Welcome to Performance Care, the blog site for Advanced Chiropractic & Rehab. We'll regularly post exercise and stretching videos. Also, please feel free to post questions/comments. We'll get back to you as soon as we can. If you'd like to be added to our newsletter letting you know when new exercises are posted, visit our website listed below. *To post a comment, click on "comments" link at the bottom of the post.

Our clinic specializes in successfully treating athletic injuries, pregnancy related pain, peripheral nerve entrapments (numbness in the extremities), jaw joint problems (TMJ), and headaches. These are also great topics for questions, in additon to those on general injuries, athletic performance enhancement, and nutritional advice.

To learn more about our clinic, please visit http://www.advancedchiropractickc.com/ .

Disclaimer: one should always consult a health professional before beginning or modifying an exercise routine. The replies posted by Dr. Iodice are meant to help readers figure out a course of action and as general advice, but it is impossible to diagnose a physical problem without a proper examination.

Monday, November 28, 2011

Squats with a ball

With the cold weather, many people hit the gym to get their workout in. Squats are a great exercise for toning the legs and buttocks. However, poor squat form is one of the most common injuries we will treat in the next couple of months. We've posted a previous video on a squat form drill. Enjoy this exercise and be cognizant of your form!

Wednesday, November 16, 2011

Running Man Glute Exercise

This challenging exercise works on glute strength in multiple directions, one legged balance, and body awareness at the same time. This is a fairly advanced exercise, and must be done with proper form to achieve the desired results. When performing this exercise, there should be very little knee bend, and you should feel it primarily in the upper outer portion of your glutes (buttocks muscles). The further back you reach with your leg, the more challenging the exercise will be. It’s normal to have some burn in other muscles of the leg. However, you should feel it primarily in the glutes. Enjoy!

Wednesday, November 2, 2011

Core Importance and Exercise

Having a strong core is important, especially since most physical activity involves these muscles. Core muscles are those muscles that make up our mid-section. They include the abdominals, obliques, lower back and glutes. These muscles are responsible for maintaining equilibrium and posture, while also providing stability for all forms of activity. By keeping the core strong, the rest of our body can function at a much greater efficiency. A strong core can help improve posture, prevent lower back pain and injury, and improve physical performance and balance. Some very effective core exercises involve abdominal bracing or “sucking in the gut”, planks, and bridges. Check out the video below for a great core work out!

The side bridge is a challenging exercise that builds strength and tones while being very safe for the low back if performed correctly. Listen for how to avoid the common error of lifting the pelvis vertically during the exercise. You can do this exercise with repetitions (ie 3 sets of 10 with a 5 to 10 sec hold), or it can be performed for time. I usually recommend starting at 30 sec and working up to 60-90 sec per side. Once you can complete a hold for this time, straighten the knees and perform the same motion, except with the feet contacting the ground (top leg in front of the bottom leg). Enjoy and have fun!

This exercise is part of a progression we might assign for back pain patients. If you or someone you know has back pain, please consider our clinic.

Wednesday, October 26, 2011

Correct Posture

Greetings! While poor posture itself can be caused by many different things, slouching and poor posture can gradually lead to a number of detrimental health issues.Injuries resulting from poor posture generally build up over a long period of time rather than the more sudden, acute type of injuries.

The human spine has three distinct curves that allow it to maintain integrity in the event of a contact injury. These curves -- the cervical, thoracic and lumbar -- form a natural S shape that poor posture gradually erodes. If you slouch while standing and sitting, the lower lumbar curve gradually rounds and loses its ability to resist and recover from injury. Injuries related to poor posture include chronic low back pain, muscular aches and stiffness, tightness of the upper shoulders and necks, and poor mobility. On the other hand, good posture helps you have better mobility and less prone to injury as well.

If you find yourself being sedentary for prolonged periods, place a reminder nearby or set a timer to help remind you to correct your posture throughout the day, and take occasional breaks to stretch your neck and shoulders.

Below is an exercise that allows overworked muscles to relax while activating under-worked muscles.

1. Sit down and spreading your feet shoulder width apart and your toes out.
2. Pretend there is a string pulling your chest up and out, extending your upper back.
3. Your arms should be at your side with your head looking straight in front of you.
4. Gently tucking your chin and rotating your palms foreword.
5. Extend your wrist and push down with your palms as if there is a bench under you. (optional
6. Perform 15 sec for every 15 min spent in a continuously seated position.

You might feel a slight muscle squeeze between your shoulder blades, but not a strong contraction.
You should still be able to talk when your chin is tucked, if you are unable to talk, relax a little bit!

Monday, October 10, 2011

Hip Hinge

We have seen quite a few injuries related to yard work in the last couple of weeks. If you're leaving the house on Monday morning with a beautiful yard and an aching back, you're not alone. A survey of over 500 chiropractors in Ontario, Canada showed that yard work is the number one cause of back pain from their patietns this time of year.

Avoiding back pain during any activity lies with proper preparation. Just as an athlete needs to warm up before exercising, leaping into yard work without properly preparing increases the chance of injury. Take a few moments to stretch out and loosen your back and hip muscles. Doing so will reduce the chance of straining a muscle. Check out previous posts for hip flexor, hamstring, and piriformis stretches, as well as the "cat camel" spinal exercise for a good warm up routine. While raking or mowing, stand as straight as possible and keep your head up. Ergonomic tools are helpful as well, as they are engineered to protect you when used properly.

Be careful not to overexert yourself. Lifting a bag of yard waste that weighs too much or carrying heavy equipment are two good ways to strain your muscles and possibly cause a bulging or herniated disc. Also, if you modify the way you bend and lift, you can greatly reduce risk of injury. This movement pattern is known as a hip hinge.

1. Stand with your knees slightly bent.

2. Keep your back straight or slightly extended.

3. Place one hand on your belly and one on your low back. Rotate your pelvis forward, feeling a slight stretch in the hamstring and glute muscles.

4. You should feel your lower stomach bulge and your lower back arch.

5. Squat down by bringing your hips backwards and down. Imagine is pulling your hips backward, making sure your knees are behind your toes.

6. As you squat towards the ground, make sure you do not round your back.

The hip hinge can be used to sit in a chair or pick something up from the ground or table.

You hands can be used to karate chop the hips back as a cue for proper hip motion.

If you or anyone you know is experiencing back ache/pain/soreness, please call to schedule an appointment today.

Wednesday, September 28, 2011

Have you flossed your nerve today?

Nerve entrapments or "pinched nerves" can occur in several areas of your body. Entrapment involves pressure on the nerve where it passes through a narrow structure. Surrounding tissues such as muscles, tendons, bones, or cartilage may be responsible for the pressure. This pressure can disrupt the nerve's function, causing "sharp or burning" pain, tingling, numbness, or weakness. Common examples include sciatica and carpal tunnel syndrome.

The sites of entrapment must be determined in order to treat the entrapment successfully. Soft tissue treatments such as A.R.T. (Active Release) and Graston are very effective in releasing the nerve and allowing it to move freely by breaking up scar tissue in the affected area. Symptoms of nerve entrapments may not resolve if the source of tension is not identified and scar tissue is not broken up.

Special nerve mobilization exercises, called nerve flossing, are also very helpful in keeping the nerves moving freely without restriction. Performing certain motions/exercises will encourage normal nerve function, which results in decreased symptoms.

These exercises are designed to prevent your arm and hand symptoms.

Median Nerve Slider:

1. Start with your symptomatic wrist bent and place on your chest with your fingers pointed towards the ground.

2. Move you arm out to the side and extend your wrist, as if you were going to release a dove.

3. Watch your hand as you move it from the start position through extension and back to start.

4. Extend your wrist as far as you can.

5. Repeat 10 times, 1set every waking hour or when symptoms return.

Notes: Do not perform is shooting electrical symptoms are produced. This may cause some stretching like pain.

Radial Nerve Slider:

1. Start with your arm in front of you and bent at the elbow.

2. Straighten your elbow and move your arm behind you as if someone is going to give you a behind the back five.

3. Look at your palm.

4. Return to the start position.

5. Repeat 10 times every waking hour or when symptoms occur.

Notes: Do not perform is shooting electrical symptoms are produced. Do not over rotate the neck. This may cause some stretching like pain.

This exercise is designed to decrease foot pain.

Heel Slider:

1. Start sitting on the floor with both of your knees bent.

2. With both of your hands grab one of your feet (or a towel wrapped around the foot) and rest your forehead on your knee.

3. Start to slide your foot out, straightening your leg.

4. As you slide your foot, look up simultaneously.

5. Do not bend the leg or hip.

6. Finish by looking up at the ceiling and holding on to your foot while having the straightest leg possible.

7. Repeat 10 times each side. Repeat 3-4 times a day or as needed (can do 1x/hr).

Notes: Do not over stretch your hamstrings. Keep a hold of your foot each time.

This exercise is designed to reduce your back and leg pain (sciatica).

Slump Slider

1. Start seated with you heel off the ground.

2. Round your back and look down (i.e. slump over).

3. Simultaneously extend your symptomatic leg and straighten your back .

4. When your back is straight, move your head so that you are looking up at the ceiling.

5. Return to the starting position.

6. Repeat 10 times every waking hour or when symptoms occur.

Notes: Do not perform is shooting electrical symptoms are produced. This may cause some stretching like pain.

If you or anyone you know is experiencing symptoms of a nerve entrapment, please check out our website or contact our office for additional information.

Wednesday, September 14, 2011

TMJ and Relief Position Exercise

Hello, Everyone! The TMJ is the joint between your jawbone and skull. Problems in this area often manifest as pain or clicking of the jaw. The jaw can also get, "locked" in certain positions. Also, 1/3 of neck pain has TMJ as a root cause and will not be resolved without effective treatment of the jaw.

Addressing key muscle imbalances in the jaw and cervical spine (neck area), along with patient education, are keys to treating this condition. Treatments include myofascial release of the muscles through A.R.T (active release technique) or Graston (instrument assisted soft tissue mobilization), and rehabilitative exercises. Some cases may require being fitted by a dentist for bite guard, or other interventions.

TMJ Relief Position Exercise:

.1. Place stickers on the objects that you see and use the most. (computer, TV remote, cell phone, etc.)

2. Remember that stickers are a reminder to use relax position.

3. Close mouth, teeth slightly apart, and tongue in the roof of your mouth.

4. Perform as much as possible, every day.

· Awareness that you are clinching is very important.

Wednesday, September 7, 2011

Repetitive Motion Injury

Repetitive motion injuries are one of the most common work-related injuries. Computer work is most often to blame as the constant, small motions keep muscles tight for prolonged amounts f time. The following stretches are designed to decrease risk of these injuries.

I recommend the following stretches to be performed 10 seconds per stretch per side (40seconds total) twice per hour. Example: Perform the forearm flexors at the 15 minute and 45 minute mark of each hour.

Forearm flexors: Stand upright, sternum up slightly. Bend the elbow at 90 degrees, palm facing up. Grasp below the wrist with opposite hand. Gently bend as you extend the elbow.Keep palm facing directly away. Hold 10 seconds per side.

Forearm extensors: Stand upright, sternum up slightly. Bend the elbow at 90 degrees, let wrist hang with palm face down. Grasp below the wrist with opposite hand. Lightly bend wrist as you extend the elbow. Gently curl the fingers. Hold 10 seconds per side.

If any of these stretches or exercises cause pain in your wrist, consult your chiropractor or healthcare professional for advice. Stay active!

Thursday, September 1, 2011

Soft Tissue Release

Today’s topic is scar tissue, how it forms and ways to treat it. When muscles (or other soft tissues) are over-stressed or injured, our bodies use scar tissue as a patch repair. This is a natural part of the healing process. However, if the source of the injury in not corrected, the tissue will accumulate too much scar tissue, which then becomes a problem. Symptoms may not resolve if the scar tissue is not broken up and the source of tension discovered.

People are often surprised to learn that many of the conditions that produce pain or limit performance are related to scar tissue. We often use a work-out related analogy. You've likely worked out hard enough to get sore before. Well, you damaged your muscles during the workout. You then likely allowed enough of a rest period so that the muscles healed and got stronger. However, if incorrect form/posture was involved or you have a severe injury, your body will heal with scar tissue instead.

Active Release Technique (A.R.T.) and Graston (instrument assisted soft tissue mobilization) are two soft tissue releases offered at ACR.

Active Release is the gold standard of soft tissue care. It is not a massage but instead works out the scar tissue and helps the tissues to heal normally with long-lasting results.

Graston uses instruments rubbed over the skin to break up scar tissue and create permanent changes. It works well for "shin splints" or tendonopathies.

If you have any questions, please contact our office! We are here to help. Have a great weekend!

Wednesday, August 10, 2011

Standing Adductor Stretch

With the intense heat of the summer we are seeing many post cramping injuries. After a cramp, it is very important to stretch the muscle frequently. The hamstrings and calves are the most common and we have covered stretching for those areas in previous videos. The adductors, or groin muscles, are also commonly involved in cramps but are commonly neglected in stretching routines. Stretching this area is especially important for those in sports with a great deal of lateral movement such as football and tennis.

Notice how I show a variation where you can twist the trunk as you stretch, which is especially helpful for runners.

Thanks and until next time stay active! (safely)

Tuesday, May 10, 2011

Core and Shoulder Workout

It's always handy when we can perform an exercise that targets multiple muscle groups in a functional manner. Our exercise video this week is called a "prone walk out." I perform this exercise regularly as it's a good way to keep my shoulders healthy and my core strong. Just make sure you allow plenty of room for yourself!

Monday, May 2, 2011

Standing Crossed Extension

Today's video shows an exercise for strengthening the mid/low trap muscles. These muscles are between and below your shoulder blades and are very beneficial for good posture and shoulder health. They are difficult to target and are often neglected in upper body routines. Be sure to listen to the common errors to make sure you perform it correctly.

Enjoy and stay active!

Wednesday, April 13, 2011

Quad, Calf, and IT Band Stretch

Stretching is an important part of any athlete's life. Maintaining proper flexibility is a key factor in avoiding injury. In preparation for the OZ run this weekend, or any runs you may be doing this summer, we've posted some of the more pertinent stretches for runners/distance athletes. You'll notice that I often show different types of stretches: "hold" stretches and oscillating. Dynamic, oscillating (sometime called "ballistic") stretches are used before an athletic event (run, etc), whereas you stretch and hold (static stretch) afterwards or if you're not about to be active. NEVER static stretch before you run. A brief warm up followed by dynamic stretches is the way to go!
Please share this with your friends. If you are experiencing an athletic injury or would like to improve your performance, please check out our website for additional information.

Monday, April 4, 2011

Squat Training

Where do you "feel it" when you perform squats? If your answer doesn't include the entire thigh AND the glutes then you need some help w/ your form! Also, you should NEVER feel them in your knees. Use this drill to help. Face a wall w/ your toes touching. Crease through the front of your hips and let your pelvis travel far backwards. You should be able to at least go parallel, if not touch the ground without contacting the wall. Use this as a warm up or an exercise! Keep your weight on the heels to avoid falling back. I hope to be a "pain in your butt" w/ this posting!

Monday, March 28, 2011


As a father of 2 kids, I don't have much time for exercise. Thus, I love efficient exercises that work multiple areas at the same time. Push-ups are such an exercise. Although traditionally thought of as a chest (pec) exercise, they also work the back, shoulders, abdominals, arms, and sometimes the legs. This video is just a small sampling of a push-up progression. There are many more variations that can be performed, but these are some of the most useful. One I forgot to include is the wide stance push up, which is performed with the hands very far apart and isolates the pecs more than other variations.
To view the video go to our website via the link below and click on the 'Exercise Videos' link on the left side of the homepage.

Enjoy and stay active!
Kirk Iodice, DC, ART

Tuesday, March 8, 2011

New exercise video: lat pull-down w/ fly-out

The straight arm lat pull-down is an exercise that is a commonly employed exercise that is great for building the lats ("wing muscles"). However, the traditional standing exercise places a great deal of stress on the shoulder tendons and joints, as well as sometimes being hard on the back. This variation, done on a ball or a mobile bench, allows you to work this area in a dynamic and full range of motion while being safe on the shoulder/low back. It can actually be beneficial to improve your range of motion if you're tight here. A key part of keeping this exercise safe for the back is to engage the abdominal muscles just enough so that your ribs do not flare upwards as you reach above the head. NOTE: due to the large range of motion, you will need to use lighter weights or bands than you would for other lat exercises.

Enjoy and be active!

Kirk Iodice, DC, ART

Monday, February 28, 2011

Arnold Press

Well, it's springtime! OK, maybe not yet:( However, it's time to start thinking about warmer weather and an active spring/summer. One muscle group that both men and women often want to work on is the deltoids. This exercise is called the Arnold press and is a very effecient way to work on multiple heads of the deltoid at the same time. Enjoy and be active!

Kirk Iodice, DC, ART

Monday, January 31, 2011

Cat Camel Spine Warm-up

This exercise can better be classified as a self mobilization, meaning that you are actively loosening your tight muscles and joints. This is especially helpful this time of year due to the weather. We are very susceptible to muscle strains and tears when we're not warmed up. If you're going to be heading out to shovel snow, it's a must that you prepare your body. Otherwise, you're at higher risk of injury. If you forget to warm up, or simply don't follow my advice, you know where to find me so we can put you back together :)

Thursday, January 20, 2011

New Exercise Video Posting: Shoulder and Core

Hello all! The new year often brings renewed energy about exercise or an interest in changing up your current exercise routine. Here's a great exercise for your shoulder, mid back, core, and back.

The tripod reverse fly is a great time saver since it incorporates so many different muscles (which my fellow parents will appreciate!). Note how I begin on my knees and progress out to being on the feet and 1 arm, the latter of which is very challenging and would be considered an advanced exercise.

Click the link to our website http://www.reliefatacr.com and go to the exercise video icon on the left side of the page.

Enjoy and stay active!

Kirk Iodice, DC, ART

Friday, January 7, 2011

Row Progression

This week we've posted an exercise on a "row" progression. Rows are a great way to strengthen and tone the muscles of the mid back, the forearms, and biceps. Be sure you don't feel these on your upper shoulders (the place you'd rub someone's shoulders). Also, the staggered and figure 8 variations can add variety to your current routine and can be accomplished with the rope attachment if you're using a machine versus bands.

If there is anything we can do to help you or someone you know achieve your Resolution, please let us know! Any new patients that mention this email or our blogsite are eligible for our $50 initial exam referral credit.