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Which type of exercise is the best for you? Let me start by saying that I am supporter of all fitness and physical activity. Admittedly, I tend to stick to the type of exercise I enjoy (and succeed at) and rarely step out of my comfort zone. As more “genres” of fitness become popular, I find that I get more questions from patients about which is good and which is bad. I’ve yet to find any bad kinds, it just depends on your preferences. When choosing the best type of fitness for you it comes down to a few things:
Over the past month, I decided to step out of my comfort zone and try some new classes. I am already familiar with weightlifting, CrossFit and yoga, but there are some that I have never experienced, such as barre, pilates and TRX. I visited some local spots; I rated each of them for difficulty, ability to modify and what benefits the class will have for you. These are unofficial scales and completely biased, but here’s what I experienced: Pilates @ Stellar Bodies Buckhead Walking into a room of these was a bit intimidating. These are called Reformers. The platform is called the carriage. Much of the class is moving the carriage while stabilizing part of your body. For example, one leg remains still while the other pushes the carriage out and pulls it back in for a lunge. My core and hips were burning within about 2 minutes of the class starting. The high paced class and energetic music creates the beat for many of the movements.  When I needed modifications or more in-depth directions, the instructor was able to help me while still keeping the class moving. It was a great workout and I was definitely humbled by some of the other pilates peeps. Let me say, for 3 days I couldn’t cough or laugh without feeling my obliques! Difficulty level 8/10 Ability to modify- Easy Goal- core and leg strength, muscular endurance TRX @ Pace23 These straps are the suspension system used for all TRX classes. For nearly every movement, either your arms or your feet will be using the straps. The instructor demonstrated the movements then we would go through a complex- something like single leg squat, jump squats and wall sits- for a song or a specific rep count. My hips and legs were definitely feeling the work, but what I found as a welcomed surprise was the shoulder workout! Even when exercising the lower half, you are to keep tension in the straps. Similar to the picture, we went through a complex with rows, high rows and bicep curls. There were plenty of options for modifications and the intensity can be increased or decreased with body position. Difficulty level 7/10 Ability to modify- Easy Goal- overall strength, muscular endurance  Barre class @ Pure Barre Decatur This could be an inviting atmosphere for those with experience in dance. Once we got into the thick of it, it felt somewhat like a club- girl power music and low level lighting. They promised a whole body workout when I arrived, and that it was! You have a little ball, loop bands and light hand weights to use throughout the class. There are leg and shoulder specific sections but always with a core focus. Again, fast paced music that sets the count for the movements. The instructors will demonstrate and come by to help you modify. For your first couple of classes, you may have to pause and check out what your neighbor is doing! They often use the cue to “tuck” your pelvis. Recently it has been challenged by PTs regarding that position. Here is my thought- rather than tucking past “midline”, they cue the tuck to ensure that you are not over-extending your low back (or sticking your booty out) which can happen as the core fatigues. What is not ideal, is tucking the pelvis and holding throughout the class. I confirmed this with the coach—who is coincidentally a PT student! Difficulty level 7/10 Ability to modify- Moderate Goal- core strength, muscular endurance  There was an obvious theme with these new-to-me fitness classes: abs on fire and holding hips in an engaged position. This is definitely a contrast to my usual training of CrossFit and weightlifting where moving quickly and being explosive are the general themes.
CrossFit & HIIT Training Known for being “for everyone,” CrossFit is easy to scale and can be applied to any population. That being said, should everyone CrossFit? I say no. Is it what you enjoy? Does it help you reach your goals? Is it sustainable? If any of these are a no, then look to other options. If you are interested in CrossFit or high-intensity training there are many options as well. Here is Atlanta there are loads of CrossFit gyms, Irontribe, kettlebell classes, powerlifting gyms, etc. Here are some gyms in the area that offer these type of classes: CrossFit Atlanta Crossfit 404 Move Functional Fitness FitWit SMUGs Fitness Atlanta Barbell Form Yoga- can’t forget the yoga! These are a few gyms that we have had experience with and we suggest to our patients that inquire about the best fitness classes around town. My suggestion is to go and try all different types. Most of these gyms offer the first class or first week for free! Take advantage and go get some fitness! Thanks for reading, Dr. Jackie, PT, DPT, OCS, CSCS
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 Before graduating with my Doctoral degree in Physical Therapy, I had the distinct privilege of completing an internship with one of the highest performing populations out there, the United States Air Force. With patients ranging from active duty fighter pilots to military retirees, I was constantly in awe of the pain and physical punishment these individuals would put themselves through to be able to perform on a daily basis. Injuries were just another part of life. Some of these patients had been dealing with weeks of shoulder pain, months of hip pain, or years of low back pain; but there was a common ground nearly all of them all shared: pain relief and improved performance from dry needling. What Is Dry Needling? Dry needling is a treatment approach that involves the strategic placement of a thin needle into spots known as trigger points to alleviate myofasical pain. When describing dry needling to my patients, my go-to analogy is a sniper. Using a needle to go directly into a trigger point versus my hands or instrument assisted soft tissue mobilization is like a gunman using the extreme skill and precision of a sniper to pinpoint the problem area. Several studies have demonstrated the ability of dry needling to cause immediate improvements in musculoskeletal pain by targeting these trigger points and eliciting a local twitch response. The proposed mechanisms of pain relief supported by research include:
These effects of dry needling have been demonstrated across orthopedic, neurologic, sports, and post-surgical populations to improve range of motion, pain, performance, and increase local blood flow and oxygenation to surrounding tissues. So It's Like Acupuncture; Right? Wrong! Well, for the most part. Both dry needling and acupuncture use a similar instrument (a needle) to perform a treatment, but the philosophies and reasoning behind why the treatment is being performed couldn’t be more different. This is similar to how both chiropractors and physical therapists perform manipulations, but the chiropractor is attempting to correct “subluxations” while the physical therapist is attempting to unlock facet joints. Some of the key differences you should know between dry needling and acupuncture are:
What Exactly Is A Trigger Point? This is a great question, and one that I answer on a daily basis with my patients. Trigger points are characterized as the presence of nodules (or knots) in tight bands of muscle that are overly sensitive or painful to the touch. Trigger points are divided into two main groups, active or latent. An active trigger point is described as a palpable nodule that can cause local or referred pain without being touched or pressed on, and a latent trigger point is essentially the same thing only it does not cause any symptoms without being stimulated or pressed.  Several theories exist in the scientific community regarding how trigger points form and what exactly their role is in the development of pain. Some of these theories include:
If you’re experiencing pain, regardless of your fitness goals, lifestyle, or injury history, I highly recommend seeking out a physical therapist in your area who performs dry needling for an evaluation. Let me be clear though: dry needling is not a magic bullet. It is a great tool in the hands of a skilled therapist to alleviate pain that would otherwise prevent patients from performing certain movements or exercises, but it is only a part of the picture. Education on areas like strength, mobility, and posture are vital to sustain a pain-free lifestyle and to perform at an optimal level. f you’re living in Atlanta, and you’re struggling with back pain, we’d love to help you. Give us a call at 470-355-2106 or fill out the contact request form and we’ll contact you. Thanks for reading, -Dr. Jake, PT, DPT, CSCS |
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