Rehab for shin splints: Biomechanical Assessments & Treatment

Article By : Auptimo (Systems for Gait & motion analysis)

UNDERSTANDING SHIN SPLINTS

To understand the rehab process for shin splints, its important to understand the correlation between running biomechanics and its effect on the tibia. 

Shin splints or Medial tibial stress syndrome (MTSS) or most specifically, medial tibial traction periostitis is a leading cause of exercise-induced leg pain (Moen MH et al 2009). 

It is described as a diffuse pain at the posteromedial border of the tibia caused by excessive loading during physical activities such as running and jumping. The middle and distal portion of the leg is most affected. 

INJURY RATES

  • With an incidence of 4% to 35%, shin splints account for accounts for 30% of all running injuries (Newman et al 2013).
  • Females are around 1.5 to 3.5 times more affected than males. 
  • Studies also suggest significant correlation between higher BMI & shin splints. (Plisky et. al, 2007)
  • Common among runners, military personnel, dancers, gymnasts, & recreational sports participants. (Bradshaw C et al 2008)

PATHOPHYSIOLOGY

The exact underlining etiology of MTSS is unclear. Hypothetically, fascial traction induced periostitis or a local bone stress reaction is considered to be the cause. (Lohrer et al 2018)

Continuous traction over the bony periosteum (by the muscle fibers that attach along the length of the medial border of the tibia and even possibly by the deep crural fascia), which also attaches to the same location, is thought to be responsible for symptoms of MTSS (Brown AA, 2016).

Moreover, this pain aggravates due to continuous impact loading of Running or jumping activities, which create additional stress within the tibia (Winkelmann ZK et al 2016).

CLINICAL PRESENTATION

  1. Tenderness on palpation along the distal medial border of the tibia extending up to ≥5cm (Lohrer et al 2018).
  2. Pain is diffuse in nature and often continues for a longer duration.
  3. Duration of pain: Initially, the pain is experienced at the onset of activity and subsides with continued exercise. However, as the condition worsens the pain may persist even during and after the cessation of the activity (Brown AA, 2016).

DIFFERENTIAL DIAGNOSIS

MTSS falls under an umbrella category of exercise-induced leg pain. Thus, differentiating it from other possible conditions is necessary.  The following entities should be strictly ruled out before proceeding with any treatment program. (Bradshaw C et al 2008, Lohrer et al 2018)

  1. Common conditions: Stress Fracture (localized pain;<5cm), Chronic Exertional Compartmental Syndrome (short duration post-exercise pain);
  2. Rare conditions: Tendinopathy, nerve entrapments, popliteal artery entrapment syndrome, DVT, osteomyelitis, bone tumors, etc.

Moreover, MTSS can co-exist in combination with two or three of these conditions. Therefore, it is important to use historical cues, clinical findings, and characteristics of pain for differentiation.

Lastly, specifically targeted imaging (radiographs, MRI, MR angiography) and diagnostic studies (dynamic intracompartmental pressure measurement, nerve conduction analyses, electromyography can be used for final confirmations. 

POTENTIAL CAUSES OF SHIN SPLINTS

Like any running injury, MTSS can be caused due to any musculoskeletal impairment, training errors, biomechanical faults & extrinsic factors like footwear etc. In this section, we will be discussing assessments we can conduct to investigate each of these 4 aspects.

As a clinician, if we are able to figure out the root cause behind the injury, we can provide effective rehab for shin splints. 

Causes of Running Injuries

PART 1: TRAINING ERRORS

Training errors appear to be the most common factors involved in MTSS, especially as athletes attempt to do ‘‘too much, too fast’’. Common training errors include:

  1. A recent onset of increased activity, intensity, or duration. Such errors can be easily minimized by ensuring a gradual increase in activity. Training guides like UW Health Sports medicine runners book can be extremely useful to advise training tips to runners. 
  2. Continuous running on hard surfaces & uneven surfaces.
  3. Individuals with previous lower extremity injuries and running more than 20 miles per week are especially predisposed to MTSS. (Galbraithet all 2009)

Training errors can be understood by taking a detailed injury & training history of the runner. Here’s sample ‘Runner intake form you can use to understand the patient better.

PART 2: EXTRINSIC FACTORS (FOOTWEAR)

Footwear can hugely affect posture & biomechanics. Hence, an evaluation of the runner’s footwear is extremely helpful in designing an effective rehab program for shin splints. 

An ‘incorrect’ pair of shoes can lead to several injuries, even if there is no physical limitation in the body. A Clinical Assessment of the runner’s feet & shoe helps assess if the footwear needs to be replaced or while prescribing a new shoe. 

Here’s a comprehensive guide you can refer to for a shoe assessment of runners. 

PART 3: FAULTY BIOMECHANICS LINKED WITH SHIN SPLINTS

A Clinical video analysis of running enables the clinician to characterize the patient’s running biomechanics , estimate the resulting joint and

Faults in the running mechanics can increase the loading at certain areas of the body & expose the runner to injuries.  Hence, detection of these faults should form an integral part of a rehab program for shin splints. 

A gait analysis is the most accurate way to detect these biomechanical faults. All you need is a video camera/smartphone along with a video analysis software to get started.  

1. Overstriding

Running with a vertical orientation of the tibia at foot strike is an excellent way to reduce tibial stress. However, a lot of amateur runners tend to extend their tibia at foot strike (initial contact), displaying an overstriding pattern. 

This strategy is helpful from an immediate performance point of view as it is increases the stride length. However, it results in increase of ground reaction forces at the tibia, leading to shin splints or stress fractures.

In addition to tibial extension, overstriding is also associated with reduced knee flexion which is another variable associated with with tibial stress fractures (Milner et all, 2006). 

Overstriding

CORRECTIONS

  1. Taking shorter steps or increasing cadence is a widely used strategy in reducing overstriding. Moreover, a mere 10% reduction in stride length has proved to reduce tibial contact force, which may have implications for preventing tibial stress injuries (Edwards et al, 2009)
  2. Secondly, a rehab program for shin splints should also include running to reduce overstriding. Refer to this link by Stanford Health for some good drills.

2. Crossover Gait

In addition to increased tibial stresses, a crossover gait pattern has also been linked with Iliotibial Band pain in runners. Crossover gait can be best identified from the posterior view. As the name suggests, runners with crossover gait tend to land across an imaginary vertical line passing through the center of the body.

Just like other biomechanical faults, crossover gait might also be a strategy to increase performance by reducing the net lateral movement of the body.

Rehab for Shin Splints_Crossover Gait

CORRECTIONS

Runners with the crossover sign tend to benefit from step width manipulation, which includes increasing the step width to reduce the overall tibial loads (Meardon et al 2014). Verbal cues to run with a wider base of support have also been helpful for runners.

For some retraining strategies that can be included correcting crossover, refer to this link

3. Medial Collapse

‘Medial collapsers’ are runners who exhibit excessive contralateral pelvic drop accompanied with excessive hip adduction, dynamic genu valgum, and knee internal rotation. 

This gait pattern shifts the load to the side of the lateral femoral condyle of the knee & exerts a bending moment on the tibia. Consequently, such runners become vulnerable to higher stresses at the postero-medial aspect of the tibia. (Pohl et al 2008)

The primary driver of the problem can either be proximal (lumbopelvic control) or distal (reduced ankle range of motion) and a thorough examination needs to be done to determine the cause. Runner’s with such a pattern often complain that they kick their shins or that their knees knock together.

Rehab for Shin Splints_Medial Collapser

CORRECTIONS

In addition to a rehab program, providing visual feedback to help the runner maintain a level pelvis is very helpful to prevent excessive contralateral pelvic drop. A verbal cue to encourage the knees to stay apart can also be helpful in reducing excessive hip adduction.

4. Excessive & Prolonged Rearfoot Eversion

During the first half of stance phase, rearfoot pronation is considered normal. However, any prolonged and excessive eversion beyond midstance makes the foot soft & flexible at push off (instead of a rigid lever).

Secondly, this alteration requires a greater effort from the intrinsic and extrinsic foot muscles to both stabilize the foot and generate sufficient torque during push-off (Becker J et al 2017).

Consequently, the continuous repetition of this process during running (without proper recovery), ultimately leads to a bony stress injury (Becker J et al 2018).

Rearfoot_Eversion

CORRECTIONS

In addition to a rehab program, studies also recommend the use of orthotics (Kannus VP,1992) or higher level of support shoes to correct subtalar overpronation.

To learn more about these biomechanical faults along with their corrections, refer to this running injuries course here

PART 4: MUSCULOSKELETAL IMPAIRMENTS LINKED WITH SHIN SPLINTS

A detailed musculoskeletal examination helps in understanding if the injury is due to a physical limitation in the body or due to any other factor mentioned above.

Mentioned below are some common tests that are useful in examining MTSS in Runners.

1. Check for bony tenderness: Palpate with firm thumb & check if it elicits periosteal tenderness at the distal 1/3 to 1/2 of the anteromedial tibial surface (Franklyn and Oakes, 2015).

2. Ankle motion: Check for all talocrural and subtalar joint motions. Limited ankle motion is a common finding in shin splints. Special emphasis should be paid to the presence of foot overpronation as it is a well-documented risk factor.

3. Muscle inflexibility: Look for tightness or muscle imbalance of the hamstring, quadriceps and triceps surae (gastrocnemius, soleus, and plantaris muscles). A simple knee to wall test can detect calf tightness, if any.

4. Muscular strength: Look for adequate hip, pelvis, and core muscle strength as it is an important link in maintaining control and proper mechanics between the ‘‘core’’ and lower extremity. 

This can be tested by the patient’s ability to maintain a controlled, level pelvis during a pelvic bridging test or a single leg standing knee bend test.

REHAB FOR SHIN SPLINTS

Conservative management is the mainstay of rehab process of shin splints.

Before initiation of the rehabilitation program, a comprehensive history should be obtained to evaluate the athlete’s weekly exercise routine and running mileage, intensity, pace, terrain, and footwear, with careful attention to recent changes in training regimens.

The conservative treatment of MTSS is divided into 2 phases (Galbraith RM et al 2009):

  • Acute, and
  • Sub-acute.

ACUTE

  • Relative rest and cessation of sport for prolonged periods of time (from 2 to 6 weeks) depending on the severity of symptoms
  • Cryotherapy directly on painful area for 10-15 min.
  • Lastly, crutches may be necessary for temporary non-weightbearing in more severe cases of MTSS and tibial stress fractures

SUB – ACUTE

  • Avoid painful exercises.
  • Stretching exercises for calf and strengthening invertors and evertors of foot.
  • Begin low impact exercises such as running in pool, gait retraining, proper technique etc.
  • Proprioceptive balance training
  • Slowly progress to sport-specific activities, jumping exercises, and hill running in a graded fashion.

EXERCISES FOR REHAB OF SHIN SPLINTS

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ABOUT THE AUTHOR

Dr Teena_Profile

DR TEENA ELSA JOSEPH

Dr. Teena is a Sports Physiotherapist who has completed her BPT from Amity University & her MPT (Sports) from Indraprastha University. Her field of clinical expertise in sports & musculoskeletal physiotherapy includes manual therapy, dry needling & myofascial release. Apart from her work at Auptimo, she is also active as clinical researcher in a various of health & sports science research work at Indian Spinal Injuries Center, Delhi. She has achieved several awards for academic excellence along with professional certifications such as Dry Needling (Basic & Advanced), AHA certified BLS provider, NAEMT certified PHTLS provider, IRCS certified Senior professional in first aid, & NIDA certified Good Clinical Practitioner.

REFERENCES:

A-M

  • Becker J, Nakajima M, Wu WFW. Factors Contributing to Medial Tibial Stress Syndrome in Runners: A Prospective Study. Med Sci Sports Exerc. 2018;50(10):2092–2100.
  • Bradshaw C, Hislop M, and Hutchinson M. Shin Pain. In Clinical Sports Medicine; 3rd 2008.
  • Brown AA. Medial Tibial Stress Syndrome: Muscles Located at the Site of Pain. Scientifica (Cairo). 2016.
  • Edwards WB, Taylor D, Rudolphi TJ, Gillette JC, Derrick TR. Effects of stride length and running mileage on a probabilistic stress fracture model. Med Sci Sports Exerc. 2009;41(12):2177–84.
  • Franklyn M, Oakes B. Aetiology and mechanisms of injury in medial tibial stress syndrome: Current and future developments. World J Orthop. 2015;6(8):577–589.
  • Franklyn M, Oakes B. Tibial Stress Injuries: Aetiology, Classification, Biomechanics and the Failure of Bone. In: Zaslav KR. An International Perspective on Topics in Sports Medicine and Sports Injury. Rijeka: InTech, 2012: 509-534.
  • Galbraith RM, Lavallee ME. Medial tibial stress syndrome: conservative treatment options. Curr Rev Musculoskelet Med. 2009;2(3):127–133.
  • Hamstra-Wright KL, Bliven KC, Bay C. Risk factors for medial tibial stress syndrome in physically active individuals such as runners and military personnel: a systematic review and meta-analysis. Br J Sports Med. 2015; 49:362-369.
  • Lohrer H, Malliaropoulos N, Korakakis V, Padhiar N. Exercise-induced leg pain in athletes: diagnostic, assessment, and management strategies. Phys Sportsmed. 2019;47(1):47–59.
  • Meardon, S.A., Derrick, T.R., Effect of step width manipulation on tibial stress during running. Journal of Biomechanics (2014), http://dx.doi.org/10.1016/j.jbiomech.2014.04.047
  • Milner CE, Ferber R, Pollard CD, et al. Biomechanical factors associated with tibial stress fracture in female runners. Med Sci Sports Exerc. 2006; 38(2):323–8. [PubMed: 16531902]
  • Moen MH, Tol JL, Weir A, Steunebrink M, De Winter TC. Medial tibial stress syndrome: a critical review. Sports Med. 2009;39(7):523–546.

N-Z

  • Newman P, Witchalls J, Waddington G, Adams R. Risk factors associated with medial tibial stress syndrome in runners: a systematic review and meta-analysis. Open Access J Sports Med. 2013;4:229–241.
  • Oakes BW. Tibial pain or shin soreness (“shin splints”)-its cause, differential diagnosis and management. In: Draper J, editor. Second Report on the National Sports Research Program. Canberra, Australia: Australian Sports Commission; 1986: 47-51.
  • Plisky MS, Rauh MJ, Heiderscheit B, Underwood FB, Tank RT. Medial tibial stress syndrome in high school cross-country runners: incidence and risk factors. J Orthop Sports Phys Ther. 2007;37(2): 40–47.
  • Pohl MB, Mullineaux DR, Milner CE, Hamill J, Davis IS. Biomechanical predictors of retrospective tibial stress fractures in runners, J Biomech. 2008;41(6):1160-5. doi: 10.1016/j.jbiomech.2008.
  • Winkelmann ZK, Anderson D, Games KE, Eberman LE. Risk Factors for Medial Tibial Stress Syndrome in Active Individuals: An Evidence-Based Review. J Athl Train. 2016;51(12):1049–1052.

COVER PHOTO CREDITS: People photo created by freepik – www.freepik.com

OPTIMISE YOUR HEALTH SPIRIT, ITS ALIVE IN YOU.

Artical By : Jyoti Kamaal (Wellness lifestylist)

As I Open my eyes and think of the day with positive and bright outlook, there is one thing I’m very happy to be incompetent of – to let my day go by without – A good fitness hour. You can choose to make it easy or hard, challenging or simple, just give it your best.  Whatever you do, fitness will pump up your spirits. For me, fitness is not only my energy tycoon, but it strikes down all the negativity, bashes the boredom, enthuses the life in me.


When I exercise, I see it opening endless options, of what you can do, when fitness is your passion, I believe in our minds, we are sure we want to be fit and maintain our lifestyle
None of us are helpless
Life is around thoughts first and action later
No isolation can restrict thoughts so action is equally possible Take support to become strong
How does that sound now!!

So, say it’s a bright day, life has many options within limitations toss them all off.

I’m a big fan of stepping my foot in a new place and decide my workout module that is permissible and certainly organic.

No need to fear if it’s a terrace, in the lockdown, you are safe as it’s in  the  house. If you are careful, you are not exposed to strange entrants. It’s sanitized and it’s not a threat from the fear of any virus.
Advice no. 1 – Be careful when you see a video with outdoor workouts, don’t blindly experiment until you are sure.  One good thing should not be a vice for the other.

Never enough is enough, I’m never bored and I have an enthusiastic feeling every time I start my fitness.
Advice no.2 – Remember a thumb rule in exercise-  Learn your body, mind and soul

I don’t think any kind of fitness is impossible, just make sure you are safe and exercising CORRECTLY

Additions, variations and new elements  in exercise, can lead you to dynamism and optimisation to a stable and motivated fitness practice.

When I find a new fitness accessory, like an elastic band, or exercise ball, I try this to test my body and create my own strengthening, conditioning and energizing fitness steps.
I’m a big one on multiple impact steps
I feel if with one step I can affect my arms, back fat and lower back, then why not try this one

The way I love to do workout is creatively use my accessories and instinct.
I love to make the impact in multiple areas.
Most importantly I don’t lose my focus on my breathing.

Advice no. 3 – So go with a flow of a body educational pattern. Learn the breathing as you start and close one step.

To take the help not to lose your strength but to be stronger.

So come and do some fitness along with me.
FITNESS is not to run away it’s to embrace.

In this virtual exercise if you can function with a personal trainer and choose your flexible time and day that is your blessing in era.

 Join and have a majestic healthy life.

Balance Diet

Article By : Dabsona Pal

What is a Balanced Diet

A balanced diet is which gives our body complete nutrition for functioning properly from inside and also from outside

Macro Calculation

Before calculating macro we have to calculate the total daily energy expenditure (TDEE) of the client

Let’s understand with an example

Suppose client’s TDEE is 2200 can and goal is to lose fat, in that case, we should go in deficit ( in starting 20% deficit is enough, long deficit also cause muscle loss, metabolism slow down, weakness, etc)

Let’s assume we will give that client 1600 calorie

PROTEIN

Then according to his lifestyle if he is already on a moderate protein-rich food diet then now recommended protein intake for him is based on his activity level

  • If he is less active then bodyweight*1.2-1.5 is ok to start we can increase with progress and time
  • If he is active then bodyweight*1.8-2.2 is optimal for max muscle hypertrophy

Now Fat and Carbs

Good fat is an essential part of diet after calculating protein-calorie rest calorie we will divide in fat and carbs in fat lose classes little fewer carbs with a complex form of carbs effect more

End of the days if we are on a deficit and protein is on point we will lose fat.

Besides protein, carbs, fat fiber is very essential nutrients which help improve digestion, reduce appetite helps us feel full for long

A healthy fiber requirement always 25-35gm/Day

End of the day besides macronutrients micronutrients requirement should be full filled

Use of Macro Nutrients

Protein –

Always best protein source is a complete protein source like whey, meat, fish, eggs, some dairy product,

Soya, tofu is a good source of protein especially for vegan we can also use combined protein like peas and different grains combination, bread and peanut butter, rich and rajma, etc

Protein digestibility is also a factor fast digest protein gives some percentage fast result like whey protein those are best to take after work out

Fat –

Healthy fat has lots of benefits like cardiovascular health, proper hormonal functioning, absorb fat-soluble vitamins, etc

In fat always we have to balance between unsaturated ratio and saturated ratio based on that

Some best sources are- Olive oil, coconut oil, ghee, butter(more saturated), avocado, different nuts, etc

Carbs –

Slow digest gives us energy slowly and fast digest carbs give us energy fast

It is good to take some fast absorb carbs in a pre-workout meal to boost the work out performance,  rest day we can take more complex carbs

Some examples are-

  • Simple-banana, liquid drinks, fruits, corn flex, etc
  • Complex-brown rice, brown bread, oats, etc

Fiber –

Always a good source of dietary fiber is green vegetables like kale, broccoli, lettuce, spinach, cabbage,e etc

If someone has a problem in vegetables they can supplement it’s also in other food contains some fiber

Water –

A healthy intake of water always need to maintain the hydration level

Online Training Fees :
Rs 1000 online training
Rs 2000/12 sessions online live training

Managing Proximal Hamstring Tendinopathy through Running Analysis

Article By : Auptimo (Systems for Gait & motion analysis)

To understand the correlation between running biomechanics and Proximal Hamstring tendinopathy, its important to consider the cause of compression on the proximal hamstring tendon against the ischial tuberosity. 

You guessed it, hip flexion.  The greater the hip flexion angle, the greater the compression of the underlying hamstring tendon against the ischial tuberosity as it curves around the inferior portion.  This is likely one of the primary reasons patients complain about sitting and deep squatting.

BIOMECHANICAL FAULTS THAT LEAD TO PROXIMAL HAMSTRING TENDINOPATHY

OVERSTRIDING

The moment of foot strike (initial contact) in a gait cycle is commonly associated with maximum hip flexion. Now, imagine a case of an amateur runner looking to increase his running performance through an increase in stride length. Such amateur runners tend to achieve this goal through excessive hip flexion & increased knee extension at foot strike. 

From a performance point of view, this might be good as it is gives that extra distance to increase the stride length. However, this puts excessive stress on the hamstring, leading to PHT.

Overstriding

CORRECTIONS: Typical overstriders hugely benefit from cadence retraining, a method that promotes shorter and faster steps instead of longer steps.

This ensures the same performance and reduces the excessive load on hamstring.

Refer to this link by Stanford Health for some drills. 

EXCESSIVE FORWARD TRUNK LEAN

Forward Trunk Lean

A small degree of forward trunk lean may place the lower spine in a more neutral position and reduced the tendency of overstriding. However, an excessive forward lean accompanied by an anterior pelvic tilt (tilting forward) can increase the provocative load on the tendon.

SOLUTIONS: Verbal or mirror-based visual feedback to reduced excessive trunk lean.

MANAGEMENT OF PROXIMAL HAMSTRING TENDINOPATHY

The underlying principle to heal a tendinopathy is to progressively load it. Loading it too much too soon can be counterproductive. On the otherhand, very little loading may lead to slow or potentially insignificant progress.

The guideline published by Tom Goom (2016) presents a systematic approach to solve this problem.

Phase I: Isometrics

Phase II: Isotonics in low hip flexion angles

Phase III: Isotonics in high hip flexion angles

Phase IV: Plyometrics and Running

For non-athletic patients, the intervention can be limited to the first 3 phases only. However, focussing on all 4 phases is essential in case of professional athletes. A running analysis is also essential to understand if a biomechanical fault like overstriding or forward trunk lean is the underlying cause of the issue. Any running gait analysis software like GaitON can be used to do a comprehensive running analysis of the runner. All you need is the software and the slow motion video feature of your mobile phone to start.

REFERENCES

  1. THE SOLUTION TO PROXIMAL HAMSTRING TENDINOPATHY, Ari Kaplan,  Available at: https://www.physiospot.com/opinion/the-solution-to-proximal-hamstring-tendinopathy/
  2. Goom TSH, Malliaras P, Reiman MP, Purdam CR. Proximal hamstring tendinopathy:  clinical aspects of assessment and mangement.  J Orthop sports Phys Ther.  2016;45(6):483-493.

Joyful Food & Fitness Mantras–For the Super Busy Indian Mom !

Article By: Harsha Nagi

Are you a Super Busy Indian Mom?
Do you love food, and the very thought of following a diet makes you run miles away from fitness websites and blogs?
Are you that Mom who is very conscious of inculcating healthy habits in your family?
Are you the busy mom who knows and believes that staying fit and functional is the key to an active lifestyle?
Are you that mom who is always going the mile to squeeze in a short workout.

If you answered YES to any of the above , then you should definitely READ ON !

This introductory post will give you a bird’s eye view to my journey and also my larger purpose with this page and the future endeavors I have visualized.

I am Harsha Nagi, Co-Founder of a creative experiential learning company called Tinkr Learning ( http://www.tinkrlearning.com), which me and my husband are very passionately engrossed in since 2015. I am also passionate fitness enthusiast, ACE Certified Personal Trainer, who strives to share her fitness journey with a lot of people around via her personal and group training sessions. I am also a Mother to two darling daughters ( aged 7 and 4) who never leave any stone unturned to add more LOVE and DRAMA to my day with their naughty yet adorable ways J.

I am truly passionate about Mindfulness, which is a balanced concoction of Joyful FOOD and FITNESS , and Yeah, thats going to be the focus of this page and of everything I write and share about J. I have undergone a huge physical and mental transformation in the last few years of my life, and have been sharing my story around personally with the people I train as part of my role as a fitness coach, and also my friends and family,
With some constant nudge from the people I love the most, starting today, I have decided to share more about this journey online, virtually with many more people with the glimmer of hope that I can help more and more people in their arduous journeys to being more mindful J
Through my page, I aspire to open up a world of possibilities for people in terms of eating more healthy, and staying active and FIT without much disruption in their daily routines, because that’s where I feel the basic struggles START AND END. We all lead hugely multitasked lives, with work, life and more forming a intricate puzzle, and it is so important to fine tune a way of life which involves joyful food and fitness , without making too many pinchy dents in that beautiful myriad of life we have woven for ourselves.

I love love love FOOD, and have a very healthy relationship with it, with a deep interest in creative cooking and baking, sharing super healthy yet tasty food to my family and friends, Over the years of experimenting, I  have curated a collection of some Awesome mantras  and recipes which make my food smart, simple, tasty and WHOLESOME. I strongly believe in being able to enjoy everything albeit in portions.

I strongly believe that Life is a collection of memories, Each Day giving us a choice to make these memories beautiful, wholesome and fit. So yeah, lets get back to my story.
38 and not counting ,for most of my life, about 32 years, I have struggled with weight and image issues. Its in the last 6 plus years that I have truly learnt the meaning of eating wholesome and the magic of fitness which can be practical yet fun :)!
And boy, what a journey it has been. Truly transformational and rewarding. I shed 27 kgs in the year 2013, using a balanced approach of clean eating and working out 5-6 days a week ( working out became fun because of the group fitness classes @www.femmefitness.in).
 I talked about this journey at length in my first blog in 2014.( http://harshanagi17.blogspot.com/2014/10/a-victory-over-self.html)

So much was the mental impact of this transformation, that I was inspired to pursue fitness coaching as a parallel profession along with my main career in leadership development learning. They say a personal transformation can trigger eons of motivation, and in my case this motivation was sky rocketing. I was super powered to share my journey with others. I had this sense of euphoria of having achieved something which I never thought was possible. Digging deeper into this sense of Euphoria, want to share a little more here, Being overweight for all my life, It was like I had closed a door in my life thinking that’s not my journey to pursue , and suddenly some magical light from one crooked opening of the door shines like a ray of hope. The Hopeful Parinda that I am, I grab it only to realize that there is so much on this path which I would have missed exploring, had I not observed that crooked opening. 
As I tread on this beautiful surprisingly revealed path ( from 2013-2020), more than 7 years have ambled along, with so many memories and learning on the way, I am even more motivated to spread this joy to a larger world out there. I have had a very enriching parallel career in fitness with Femme Fitness ( http://www.femmefitness.in) as a group fitness coach . Femme Fitness has also been my playground in fitness for the last 7 plus years :), and what an interesting one at that !

Regarding the Closed door analogy, You will relate to me if you have been overweight for some part of your life, and/ or have been struggling with eating habits, despite trying to follow many diet plans, and not succeeding at any of them. One starts to get a belief (A rather limiting one at that if I may sayJ), that we are meant to be like this. Some of the many beliefs which may get reinforced in our minds are:

  1. I am genetically programmed this way, cannot do much about this.
  2. Well, I did try that diet, it didn’t work, so I am better off eating what I really like (and yes there are some key words here which we will dig deeper into when I talk about wholesome eating ).
  3. Oh Carbs, they are the soul of my eating, cannot give up on them, and without giving up on them, I cannot get fitter, so yeah !!
  4. am a super busy working mom/working professional, I don’t have time to cook all the special meals these diets prescribe, so yes not possible for me, and hence I am just happy the way I am.
  5. I have so much to do in my highly multi-tasked life that staying active and fit is very important , but I don’t have time to workout !

What if I told you that all the above and many more are all LIMITING BELIEFS and there could be and THERE IS a way in which we could craft empowering beliefs to REPLACE these limiting beliefs which crowd our mind and sometimes reign over it so much so that we refuse to see that crooked little ray of hope peeping in from the edge of that door. You can watch me talk about empowering beliefs ( I Can beliefs) and their role in my transformation in my TED TALK link below https://www.youtube.com/watch?v=0JFw_7xMveg ( watch for 2 minutes starting 9:07 time stamp)

What If I told you that IT IS POSSIBLE to make small tweaks to our current lifestyle and when done in a sustainable way, can lead to a huge impact in the way we lead our lives. It is like the pareto 80/20 principle, or the butterfly effect which we will talk about in my coming threads.

So YEAH as I embark on this exciting journey to share with the WORLD, the deepest passions and desires which FUEL ME, I Invite and urge you to join me in this journey, which I can assure you will be exciting, filled with some twists and turns, lots of wholesome food hacks, smart yet tasty and healthy cooking tips, staying active and improving our fitness with short bursts of workouts which we can needle into our intricate myriad of a puzzle called LIFE !

Through my page I aspire to debunk all the above myths and more, and open a world full of beautiful possibilities for all of us to chart together 🙂
So Let us BEGIN, Like my Page and stay tuned for more exciting experiences coming up soon!

RIP-SPOT FAT REDUCTION

Article By:

Urvashi Agrawal

I was working out in the gym sometime back. An acquaintance complimented me on my pics posted on social media and said:

“The pictures are really nice.

You have a flat stomach even after two kids. That’s incredible. I have been struggling to flatten my tummy for a long time. What abdominal exercises do you do? My abs routine doesn’t show any result. Why don’t you share yours. It will help everyone.”

There was a pregnant pause….

I looked at her long and hard and deduced her fixation with flat abs.

I said, “You are right! I should share my abs routine with all of you.

Happily, she went back and here I am with the COVETED Abdominal routine.

Do these exercises religiously twice a week:

  1. V ups
  2. Crunches
  3. Leg drops
  4. Bicycle crunches
  5. Full sit-ups
  6. Mountain climbers
  7. Elbow Plank
  8. Side Plank
  9. Wood chop
  10. Floor Wipers

There you go…..

The cat is out of the bag. I have shared all exercises that I do.

NOW…

If you are reading all of the above with bated breath….

AND…

You feel that this is your moment of epiphany

AND…

That exhilaration is building in you

AND…

You scream…Eureka Eureka!!!!

That you finally have the “HOLY GRAIL” of flat abs…

LET ME BURST THE BUBBLE😈😈

The above exercises WILL NOT give you washboard abs.🤷‍♀️🤷‍♀️

Yep!! You read it right and I am not going to sugar coat anything today. I know that you are confused and you want an explanation.

So here it is:

I want you to gently pinch your stomach.

Go ahead….

You will feel you skin.

Right below that layer is the subcutaneous fat. Yep!! That jiggling layer is the culprit🤨🤨

Now…..

Under that fat are the muscles.

All of the above exercises will definitely strengthen and tone but what is the point if the fatty layer is masking the toned muscles. That damn, subcutaneous fat has to be removed!!!

You may mistakenly believe that you need to do hundreds of crunches in order to get strong, ripped abs. While you might build strength in your abdominal muscles, you may never see defined abs unless you lose your belly fat and breaking news is that you can’t lose fat only from your belly. That’s wishful thinking.

What???? No way?????

Aha! If you are still reading this blog then it’s time for the breaking news😉

SPOT REDUCTION IS A MYTH

YES!

Experts say it…

Research states it…

This tempting belief should have been buried long time back but it’s still alive and kicking with vigour. There is no way fat can be reduced from a particular body part through targeted exercises. You don’t get to choose where you store or lose fat in your body. Genetics, hormones, gender are some of the factors which rule the roost here. The gimmick of spot reduction is thriving due to people’s ignorance, lop sided beliefs, glib and crafty marketing strategies. Don’t fall in the booby trap😌

So, now, let me answer the million dollar question; how to get six pack or flat abs?

You need to drop the fat percentage of your body!!

How?

Via a holistic approach: Do cardio along with weight training and more importantly, follow a healthy and nutrient dense diet. ‘Coz abs are not made in the gym, they are made in the kitchen.

Does this mean abdominal workout is a waste of time? 🤷‍♀️🤷‍♀️🤷‍♀️🤷‍♀️🤷‍♀️

No!! and allow me to explain Abdominal muscle anatomy.

There are four main abdominal muscles:

  1. Rectus abdominis.
  2. Transverse abdominis.
  3. External oblique.
  4. Internal oblique.

It is important to maintain strength in all these muscles along with a strong core!!!!!

A strong core and toned abdomen muscles do more than just make you look and feel good. They stabilise your spine and reduce your potential for back pain. Your core muscles act like an internal corset, holding in your gut and providing a sturdy base of support for your spine.

A strong core may also improve your ability to move easily and perform your activities of daily living with less discomfort. They help improve your balance and stability, which becomes especially important as you age.

So, there should be a paradigm shift in you.

Instead of mindless crunches, think of cardio, resistance training and a healthy diet.

So folks, hold a moment of silence for SPOT FAT REDUCTION and start your six pack journey with a well informed and educated outlook.

Patience is paramount here.

Remember-Patience is not the ability to wait, but the ability to keep a GOOD attitude while waiting.

TRUST ME! You would be sporting washboard abs!!!!

PLANK VARIATION

Article By : Jyoti Kamaal

When I have to do my plank I believe it is not easy to do it and hold or a lot the seconds.
I have heard many people say and boast, they can be do planks for 5 to 10 minutes. As a beginner it’s challenging to hold for even 20-30, even as an expert, 5 minutes @ 60 seconds into 5 times, it is not at all easy to hold. I learnt new ways to hold and do impactful planks for longer period. Start with baby steps for 20-30 seconds initially and gradually you can do up-to 60 seconds. If you feel you want to do your plank more affectively and not just jump off the floor in 30 or 60 seconds, here I can show you some interesting videos, there is a simple variation whereby, we can move the hold to the palms and keep the remaining weight on the toes.

Why are you to trying very hard to do your planks? I’ll show you by shifting the weight and holding in a twist angle, your planks will be a cheesecake

Let’s start, Stand feet, 1 foot apart, hands up in the air, bend forward, knee straight, and walk forward with your palm, once you hold the plank, shift your body weight to left hand and raise your right side. You can take your hand up to the sky, like a straight line matching to 180 degree to the floor. Your neck is moves slightly, twisting your body to the sky. This is where your weight is on two toes and one hand on the other hand is trying to stretch your body, starting from your head up till your way up. Lovely, I can see I and you are getting a fantastic stretch. Hold for 3-5 seconds and then bring your hand back to the floor.
Do the same thing on the left side and repeat it and if you can you hold starting with a count of 3 seconds gradually increase the count to 5 seconds, do it for 3 days and then increase the same count of 5 and then 10 seconds. Add counts if multiples too, let’s Do It.
In releasing your plank, walk backward on your hands and stand your body straight to beginning position. This way, you don’t get the pressure on your hands for a longer period. What happens also is that, you can actually do your plank longer you can do your plank and you have a better impact.

Straight plank is a secret that makes your body core, shoulders and balancing strong. However, to reach that level you do not have to feel the success or the failure of the time you can hold it. With the variation, you can walk up back to standing straight and with a count hold of 3-5 seconds, bend back walking on your palm and repeat this side twist. So, without losing the continuity, you can do the plank for longer.


In the plank, as you see this new step. Im sure your palms could feel they are taking the weight in in hand all the while. Now in this variation we can shift the weight from your hands /palms/ wrist to your legs. As, you can see in the second video, the body bends down after you are set in the straight hand plank, now you bring your one leg forward fold it towards your body. It’s closer to the chest, but not inside the body frame, it’s on the side of the body. It’s parallel to your ribs. Being slightly outside of the body it gives a free movement, so it is standing on the side of your waist and your chest.

With a little bit of an extension, you can raise the same hand up to the sky and move your head to face upward. Remember here, we’ve shifted the body weight from the hands off to the knee and leg. So, your body can take it longer, why not be smarter and extends from 5 seconds maybe 10 seconds.
Now you can see the body has got the balancing, you have your weight shifting from the hands of switching with hand and leg. The body has now taken the weight division and can stand longer on this position.
Now I’m going to start a new plank position generally called the mountain climber. But I have a small variance to achieve your goal of more flat abs for you

Wellness Sessions

In this position, we are on our plank again, but we will start moving our legs alternatively in diagonal direction. The palms, hands and upper body is static on the floor. The body is just shifting the weight from one leg to another, our upper body is now going to be firm. The knee will move to stretch to come towards the opposite shoulder. There is no need to hold, we move in a frequency of alternative knees, folding to reach nearest point to the opposite shoulder. Put the right knee back and lift the left knee in the same way. We will do then a count that will generate the cardio workout and also stretch the middle and side oblique.
I believe this 5 minute multiplied in three sets is good and you will thank me for the core, shoulder, cardio and booty magic changes.
Do contact me for online fitness and wellness sessions.
We can do simple and time saving result oriented personal training.

Virtual online interactive workout

Just give 30 minutes 4 times a week and live a fitness lifestyle. Workout with me and virtual online interactive online personal class is available This venture was pioneer by me so, I can share the workouts for you to keep up, even when you are on the move, need flexible timings and want to be corrected and upgraded for your fitness lifestyle.

1. Fit in your flexible timing
2. Workout live online
3. Teach you multiple exercise
4. Do and interact with you
5. Guide and mentor you
6. Change your lifestyle in simple steps

“Who can change your lifestyle and make you fit, so you can be independent to be fit, when you travel or have off hours of work This is a unique that you have dreamt of and here it is“

HUMAN ENERGY SYSTEMS

Article By : Dr Neeraj Mahorekar, (PT)FITBIT Sports PhysioMPT (Sports & Rehab)CKTP, CMT, CDNP, CCTP

Did you know, Up to 45% of your total mass of the body is made up of skeletal muscles. Skeletal muscle is the tissue responsible for generation of the force needed to move your joints needed for exercise.Athletic performance is a combination of Genetics, Proper training, Rest, Recovery, Hydration & Optimized Nutrition.There are 3 types of exercises which is as follows:-

  • Endurance Exercises which are prolonged activity at lower intensity helps in metabolic adaptation like increase oxygen supply
  • Resistance Exercises which is short, intense burst of power output helps in increase strength, power and muscle mass.
  • Sporting Activities which include combination of strength and endurance helps mostly in sports specific.

Ask yourself which activity do you involve

Requirements for all exercises are Energy, Oxygen, Nutrients with exhaust of Metabolic waste & Heat. Also we have to know what impacts exercise capacity are

  • Muscles total cross sectional area
  • Types of muscle fiber 
  • Numbers of active motor units
  • Motor neuron firing frequency
  • Muscle length
  • Velocity of contractions of muscles

Now lets we discuss some about muscles fibers,  How these helps you to understand which energy systems is best for your muscles. There are 2 types of muscles fibers Slow twitch and Fast twitch.

  1. SLOW TWITCH is Type 1 Muscles Fibers which are fatigue Resistant,Work on Aerobic/Oxidative energy systems, well supplied by capillaries and used for prolonged low intensity activities for e.g. Marathon.
  2. FAST TWITCH is Type 2 Muscles Fibers further divide in to two Fast Twitch A(FTa) & Fast Twitch B(FTb) known to be more fatigable, utilize energy more from anaerobic/ glycolytic systems, less rely on aerobic/oxidative systems and better suited to high intensity exercises for shorter duration for e.g. weight lifting

The types of fibers is determined by GENETICS & TRAINING INDUCED VARIATION. As by research Elite Endurance Athletes consist of 70-90% of slow twitch muscle fibers and Sprint & Explosive sport athletes have more fast twitch fibers approx 70%.You may be asking yourself why we need to more about ENERGY SYSTEMS, knowing which energy system used for various activities and helps us to understand. SO WE CAN TRAIN BETTER

THERE ARE 3 TYPES OF METABOLIC SYSTEMS WHICH SUPPLY ENERGY TO THE BODY

  • ATP-CrP (adenosine triphosphate-creatine phosphate) which function in the absence of oxygen
  • Anaerobic or Glycolytic system also independent of oxygen
  • Aerobic or oxidative system which function in presence of oxygen

The type of system utilized by the body depends on the duration, intensity and time of physical activity that u are take part in.To produce movements our muscles have to contract and relax and these are served by ATP which is found in mitochondria of cells hence mitochondria is known as powerhouse of the cells. Our body relies on continuous supply of energy through ATP. ATP is made up of molecule ADENOSINE and three phosphates, the bond between the last two phosphate is vital because when it breaks, energy is released and subsequently used for muscles contraction. now ADP is left behind which is Adenosine and 2 phosphate. In order to provide energy ATP must be replenished.

Lets explore how ATP replenish through different energy systems.

The first one is ATP-CrP System – CrP is a high energy compound

Which is available in limited amount in body and it is the fastest way to replenish ATP. As the system replenish very quickly it does not rely on oxygen. since the system is quick it burn out very fast. so the body needs to go on a different energy system to continue the activity. That,s why the body is not dependent of one energy system & hence changes the energy system according to intensity and duration of activity.Creatine is made up of amino-acids which are the building blocks of  protein so it can replenish through protein rich food sources. In order for Creatine Phosphate to donate a Phosphate for replenish of ATP it must first be broken down by an enzyme called CREATINE KINASE, it takes Creatine Phosphate and breaks it down in individual Creatine and Phosphate molecules and now Phosphate joins ADP to make ATP. Again revising because of limited amount of CrP and quick system no oxygen is required.

The second one is Anaerobic or Glycolytic system, it means without oxygen.

GLYCO = GLUCOSE & LYSIS = BREAKING DOWN

that means Glycolysis is the breakdown of Glucose to donate a Phosphate to ADP to form ATP in the absence of oxygen. The Glucose is obtained from 2 main sources i.e. Glycogen from muscles stores is first broken in to Glucose and secondly Glucose from dietary intake of Carbohydrates. The body can also obtained Glucose from other sources like the liver also. This system also supply energy for shorter period of time approx 60-120 seconds & depletion started. the Byproduct of this system is Lactic acid/Lactate.

Lactate is not only the waste product of this cycle but also an intermediate nutrients of CORI CYCLE (The Lactate moved from the muscles to the liver which converted in to glucose after getting  recycled  & than again used in glycolysis). Unfortunately this pathway is energy insufficient and can not be sustained for longer period of time. when there is insufficient energy to convert the lactate to glucose, the lactate builds up and causes the muscles to fatigue which will slow or hold the activity.

The last one is Aerobic Energy System which is also known as Oxidative System.

It is activated when activity continue for prolonged time at low intensity with requirement of Oxygen.

The substrate used in this system is Carbohydrates, Lipids and very much lesser extract of Amino-acids. These substrate comes either from exogenous sources i.e. DIET or by endogenous sources i.e. BODY STORAGE. The amount of Carbs vs Lipids used depend on exercise Intensity and Duration, Preceding Diet, Substrate Availability and Training Status & Environmental Factor.

Lets recap- ATP loses the phosphate and generate energy & leaves ADP behind. when a prolonged and sustained energy is needed Aerobic system is used, its a longer and more complicated system that needs Oxygen. Glucose can be obtained from your Glycogen stores or from diet & Lipids obtained from Adipose/fat tissue or diet which broken down by the process Aerobic Glycolysis and Aerobic Lipolysis simultaneously to form the Phosphate which is used to replenish ATP from ADP.

 Glucose is our body preferred fuel which will used first and only when it depletes the body access fat/lipids. The Byproduct of this cycle is CO2  which is breath out, this is low and slow process which is used for long period of time .

Lets understand the energy systems with the help  of diagram

In the last lets summarize  ENERGY SYSTEM in various intensity and duration of exercise.

  • For High Energy and Short Duration we use ATP-CrP and Anaerobic System. Example- Weightlifting
  • For Stop Start Sports we use a combination of Anaerobic & Aerobic Energy System. Example- Basketball, Football, Swimming etc.
  • For Moderate Intensity we use mainly Aerobic Energy System and with some extent of blood glucose & circulating fatty acids. Example- jogging, dance, cycling etc
  • For Moderate to Low Intensity we predominantly use Aerobic Pathways (Glycolysis then Lipolysis). Example- Walking

NOTE- The longer you work or exercise at low intensity the more fat is used.

Immunity Boosting Measures for Self-Care during Covid 19

Article By : Dr.Rohit Bahuguna (PT) & Jyotsna Bahuguna(Dt), BFY Sports & Fitness.

GENERAL MEASURES :

  • Daily Practice of Yogasana, Pranayama ,home exercise and Meditation for at least 30 minute.
  • Spices like Turmeric (Haldi), Jeera (Cumin), Coriander (Dhaniya) and Garlic (Lasun) recommended in Cooking
  • Maintain cleanliness in and around the home for all individual and the family. Avoid unnecessary visits to crowded places.
  • Drink warm water throughout the day.
  •  Wear a disposable mask. Clean your hand properly. Avoid unnecessary  touching to eye, nose, and mouth.
  •  Stay away from patients having a cold and cough. Do not sleep especially during the day. Do not stay waking up late at night.

Ayurvedic  Tips :

  • Take Chyavanprash 10 gm (1 table spoon) in the morning. Diabetics should take sugar free Chyavanprash.
  • Drink Herbal Tea/Decoction (Khadha) made from Tulsi (Basil), Cinnamon (Dalchini), Black Pepper (Kali Mirch), Dry Ginger (Shunthi) and Raisin (Munakka) – once or twice a day.Add Natural Sugar (Jaggery) and/or fresh Lemon Juice to your taste, if needed.
  • Golden Milk – half tea spoon of Turmeric (Haldi) powder in 150 ml Hot Milk – once or twice a day.

Simple Ayurvedic Prcodures :

  • NASAL Application – Apply Sesame Oil / Cocunut oil or Ghee in both the nostrils in morning and evening.
  • Oil Pulling Therapy – Take one table spoon Sesame or Coconut Oil in mouth. Do not drink, swish in the mouth for 2 to 3 minutes and split it off followed by warm water rinse. This can be done once or twice a day.
  • Steam inhalation with fresh Mint leaves (Pudina) or Caraway Seeds (Ajwain) can be practiced once in a day. Clove (Lavang) powder mixed with Natural Sugar / Honey can be taken 2-3 times a day in case of cough or throat irritation.

Advisable diet :

  • Drink warm boiled water or take boiled water with ginger powder. Avoid eggs as well as meat.
  • Eat homemade, easily digestible, lite, and warm food. Do not consume stale foods, fermented items, items made of maida flour, curd, and dairy products, junk food, cold drinks, and fridge water.
  • Do not consume cross contamination food. Also do not eat anything stored in the fridge for too long.
  • Spices like Turmeric (Haldi), Jeera (Cumin), Coriander (Dhaniya) and Garlic (Lasun) recommended in Cooking
  • Drink hot soup with green lentil (moong), redlentils (masoor), chickpeas, and kale. Consumevegetables such as bitter gourd (karela), pointed ground (parval), raw radishes (mooli), bottle gourd (dudhi), pumpkin, drumsticks, ginger, turmeric, garlic, and mint.
  • Do not eat slow digestive or sticky vegetables. Take fruits such as papaya, pomegranate, and amla.

Notes: Above mentioned Measures is to Boost Immunity for Self-Care, it does not claim to be COVID-19 Treatment. . These measures generally treat normal dry cough and sore throat. However, it is best to consult doctors if these symptoms persist.