5 Step Hamstring Rehab Progression With Eccentric Exercises

Here are a few variations of eccentric hamstring exercises that do not require a partner from Dr. Nicole Canning, DPT, CSCS (written for Modern Manual Therapy, The Eclectic Approach):

1) Hamstring Walkouts:
🔸 This is a very basic exercise in which you maintain a bridge position while slowly walking your feet out a little bit at a time until your legs are straight. This causes to hamstrings to work throughout their range of motion.
🔸 Step your feet right back up to the starting position to take away the concentric component.
2) Sliders:
🔸 Here, you are going to have a slider under one heel. Perform a bridge, lift one leg up, then slowly straighten the working leg. Drop your hips down to the floor and start at the beginning.
🔸 You may feel a little hamstring cramping when you first start performing this exercise. That is totally normal!
3) Sliders on Floor:
🔸 In this variation, all you need is a tile or wood floor and a sock!
🔸 Lift your hips into a bridge position, lift one leg up into the air, and slowly extend the working leg. Let your hips drop to the floor and return to starting position.
4) Physio Ball:
🔸 Same idea as the sliders, bridge up, lift one leg into the air, and slowly extend the working leg. Put your other leg back on the ball to bring it back to the starting position. (2 legs in 1 leg out).
🔸 For more of a challenge, curl the ball back in with only the working leg. This will work both the concentric and eccentric phases.
5) TRX:
🔸 In this variation, both heels are in the loop of the TRX. Bridge your hips up, then slowly extend your legs out to a straight position. Drop your hips down before bringing your knees back up.
🔸To make this more challenging, stay in a bridged position during both the concentric and eccentric portions.



Looking to see full hamstring rehabilitation,

Dr. Phil Kotzan, DC

4 Mistakes People Make When Rehabilitating Hamstring Strains

When it comes to hamstring strains, two things are certain:

  1. They are very common in athletes, with research showing almost 30% of all lower extremity injuries in sports are hamstring strains.
  2. The recurrence rate is high, with research showing up to a 30% recurrence rate for hamstring injuries.

Call me crazy but I feel like the recurrence rate is just way too high, showing that we either are rushing people back too soon, don’t have an adequate return to sport criteria, or simply are not rehabilitating these hamstring strains very well.

It’s likely a combination of the three. We can do better.

In my experience, people often make 4 common mistakes with hamstring strain rehabilitation. By focusing on these 4 key areas, I think we can do a better job returning athletes to their sport following hamstring strains, and keep them out on the field without reinjuring their hamstrings.

Loading the Hamstring Too Early

The first mistake I often see is simple. People often load the hamstring tissue too early.

I think it’s obvious that contracting a strained hamstring causes pain, so this is often avoided, but for some reason people tend to want to stretch through this pain and discomfort, thinking that if they get looser it will feel better.

I don’t think this is true, and overstretching too early is just going to delay healing. In fact research has shown that too much stretching can actually delay the return to sport.

This can occur in the rehabilitation setting, but also from the athlete themselves as the constantly want to stretch or “test” the area throughout the day.

One of the easiest things you can do acutely after a hamstring strain is to avoid stretching. Don’t get me wrong. I want to start some gentle range of motion in the acute phase, but I don’t want to stretch the tissue that was essentially just damaged by an overstretch type of injury.

Trust me, take a step back in the acute phase and avoid stretching and you are putting the tissue in a position to succeed in the future phases on rehabilitation when we need to start applying more load.

 Not Performing Eccentric Exercises

It has been theorized that hamstring strains are so common due to the large eccentric contractions observed during the swing phase of running as the hip flexes and the knee extends.

This seems to make sense.

So it also makes sense that hamstring strain rehabilitation and even prevention programs that incorporate eccentric hamstring exercises tend to have better results.

After a hamstring strain, it has been shown that eccentric hamstring strength is impaired.

The common theory is that there is a change in the force-length relationship of the hamstring after an injury, resulting in peak force at a shorter length. But, eccentric training shifts this relationship and allows peak force at a longer length.

This makes is important to include eccentric exercises for the hamstring during rehabilitation. I also recommend you include eccentrics with exercises at various degrees of hip flexion, for example the Nordic hamstring exercise at 0 degrees, and a single leg RDL, which includes hip flexion.

 Not Performing Dynamic Hamstring Exercises

While it’s important to include eccentric exercises, I’m actually surprised at how little I read about people recommending dynamic exercises.

It’s one thing to perform a slow eccentric contraction, and another to perform a dynamic and explosive contraction.

I often use lower body plyometrics for this, as it allows both a rapid eccentric contraction, followed by an explosive concentric contraction. That’s what happens in sports.

Returning to Sports Too Early

Several studies have been published showing that many athletes return to sport too early, showing signs of hamstring weakness and imbalances.

Part of the problem is that there is no validated criteria to determine return to sport. But, we are getting there.

It’s probably best to understand the factors that are associated with prolonged hamstring injuries, you can read a nice review of those in AJSM.

But we also may have a new clinical test that can be performed. The Askling test involves have the person rapidly perform an active straight leg raise to assess their ability to perform and pain. It has been shown that the recurrence rate of hamstring strains that passed the Askling test was less than 4%, much lower than the normal rate.


Written and published by Mike Reinold, PT



Looking to rehab hamstrings,

Dr. Phil Kotzan, DC

FAT Fears!

Does Cooking Make Your Oil Dangerous?


“Olive oil, due to its chemical structure, is susceptible to oxidative damage when heated,” says thekitchenskinny.com. “When it comes to high heat cooking, coconut oil is your best choice,” says healthline.com Befuddled about which oil to use? Here’s how one expert clears up the confusion.

“Coconut oil is the best oil you can use for cooking because it can resist heat-induced damage, so you can avoid ingesting oxidized fats,” says mercola.com.

Oxidative stress—that is, an excess of free radicals caused by oxidation—may damage DNA and raise the risk of cancer, heart disease, and other illnesses.

But your oil is unlikely to become oxidized in the frying pan or work.

“For the amount of time you’re going to cook, and the temperatures you’re going to get to, your oil is not going to undergo oxidation,” explains Eric Decker, an oil expert and chair of the department of food sciences at the University of Massachusetts Amherst.

What’s more, adds Decker, “every oil naturally contains vitamin E, which is an antioxidant.”

Extra-virgin olive oil has another plus. “It isn’t refined, so it has a lot of naturally occurring antioxidants.”

Decker’s take-home message: don’t worry about oxidizing oils on your stovetop. “If you’re just pan-frying, no oxidation probably occurs. Even with deep-fat frying at home, oxidation is minimal.”

So fear of frying is no reason to stop using monounsaturated oils (olive, peanut, canola) or polyunsaturated oils (soy, corn, sunflower), which lower LDL (“bad”) cholesterol, and switch to coconut oil, which raises LDL.


Smoke Point

Some oils do hold up better at high temperatures, though.  Any oil starts to degrade once it reaches its smoke point, which varies from oil to oil.

“If you put oil in the pan and heat it too much or let it go too long, the oil starts smoking,” Decker says.

And then you could be in trouble. “The smoke point is followed by the flash point,” notes Decker. “That’s when your oil catches on fire.”

If you accidentally let your oil smoke, get rid of it and start over.

Refining an oil raises its smoke point by removing impurities, which is why refined oils—like most canola, soy, and peanut, as well as “light” or “pure” olive oil—work well for high-temperature cooking.



Do oils ever become oxidized? Yes, but it’s easy to tell when that happens.

“When oxidation occurs, the fatty acids break into small molecules, which have a smell,” says Decker. “That’s what we call rancidity.”

But a high temperature isn’t the biggest cause of oxidation, says Decker.

It’s time.

“I just cringe when I see people buying five-gallon containers of soybean oil, because there’s no way—unless they’re deep frying every day—they’re going to use it up before it goes rancid.”

While oils can become oxidized, “the more unsaturated the fat is, the more susceptible it is,” adds Decker.

What to do?

“Buy smaller bottles and store them in the refrigerator,” says Decker. “That’s what I do at home. And if your oil smells bad, don’t’ use it.”

There’s no need to keep olive oil cold, though. “It will harden in the refrigerator,” says Decker. “Plus, it’s more stable than polyunsaturated fats. So you can keep it at room temperature.”

The bottom line: For home cooking, almost any oil should be fine. Coconut oil? For your heart’s sake, leave it on the shelf.

Written by Caitlin Dow for the Center for Science in the Public Interest


Looking to bring light to oils and cooking,

Dr. Phil Kotzan, DC

Got Jet-Lag?

Summer is almost here and some of you will have travel plans. You can’t get rid of jet-lag altogether.  It typically takes one day per time zone travelled for your internal clock to adjust.  But these tips may help ease the transition.


During the flight, drink lots of water and avoid alcohol and caffeine.  Try to eat in-flight meals in line with your destination time.

Upon arrival, take a 30 minute nap if you feel tired.  Eat meals in line with local time.

–For EASTWARD travel:

Each night for three nights before your flight, go to bed an hour earlier than normal.

At your destination, try to get early morning light.  Take melatonin (0.5 to 5mg) 30 minutes before local bedtime until you have adjusted.

–For WESTWARD travel:

Each night for three nights before your flight, go to bed an hour later than normal.

At your destination, try to get late afternoon light.  Take melatonin (0.5 to 5mg) 30 minutes before local bedtime until you have adjusted


Written by: Michael V Vitiello professor of psychiatry and behavioral sciences at University of Washington for the Center for Science in the Public Interest


Looking to end jet-lag,

Dr. Phil Kotzan, DC

Strength Exercises As Vital As Aerobic New Research Finds

Written by the University of Sydney:

Push ups and sit ups could add years to your life according to a new study of over 80,000 adults led by the University of Sydney.

The largest study to compare the mortality outcomes of different types of exercise found people who did strength-based exercise had a 23 percent reduction in risk of premature death by any means, and a 31 percent reduction in cancer-related death.

Lead author Associate Professor Emmanuel Stamatakis from the School of Public Health and the Charles Perkins Centre said while strength training has been given some attention for functional benefits as we age, little research has looked at its impact on mortality.

“The study shows exercise that promotes muscular strength may be just as important for health as aerobic activities like jogging or cycling,” said Associate Professor Stamatakis.

“And assuming our findings reflect cause and effect relationships, it may be even more vital when it comes to reducing risk of death from cancer.”

The World Health Organization’s Physical Activity Guidelines for adults recommend 150 minutes of aerobic activity, plus two days of muscle strengthening activities each week.

Associate Professor Stamatakis said governments and public health authorities have neglected to promote strength-based guidelines in the community, and as such misrepresented how active we are as a nation.

He cites the example of The Australian National Nutrition and Physical Activity Survey which, based on aerobic activity alone, reports inactivity at 53 percent. However, when the World Health Organization’s (WHO) strength-based guidelines are also taken into account, 85 percent of Australians fail to meet recommendations.

“Unfortunately, less than 19 percent of Australian adults do the recommended amount of strength-based exercise,” said Associate Professor Stamatakis.

“Our message to date has just been to get moving but this study prompts a rethink about, when appropriate, expanding the kinds of exercise we are encouraging for long-term health and wellbeing.”

The analysis also showed exercises performed using one’s own body weight without specific equipment were just as effective as gym-based training.

“When people think of strength training they instantly think of doing weights in a gym, but that doesn’t have to be the case.

“Many people are intimidated by gyms, the costs or the culture they promote, so it’s great to know that anyone can do classic exercises like triceps dips, sit-ups, push-ups or lunges in their own home or local park and potentially reap the same health benefits.”

The research, published in the American Journal of Epidemiologytoday, is based on a pooled population sample of over 80,306 adults with data drawn from the Health Survey for England and Scottish Health Survey, linked with the NHS Central Mortality Register.

The study was observational, however adjustments were made to reduce the influence of other factors such as age, sex, health status, lifestyle behaviours and education level. All participants with established cardiovascular disease or cancer at baseline and those who passed away in the first two years of follow up were excluded from the study to reduce the possibility of skewing results due to those with pre-existing conditions participating in less exercise.

Summary of key findings:

  • participation in any strength-promoting exercise was associated with a 23 percent reduction in all-cause mortality and a 31 percent reduction in cancer mortality
  • own bodyweight exercises that can be performed in any setting without equipment yielded comparable results to gym-based activities
  • adherence to WHO’s strength-promoting exercise guideline alone was associated with reduced risk of cancer-related death, but adherence to the WHO’s aerobic physical activity guideline alone was not
  • adherence to WHO’s strength-promoting exercise and aerobic guidelines combined was associated with a greater risk reduction in mortality than aerobic physical activity alone
  • there was no evidence of an association between strength-promoting exercise and cardiovascular disease mortality.

Encouraging strengthening protocols,

Dr. Phil Kotzan, DC

Why That Diet Didn’t Work

Written by fitness coach Nia Shanks for her own website:

During your workout you saw a fellow gym-goer for the first time in several weeks. You hear her telling another member about her recent weight loss. “I swear, the ketogenic diet is the best thing ever. I dropped 10 pounds in four weeks,” she raved.

The next day in the break room, one of your co-workers is incessantly chatting about the meal plan she’s been following for a few weeks, because she’s already lost five pounds.

Intrigued and curious, you try these diets too. But, when you try them, they just don’t seem to produce the same holy crap I’ve found “the one” experiences as the women who sing their praises.

WTF, right? Why didn’t that diet work for you when other women seemed to achieve fast results?

Before we answer that question, here’s an important fact: there is no “perfect” or “magical” diet. Never has been, and never will be. Any diet can produce weight loss as long as you’re in a caloric deficit. Yes, this applies to Paleo, ketogenic, low-fat, vegan, and other diet you can think of. Some people may “go Paleo” and rave about how much fat they’ve lost, but it’s not the “Paleo” part that produced the weight loss. It’s because they were in a caloric deficit, which is most likely due to the fact that the Paleo diet eliminates grains and dairy, so that cuts out a lot of palatable foods that are easy to overeat (e.g., desserts like ice cream, cakes and cookies).

To use one more common example, it’s why some people lose weight quickly when they do a “sugar detox.” Not because they stopped eating sugar, but because they stopped eating calorie-dense, hyper-palatable foods that were also high in fat: desserts, snack cakes, doughnuts, and other heavily processed foods. By not eating those foods, they decreased the number of calories they consumed. The caloric deficit led to weight loss.

It’s not magic. It’s math.

This also explains why someone can “go Paleo” (or any other diet) and not lose weight, because they were not in a caloric deficit. While they eliminated certain foods and food groups, they ate more of other things. (It’s easy to eat more than you realize with high-fat foods like nut butters and coconut oil, and it’s one reason why people who eat healthy can’t seem to lose weight.)

The “I tried this diet and lost weight so that’s indisputable proof that it’s the ultimate style of eating” rhetoric is what causes people to define themselves by a way of eating, and to develop a religion-like relationship with food. No longer is the way they eat something that simplifies and enhances their life — it consumes their personality. They’ve seen the “supreme style of eating” light and are anxious to share the good news with everyone who crosses their path about healthy carbs and acceptable fats and sinful processed evils that will lead to their ultimate demise.

You too can be saved if you bow to the one true nutrition god and forsake all others. Resist, and ye shall burn in a fiery, gluten filled hell and choke on the smoke from smoldering carby-goodness. In the name of clean eating, amen.

This is Why That Diet Didn’t Work

The four Ps explain why that diet didn’t work. One diet or style of eating will not work for everyone because we all have a different past, and we have different personalities, perceptions, and preferences.

We all have different pasts. What you’ve experienced influences you. It’s why someone who grew up in a home where things were constantly changing (divorce, having to move frequently) may be an adult with control issues. Because she didn’t have any control over much of what happened in her childhood, she wants to control everything now.

Similarly, your past experiences with food will affect how you view food now. Using myself as an example, my years of battling obsessive and binge eating habits is why I can’t follow meal plans or count calories without dire consequences. If I had to track and eat 1800 calories a day, within one week I’d likely dive head first back into binge eating and other restrictive eating habits. My past experiences with rigid diets make counting calories an option that is not viable for me.

Someone who has never obsessed over food and doesn’t know what it’s like to have food dominate their lives may have a very different experience. In fact, tracking calories may help them reach their goals without any negative consequences. Whereas it would stress me out and lead to binge eating, it could simplify the process and help them easily stay on track. Past experiences matter when it comes to present actions.

We all have different personalities. Some people can effortlessly make healthy food choices, even when they’re ravenous and short on time. Someone else may opt for whatever sounds best and is most convenient, which is usually something heavily processed and calorie-dense. Someone can live in a home filled with cookies, ice cream, and other tasty goodies without constantly being tempted to eat them. Someone else may be more likely to eat all those things because they’re around.

Someone may prefer to organize and prepare meals for the entire week to make it easy to stay on track. Someone else may loathe the idea of eating out of tupperware containers.

When it comes to why we eat what we eat, our personalities play a crucial role. You need to understand your personality, and then work with it, not against it.

We all have different perceptions. Some people respond emotionally to less than ideal food choices. Whereas one woman may be plagued with guilt from eating a sleeve of cookies and will vow to punish herself with an extra workout, another woman may simply be able to shrug it off and move forward with healthy food choices.

One woman may see the number on the bathroom scale as objective data, but for another woman it may have the ability to make or break her entire day, and self-esteem.

Two people can perceive the same event entirely differently.

We all have different preferences. What if you like carbs? Nay. You don’t merely like them — they’re some of the very foods that make life worth living. Like a freshly baked loaf of Challah bread, or homemade mashed potatoes. If you’re like me and love carb-rich foods, then attempting a ketogenic diet for weight loss would be an excruciating endeavor.

Maybe you like beets and enjoy adding them to a salad; maybe I’d rather gnaw on the sole of my tennis shoe then pop one of those dirt-tasting red balls of misery in my mouth.

The point is, not everyone likes the same foods; not everyone feels best eating the same foods or combination of macronutrients (some people prefer to eat a higher-carb diet, others a lower-carb). Not everyone likes to eat three meals per day — some prefer two big meals, some prefer five small meals.

And this is why that diet didn’t work for you.

It likely didn’t meld with your personality or perception, or it agitated an old wound from past experiences. Or, perhaps, it simply didn’t suit your preferences.

Or, and this is a distinct possibility — it was a crazy ass diet with rigid rules that was impractical and unsustainable and reeked of bullshit claims about its superiority to all other styles of eating, or it was based on sensationalized or fear-based marketing.

How to Create a Diet That Works for You

I use the word “diet” because it’s a term people are familiar with, but it simply means a style of eating.

Rather than a traditional diet or meal plan or some other restrictive eating regimen, embrace flexible guidelines. Specifically, guidelines that can be tailored to your past, personality, perception, and most definitely, your preferences.

Regardless of what slant your eating habits have — the number of meals you prefer to eat each day, foods you love and dislike — here’s what science has proven to work for losing weight (or maintaining a healthy weight) and building muscle.

Eat a variety of mostly real, minimally processed foods. This is a good way to get plenty of satisfying, nutrient-dense foods that can not only help you build a better looking body, but a healthier body, too. And let’s face it — that’s something most people put at the bottom of the priority list. This means choosing a baked potato over french fries from the drive-thru. Or a grilled chicken boob over fried nuggets.

And, no, there are no “off limit” foods or food groups. (The obvious exception: you have an allergy or medical condition and have been instructed to avoid certain foods from your doctor.) There is no single food group or macronutrient solely responsible for weight gain or fat loss.

Include a good source of protein in all meals. I’m assuming you strength train since you’re on this website (or you plan to start strength training). If you’re not, you should be — there are too many amazing benefits from this doesn’t-demand-much-time activity.

Not only does eating a good source of protein with all meals help you feel satisfied, but it also spares muscle loss when you’re eating in a caloric deficit.

Work in all other foods occasionally, and in moderate amounts. “All other foods” are things that don’t fall into the “real, minimally processed” category, or things simply considered “not super healthy foods.” Foods like pizza, fried chicken, ice cream, or whatever the heck you love that’s calorie-dense and not the healthiest option but tastes dang good.

One eating method will not work for everyone, and this is why your friend or co-worker may achieve great results from a diet, but you don’t. The solution is clear: you must be your own guru. You must find what will work for you.

Consider your past experiences, and your personality, perceptions, and preferences. Then create sustainable habits that form a lifestyle.

Does Wearing Compression Garments Overnight Speed Up Recovery

Here is an article written by Andy Peloquin of the website Breaking Muscle:

Compression garments are worn for the purpose of improving circulation. They are often used post-surgery, but athletes wear them to speed up post-workout recovery (better blood flow = faster nutrient delivery to the muscles = faster muscle repair).

Most compression garments are used during and in the hours immediately following the workout. However, one study examined what happened when wearing a compression garment overnight — specifically, whether or not a compression garment could speed up muscle fatigue recovery after high-intensity exercise.

Seventeen male college students were gathered for the study and were divided into two groups: those who wore compression garments and those who didn’t. Before going to sleep, the students performed ten sets of ten reps of eccentric and concentric knee extensors. For up to 24 hours after this workout, the maximum voluntary isometric contraction (MVIC) force in their knee extensor muscles was monitored.

When the scientists examined the data, they found that the group that wore compression garments recovered more quickly than those who didn’t. MVIC at the 24-hour mark after the workout was 10% higher in the compression garment group, indicating that localized muscle recovery was improved as a result of wearing the compression garments overnight.

On the flip side, the electromyographical (EMG) variables didn’t change significantly, regardless of whether the students were wearing the compression garments or not. The compression garment had no significant influence on the neurological factors involved in post-workout recovery.

It can enhance localized recovery in the area specific to the muscle beneath the garment.

If you’re looking for ways to speed up your recovery from an intense workout, wearing a compression garment overnight may be a good option. It can enhance localized recovery in the area specific to the muscle beneath the garment. However, it’s not a solution for speeding up whole-body recovery — only in the specific area where you wear the garment.


1. Shimokochi, et al. “Effects of wearing a compression garment during night sleep on recovery from high-intensity eccentric-concentric quadriceps muscle fatigue.” Journal of Strength & Conditioning Research: Post Acceptance: July 03, 2017 | doi: 10.1519/JSC.0000000000002116


Interested in Compression Garments,

Dr. Phil Kotzan, DC

5 Exercises You Should Perform If You Sit All Day

Rehab Specialist Mike Reinold, provides the following article to make sitting not so bad for the body:


Do you sit all day? Don’t worry you are not alone.

Sitting throughout the day, and a more sedentary lifestyle in general, has dramatically increased over the last several decades as desk jobs have become more popular and our devices have taken over as our form of entertainment.

The media loves to tell you that “sitting is the new smoking.” This is backwards in my mind, and something I’ve discussed in detail in a past article sitting isn’t bad for you, not moving is.

In the article, I listed 3 things you should do if you sit all day to stay healthy:

  1. Move, Often
  2. Reverse your posture
  3. Exercise

For those looking for some specific exercise, here are 5 great exercises to perform to combat sitting all day.


5 Exercises You Should Perform if You Sit All Day

I’ve been talking about the concept of Reverse Posturing for years. The concept is essentially that we need to reverse the posture that we do the most throughout the day to keep our body balanced and prevent overuse.

Sitting involves a predominantly flexed posture, so doing exercises that promote the posterior chain would be helpful. These will depend on each person, but if I had to pick a basic set of exercises these would be the 5 exercises to combat sitting all day.

Thoracic Extension

The first exercise is for mobility of your thoracic spine. This is the portion of your back that becomes the most flexed while sitting all day. This is probably the biggest bang for you buck exercises in my mind:

Thoracic Extension Stretch

True Hip Flexor Stretch

The second exercises is another mobility drill, this time for the pelvis. We always perform mobility drills first to maximize range of motion. This exercise is called the true hip flexor stretch, something I termed several years ago after seeing so many people do this stretch poorly.

This exercise will help prevent your hips from getting too tight, as well as put your entire spine in a better position.

True Hip Flexor Stretch

Chin Nods

Now that we’ve done a couple of mobility drills, let’s try to reinforce a few movement patterns to reverse your sitting posture and activate a few select muscle groups.
The first is the chin nod, which is great for the neck muscles and forward head posture. Many have heard of the chin tuck exercise, but the chin nod exercise is a little different in my mind.

Chin Nods Stretch

Shoulder W’s

The next exercise builds off the chin nods, and now combines the chin nod posture with retraction of your shoulders. This will help turn on your posterior rotator cuff and scapular muscles all in one drill.

Shoulder W’s Stretch

Glute Bridge

Lastly, we want to focus on the glutes and their ability to extend the hips, and taking some pressure off your low back. This glute bridge exercise, in combination with the above true hip flexor stretch, will be a great combo to help with your overall posture and core control.

Glute Bridge Stretch

How to Integrate These Exercises into Your Day

An easy way to start and keep it simple is to perform each of these 10 times. These should take less than 5 minutes to perform and will make a big impact on how you feel throughout the day.
Many people ask, “how many times a day should I perform these?” Or even, “do I need to do these every day?”

You don’t need to do these every day. Just on the days that you sit… 🙂

But seriously, remember these are 5 exercises you should do if you sit all day, so doing them at the end of each day to reverse your posture is a great idea. Many people who sit for a really long time like to perform them during the day as well.

As you get comfortable with them, you may find that certain ones help you feel better than others. Feel free to add repetitions to those as needed.

Written by Mike Reinold, PT


Looking to make sitting not so bad,

Dr. Phil Kotzan, DC

Sorry, Sitting Isn’t Really That Bad For You

Here is rehab expert Mike Reinold’s article on sitting:

Over the last several years, the health concerns surrounding sitting have really been highlighted by the health and fitness crowds, as well as the mainstream media.  In fact, there have been entire books published on this topic.  I’ve seen articles with titles such as “Sitting is Evil,” “Sitting is the New Smoking,” and even “Sitting will kill you.”

Wow, those seem pretty aggressive.  We’ve been sitting since the beginning of time!  I’m going to really shock the world with this comment…

Sorry, sitting isn’t really bad for you.

Yup.  There is nothing wrong with sitting.  I’m actually doing it right now as I write this article.  You probably are too while you read this article.

Don’t get me wrong, sedentary lifestyles are not healthy.  According to the World Health Organization, sedentary lifestyles increase all causes of mortality and raises the risk of health concerns such as cardiovascular disease, diabetes, obesity, cancer, and even depression and anxiety.

But let’s get one thing straight:

It’s not sitting that is bad for you, it’s NEVER moving that is bad for you.

By putting all the blame on sitting, we lose focus on the real issue, which is lack of movement and exercise.  We are seeing a shift in people switching to standing desks at work, still not exercising, but thinking that they are now making healthy choices.

This is so backwards it boggles my mind.

It it all begin with the negative myth that “sitting is the new smoking” and completely ignores the true issue.

The body adapts amazingly well to the forces and stress that we apply to it throughout the day.  If you sit all day, your body will adapt.  Your body will lose mobility to areas like your hips, hamstrings, and thoracic spine.  Your core is essentially not needed while sitting so thinks it’s not needed anymore during other activities.  And several muscles groups get used less frequently while sitting and weaken over time, like your glutes, scapular retractors, and posterior rotator cuff.

Your body is a master compensator, and will adapt to the stress applied (or not applied) to make your efficient at what you do all day.

Unfortunately, when all you do is sit all day, and you never reverse this posture or exercise, your body adapts to this stress to make you the most efficient sitter.
That’s right, you get really good at sitting.

For example, think about what happens to the core when you sit all day.

One of the functions of your core is to maintain good posture and essentially to keep the bones of your skeleton from crashing to the floor.  The core is engaged at a low level of muscle activity throughout the day for postural needs.

The problem with sitting is that the chair also serves this function, so your core isn’t needed to keep you upright, the chair serves this function. If sitting is all you do, then when you stand up, your core essentially isn’t accustomed to providing this postural support so you rock back onto your static stabilizers by doing things like standing with a large anterior pelvic tilt and lumbar extension.

Unfortunately, this becomes the path of least resistance, and most energy efficient, for your body.  Your core gets used to relying on the chair to function, then when you need it, gets lazy.

Despite what you may read in the media, it’s OK to sit all day.  That is, as long as you are reversing this posture at some point.  This can be as specific as exercises designed to combat sitting and as general as simply taking a walk in the evening.

3 Strategies to Combat Sitting All Day

I want to share the 3 things that I often discuss with my patients.  You can apply these yourself.  But if you sit all day, you really should:

  1. Move, Often
  2. Reverse your posture
  3. Exercise

But the real first step is to stop blaming sitting and start focusing on the real issue.  It’s lack of movement and exercise that is the real concern, not sitting.

Step 1 – Move, Often

The first step to combatting sitting all day is to move around often.  The body needs movement variability or it will simply adapt to what it does all day.

I get it, we all work long days, and sitting is often required in many of our jobs.  But the easiest way to minimize the effects of sitting all day is to figure out ways to get up and move throughout the day.

This doesn’t need to be 10 minutes of exercise, it could simply be things like getting up to fill up a water bottle or taking quick 2 minute walk around the office.  When I am not in the clinic or gym, I personally tend to work in my home office.  What I do is try to work in one hour chunks, so I will get up and walk around in between chunks to get a glass of water, snack, or use the bathroom.

This works well for me, but you need to find what works for you.  I know of others that use things like Pomodoro timers, or even some of the newer fitness tracking devices, which can remind you to stand up and move around at set times.

Step 2 – Reverse Your Posture

I’ve been talking about the concept of Reverse Posturing for years.  The concept is essentially that we need to reverse the posture that we do the most throughout the day to keep our body balanced and prevent overuse. Sitting involves a predominantly flexed posture, so doing exercises that promote the posterior chain would be helpful.

Step 3 – Exercise

Remember going back to some of the past concepts above, the body adapts to the stress applied.  To combat this perfectly, a detailed exercise program that is designed specifically for you and comprehensively includes a focus on total body and core control is ideal.

This will assure that the muscle groups that are not being used while sitting all day get the strength and mobility they need, while the core gets trained to stabilize the trunk during functional movements.

If you want to get the most out of your body and stay optimized, you need to do things like work on your hip and thoracic spine mobility, strengthen your rotator cuff, groove your hinge pattern, and learn how to deadlift and work your glutes.

Sitting Isn’t Bad For You, Not Moving Is

As a profession, we need to get away from blaming sitting as the enemy and labeling it evil.  Our society is sitting more and more each generation.  We need to be honest with ourselves and realize that sitting isn’t the problem, it’s not moving enough that is the concern.  We need to stop pointing fingers and get to the root of the problem.

Go ahead and sit, just move more often and use these 3 strategies to combat sitting all day.

Written by Mike Reinold, PT

Sit yet move…

Dr. Phil Kotzan, DC

5 Ways To Get More Out Of Your Self-Treatment

“It’s not always just about WHAT you are using to roll out, it’s also about HOW you are performing self myofascial release that is important,” says physical therapist Mike Reinold. “If you combine some of our basic understanding of functional anatomy with our understanding of movement, we can really enhance how you perform self myofascial release to get even better results.”  He suggests to follow these 5 techniques:


Reduce The Surface Area for certain areas of the body

Roll In 360 Degrees to loosen tissue in multiple directions

Hold A Spot to decrease tenderness

Add Active Motion to run the tissue through its range of motion

Move Another Muscle to release it from the one you’re stretching

Credit: Mike Reinold, PT

I hope these help you’re self-treatments.  If you have any questions, please feel free to ask. Good luck!

Dr. Phil Kotzan, DC