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Environmental Factors Behind Thyroid Disease | Wellness Clinic

The thyroid gland is a butterfly-shaped organ located in the base of the neck. It's in charge of releasing essential thyroid hormones which control the body's metabolism, the way the body uses energy. The thyroid gland's hormones regulate vital body functions, such as breathing, heart rate, central and peripheral nervous systems, body temperature and more.

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Environmental Factors for AITD
A number of environmental factors have been associated with the development an…

Core & Posture Stabilization: A Scientific Approach Part II


Core chiropractor, Dr. Alexander Jimenez continues from part I through the core stability routines.

Menu 6: Pulley, Standing

This menu challenges pelvic stability during unilateral standing upper body movements. The kinds of arm movements undertaken in many sports create strong rotational forces that have to be controlled by the trunk and pelvic muscles. The aim of these exercises, therefore, is to develop co-ordination and control of the pelvis.

Research has shown that unilateral exercises increase the recruitment of the core musculature. The core and pelvic muscles will all be using static contractions to hold the required postures, while the upper body muscles will be producing the limb movements. The resistance load on the arm is secondary to the stability challenge of the core. Overall this menu is intermediate.

Rear Sling


Overview: The challenge of this exercise and its pair (see opposite) is to establish perfect pelvic alignment, while standing on one leg, against a rotational force from the upper body.

Level: Intermediate

Muscles targeted: Abdominal wall Adductors, Gluteus medius, (Deltoid and rotator cuff)

Technique: Stand on one leg to the side of the pulley column. Handle is attached at below-hip height. Grasp the handle with the hand on the opposite side (opposite to standing leg). Set perfect posture and pelvic alignment.

Brace the core and then pull the weight up and around the body, keeping the elbow straight, so that the arm rotates up and out. Finish with hand above your head and out to the side slightly. The aim is to maintain perfect balance and pelvic alignment as you raise and lower the arm diagonally. Reposition to repeat exercise for opposite leg/arm.

Perform 10 reps each side increasing to 20 reps; 2 to 3 sets.

Progression: Increase the weight.

Front Sling


Overview: This is the natural opposite of the rear sling exercise. It involves a forward arm rotation, which must be controlled.

Level: Intermediate

Muscles targeted: Abdominal wall Adductors, Gluteus medius, (Pectorals and rotator cuff)

Technique: Stand on one leg to the side of pulley column. Handle is attached at above shoulder height. Grasp the handle with the arm nearest the column (opposite side to standing leg). Set perfect posture and pelvic alignment.

Brace your core; pull the weight down and around the body, keeping the elbow straight so that the arm rotates down and round. Finish with hand next to your hip across your body. The aim is to maintain perfect balance and pelvic alignment as you lower and raise the arm. Reposition to repeat with opposite leg/arm.

Perform 10 reps each side, increasing to 20 reps; 2 to 3 sets.

Progression: Increase the weight.

One Leg, One Arm Rowing

Overview: The challenge of this exercise is to maintain stability while standing on one leg and controlling against a pulling force from the upper body. The pelvis must stay fixed when the upper back and shoulder are pulling backwards.

Level: Intermediate

Muscles targeted: Abdominal wall, Adductors, Gluteus medius, (Rear deltoid, rhomboids, latissimus dorsi)

Technique: Stand on one leg, facing the pulley column. Handle is attached at waist height. Grasp the handle with the opposite arm (same side as lifted leg). Your hand will be out directly in front of you in the start position. Set perfect posture and pelvic alignment, standing tall with shoulders back.
Brace your core; pull on the cable, leading with the elbow in a rowing movement Finish with hand by your side and elbow behind you. The aim is to maintain perfect balance and pelvic alignment as you perform the rowing movement. Reposition to repeat with opposite leg/arm.

Perform 10 reps each side; 2 to 3 sets.

Progression: Increase the weight.

Menu 7: Medicine Ball, Floor

The four exercises in this menu all involve throwing and catching the medicine ball while performing a trunk flexion or rotation movement. The action of throwing the ball during the muscle-shortening phase of each of the exercises increases the force production of the trunk muscles. The action of catching the ball at the start or during the muscle-lengthening phase of each exercise not only increases the force production but also the overall stability challenge.

The impact that the catch has on the upper limb has to be controlled by the trunk. You should be aiming to maintain good spine alignment and correct movement while making the catch. Only use a weight of medicine ball that will allow you to perform the exercises with good technique. If the ball is too heavy, you will sacrifice core stability, irrespective of your arm strength.

Overall these exercises are advanced. However they are also safe and effective for young athletes using light medicine balls to develop dynamic trunk movement and control.

Sit Up & Throw

Overview: An advanced version of a sit-up exercise, in which the throwing action makes the crunch phase faster and the catching action adds load to the return phase.

Level: Advanced

Muscles targeted: Abdominals (Plus upper body)

Technique: You will need a partner to receive and pass the ball. Alternatively perform the exercise in front of a wall and use a medicine ball that will bounce back.

Start in the sit-up position (knees bent) with hands up ready to receive the ball. Catch the ball and begin to lower back down. Do not collapse back down, control it with the abs and keep hands above the head as you lower down.

Once shoulders are touching the floor (keeping head up and eyes forward), reverse the movement. Throw the ball forward and crunch up at the same time. Follow the throwing action and complete the sit-up as fast as possible. Make sure you crunch as you throw so that the abs contribute to the force of the throw and help you sit up faster. Men should start with a 5kg ball; women with a 3kg ball.

Perform 10 to 20 reps; 2 to 3 sets

Progression: Progress to heavier ball once 3 sets of 20 reps is comfortable

45-degree Sit, Catch and Pass


Overview: A very tough stability exercise that requires massive trunk musculature co-contraction to hold a good spine alignment against the impact of making the catch.

Level: Advanced

Muscles targeted: Erector spinae, Abdominals, Obliques

Technique: Sit up with knees bent and lean back at 45 degrees. Aim to hold a ‘lengthened’ spine, with lumbar spine in neutral, shoulders back and neck long and relaxed. It takes a fair amount of control and strength endurance simply to hold this posture perfectly. Aim to get this right before progressing on to the catch and pass.

Raise hands in front of your face and receive a pass from a partner, around this height. As you catch the ball you must hold the long spine position. Do not flex the low back, or become round-shouldered. Gently throw the ball back. Men should start with a 3kg ball; women with a 2kg ball.

Complete a few passes, holding the position for 30 seconds. Perform 2 to 3 sets.

Progression: Raising the hands to above head height makes the stability challenge of the catch significantly harder. Catches made to either side of the head are also more challenging.

Sit & Twist Pass

Overview: A trunk rotation exercise involving catching and passing the medicine ball, which provides a challenge to the obliques to produce powerful rotation, but also pelvic stability, so that the sitting position is stable throughout the movement.

Level: Advanced

Muscles targeted: Abdominals, Obliques

Technique: Sit up with knees bent and lean back at 45 degrees. Aim to hold a ‘lengthened’ spine, with lumbar spine in neutral, shoulders back and neck long and relaxed. Your feet, knees and hips should remain reasonably still throughout this exercise, the rotation coming from your waist and not your hips.

Hold hands to one side ready to receive the ball. Catch the ball to one side and absorb the catch by turning your shoulders further to that side. Reverse the rotation, turning back to the middle and release the ball. Continue rotating to the other side; receive the ball the other side and continue. Ensure you can hold good posture throughout the movement, with a long spine and wide shoulders. Men should start with a 4 to 5kg ball; women with a 2 to 3kg ball.

Perform 10 to 20 reps.

Progression: Increase the weight of the ball once you can perform a set of 20 reps comfortably with perfect technique.

Kneeling Twist Pass


Overview: To perform the rotation movement in this position demands a greater range of motion, helping to develop strength through the full range of trunk rotation. It may also help to develop trunk rotation range of movement.

Level: Intermediate to advanced

Muscles targeted: Obliques

Technique: Kneel upright with good posture (lumbar spine in neutral, chest out, shoulders low). Start with the ball in hands and twist shoulders and head round as far as you can. Then, under control, twist around to the other side as far as possible, and hand the ball to partner. Turn back to the start position, receive the ball again and continue.

The aim of the movement is to rotate through the biggest shoulder turn you have. You can allow the hips to rotate a little with the shoulders, but not too much. You should feel a stretch in the side at the end of each twist.

As you gain greater flexibility and stability you will be able to fix your pelvis square to the front and rotate through an increasingly full range of motion. Men should start with a 5 to 6kg ball; women with a 3 to 4kg ball.

Perform 10 reps then take the ball to the opposite side and repeat.

Menu 8: Medicine Ball, Standing

The aim of this menu is to perform trunk movements while standing on one leg. This is functional training for balance in sports and daily living activities. These exercises are advanced because of the requirements for lower limb balance and body movement awareness, which makes controlled performance of these trunk movements quite difficult. These moves also use the hip rotator and abductor muscles for control and stability.

One-leg Twist Pass


Overview: A trunk rotation exercise performed on one leg. This requires good pelvic stability at the hip of the standing leg, for the trunk rotation to be dissociated from the pelvis.

Level: Advanced

Muscles targeted: Gluteus medius, Piriformis, Abdominal wall, Obliques

Technique: Stand on one leg with hips facing square to the front. Hold medicine ball slightly out in front. Slowly twist from side to side. The rotation comes from the waist only, head turning with the shoulders. Keep pelvis fixed square and knee in line with second toe throughout. Men should start with a 5 to 6 kg ball; women with a 3 to 4 kg ball.

Perform 10 slow reps; 2 to 3 sets. Repeat on other leg.

Progression: Swap the ball for a pulley machine and add resistance, once you have mastered the controlled balance on one leg.

One-leg Deadlifts with Rotation

Overview: An advanced exercise for the posterior chain of muscles, which includes rotation to challenge control of pelvis.

Level: Advanced

Muscles targeted: Erector spinae, Gluteals (max and med) Hamstrings, Piriformis

Technique: Stand on one leg. Flex the free leg a little at the knee to lift it off the floor, but do not flex or extend the hip of the free leg throughout the movement, in order to keep pelvis in control. Hold the ball in front of you.

Bend down, flexing at the knee and the hip. Lower down until the ball touches the floor by your foot, all the time keeping your arms straight and without reaching excessively with your upper back (ie, maintain a reasonably flat back). Stand back up, pushing down through the foot to use your gluteals correctly to extend the hips.

Alternate between touching the ball down on the inside and then the outside of the standing foot. This means you are internally or externally rotating the hip on alternate repetitions, challenging control of hip rotation. Keep the knee in line with second toe as much as possible throughout. Men should use a 5kg ball; women use a 3kg ball.

Start with 5 slow controlled reps, 2 to 3 sets. Build up to 10 reps. Repeat on the opposite leg.

Progression: Increase the weight of the ball or use a dumb-bell as you get stronger.

One-leg Catch & Pass

Overview: The main aim of this exercise is to control the impact of the catch without losing balance or rotating excessively at the hips. It’s all about how effectively you can anticipate the impact and produce the required stiffness throughout the body to retain good posture and control. This is a very useful ‘reaction’-type stability exercise.

Level: Advanced

Muscles targeted: Everything

Technique: Stand on one leg with good posture (lumbar spine neutral, chest out, shoulders wide) and with hips square to the front. Hold hands up ready to catch. Receive catches anywhere within arm’s reach. Make sure the passes are varied in their placement. Aim to restrict movement to arms and/or turning your shoulders, keeping the pelvis and lower limb stable. Use a 2 to 3kg ball that is not too big, so it is easy to catch.

Start with 30 sec bouts of catch and pass on each leg; 2 to 3 sets.

Progression: Receive more forceful passes so the impact of the catch is greater.

Menu 9: Resistance-Based

Menu rationale

The aim of these three exercises is to progress the loading in order to build high-level trunk muscle strength. These exercises can be performed in the 5- to 10-repetition range with a suitably high weight for this number of reps. As you get stronger, you should prioritize an increase in weight rather than an increase in the number of reps. Overall, these exercises are very advanced.

Crunch with Weight


Overview: The standard isolated abdominal exercise with increased load.

Level: Advanced

Muscles targeted: Abdominals

Technique: Perform the crunch in the usual way: knees bent, low back flat, head up and looking forward. Curl the shoulders up and down using just the abdominals. The weight (medicine ball, dumb-bell or barbell weight plate) should be held above or behind the head. Arms are fixed, all they do is hold the weight in place. Do not use arms to move the weight relative to head as the crunch is performed. Keeping the elbows out helps to achieve this.

Perform 5 to10 reps; 2 to 3 sets.

Progression: Increase weight, maintaining the range of 5 to 10 reps per set.

Reverse Hypers

Overview: An excellent hip and back extension exercise to which it is very simple to add load.

Level: Advanced

Muscles targeted: Erector spinae, Gluteals

Technique: Lie on your front on a horizontal bench, with hips just off the end of the bench. Grasp bench legs firmly for support. Your legs should be straight with a dumb-bell between the ankles for resistance. Squeezing the gluteals, extend hips and lift legs and the dumb-bell off the floor. Stop when your back is slightly hyper-extended and hips are fully extended. Lower slowly until feet are just off the floor and continue.

Perform 8 to 10 reps; 2 to 3 sets.

Progression: Increase weight, maintaining the range of 8 to 10 reps per set.

Reverse Crunch with Weight


Overview: This is a great exercise, as it requires good co- ordination and strength. Research shows that the obliques as well as the abdominals work very hard during this exercise, making it excellent value.

Level: Advanced

Muscles targeted: Abdominals, Obliques

Technique: Lie on back with hands behind head and elbows out to the sides. Knees should be bent and heels close to bum. Hold weight between your legs. Initiate the movement by curling the pelvis upwards (flattening the back into the floor) and then continue to use the abs to pull the low back and pelvis off the floor. This is the bit that requires good co- ordination, as the temptation is to kick with the legs and pull the hips up with the hip flexors. Learn to focus on the abs before you add weight, as if you do this strictly it is very tough, especially for women (whose pelvises are relatively heavier).

Perform 5 to 10 reps; 2 to 3 sets.

Progression: Increase weight, maintaining the range of 5 to 10 reps per set.

Menu 10: Hanging Bar

Menu rationale

The aim of these three exercises is to work the abdominals as hard as possible with very advanced, gymnastic-style movements. Reasonable upper body strength is required for these exercises.

Hanging Leg Lifts

Overview: This exercise requires you to lift the full weight of your legs and (if possible) your pelvis, while hanging from a bar. Anyone who can perform these movements well through a good range of motion has achieved good strength.

Level: Advanced

Muscles targeted: Abdominals, Obliques, Hip flexors

Technique: Hang from a bar with arms straight. Lift knees, bringing them up as high as possible. At the top of the movement the knees should be near the chest and pelvis should be curled upwards (low back flexed). This extra curl of the pelvis ensures that the abdominals are working maximally. Do not kick legs up or swing the body excessively. Simply draw up knees, crunching as you lift. It is important to feel that the abdominals are doing the lion’s share of the work rather than the hip flexors or front of thigh muscles.

Perform 5 to 10 reps;, 2 to 3 sets.

Progression: Perform the same exercise with straight legs, lifting them up to 90 degrees in front of you, curling the pelvis at the top of the movement.

Windscreen Wipers

Overview: The ultimate ab-buster. Anyone who can do 10 reps of this exercise with good technique has a very strong core!

Level: Super advanced

Muscles targeted: Abdominals, Obliques, Hip flexors

Technique: Hang from bar with arms straight. Lift legs up in the air until feet are at approx head height. Maintaining the height of the lift, take the legs from side to side in an arc. The movement will look like a windscreen wiper, moving from side to side. Aim for at least 45 degrees of movement to each side.

Perform 5 to10 reps; 2 to 3 sets.

Progression: The straighter the legs, the harder the exercise. Increasing the range of movement to each side also makes it tougher.

Candlesticks

Overview: Another beauty! Lots of strength required to control this movement; only for the very strong.

Level: Super advanced

Muscles targeted: Abdominals, Obliques, Hip flexors

Technique: Lie flat and raise yourself up to a shoulder stand position, holding on to a bench/table leg/partner's leg with your hands above your head. Establish a fully extended hip and leg position and then begin to lower your body down slowly to the floor. The body should move in an arc as a single unit (no sagging in the back, or bending at the hips or knees). Lower under control from vertical to just above horizontal.

Gripping firmly for stability, lift your body back up into shoulder stand, again keeping everything straight and aligned in a single unit.

Slow and controlled movement on the way down will help, and a maximal contraction of everything will get you back up.

Perform 3 to 5 reps; 2 to 3 sets.

Progression: There it is.



The information contained in this publication is believed to be correct at the time of going to press. Whilst care has been taken to ensure that the information is accurate, the publisher can accept no responsibility for the consequences of actions based on the advice contained herein.

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