May 28, 2015

3 Best Pilates Series to Manage Knee Pain

If you took a trip to see your favorite doctor this year for knee pain, you were in good company. According to the American Academy of Orthopedic Surgeons, in 2010 10.4 million people reported knee injuries to their doctor. Some knee injuries, such as fractures and ligament tears, require surgery followed by physical rehabilitation. Others, however, need to be managed on a long-term basis. But what does this mean? How do you keep your knee healthy, happy, and ready to run or walk at a moments notice?

Managing your body’s health requires three aspects: strength, stability, and mobility. The knee is dependent on the health of the joints below and above it. Movement and stability in the ankle and strength and stability in the core and hip are the most important aspects to keeping the knee healthy.

Pilates is a fantastic option for addressing these components. It provides a comprehensive approach and a qualified instructor will be able to customize the workout to your personal needs. I grabbed my friend, Dawn Casella, a certified Power Pilates instructor at Mind Body Studios at Total Fitness in Bristol, RI to demonstrate the three best Pilates series for managing knee pain.

Series 1:  Leg Circles/Frog – Reformer


This series connects core stability of the Short Box Series with increasingly challenging hip stability. The reformer provides support for the low back which allows the hips to work harder.

1.  Non-weight bearing exercises allows individuals to strengthen the hip while avoiding unnecessary strain on the knee

2.  Incorporates the bigger hip muscles to improve power and overall strength

3.  Coordinates movement between the low back, hip, and knee to improve balance

Series 2: Short Box Series – Reformer



This is series improves core stability and hip strength. The low back is unsupported so your core muscles have to do the work!

1.  The first step in healthy knees is healthy core and hips.

2.  This series does not put unnecessary strain on the knee

3.  Great for beginners, or individuals who are returning after a knee injury. Make sure you have no knee pain with any movement.

4.  Added benefit of improving ankle strength

Series 3:  Press Down – High Chair

IMG_0359IMG_0360This series challenges foot and ankle stability with hip strength and core stability.

1.  Coordinates the foot, ankle, knee, hip, and low back to create strong and stable movements

2.  Incorporates the strength built in the Short Box and Leg Circles/Frog exercises with the added challenge of balance

3.  Strengthens every muscle around the knee and hip

Your knee health can be very easily managed with just a few simple exercises. You have already committed to exercising. Why not make sure you are getting the most out of your training? Understanding what your body needs is individual and should always be discussed with your doctor, physical therapist or chiropractor. However, strength, stability, and mobility are the fundamentals of every comprehensive fitness plan. Taking control of your knee pain will leave you empowered to live the life you want.

Interested in learning more about how you can turn your everyday exercises into injury preventing exercises?  We don’t blame you!  Take the first step with our signature exercise.  This one is on us!








May 22, 2015

Foam rolling vs. Rumble Roller

Home myofascial therapy is a fast moving storm.  There are countless options on the market and in the flurry of products, the technique of each can be lost.  Foam rolling is a general myofascial therapy technique that can be very effective for tackling stubborn tightness and recovering from training.  The Rumble Roller is a great option for the more experienced of rollers.

Both products are effective; however, I have found in talking with patients that the technique is unclear.  We put together a great little video for you, guest starring Jack the Dog, to take some of the anxiety out of rolling.

May 17, 2015

The Rumble Roller – the best kept secret in home exercise equipment

Foam rolling is catching on as a great home therapeutic tool.  It can help break up nagging tightness, improve circulation, and help with recovery.  The rumble roller is a version of the foam roller that is a bit more aggressive.  It can also be more beneficial.  However, the way the rumble roller is used will determine it’s effectiveness.  If you are finding that it is ineffective or that it is very painful, chances are you may not be using it in the best way.

We put together a short video to make sure you are using the rumble roller correctly.  Good luck!

May 10, 2015

Troubleshooting The PreTrain Brace

The PreTrain Brace is one of our signature exercises of The PreTrain Fundamentals program.  It is a simple concept:  an exercise that makes sure you are activating and using your deep core muscles.  In practice, it can take a little bit to learn how to do correctly.  Our deep core muscles can be largely underutilized in daily life.  The diaphragm and pelvic floor muscles are two key components of the deep core muscles that protect our low back and pelvis.  Desk work, driving, and daily stress can leave the diaphragm muscle weak.  Childbirth and time can leave the pelvic floor muscles weak, leading to complications such as incontinence, low back pain, and overuse injuries.

The PreTrain Brace is important.  We put together a troubleshooting video for you to make sure that you can perform The PreTrain Brace correctly, and that you understand how to apply it to your daily life.

April 30, 2015

How Pilates Helped My Sister Heal

Three years ago, my sister, Vanessa, had back surgery. As the daughter of a physical therapist and nurse, and the sister of a chiropractor and a registered dietician, the thought of having back surgery at age 32 was seemingly impossible. My sisters and I were all athletes and Vanessa was by far the strongest. However, a bad waterskiing fall coupled with two years of a work schedule that required business attire (i.e., heels), weeks of travel by air, train, and car, and a workout routine that was determined by convenience and consisting mostly of running, resulted in a herniated disc with nerve pain that was unbearable.

Vanessa was fortunate in her care. She had a wonderful chiropractor in New York who led her to a good neurosurgeon. A successful surgery was followed by 6 weeks of twice-daily physical therapy with our father.  To complement her home therapy program, Vanessa searched out a local Pilates studio. She began with one-on-one sessions at three times a week with a skilled instructor. The improvement was remarkable and life changing.

A complete workout program incorporates three key areas: flexibility, stability, and strength. As individuals, our movement and function is dependent on these three aspects. We often think of each element independently of the others. We “do cardio” followed by some “core strengthening” followed by some “stretching” and call it a day at the gym. Perhaps there is a yoga class thrown in once a week for good measure. In real life, however, our bodies naturally and instinctively combine flexibility, strength, and stability: we coordinate them together to move as a whole. In order to train for “real life,” we need to train our body to seamlessly adapt to the environment around us. Ultimately, we exercise to improve our quality of life. It follows, then, that we should train to mirror our daily requirements.

A Pilates instructor’s training is thorough and detailed, and a quality instructor is key to any instructional program. The reformer equipment used in Pilates actually acts as a second trainer. The reformer allows you to understand the way your body is supposed to move, bringing an awareness to your movements that is often overlooked in traditional programs. Being able to activate your core muscles is important. Being able to train your core to work in conjunction with your hips, shoulders, legs, and arms addresses a real life need. This is the value of Pilates training.

Think for a moment about your workout routine. What aspects of flexibility, strength, and stability do you incorporate? What do you want to accomplish with all your hard work? Chances are, you are focusing on building the parts of your movements. You are lifting weights for strength, stretching to improve flexibility, and performing some core work for stability. The benefit of Pilates is in building on the work that you have already done, while teaching your body to function as a whole, rather than as a sum of parts. This is the heart of Pilates training.

This winter, Vanessa was walking to her car and slipped on the ice. As she fell, she felt her core engage to protect her. The months of Pilates training was validated in that one instant. Her body has been trained to react in a coordinated manner, combining her strength, stability, and flexibility. The fall left her bruised, but she had trained her body for real life, and she was otherwise uninjured.

To learn more about how you can minimize your risk of injury, visit

April 23, 2015

Can injuries really be fixed? 4 steps to a better understanding.

The other day, I started thinking about this concept of “fixing” ourselves. It seems sometimes that injuries and pain are something we see as a part of us that is “broken” that can therefore be “fixed.”

“Can you fix this?” A patient will ask.

“Absolutely,” I’ll say. I mean this from the bottom of my heart and with the sole purpose to help this person get out of pain. But if I’m really honest, it actually isn’t fair to say because it’s not my body to heal, and there isn’t anything to fix. I also think that this concept of “fixing” what is “broken” is, well, a little harsh.

In reality, our lives and our bodies are both about management and we all have something we are managing. Our relationship with our body is the same as any other relationship. It takes focused attention and an ability to not only listen, but to understand what our body is telling us that it needs. We often think of our body as something outside of ourselves but in reality, it IS us. This shift in perspective is powerful and is step one in learning how to love your body in a way that you love other people: with respect, understanding, and kindness.

If you want to learn how to better treat your injuries, it starts with respecting and understanding your body for what it is. It’s you.

Here’s the short list:

1.  Take a breath and refocus.  Look at your injury and really begin to understand it. You may need to seek out medical care and the important aspects in any musculoskeletal evaluation are palliative and provocative factors.

  1. What makes the pain better?
  2. What makes the pain worse?
  3. What can you do and what do you need to avoid?

By taking a deeper look you will begin to listen to your body, and by talking with a health care professional, you’ll be able to understand what the symptoms mean. Education is empowering and you’ll find that you are able to make better decisions about your body and your health

2.  Be kind to your body. This may take a few different forms.

  1. Seek help and advice when needed. Call your doctor, physical therapist, chiropractor or other trusted health care provider.
  2. Rest and heal if it is necessary. Resting is taking off the load by temporarily removing the aggravating activity from your life. Healing is a much more complex concept and includes proper nutrition, treatment (home or professional), exercises, and rest.

3.  Don’t be a jerk to your body.

  1. Don’t “push through” the injury. You’re probably not a professional athlete and the cost/benefit analysis of causing more harm by constantly re-injuring yourself will not include a multimillion-dollar contract. Don’t do it.
  2. Do something, not nothing. The opposite of pounding on an injury can be just as costly. Seek help if you don’t improve with some time off as it may be something more serious.
  3. Use medication as it is intended. A physician or pharmacist, even if it is over-the-counter, should always approve regular use of medication for an extended period of time.

Read, listen, learn, question. There is some great information out there and some really bad information out there. Your responsibility is to question it all. My goal with PreTrain is to provide an open environment where the information is conservative when necessary and a little more assertive when appropriate.   Ultimately, your body is only going to be as strong, stable, and flexible as you allow it to be.

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April 16, 2015

How to pick the right foam roller for you.

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I get a lot of questions regarding different exercise programs, home gym equipment, training methods, injury-prevention tips, treatment programs. To answer these questions and more I’m dedicating at least one blog post a month to reviews. Got something you want answered? Just let us know and we’ll get on it!

As we move along with our “Exercise with Intention” theme, our reviews will take an educational approach. There is not one way for everyone and our goal will be to help you to understanding each product and it’s purpose so you can decide which product is best for you.

So what is our inaugural product? Foam rollers!  This is a common source of confusion and I know so many people have questions. First, let’s understand the concept behind foam rolling and then we’ll look at some of the different options on the market.

Myofascial adhesions, commonly known as “scar tissue,” develop over time and are a direct contributor to overuse injuries. As muscles are used, they are constantly being damaged and healed. This is why there is such a market for “recovery supplements” which we can definitely talk about later. If muscles do not have adequate time to heal or are not provided with appropriate nutrition, formation of myofascial adhesions reach a point over time where they can weaken the muscle as a whole. This weakness can lead to injury.

Soft tissue techniques such as Active Release Technique, Graston Technique, and general myofascial release, work to break up this scar tissue and allow the muscle to heal properly. Foam rolling provides a self-guided version of these manual techniques that can target superficial parts of muscles. Foam rollers create friction and tension on a muscle and will break up superficial scar tissue while bringing vital blood and oxygen into the area. In this manner, it can help with healing as well.  The different foam rollers on the market provide varying degrees of intensity and can reach different levels of muscle. This variation in purpose also leads to variation in technique.

  1. Foam roller without texture.

Overuse injuries, foam rollerThis is a great option for beginners to get both a feel for the compression and for the technique to roll. Foam rolling takes a bit of grace! You’ll notice that this version has a smooth surface that will provide a larger surface area on which to roll. Different colors correspond to different levels of density. White has less density, followed by red, followed by black with the most. In general, the higher the density, the more intense the treatment. That being said, it is important to keep in mind the purpose of foam rolling is to break up scar tissue and also to help muscle relax. It is tough to relax if it is too painful, so shoot for a “good hurt” with foam rolling. This is not a “no pain, no gain” situation

Who it’s best for:      All levels including beginners

Where it shines:       Great for legs and shoulders

When to move on:    If you have a stubborn muscle tightness, move onto a textured foam roller.

  1. Triggerpoint foam roller.

Foam roller, trigger point roller, overuse injuries

This option is great for someone who is just beginning with foam rolling, or someone who needs a little more oomph to their roll. I have to say, I do like the educational feel that this company portrays. The orange triggerpoint foam roller was the first one I tried and the texture provides a slight therapeutic effect. The material does tend to compress a little more than it seems like it should; however, if you have some DOMS or need more mobilization through the mid back and hips this is perfect. It is more comfortable for mobilization of the mid back that we incorporate into our Module 2.1.1 than the general foam roller. The small one looks so cool but functionally, I like the big one!

Who it’s best for:      Athletes after training, mobilization of joints in mid back and hips

Where it shines:       It provides texture without overly compressing the tissues. It’s great for recovery after training and can help bring blood into the area if you are sore following activity.

When to move on:    Significant restrictions in muscles that will not respond to stretching and foam rolling without texture

  1. The Rumble Roller.

rumble roller, foam rolling, overuse injuries

I have to admit, after working through a stubborn hip issue, I became a fan. However, the challenge with the rumble roller lies in technique. The best way I have found to use the Rumble Roller is to treat it as a trigger point therapy rather than a foam rolling therapy. This means rolling at a painfully slow rate and allowing the knobs on the Rumble Roller relax into the deeper layers of the muscle. If you just roll quickly along your muscles, it will be really uncomfortable a less effective. In our Module 2.1.1, we talk about foam rolling along the quad/IT junction for IT band syndrome. The rumble roller used along this same line should take a good 2-4 minutes to roll from hip to quad one time and back. Slow and intentional is the way to make the Rumber Roller work for you.

Who it’s best for:      Individuals who need intense and deep muscle work

Where it shines:        Best for the legs and hips. It’s a bit much for the shoulder and back area.

When to move on:    Give it a good week of daily work to loosen up the muscle and other soft tissues. If you still feel a lot of restriction, along with any pain, consult a soft tissue specialist.

The key to tackling any treatment begins with a clear understanding of injuries and where they begin.  Our fantastic ebook, “Where Do Injuries Come From?” is a great starting point to making great decisions about your health.

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March 30, 2015

5 Reasons You May be Susceptible to Overuse Injury

Shoulder, knee, hip, ankle, back, neck, elbow, wrist.  You name it, it is susceptible to overuse injuries.  Overuse injuries bring volumes of patients into doctors offices every year and cause countless moments of frustration with time off of training.  How do you feel if you can’t exercise?  If you’re like me not only do you suffer physically, but your emotional health takes a hit as well.  Luckily, there is something you can do about it.

Overuse injuries occur when the work you put on your body exceeds the ability of your body to do that work.  In other words, when you do too much.  This can happen one of two ways:  with a drastic increase in training over a short period of time, or through compensations of your body over a long period of time.  For most people, overuse injuries occur slowly overtime, and they don’t even realize there is a problem until they have pain.  Let’s take a look at some signs that you may have an overuse injury brewing.

1.  Lack of stabilizing exercises in your exercise routine.  Stabilizing exercises target the smallest muscles that are closest to the skeleton.  These muscles hold the joints stable while the bigger muscles move us.  If these small stabilizing muscles are missed in your normal exercise routine, they will become underworked and weak.  Your body will compensate, requiring other muscles to work more until they become overworked to the point of injury and pain.  Targeting these small muscles takes focused and intentional work and the benefits are many.

2.  Inadequate strength training.  Like it or not, our bodies sit way more than they are meant to. Because most of our work is done in front of us every day, exercise training should work in part to counteract these forces.  In order to counteract this daily force, the focus on weight training, even body weight training, should be more on the back of us than the front of us.  A good rule of thumb that I have found is 3:1 posterior chain (glutes, hamstrings, back) exercises to anterior chain (chest, biceps, quads).

3.  Improper flexibility and mobility.  Flexibility is how well your muscles move and mobility is how well you move globally.  Mobility includes motion at the joint as well as with the muscle.  Home tools such as foam rollers can help with flexibility and joint mobilization with physical therapy or chiropractors will help target restricted joints.

4.  Imbalance between the stability, strength, and flexibility/mobility in your body.  Some people may have strength, but they do not have adequate stability and control over their strength.  Others have a great deal of stability but have limited range of motion in their muscles and joints.

5.  Lack of coordination between their strength, stability, and flexibility.  This is common in people finishing up rehabilitation programs from an injury.  The focus of rehabilitation programs is to get the affected area, say a sprained ankle, back to working order.  However, the next step needs to be re-coordinating the movements of the healed ankle to work again with the rest of your body.  If not, the compensations in your body that developed as you hobbled around on that sprained ankle will remain.

There is so much that can be done to minimize the risk of overuse injuries.  It begins with understanding HOW overuse injuries occur.  Our ebook, “Where do injuries come from?” is the best resource to increase your understanding of overuse injuries, and how to evaluate your existing exercise program for areas of improvement.

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