you so far…and will leave you feeling and performing at a fraction of yourself! It will also leave you susceptible to more structural problems down the road (remember, you can tear something more than once!).

In order to fully recover from an injury, a portion of the treatment MUST be targeted at ensuring that the body part(s) are functioning properly, which is most often overlooked and neglected.  This, by the way, is exactly why you see players return from an injury that required surgery but they struggle to perform at the level they did prior to the injury. Yes, conditioning plays a factor. But the biggest issue is due to lack of functionality…and until the muscle has regained proper functionality, the player’s performance will be hindered.  

Bottom Line: If you have experienced a structural injury which has fully healed but you are wondering why you still don’t feel 100 %….it’s likely because no one has diagnosed and treated the functional impairments to ensure that all the moving parts are working the way they need to.

Stay tuned for my next blog when I better describe functional problems, the way they can be corrected, and what will happen if you leave them untreated!

Stay informed! Stay Healthy!

p.s. sorry for the long read

Golf Season is Here….. Are you ready? By Dr. Stephanie Harris

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The warm weather is finally here and golf season is right around the corner! Public courses have already opened their doors for the season and I’m sure a lot of you have already dusted off your clubs and are itching for your first round of golf. With this beautiful weather and the excitement of golf in the air, it’s almost impossible not to run onto the course and get right back into the ‘swing’ of things. But playing your first round of the season can bring both joy and sorrow. Too often I see people come into my office around this time of the year because they’ve injured themselves on the golf course very early in the season. So I thought I’d post some tips on how to get you ready and keep you healthy for the golf season:

• Go to the range (a few times) before your first round.
• At the range, take your time. Spend 1 – 3 minutes with each shot and go through your routine each time. Avoid hitting too many balls in a short period of time, which will only increase your chance of injury!
• Work on flexibility. A good daily stretching routine will work wonders on how you feel both on and off the course.
• There is still time to improve your balance and strength. Get into the gym and work on the areas that need to be addressed.
• A few lessons pre-season are always a great idea to help get you back into proper swing mechanics.

There is still time to work on these tips before your first tee time. Try a few and you’ll see the difference it will make in how you feel on and off the course.

Stay tuned for my next post, which will discuss the do’s and don’ts of stretching before golf.

Dr. Harris is trained through the Titleist Performance Institute as a certified golf fitness instructor. She is an expert in golf swing biomechanics and uses physical screening techniques, specialized manual therapy and specific exercise prescriptions to identify and eliminate physical restrictions within one’s golf swing. She believes that to achieve consistency and power in your golf game, the key is fixing the root of the problem.

Stay Healthy by Avoiding These Exercises! – Part 5 of 5

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Exercise #5 NOT to do!

Overhead tricep extension and/or bent-over tricep extension: It was a toss up between these two tricep exercises, so I decided to include them both on my ‘exercises to avoid’ list. The overhead tricep extension puts excess stress on your neck/shoulder for reasons similar to the barbell shoulder press (see previous post).  As for the bent-over tricep extension, it puts stress on your lumbar (low back) discs and overtime can result in a lower back injury. Furthermore, there is minimal benefit to the development of your tricep musculature by doing a tricep extension exercise while bent over.

Don’t do!

Preferred replacement: If you have access to a pulley system at your gym, then the preferrable replacement is a standing tricep pulldowns/extensions; it targets the tricep without putting unnecessary stress on other parts of your body.  If you do not have access to a pully system, then skull crushers are a great substitute (with dumbbells or a barbell…your choice!).

So there you have it, my 5 exercises to avoid in the gym!

Stay Healthy and Keep smiling!!

Stay Healthy by Avoiding These Exercises! – Part 4 of 5

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Exercise #4 NOT not to do!

Barbell Shoulder Press:

The shoulder press is a great exercise but not if you use a barbell!! The problem with using a barbell is that in order to avoid hitting your head with the bar you are forced to either flex/extend your neck, hyperextend your low back, or move your arms too far out in front of you, exposing you to a neck, back, or shoulder injury respectively.

          Don’t do!

Preferred replacement: Dumbbell shoulder press or machine shoulder press are both great substitutes that will help you avoid injury, ensure symmetry, and maximise your results!

Stay tuned for the final part of this series…

Stay happy and healthy

Stay Healthy by Avoiding These Exercises! – Part 3 of 5

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Exercise #3 NOT to do!

Upright row:

Although you often see people doing this exercise in the gym and it’s commonly found in popular exercise videos, this  exercise makes absolutely no sense! It’s  non-functional (not a motion your body is intended to perform) and it does not even effectively work the muscles it is claimed to work. Furthermore, it significantly increases your risk of getting supraspinatus tendonitis (a shoulder injury that will cause you pain and eventually force you to skip workouts). Bottom line, don’t do it!

    Don’t do!

Preferred replacement: An upright row is intended to work your upper traps, deltoids, and biceps; so I recommend replacing it with more traditional exercises that predominately work the muscles groups individually. These include:  side laterals, bicep curls, and shoulder shrugs.

Stay tuned for Part 4…

And as always, stay healthy and keep smiling!

Stay Healthy by Avoiding These Exercises! – Part 2 of 5

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Exercise #2 NOT To Do!

Stiff legged deadlifts:

This exercise is a non-negotiable absolute no-no!! The overwhelming risks to your spine (including discs, muscles and ligaments) could leave you with structural (and functional) impairments that negatively affect you for the REST OF YOUR LIFE!!  In my opinion, anyone who recommends this exercise to you should not be trusted with your health and wellness!

Don’t do!

Preferred replacement: This answer depends on whether or not you’ve had previous/current lower back issues. If you do not have any issues with your back, then you can do Romanian deadlifts (bent legged)…Google it if you need clarification! This exercise primarily targets your glutes, hamstrings, and low back. However, if you want/need to be cautious with your back (especially if you had disc issues) then replace deadlifts with isolated exercises such as: hamstring curls, ball squats, and back extensions (but do not do back extensions if you have a history of recurrent joint-related back problems…and never hyperextend!)

Stay tuned for Part 3…

Stay healthy and keep smiling

Stay Healthy by Avoiding These Exercises! – Part 1 of 5

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My primary goal in writing this 5 part blog is to help you avoid exercise-induced injuries. More specifically, to stop you from doing some of the most commonly performed exercises that inevitably WILL cause you injury.  These exercises do not support proper body mechanics and function, yet, frustratingly, they are recommended by way too many so called “fitness experts”.

Fact: The majority of injuries I see in my clinic are a result of exercise

Fact: Many of those injuries are a result of exercises that have inherent flaws which pose a much greater risk to the individual than reward

Fact: Many of those injuries are preventable by simply replacing those exercises with safer ones

Fact: The internet is oversaturated with exercises recommended by “experts”

Fact: There are many great trainers out there, but there are also many poor ones who unintentionally injure their clients by providing them with flawed programs and guidance

In my day-to-day practise I deal predominately with active individuals who care about their health and who rely on exercise to maintain, improve, and maximize their health.  If you exercise, you know how important it is to your lifestyle, and how depressing the thought of being injured is.

I applaud those who make the effort to exercise, but I also cringe at the hundreds of patients’ visits I have each year due to ill-advised exercise.

So I have chosen 5 exercises (with weights) that I have seen pose a high risk of injury. Please note that although you may not feel the problem while doing the exercise, it does NOT make it safe!  Many exercised induced injuries can be classified as repetitive strains injuries, meaning they occur over time from doing the motion over and over again.

One last thing: knowing how focused many people are in achieving exercise results; I am not simply removing the exercise from your routine. I am replacing it with an alternate exercise that is safer and in most cases will yield better results!!

(There is no particular order to the exercise to avoid)

Exercise #1 NOT To Do!

Barbell Bench Press (incline or flat): Using a barbell means that your hands are fixated in one position, which prevents you from bringing your shoulder/arms through its natural range of motion (towards the midline).  When you push the bar up and your hands do not go towards your midline. Excess stress is put on your AC joint and leads to rotator cuff strains (or tears)…In laymen terms, it results in shoulder injuries!! These shoulder injuries make up approximately 35 % of my day-to-day practice…and always result in patients being forced to missed time in the gym!

          Don’t Do!