Everyone knows what he or she "should" do to obtain good health. But the mere knowledge of what we should be doing is never enough. If we've not been in good shape for some time, if we can't remember the last time we did any meaningful exercise on a consistent basis, and if we've added more pounds over the years than we care to admit, then the task of getting back in shape seems an impossible mission. But like the Mission Impossible team in the fabled television series and the hugely successful film adaptations, we too can turn the task of regaining high levels of fitness into "mission possible".
The primary requirement for your personal restoration project is establishing a new mindset. No one wants to do what other people think they "should" do. Having your spouse tell you that you should lose weight or having your doctor tell you that you need to do more exercise is never pleasant. These admonitions never really work and only serve to create stressful encounters and interactions. Even though the people close to you have good intentions and want the best for you, they usually don't realize the willingness to change is never sourced from outside a person. The only way you're going to take on the time and effort of implementing new lifestyle activities is if you yourself choose to do so. Making the active choice to exercise and making the active choice to eat healthy foods will create the powerful difference by which you begin to actually accomplish the action steps necessary to change the quality and characteristics of your health and well-being.1,2
Thus, your own personal choice is what's required to get you started. Importantly, making such a choice is not a one-time event. Circumstances always intervene and your choice to exercise and eat nutritious foods will need to be reinforced frequently. There may come a time when you choose to sleep late and skip your exercise session for that day. Or you may choose to eat a whole pint of ice cream in the middle of the week. It will be helpful to recall that such deviations from your main plan are always your choice, and returning quickly to your regular exercise routine and regular food program will also be your choice.
None of this needs to be dull, boring, or onerous. Remember that if you think you "have" to do your exercise and "have" to eat fresh fruits and vegetables, then you probably won't do these things for very long. But if you remind yourself that you have actively made a personal choice to engage in healthy activities, then you will recreate your opportunity for powerfully participating in the ongoing restoration of your own vibrant health and well-being.3
1Sardinha LB, et al: Criterion-referenced fitness standards for predicting physical independence into later life. Exp Gerontol 61:142-146, 2015
2Hafstad AD, et al: How exercise may amend metabolic disturbances in diabetic cardiomyopathy. Antioxid Redox Signal 2015 Mar 4. [Epub ahead of print]
3Crous-Bou M, et al: Mediterranean diet and telomere length in Nurses' Health Study: population based cohort study. Brit Med J 2014 Dec 2;349:g6674. doi: 10.1136/bmj.g6674
Simon and Garfunkel [and later, The Bangles] had it right. Winter light is hazy - it's more diffuse. The sun is lower in the sky and the sun's rays reach the Earth at an angle, losing much of their power. And of course, there's less sunlight during each 24-hour day of winter than during the rest of the year.
All these facts make it more important during winter to ensure you're getting your daily dose of sunlight. Humans depend on sun exposure to satisfy daily requirements of vitamin D.1 Vitamin D deficiency is classically associated with loss of bone mass, and is also associated with rheumatoid arthritis, cardiovascular disease, cancer, and type 1 diabetes.2
Humans need sunshine. It's not just a matter of aesthetics or a personality quirk like being a sun-worshipper. In Southern California and the rest of the Southwest there's plenty of sunshine all year round. Everywhere else in the United States, though, direct sunlight is much harder to find.
Humans also need exercise. And, as time is a precious commodity for all of us, it makes sense during winter to exercise and get your daily dose of sunlight at the same time.
Doing aerobic exercise outdoors perfectly fulfills our requirements. Walking, running, and cycling get us out into the fresh air and sunshine. If you're used to riding a stationary bike or walking or running on a treadmill at home or at the gym, winter is the time to take it outside.
Your bones will benefit greatly by increased contact with direct sunlight. And, interestingly, your entire body will benefit from your new outdoors focus. Machines such as treadmills and stationary bikes are great - they make it easy to exercise. But there's a big difference in terms of overall benefit when you're actually riding a real bike up a real hill or running on a real surface that changes configuration on almost every step.
The difference relates to proprioception3 - your body's response to physical changes in three-dimensional space. Bottom line - the more overall use you make of your body, the more you'll benefit. Exercising outdoors provides whole-body training in ways machines never can.
The need to actively seek out sunshine during winter creates a wonderful opportunity to broaden our exercise horizons. Make sure to dress appropriately and to wear UV-protecting sunglasses.
Many affordable brands of high-performance sportswear are available that wick moisture away from your skin and provide good insulation. Layering is the way to go. You can remove layers as you get warmer. Wicking-and-insulating caps and gloves are also available. It's better to be a little too warm than a little too cold.
Be sure to consult with your chiropractor about the most effective forms of exercise for you. She will be able to help you design a customized exercise program that works for you.
1Holick MF: Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr 80(6):1678S-1688S, 2004
2Mohr SB, et al:The association between ultraviolet B irradiance, vitamin D status and incidence rates of type 1 diabetes in 51 regions worldwide. Diabetologia 51(8):1391-1398, 2008
3Buccello-Stout RR, et al: Effects of sensorimotor adaptation training on functional mobility in older adults. J Gerontol B Psychol Sci Soc Sci 63(5):P295-300, 2008
It seems that at least once a month, some sort of senior fitness competition is featured on the sports page of local and national newspapers. The Senior Olympics was the forerunner of these types of events, and the designation quickly morphed into the National Senior Games. Soon localities and municipalities began hosting their own senior track, swimming, and ironman competitions. Sociologists would call this a trend.
However, just as younger national-class competitive athletes and professional sports stars are not representative of the population at large, none of these senior athletes is representative of seniors as a group. The important takeaway from the surge of senior athletic events is that anyone at any age can become physically fit and maintain high levels of health and fitness. It's not necessary to achieve an extraordinary level of competitive fitness. What is necessary is to be a person who is fit, healthy, and well.1,2
With very few exceptions, any person, regardless of her or his current status, can become physically fit. The steps to take have been well described over many decades. Broadcast, print, and online media are saturated with articles and programs dedicated to teaching people how to lose weight and start exercise programs. In reality, everyone knows what he or she needs to do. One big step is portion control. Most adults consume far too many calories per day, much more than they need to maintain daily metabolic requirements. In contrast, for most adults, a daily diet containing 1800 healthy calories per day would result in substantial weight loss. The next big step is to begin and maintain a long-term exercise program, consisting of at least 30 minutes of exercise five days a week. A healthy diet and regular exercise, maintained over time, will result in ongoing high levels of physical fitness and wellness.3
But, if everyone knows what steps to take to accomplish these goals, why isn't everyone physically fit? The answers, for specific individuals, may be complex, but the overall answer is lack of motivation. Merely knowing how to do something isn't enough. You have to want to do something. You have to have the desire to do it. There has to be something in it for you. Having your spouse, doctor, or even religious counselor tell you you need to lose weight and start exercising will never get you to stick with the program. In order for you to make meaningful change, you must provide the motivation yourself.
Importantly, this internal motivation needs to be ongoing. There may be times when you do some binge eating or stop exercising. But the secret is to find the means of re-motivating yourself and returning to your fitness programs. By doing so you will derive tremendous satisfaction and gain real, long-term health and wellness.
1Buford TW, et al: Optimizing the benefits of exercise on physical function in older adults. PM R 6(6):528-543, 2014
2Hills AP, et al: Physical Activity and Health: "What is Old is New Again". Adv Food Nutr Res 75:77-95, 2015
3Myers J, et al: Physical activity and cardiorespiratory fitness as major markers of cardiovascular risk: their independent and interwoven importance to health status. Prog Cardiovasc Dis 57(4):306-314, 2015
Let’s say you’ve been taking some time off from the gym. Maybe you reached the end of your 12-week training cycle and you’re taking a week off. It’s possible that one week turns into two or even three or four weeks. Life happens, you need to attend to some pressing matters, and going to the gym starts to take a back seat. Before you know it, two or three months have passed by. Suddenly, you’re no longer a person who goes to the gym, but a person who needs to figure out a way to get back to the gym on a regular basis. “What happened to me?” you wonder. “Where did the time go?” Now you have to actually exert effort to fit “workout time” into your schedule. You scratch your head and ponder. “I thought I had this all covered,” you think, not for the first time.
What happened to you and your well-made plans was entropy, that insidious force in the universe that turns order into disorder. The basic rule is that any organized system, left unattended, will immediately begin to break down. As a mundane example, those piles of papers on your desk keep reaccumulating as a result of entropy. The weeds in your garden? Entropy. The dust bunnies in your attic and basement? Entropy. The collapse of your plan for doing regular workouts? Entropy.
What’s worse, entropy takes a serious toll on your physical fitness.1,2 If you miss enough time from the gym, all your fitness gains begin to melt away. First, your muscles begin to lose their stores of energy. Glycogen, the complex sugar that supplies energy for muscle work, is broken down for use elsewhere. Arterioles and capillaries, small blood vessels that were needed to supply nutrients to your growing muscles, are no longer required and rapidly disappear. Muscle fibers that were continually added to support your exercise activities are cannibalized, so that their constituent parts may be used for other physiological processes. Entropy launches a process of randomization that breaks down your carefully built-up muscular structure. Your body, being very smart, metaphorically swoops in and moves all those metabolic components to other structures and systems for more efficient use.
The superficial result is loss of muscle definition. The deeper result is loss of muscle tone.3 Your cardiorespiratory system (heart and lungs), digestive system, and metabolism are all affected, as these physiologic systems are no longer required to be functioning at peak to support a regular vigorous exercise program. Entropy sets in to all these systems, as well. The overall result is a profound impact on your health and well-being.
The good news is we can help keep entropy at bay. But doing so requires attention and determination. We want to attend to our bodies as carefully and regularly as we attend to the environment of our home, office, and garden. Just as our cars, motorcycles, and bicycles require periodic maintenance, our bodies require much more frequent care, care on a daily and weekly basis. It’s fine to occasionally skip a week or two, or even a month if needed, of exercise. But we must make sure we get right back on schedule to ensure benefits to our short-term and long-term health.
1Barwais FA, et al: Physical activity, sedentary behavior and total wellness changes among sedentary adults: a 4-week randomized controlled trial. Health Qual Life Outcomes 2013 Oct 29;11:183. doi: 10.1186/1477-7525-11-183
2Loprinzi PD, Lee H: Rationale for promoting physical activity among cancer survivors: literature review and epidemiologic examination. Oncol Nurs Forum 2014 Mar 1;41(2):117-25. doi: 10.1188/14.ONF.117-125.
3Ricci-VItor AL, et al: Influence of the resistance training on heart rate variability, functional capacity and muscle strength in the chronic obstructive pulmonary disease. Eur J Phys Rehabil Med 49(6):793-801, 2013
As we get older, rotator cuff injuries become more common, a result of the natural aging process. A similar mechanism operates in the discs separating the vertebras in your lower back. These cartilaginous structures lose water over time, becoming less flexible and more brittle as the decades roll by. In the case of the shoulder, the rotator cuff tendon is pulleyed to and fro as the arm swings forward and back and up and down. As the years pass, this constant motion may cause fraying in the rotator cuff tendon and inflammation in the muscles that comprise the rotator cuff. Eventually, partial or full thickness tears may develop in one or more of these musculotendinous units, causing pain and some loss of function. Importantly, conservative care may be all that’s needed to reduce pain and restore needed motion.
The shoulder joint is beautifully designed and a marvel of engineering. Its construction makes possible a full 360-degree arc of motion in both the sagittal and frontal planes. In other words, you can swing your arm in a complete circle from front-to-back and to-the-side-and-up-and-around. In the third, horizontal, plane, 180 degrees of motion is available. The overall combination of movements in three-dimensional space makes the shoulder joint the most freely movable joint in your body. However, as with all freedoms we enjoy in this life, there is a price. The shoulder joint’s great mobility is countered by its very limited stability.
The shoulder’s lack of stability needn’t concern us in our average day-to-day tasks. Protection to the joint is built-in by way of the rotator cuff muscles, which form a strong hood that envelops the intersection of the arm bone and shoulder blade. Falling on an outstretched arm may result in a dislocated shoulder, so we need to have some care in this regard.
If you’re a young athlete and have suffered a rotator cuff tear, surgery may be an appropriate option.1 But for the vast majority of people, especially for those over age 40, most rotator cuff injuries are chronic rather than acute and can be treated with rest and rehabilitative exercise. Again, if you’re a 60-year-old skier who has torn his or her rotator cuff in a downhill accident, surgery could be indicated. For the rest of us, rehabilitative exercise is the key.2,3
Four or five primary strength training exercises are involved in shoulder or rotator cuff rehabilitation. The three basic shoulder exercises are (1) seated overhead press, which trains all the shoulder girdle muscles simultaneously; (2) standing side [lateral] raise; and (3) seated or standing bent-over raise. The lateral raise specifically trains the middle deltoid muscle and the bent-over raise specifically trains the posterior deltoid muscle. Specific rotator cuff strength training exercises include internal rotation and external rotation on a flat bench using very light dumbbells. More painful injuries with greater loss of mobility may require (1) Codman pendulum exercises and (2) finger-walking (up a wall) to the front and to the side.
The goals of rotator cuff rehabilitation, as for any mechanical injury, include decreased inflammation, decreased pain, return to more full active range of motion, return to more full muscular strength, and restoration of function.
1 Plate JF, et al: Rotator cuff injuries in professional and recreational athletes. J Surg Orthop Adv 22(2):134-142, 2013
2 Escalmilla RF, et al: Optimal management of shoulder impingement syndrome. Open Access J Sports Med 5:13-24, 2014
3 McMahon PJ, et al: What Is the Prevalence of Senior-athlete Rotator Cuff Injuries and Are They Associated With Pain and Dysfunction? Clin Orthop Relat Res 2014 Mar 12. [Epub ahead of print]
The great TV classic ER helps teach armchair physicians to become amateur diagnosticians. He's in shock! She's got kidney stones! Rule-out pheochromocytoma!
But sometimes a little knowledge can be a dangerous thing.
You've learned somewhere - on the network news, in the Science section of The New York Times, or in a CPR class at your job - that shoulder pain can mean you're having a heart attack. Now, seemingly out of the blue, your shoulder begins to ache and throb. Very concerned, you rush to the local emergency room.
The resident's first question, of course, is "where does it hurt"? You point to your right shoulder and blurt out, "Am I having a heart attack?" The resident smiles, gently reassuring. "A heart attack might give you pain in your left shoulder," she says. "Have you been to the gym lately? This might be a rotator cuff strain."
The resident knows that heart attack symptoms usually involve chest pain (in two-thirds of cases), and may include faintness, shortness of breath, sweating, and a feeling of impending doom.1 Chest pain may spread to the back, jaw, and arms. Left arm pain may radiate to the inside of the forearm and the ring and little fingers. So, shoulder pain by itself probably doesn't suggest a heart attack.
She orders an MRI which shows mild damage to the right rotator cuff. What's going on? What exactly is the rotator cuff?
The rotator cuff is a muscular sheath that surrounds the head of the arm bone (the humerus) and the entire shoulder joint (really, two joints - the acromioclavicular and glenohumeral joints). The four muscles that comprise the rotator cuff help raise the arm to the front and the side and help turn the shoulder inward and outward.
If you're a sports fan, you know that rotator cuff injuries affect baseball pitchers, tennis players, swimmers, and football players. Such injuries are due to repetitive motion, and may also result from falling on the shoulder or arm or lifting heavy weights.
Rotator cuff injuries may also be slowly developing and chronic, related to arthritic and degenerative changes in the rotator cuff tendon and the two shoulder joints. Low-grade pain may develop, and the pain may become aching, throbbing, and chronic. Raising the arm may cause pain, and there may be loss of mobility.2
In the above-40 population, lack of exercise and chronically poor posture may contribute to rotator cuff problems. Sitting at a desk all day, with the neck jutting forward and slumped shoulders, places long-term mechanical stress on the rotator cuff.
Chiropractic treatment may be very useful in helping to rehabilitate chronic rotator cuff injuries. The chiropractic physician is expert in evaluating postural problems and associated spinal conditions. By providing effective treatment, postural corrections, and rehabilitative exercise, chiropractors offer a comprehensive therapeutic program to reduce pain, improve shoulder mobility, and regain function.
1Source: Cedars-Sinai www.cedars-sinai.edu
2Baring T, et al: Management of rotator cuff disease. Best Pract Res Clin Rheumatol 21(2):279-294, 2007.
As with much in life that we take for granted, we are not usually concerned with the mechanisms of how our bodies work and how they do what they do. Such knowledge is not required for use of these magnificent machines that have been freely given to us. But just as a wise consumer will care for her or his car in terms of regular scheduled maintenance, our bodies require ongoing attention in order to maintain proper function. The shoulder joint, in particular, requires such proper care.
The shoulder has the greatest range of motion of any joint in the human body. The shoulder is capable of 360º of mobility from front to back (the sagittal plane), 360º of mobility in the frontal plane, and 180º of mobility to the right and the left (horizontal plane). Taken together, these optimal ranges are termed circumduction. But the shoulder's remarkable capabilities come at a price. The shoulder girdle is the least stable joint structure and is readily subject to sprains (of the acromioclavicular joint) and dislocation injuries (of the glenohumeral joint). Additionally, the rotator cuff, the group of muscles that protect the shoulder girdle and move the shoulder joints through three-dimensional space, is commonly injured, owing to the substantial mechanical stresses involved in such extensive motion.1
We can help prevent such injuries by engaging in regular physical exercise such as yoga and strength training. These activities place weightbearing loads on the shoulder, progressively training the muscles, tendons, and nerves that supply the shoulder joint structures to handle mechanical stresses.2,3 As a result of such training, when called upon to manage the shock of an unusual mechanical force, the shoulder will be able to respond effectively while likely preventing injury.
The choice of yoga versus strength training is not mutually exclusive. Many people will enjoy taking one yoga class per week and doing two strength training sessions per week. For persons taking yoga class, the two strength training sessions could focus on (1) the chest and back and (2) the shoulders and arms. Almost every yoga exercise involves weightbearing loads on the arms. Regarding strength training, a representative shoulder program includes seated dumbbell or barbell press (for the entire shoulder girdle), standing lateral raise (for the middle deltoids), and seated bent-over raise (for the rear deltoids). If you're doing yoga, strength training sessions for the legs may not be necessary. Of course, a complete exercise program includes specific cardiovascular exercise such as walking, swimming, bicycling, or running.
It may not be possible to prevent every shoulder injury. Engaging in a regular program of vigorous exercise, including yoga, strength training, and cardiovascular exercise, is the best means of ensuring optimal biomechanical health and wellness and the best overall method for preventing injury.
Sources
1Camargo PR, et al: Eccentric training as a new approach for rotator cuff tendinopathy: Review and perspectives. World J Orthop 5(5):634-644, 2014
2Miller RM, et al: Effects of exercise therapy for the treatment of symptomatic full-thickness supraspinatus tears on in vivo glenohumeral kinematics. J Shoulder Elbow Surg 2015 Nov 24. pii: S1058-2746(15)00485-1
3Awad A, et al: Effect of shoulder girdle strengthening on trunk alignment in patients with stroke. J Phys Ther Sci 27(7):2195-2200, 2015
Strong bones are important for all of us, not only for the aging baby boomers about whom we're hearing so much lately. And, "strong bones" are much more than a marketing ploy cooked-up by the dairy industry and pharmaceutical companies.
Bones are incredibly dynamic, constantly reshaping themselves in response to physical forces. Bones provide structure for our bodies, and they carry our weight around as we move from place to place. Long bones such as the thigh bone act as factories to produce blood cells. So, bones are an important part of our overall health and well-being.
Lots can go wrong when your bones aren't strong. If you suddenly fall onto an outstretched arm, you'll probably be OK if your bones are healthy. If not, you'll probably be in a cast for four weeks to help repair a wrist or forearm fracture.
If an older person falls, hip fractures are the main concern. A fit, healthy person can usually walk away. With weakened bones, hip fractures can result in many other problems, both immediately and long-term.
Bones lose their strength due to a calcium imbalance and/or not enough physical exercise. For most of us, these factors can be corrected. The best approach, of course, is to be proactive and ensure enough calcium in the diet and regular exercise.
How much calcium and how much exercise? Recommended daily calcium requirements1 vary, and 1000 mg per day is a good ballpark amount. Dairy products are the best natural source of calcium, and dark leafy greens such as spinach and broccoli, as well as dried beans, are also good sources. Vitamin/mineral supplements typically provide 25-50% of the daily calcium requirement.
Regarding exercise, both the American Heart Association2 and the American College of Sports Medicine recommend 30 minutes of exercise, five days a week. This takes some effort and planning, particularly if regular exercise is a new addition to one's routine. By making the effort and spending the time, we're saying "yes" to health and wellness, empowering ourselves as well as our family and friends.
Importantly, regular exercise in combination with sufficient dietary calcium is the key. Taking calcium alone will not be effective in maintaining strong bones. Unless long bones are undergoing consistent mechanical stresses, as with exercise, there's no need for them to use the calcium that's available. Exercise plus calcium makes the difference!
Core strengthening3 is a hot topic in the world of fitness - Pilates training and its offshoots. But the principles of core strengthening have been around for many decades - dancers, gymnasts, boxers, and wrestlers have been doing these things all along. Only the term "core fitness" is new.
Core fitness turns out to be critically important for all of us. By adding a handful of core exercises - 10 minutes at most - to your regular routine, you will profoundly improve the mechanics of your lower back, hips, and pelvis. And, these remarkable exercises improve the efficiency of your heart and lungs. A very big "bang" for your exercise "buck"!
Your chiropractor will be able to provide expert advice and guidance on these nutritional- and exericise-related topics.
1Daly RM, et al. Long-term effects of calcium-vitamin-D3 fortified milk on bone geometry and strength in older men. Bone 39(4):946-953, 2006.
2Haskell WL, et al. Physical Activity and Public Health. Updated Recommendations for Adults from the American College of Sports Medicine and the American Heart Association. American Heart Association, 2007.
3Akuthota V, Nadler SF. Core strengthening. Arch Phys Med Rehabil 85(3 Suppl 1):S86-92, 2004.
1. Why stretch? Stretching lengthens muscles and improves flexibility. Also, stretching the big leg muscles - the hamstrings, calves, and quads - simultaneously loosens and lengthens the muscles of your lower back. So, when you stretch, you're helping your back!
2. When to stretch? Recent exercise physiology studies show that static stretching is best done after exercise. Pre-exercise "dynamic warm-ups", such as torso twists, arm circles, and light jogging, prepare the body for work. Importantly, for those of us with back issues, it's still a good idea to do the familiar static stretches even before the dynamic warm-up!
3. Don't rush! Stretching is as important as what you're going to do after you stretch. And, if you rush, you might pull a muscle or worse. Be sure to include 10 to 15 minutes of stretching as part of your exercise time.
4. Stretch gently and slowly. You're not trying to accomplish anything while stretching. In other words, you're not trying to stretch "this much" or "this far". Nice and easy does it. Stretching is a Zen activity. There should be nor "effort".
5. Pay attention! If your mind drifts, you're headed for a pulled muscle.
6. Visualize! See (in your mind) what you're doing. Hold a mental visual image of the muscle group, where it comes from, where it goes. Visualization helps establish a brain-muscle connection, making your muscles much smarter!
7. Stretch your hamstrings first. Lie on your back with one knee bent [start with the left leg bent; you'll be stretching the right hamstring]. The left foot is on the floor and the left knee is bent approximately 90 degrees. Holding behind the right knee, gently bring that knee to your chest. Alternate this chest movement with a movement that begins to straighten the right leg in the air. The eventual goal on straightening is to achieve a 90 degree angle (or close to this) between the leg and your torso.
8. CAUTION - Progress may be quite slow. Remember - you are where you are. Stretching is gentle and slow. Alternate the bending and straightening movements gently, achieving a slightly greater straightening each time. You should work each leg for between three and five minutes.
9. Calf stretches - face a wall and place both hands lightly on the wall. Keeping both feet facing front, bend the front knee and place the foot of the leg to be stretched directly behind you. Your weight is being supported by the front leg. The back knee is pretty straight and the back heel is on or close to the floor. Maintain the stretch for 10 seconds, feeling the stretch in the calf as the back heel reaches toward the floor.
10. Quad stretches - stand on your left leg, placing a hand lightly on a wall to support the upright posture. Grasp just above the right ankle with your right hand and bring that heel close to the right buttock. The quadriceps is stretched by bringing the right thigh in line with the left thigh, just as if you were standing on both legs. The knees should also be close, in a line. You should feel a stretching sensation down the right thigh. Imagine a straight line running from your right hip socket all the way to the floor.
1Ferreira GN, et al: Gains in flexibility related to measures of muscular performance. Clin J Sport Med 17(4):276-281, 2007.
2Peeler J, Anderson JE: Effectiveness of static quadriceps stretching in individuals with patellofemoral joint pain. Clin J Sport Med 17(4):234-241, 2007.
3Behm DG, et al: Effect of acute static stretching on force, balance, reaction time, and movement time. Med Sci Sports Exercise (36(8):1397-1402, 2004.
