Dr. Fung’s Five Fingers Experience

From a cursory glance on the web, social media, streaming channels, and on the running trail – one can quickly notice the growing trend of barefoot running and the minimalist shoe movement. Currently, the “Five Fingers” fascination is in relative infancy and predictably, as with any emergent phenomenon, is under initial skepticism and scrutiny which is well matched by fandom and craze.  Caution to new explosive trends is wise as many entities in the past have tried to pass their own version of the magic pill, secret serum, or superman exercise apparatus – each debunked over time. As time passes, controlled trials and repeated research will be combined to give the public a middle ground conclusion on the matter which will be revisited every decade or so with gentle sways in the valence of support or caution. Despite the science, there is a very human element that needs to be addressed in the world of human movement and physical health.

As a clinician, I hold myself to the standard that I will never ask my patients or clients to do anything I wouldn’t do myself or ask of my loved ones. Since the minimalist trend has piqued my interest, I’ve been looking for a way to satiate my curiosity of the “five fingers” experience. My interest in barefoot mechanics stems not only from clinical curiosity, but also from my early life experiences in martial arts and my background in surfing - both which are primarily done in barefoot or minimalist footwear. Additionally, there are a good number of high performance sports of which athletes participate or train barefooted, or, in minimalist footwear.

Thanks to a Twitter connection with @MoveFowardPT and Pacers Running Stores (@RunPacers), I was finally able to procure a pair of Vibram® Treksport and experience it for myself.

The first thing I did once I got my Vibram®’s was take a quick trot around the neighborhood. I noticed immediate differences in my gait and running mechanics. I then decided to test it for some prolonged ambulation. 6400 steps later (according to my pedometer), I noticed definitive activation of my foot instrinsics and that much of my weight bearing occurred in the forefoot. Additionally, I felt that my weight acceptance during each stride was much more evenly distributed over time; it felt as if was I walking “softer” and “smoother” – my family stated in jest that I was walking around like a ninja.

I followed this little experience with a basic pair of flat sneakers to compare the difference. While the only “strain” I noticed using the Vibram®’s was increased forefoot use, I noticed in less steps an unsettling experience in left hamstring/gluteal fatigue, poor eccentric control during heel strike, lazy posture, and bilateral medial arch & hindfoot soreness. I did not expect such a pronounced difference between the two types of footwear.

For high mileage bipedal travel, I typically wear running shoes and use a custom foot orthotic due to my generously flat medial arches. However, what tends to happen with orthotics is that my feet are simply supported by the device - much like a sling or a splint. The difference I specifically noticed with my “finger shoes” is that the device was able to work WITH my feet; the subtle tension when wearing my Vibram®’s gave me the perception of increased proprioceptive sensitivity.  This was a familiar sensation for me. It actually reminded me of when I train kettlebells, barefoot in the sand. I was compelled to mix the two to top off my Five Fingers Experience and find out for sure. Indeed, training kettlebells, using Vibram(R)’s allowed for a more sensitive proprioceptive experience during exercise. For those of you who haven't tried performing heavy snatches or windmills in the sand - try it! It will blow your mind.

It may be too early to make a definitive judgment of the Five Fingers Experience, however, I offer an analogous anecdote in my experience with kettlebells. It goes without saying that I highly support the use of kettlebell exercise as a mode for fitness, physical therapy, and corrective exercise. However, I do not prescribe kettlebell exercise to ALL patients or clients; only those who are appropriate and would benefit from the exercise receive instruction.  Similarly, my initial impressions of the Five Finger’s experience is that it certainly has its place in the world of fitness, health and wellness. For my own two feet, the Five Fingers experience was definitely a positive one; I traded out soreness at the medial-arch & hindfoot for increased use of my instrinsics and a slightly sore forefoot.

Only time will tell what the scientific literature makes of the barefoot movement - not to mention what prolonged use of the "finger shoes" will do to my body (you can be sure I will blog on that experience when it comes). If history is any measure, there will always be several trains of thought regarding the minimalist footwear experience. However, when it comes to application, it all comes down to matching this experience to the right person, in the right manner, for their best outcome.

The Kettlebell Connection

Before I begin this post, I want to thank all of my readers, followers, friends, and of course my family, for the overwhelming love and support you’ve given during this time my wife and I have been dealing with our recent miscarriage. In our age, the social connections we make go far beyond that of physical presence; the willingness to bond across these new digital frontiers truly demonstrates the generous capacity to share the human experience in ways we are only beginning to understand. One thing is for sure: this experience can be shared at the deepest and kindest levels of sympathy.  Again, all my thanks to YOU!

Last week, I had the pleasure of sharing energizing hours of conversation & interaction across two separate days with Dr. Tim Olson, PT, DPT, CSCS.  Dr. Olson and I found in our discussions a common passion for functional movement, physical performance, and innovative systems for the Physical Therapy profession at large.  Of course, when talking with yours truly, you can hardly get away from the inevitable conversation about kettlebells. Naturally, the topics included the physical rehabilitative qualities of kettlebell exercise, the physics of the kettlebell tool itself, and the various treatment diagnoses of which kettlebells are of benefit.

During my time with Dr. Olson, I found him to be an exceptional expert of human movement and outside-the-box thinking.  From the stimulating discussion and several challenging questions, my eyes were opened to some expanded concepts of integrating kettlebells and Physical Therapy.

Three Lessons from the Kettlebell Connection with Dr. Olson:

• In addition to the Natural Physics of kettlebell exercise, kettlebells have an innate property to produce proper form during and after exercise. The kettlebell tool itself also acts as an ongoing source of biofeedback (visual and somatosensory) which can produce superior movement when other sources and techniques of facilitation and instruction have been exhausted.  This is most convincingly seen in exercises such as Bottoms Up activities and the Turkish Get-Up. Unlike dumbbells, barbells, cables or resistance bands, the distance between the handle and the center of kettlebell mass provide an additional kinetic chain where the gravitation pull on mass is off-center when grasped. This causes the body to continually adjust and re-adjust with every movement and acts upon the body in a manner which seems to serve as it own form of proprioceptive neuromuscular re-education. This discussion lead to lesson #2.

• Sometimes the simplest approach is the best approach (ie. K.I.S.S. – Keep It Simple, Stupid).  Many times, the threshold for over-thinking, over-repetition, and over-facilitation is far lower than one would otherwise anticipate. Many times, conscious body movement is its own greatest enemy when aspiring to improve functional performance. Training movement in simple, automatic terms rather than attempting to force the body in sequentially complex arrays often yields superior results in a time efficient manner.  That being said, the kettlebell is arguably one of the simplest exercise tools ever conceived. And yet, in an age of technological wonder, the breadth of potentials when using a simple kettlebell is plain impressive.  The simplicity of the kettlebell’s design and the numerous available applications pose an interesting question when faced with availability of advanced technological complexities: Could it be that the humble tools pave a clearer path to the serenity of human performance?

• Simplicity in design demands wealth in wisdom. Dr. Olson pointed out that many kettlebell exercises seem related if not overly similar when seen at a glance. In general, kettlebell exercises can be categorized by the emphasis on the focused attention or combination of: ballistics, power techniques, dynamic stability, core strengthening, mat based exercises, prone based exercises, sports specific, and tactical. Of these various categories, each branch holds a core familiarity of technique and form. An obvious example is how the dead lift progresses to the pre-swing which progresses to the swing, then the clean, then a high pull, then a snatch. I have always held the operational definition that “Wisdom is knowledge applied.”  The ballistic progression for kettlebells is a great example of how multiple principles of exercise science sublimely unite during application:

1. Overloading Principle: Kettlebells are dense heavy objects which tend to be heavier than objects manipulated in every day life. Additionally, the exercise techniques used with kettlebells are done in movements far more explosive and intense than that of normal every day life.
2. Individual Response Principle: Kettlebells must be customized to each individual per exercise and per progression. Kettlebells which are too light allow for individuals to “cheat” and “muscle” the kettlebell to mimic proper form. An easy way to check if a beginner is cheating on the swing is to add another kinetic link to the swing itself by looping a towel or rope around the handle of the kettlebell. If the beginner is indeed cheating, the bell will droop downward with gravity as the individual can no longer death grip the kettlebell into submission during the swing itself.  This principle holds true in the opposite extreme; kettlebells which are initially too heavy for beginners are simply dropped during exercise or self-limiting due to form.
3. Adaptation Principle: While many kettlebell exercises may seem similar at a glance, the intricate biophysics for each variation is highly different as experienced by the body.  With careful instruction, a small circuit of the various categories of kettlebell exercises can prove to be an extremely challenging feat even when performed by the most veteran of kettlebellers.
4. Specificity Principle: As discussed in my “Restoring Movement with Natural Physics” article, a major advantage of working with kettlebells is that we train our bodies in the same physics as the functional activities we strive to improve upon.  This training effect carries over for better performance during function and can be easily adapted for each specific sport, activity, tactical situation, functional movement, or activity of daily living.

My time with Dr. Olson was a refreshing and rejuvenating experience.  To strengthen oneself, one must sharpen iron with iron; being challenged is as important as being inspired. Many times, they are one in the same.  My interactions with Dr. Olson generated for me a deeper consciousness of human movement and functional performance. I express my sincere appreciation and humble thanks to Dr. Olson for his time, his thoughts, and his passionate dedication to his profession, his colleagues, and his patients.

Dr. Tim Olson, PT, DPT, CSCS provides a holistic Physical Therapy service through METROSPORT Personalized Physical Therapy. For more on Dr. Olson and his unique private practice, please visit: http://metrosportpt.com/ and follow Dr. Olson at @timolsonPT.

Resolution Reality Check: Simple, Logical, Effective (Part 2)

Last post, we discussed the components of a successful Health-Fitness New Year’s Resolution.  Three components are must-haves to attain success; the resolution must be “simple, logical, effective.”  We also discussed the logic and science behind kettlebell exercise as a solid tool in achieving success.

To close out our “reality check” on the New Year’s Fitness Resolution, I am introducing a workout routine which fulfills those requirements.  One of the many advantages of kettlebell exercise is that it addresses the whole body.  Instead of isolating body parts which are meant to work together, kettlebells train the body to integrate – the “Five Star” Kettlebell Routine is a workout which does just that.

The Five Star is comprised of five kettlebell exercises done in sequence and switched from side-to-side.  The exercises are as follows:

1. One Handed Swing – The foundational kettlebell ballistic exercise which trains lower quarter power, core stability, and corrective functional biomechanics.
2. Clean and Press – Good explosive functional power along with upper quarter strengthening and shoulder girdle stability.
3. High Pull – Explosive dynamic reversal along with core stability and balance.
4. Snatch – Intense muscular explosivity and cardiovascular demand.
5. Windmill (and switch swing to other hand) – Dynamic control of upper quarter, shoulder girdle, core, and balance.

The Five Star Kettlebell Routine is a workout which is quick and efficient for the busy day.  These five exercises cover all regions of the body dynamically, functionally, combined with strength and endurance. Finishing a one repetition cycle of this five exercise sequence usually takes 15-25 seconds.  On average, hammering out ten repetitions on both sides will take approximately 6-8 minutes resulting in a quick and efficient full body workout.

Finally, I want to thank all of you for support Kettlebell Therapy™ as we’ve continued to develop our site and resources. We've added to our sidebar several links and classes I highly recommend.

For those of you in San Diego looking for an award winning kettlebell class, Sharp Healthcare now holds "Kettlebell and PhysioKinetic Fitness" on Tuesdays and Thursdays from 5:00pm - 6:15pm as well as 7:30am - 8:45am.  These classes are ongoing and can be joined & renewed at any time! Register Here!

Finally, I would like to make special acknowledgements to Dr. Erson Religioso at The Manual Therapist, and, to The Physical Therapy Web Space for their support and collaboration during the early launching & development of Kettlebell Therapy™.

My best to you all!

-Dr. Ben Fung

Resolution Reality Check: Simple, Logical, Effective (Part 1)

It’s nearing the end of January 2012 and it is time for a Resolution Reality Check!

One of the most common New Year's resolutions involves a goal for fitness and physical health.  Many individuals head to gyms, boot camps, special programs, running, diets, yoga, pilates, lifting, support/self-help resources, social exercise groups, etc… each with their own benefits, styles, and results.  However, more often than not, the New Year’s health-fitness resolution tends to fail in some degree. We all know this intimately as many of us re-make this particular resolution every year. Most of the time, fitness resolutions result in failure due to poor planning and choosing the wrong type of exercise to pursue your goals. To avoid failure and achieve success, we need to break down the resolution with a reality check.

Whatever components your health-fitness resolution may have, success is more likely to occur when strategized. Sometimes, a spirit of determination can only get you so far… sometimes you must find ways to set yourself up for success.

The successful health-fitness resolution holds within it three crucial components; it MUST be:

1. Simple
2. Logical
3. Effective

Simple:  The modern day lifestyle is busy enough as it is to squeeze in 90-120 minutes of additional commitment several days a week.  While it IS possible to do so, most of us would get only a handful of hours of sleep a day if we were to commit to such routines.  Sometimes, the simplest solution is the best solution – and after all, a kettlebell is a cast iron ball with a handle on top from which you can achieve a fine workout in just 15 minutes. Simple enough.

Logical: First off, the health-fitness resolution must hold logical water. Unrealistic goals are unrealistic – period. Also, the resolution and the path to achieve it must make sense. We must take into consideration the science of human movement as all forms of exercise require human movement. The body moves as integrated kinetic chains where multiple muscle groups and areas of the body work together. The logical approach during exercise is to improve the functional performance of the body as a whole, thus, we should include routines which train in functional arrays rather than isolative movements.

Effective: It isn’t enough to engage in exercises because they look & sound good. We need to choose an exercise because it has been proven to work. According to research, high intensity kettlebell exercise can burn up to 20 Calories a minute... that's more than 1000 Calories per hour during exercise! While strict aerobic exercise typically burns only 80-110 Calories per mile, kettlebell exercise burns far more Calories per hour, and, addresses both cardiorespiratory endurance and lean muscle strength training at the same time (Fung 2010). The lean muscle building yields a high metabolic demand for adipose calories which only results in a healthy & leaner body composition.

If your New Year’s Fitness Resolution includes things like weight loss, body composition fat loss, toning up, and getting stronger – then add some kettlebell swings to your day!

Kettlebells are simple, logical, and effective – a solid tool for success!

Coming Up: Resolution Reality Check: Simple, Logical, Effective (Part 2).  In my next post I will introduce my “Five Star Kettlebell Routine” – a quick and effective workout for the busy day.

Kettlebells – Bottoms Up!

The Bottoms Up grip with kettlebells is another great example of how the unique physics innate to kettlebell exercise gives a distinct advantage over traditional weight training and uni-dimensional gym machines.  The Bottoms Up grip can be applied during Cleans, Snatches, Presses, Windmills, Turkish Get-Ups, … in any exercise where stability and controlled movement needs to be attentively combined.

While one of the big draws to kettlebell exercise is high rate of carryover to “function”, sometimes the performance and even completion of a functional task gathers more attention than the quality & control of movement during function itself.  Here’s the classic example: Lifting a 25 lb box from the ground to a waist high surface.  This can be done in a near infinite combination of sequences at all the various major joints and kinetic chains.  However, there are several general rules that keep the human body’s biomechanics at minimal risk for excessive tissue stress (such as maintaining neutral spine) and resultant injury from the poor biomechanics. Typically, we call this “ideal” biomechanics. It is this conceptual detailed attention to the quality and control of movement that Bottoms Up specifically addresses for the upper quarter.

Most upper quarter functional tasks we perform as humans requires grip. As discussed in my article “Restoring Movement with Natural Physics” (as published by the Physical Therapy Web Space & The Manual Therapist), kettlebell physics work with the body rather than against it.  This is particularly advantageous during grip based exercises.  Combined with the strength training “overloading principle” which we all use during exercise, the Bottoms Up grip provides several distinct overloading factors:

1. The center of gravity of the gripped object (kettlebell) is at the least stable position during exercise. This means that any deviation from a controlled and precise movement during exercise will cause the kettlebell to lose position and naturally drop.
2. To maintain a stable Bottoms Up, a natural and neutral wrist position is required during the entirety of exercise. This is different from the usual extended wrist position as seen during barbells and dumbbells.
3. A strong manual grip is required to be simultaneously balanced dynamically with muscles of the hand/wrist for infinitesimal adjustments to movement & effect of gravity during exercise.
4. The position of the wrist and elbow must be constantly accounted for by the position of the shoulder girdle during exercise.
5. This requires that the position of the shoulder girdle must not only be strong but dynamically stable during exercise, otherwise, the elbow will be out of position which will cause biomechanical weakness at the wrist which causes the bell to drop.
6. A strong and dynamically stable shoulder girdle requires that the core is also in a stable position (otherwise, again, the kettlebell naturally drops due to it being in the least stable position possible during grip)
7. Not only does Bottoms Up require for the core to be in a stable and in a biomechanically sound position, it requires the core to transition between required postures during exercise in a controlled manner as well.
8. Bottoms Up requires for the body to react to all three dimensions of movement for all the involved kinetic chains throughout entirety of exercise.

The result from training in Bottoms Up is a Upper Quarter and Core which work together in various postures, throughout dynamic movements, and in multi-planar arrays.

Below is a short video on the Bottoms Up grip during the clean and press and windmill.

For the higher performing populations, I frequently prescribe the 'supine to sit' (punch & crunch) segment of the Turkish Get Up with a bottoms up light kettlebell to normalize dynamic control at the shoulder girdle – especially for those with Serratus Anterior deficiencies (which can contribute to Scapular Winging, Shoulder Impingement, Limited Range of Motion, and Pain).

As you can see, Kettlebells Bottoms Up is a versatile tool to engage in multi-planar dynamic stability of the upper quarter.  This naturally requires the core to be not only engaged but controlled. I would suggest that in many cases, the ability to control movements as segmented parts of a functional task precedes the completion of the task itself during training events.  I have used this concept with much success for many cases especially for the shoulder girdle.

Coming Up Next: Resolution Reality Check & The Five Star Kettlebell Routine. Having a busy day and needing to squeeze in an effective workout? In my next post I will discuss the Resolution Reality Check and introduce my "Five Star Kettlebell Routine".

Optimizing the Fung Protocol (Part 2)

In my previous post, I laid the foundational science to optimizing the Fung Protocol. We focused on two key pieces of information gleaned from my study:

1. One must remain their kettlebell weight class to less than or equal to 13% of your body weight for metabolically aerobic exercise during the Fung Protocol
2. Aerobic steady state kettlebell exercise is typically achieved at minute 6 during the Fung Protocol

We can now optimize the Fung Protocol for maximal metabolic efficacy. To do this, you will need two different weight classes: a “heavy bell” and a “cardio bell”.

First, during initial exercise, we need to deplete the local stores of energy to booster start our body for the duration of exercise.  The strategy is to force the body to quickly transition into metabolically aerobic exercise without exhausting our body prior to reaching steady state.  The best way to do so is to use a “heavy bell” during initial exercise. For this “heavy bell”, I suggest the weight class to be the combination of two factors – the heavy bell should be:

1. Heavy enough to thoroughly and maximally challenge you during the overhead press for 10 isolated repetitions (10 rep max).
2. Light enough that you will not reach exhaustion or experience injury after 6 minutes of exercise including swings, clean & presses, and snatches.

Using this weight class, begin initial exercise using the Fung Protocol 30-on: 30-off cycle of Snatches, Clean & Presses, and Swings for the first 6 minutes.  Again, the purpose of the first 6 minutes is to metabolically deplete local muscle energy stores and jumpstart the body into the aerobic system. This should be a high intensity 6 minute cycle.

After the first 6 minutes, finish with the usual 30 second “off” cycle for active recovery and then go for your “cardio-bell”.  The cardio-bell is going to be a kettlebell less than or equal to 13% of your body weight. For the next 6 minutes, continuously engage in ballistic kettlebell exercises (swings, cleans, high pulls, snatches, etc.).  Any ballistic kettlebell exercise will suffice because we want that nice ballistic cadence. The rhythmical nature of kettlebell ballistics allows the body’s exertional response to engage in the aerobic domain of exercise.  I highly suggest switching up your exercises every 10-20 reps as to not exhaust the muscles of grip.  After the 2^nd 6 minute cycle, take a 30 second break and finish with the last 6 minute continuous cycle, again utilizing a diverse grouping of ballistic exercises to preserve the muscles of grip.

These three 6 minute cycles comprise the optimized 18 minutes of the Fung Protocol.  The difference is in the use of the 30-second-on: 30-second-off active recovery.  The original Fung Protocol utilized the 30:30 cycling throughout the entire 18 minutes.  However, the Optimized Fung Protocol only used the 30:30 cycling in the FIRST 6 minutes.  The 2^nd and 3^rd 6 minute segments are CONTINUOUS after the 1^st cycle as the body is now equal to or greater than “steady state” exercise after use of the “heavy bell”. The transition from the “heavy-bell” into the “cardio-bell” allows for not only a rapid recovery but also a quick gear change into aerobic exertion (Fung 2010).

So here it is in plain English:

6 minutes: Initial exercise with the Heavy Bell

- 30 seconds on, left snatches, 30 seconds off active recovery

- 30 seconds on, right snatches, 30 seconds off active recovery

- 30 seconds on, left clean & press, 30 seconds off active recovery

- 30 seconds on, right clean & press, 30 seconds off active recovery

- 30 seconds on, swings (starting left, switching every 5), 30 seconds off active recovery

- 30 seconds on, swing (starting right, switching every 5), 30 seconds off active recovery

After the final 30 second recovery of the 1^st cycle, initiate 6 minutes of continuous ballistics (with varied exercises for grip preservation) with the “cardio-bell” weighing 13% or less than your body weight.  After 6 minutes, initiate 30 seconds of active recovery, repeat the 6 minutes of continuous ballistics with the “cardio-bell”, and … congratulations! You have just completed the Optimized Fung Protocol!

Using this protocol, exercising 4 days a week, I personally lost 2 inches of waist in less than 6 weeks! Give it a try and let me know how it goes!

Coming Up: Kettlebells – Bottoms Up. In this next post, I will discuss the secret to multi-dimensional dynamic upper quarter stability with combined core control.

Optimizing the Fung Protocol (Part 1)

Happy New Year to everyone!  I’d like to start the New Year with a follow up post to the Fung Protocol.  One of the most common New Year's resolutions involves a goal for fitness and physical health.  However, all too often fitness resolutions result in demoralizing failure due to poor planning and choosing the wrong type of exercise to pursue your goals.

Previously, we discussed that the original Fung Protocol allows for wide ranges of individuals to safely engage in high intensity exercise which utilizes the body’s muscle building anaerobic systems as well as endurance based aerobic systems for 18 minutes at 90% of Maximum Predicted Heart Rate all while achieving the VO₂ equivalent of a brisk jog.

There was, of course, other data revealed in my study which proved very interesting. One such piece of data was uncovered during maximal exertion tests using kettlebell exercise.  I discovered that due to the weight of the kettlebell, the body is forced to work in the anaerobic world unless the weight of the kettlebell is less than or equal to 13% of one’s body weight.  It is at this threshold that the body experiences kettlebell exercise per the Fung protocol at a level of intensity where the Respiratory Quotient (RQ) is less than or equal to 1 – denoting metabolically aerobic exercise.

We also know from exercise physiology that the body utilizes the ATP/PCr cycle for local muscle energy in the beginning seconds of initial exercise. Also, we know that the Glycolytic System lasts less than 2 minutes during initial exercise until the aerobic system picks up around minutes 3-4.  It is around this time during exercise that most individuals begin to reach steady state aerobic exercise.  It was at this point during exercise where another interesting piece was uncovered in my research.  Using the Fung Protocol, individuals reached a steady state kettlebell aerobic exercise in approximately 6 minutes (ranging from 4.5-6.5 minutes). While this is slightly delayed compared to traditional aerobic exercise, it does make perfect sense; kettlebell exercise is not strict aerobic exercise and is more akin to interval training which accounts for the delayed affect.  Nevertheless, with these two pieces of information, we have a hard science formula to optimize the Fung protocol for maximal efficacy.

Coming Up: Optimizing the Fung Protocol (Part 2). In my next, post I will discuss how to personalize the Fung Protocol for maximal efficacy and optimal metabolic results.

The Fung Protocol

My thanks again to all of you who supported, organized, and helped prepare for the very successful 2011 National Speaking of Women’s Health Conference via Sharp Healthcare in San Diego.

First things first: I’ve received numerous e-mails asking for information on my kettlebell classes held through Sharp Healthcare. Click here for the link to registration.

Also, I also know cost effectiveness is always a concern and that many who attended Sharp’s Women’s Conference wish for additional affordable class times (ie. day time classes, weekend classes, etc.), and, additional locations (ie. East County - San Diego).  If you wish to pitch in your vote, please e-mail me: Contact@DrBenFung.com and let me know your ideal class time/location.

Onto the new post! What is the Fung Protocol?

The approach of Kettlebell Therapy is 100% based on research evidence and clinical science. One of the founding pieces is the 2010 Fung Protocol as published by American College of Sports Medicine. The Fung Protocol is defined as a repeating 30 seconds “on” (exercise) – 30 seconds “off” (active recovery) routine which cycles 3 times between the following 6 exercises:

-          Left Handed Snatch

-          Right Handed Snatch

-          Left Handed Clean & Press

-          Right Handed Clean & Press

-          Left Hand leading Switch Swings (switch on every 5th swing)

-          Right Hand leading Switch Swings (switch on every 5th swing)

This cycle of 6 exercises is repeated 3 times making a total of 18 minutes of exercise following the 30:30 on/off repetition.  Of the many results of my doctoral work, this particular protocol demonstrated an exercise response of 90% of age predicted maximum heart rate (HR Max) and was shown to metabolically utilize aerobic and anaerobic systems simultaneously during kettlebell exercise as measured by VO₂ & VCO₂.  Additionally, this protocol and the amazing response to exertion allowed for participants to safely exercise at these levels with a wide range of baseline activity levels from semi-sedentary to former college athlete. In fact, I have successfully applied the Fung Protocol to senior clients with no complication or injury.  That’s the power of science!

Thanks again to all my followers, supporters, clients, and patients. With the loving support of my family and friends, YOU make the high quality education and expertise of Kettlebell Therapy possible.

Season’s Best!

-Dr. Fung

You may also enjoy reading: Optimizing the Fung Protocol

Blasting Abdominals With Kettlebells

Training healthy abdominals requires an artistic balance of muscular strength and movement control.  For the core to truly be functional and effective at preventing back injuries, one must address both aspects of core training.  More often than not, “strong” individuals engage in lifting activities with “rock solid” abs. For many of these individuals, their control of the abdominals, and thus, the control of segmental stabilization of the spine is poor. A hypermobile spine during exertional activities amounts to a major risk of spinal injury.

The supine position is a good starting point for training the abdominal muscles.  One of the safer and more efficient exercises that address abdominal strength in a controlled dynamic movement is the “Pull Over”. The Pull Over consists of a supine posterior pelvic tilt combined with glenohumeral extension. The combined motion sandwiches the core with the upper and lower quarters of the body forcing it into a controlled and co-activated contraction.

To begin, one must eliminate lumbar lordosis by flattening the “small” of the low back to the ground. This can be done by tightening the abdominals and relaxing the legs.  Other cues can be drawing in your belly, or, hollowing out your belly.  The lordosis of the lumbar spine should be so eliminated that one cannot slide a piece of paper under the low back.  It is only then that the core is properly engaged and bracing the spine for controlled activity.

This is an example of excessive lumbar lordosis.

This is an example of “core bracing” where the core is engaged and lordosis is eliminated.

Begin the pull over by reaching for the kettlebell and ...

... pulling it "over" your head into the “Driver’s” position.

To maximize core contraction and even engage the shoulder girdle, bring the kettlebell into the “Pull Back” position.

One can then make this pattern a dynamic exercise by repeating the pull over.

Of course, one can get increasingly creative by involving lower extremity extensions both unilateral and bilateral – really, the sky’s the limit for these mat exercises.

Finally, I’d like to introduce you to my patient, client, and friend – Jacob.  Jacob was kind enough to provide us a video testimonial regarding his experience with Kettlebell Therapy.  I’m truly proud of Jacob for the manner in which he handled injury, and, his positive attitude and perseverance to not just recover, but to excel.

Coming up:  I will be speaking at the National Speaking of Women’s Health conference sponsored by Sharp Healthcare in San Diego.  The topic: “Melting Fat in 15 Minutes: An Introduction to Kettlebell Exercise”.  Also, I’ll be in the Expo hall exhibiting the Physio Health & Fitness Screen. Click here to register!

Breaking Down The Functional Wall Squat (Part 6)

Continued from my previous post, “Breaking Down TheFunctional Wall Squat (Part 5)”:

In the last 5 posts regarding the Functional Wall Squat (FWS), we’ve discussed the foundational knowledge of ideal posture, the FWS as a Physiotherapy (PT) functional assessment, and the FWS as a PT intervention. In this closing post of the FWS series, I will discuss the Functional Wall Squat as Preventive Therapy and as a modality of exercise.

The FWS as Preventive Therapy:

Kettlebell Therapy’s approach to Preventive Therapy is not just one of prevention, but, it is a life long approach to optimizing and maintaining health.

Below is a sequence of corrections to common functional deviations seen during the FWS assessment:

Thoracic Kyphosis with Rounded Shoulders & Head Forward Position: This deviation is particularly common in the computer and desk job populations. This risk includes (and are not limited to) poor lifting mechanics, musculoskeletal discomfort due to muscular imbalance, headaches, compression fractures, and nerve compression.

• To correct this, begin with shoulder retraction. Tell the individual to pinch their shoulder blades together.
• Ensure that the scapulae retract posteriorly and slightly inferiorly to avoid activating the upper traps.
• Then incorporate thoracic spine extension with pushing the chest out.
• Finally, encourage cervical spine retraction/elongation which should naturally occur as a process of the scapular and thoracic spine corrections.
• From here, cue the individual to engage in a mini-squat and lower until the next deviation which is typically…

Flat Back & Posterior Leaning: Flat back tends to happen with weak lumbar spine extensors and a stiff lumbo-pelvic girdle. Flat back is also associated with posterior leaning. This occurs as a mismatched balance strategy – as one squats, ones center of gravity will shift. In order to balance, the proper strategy is to move into a spinal extension bias and shifting the lower trunk posteriorly and maintaining the upper trunk anteriorly over ones base of support.

However, if one has a flat back deviation, the only available strategy is to move the upper trunk. Since the flat back naturally shifts lower trunk weight anteriorly, the only option for the upper trunk is to shift weight and lean posteriorly to maintain balance.

In general, posterior lean can occur during a functional squat due to several factors including:

• Tightness in the Lumbo-Pelvic girdle (primarily Hip Flexors)
• Weakness in the Lumbar Spine Erectors
• Weak Hip Extensors / Over-dominant Knee extensors
• Tightness in the Muscles of the Calves (Plantarflexors)
• Weakness in the Ankle Dorsiflexors

To correct this during the FWS:

• Begin with cuing the individual to stick out his/her buttocks.
• Next, instruct the individual to accentuate the lumbar lordosis “C” curve of the low back.
• Continue with tactile cuing of the thoracic spinal erectors by drawing the scapulae together with your fingers in a pinching manner.
• Combine this neuromuscular facilitation with downward & posterior pressure to the ASIS to encourage anterior pelvic tilt as such will accentuate the favored spinal extension bias and prevent the next functional deviation…

Lower Quarter Torsion and/or Collapse: Weakness in the hips is most commonly expressed with deviations in the knee and ankle/foot joints. Most commonly seen is the combination of genu valgum combined with internal rotation of the femur and resulting in pes planus (excessive pronation of the ankle/foot).

• Genu Valgum: The knock kneed position is most commonly a result of a weak gluteus medius.  With poor hip abduction control, the femur easily veers medially.  To correct this functional deviation, instruct the individual to favor their knees outside their base of support.
• Internal Rotation of the femur: Weak Hip External Rotators allow for the femurs to excessive internal rotation which also contributing to genu valgum.  To correct this functional deviation, instruct the individual to point their knees away from midline.
• Pes Planus: Weakness in the muscles of the arch contributes to this functional deviation. To correct this functional deviation, instruct the individual to hollow out the foot into a cave along with the corrections above.

For the purpose of this video demonstration, the anterior view is given:

As you can see, this sequence of Neuromuscular Re-education can correct and re-sequencing lifting, squatting, and postural mechanics. The result is a habitual lifestyle of good movement in ideal body mechanics – this spells PREVENTION.

The Functional Wall Squat (FWS) as a modality of exercise:

Once the sequence of the FWS is perfected, one can move into the overloading principle of exercise physiology into strengthening and conditioning.  Here are a few variations to the FWS as an exercise shown in the following order:

• Functional Wall Squat, Horn’s Grip Position
• Functional Wall Squat, Suitcase Grip
• Functional Wall Squat, One Handed Clean Position
• Functional Wall Squat, Press Squat variation

The guiding principle behind good exercise is and will always be proper biomechanics. The Functional Wall Squat (FWS) is a versatile exercise which can be used to assess functional deviations, neuromuscularly re-sequence movement patterns, and strengthen proper biomechanics to prevent future impairments.  Used as a foundational exercise to lifting mechanics and postural correction, the FWS is a strong base for a successful building.

Coming up: Preventing Knee Injury with Kettlebell Therapy. In my next post, I will discuss an exercise I introduced at the 2010 National Speaking of Women’s Health Conference specifically addressing gluteus medius weakness, and, will discuss a screening exercise for the dynamic integrity of the knee joint.

Lecturing on Kettlebells

I'm proud to announce I will be lecturing on Kettlebell Exercise, and, featuring the Physio Health & Fitness Screen at the National Speaking of Women's Health Conference sponsored by Sharp Healthcare on Nov. 19th, 2011.  My thanks in the collaboration with the Cushman Wellness Center.

The final post for "Breaking Down The Functional Wall Squat (Part 6)" is almost ready. Also, due to popular demand, future posts will be on Kettlebell Therapy's approach to abdominal strength & core stabilization as well as specific address to Knee-Hip health as it has been a very hot topic as of late. Stay Tuned!

Delayed Onset Muscle Soreness (DOMS)

The most common thing I hear after someone experiences kettlebells for the first time is how sore they feel a day or two after. Of course, they ask me, “Dr. Fung, why am I so sore?” The answer: DOMS.  Many kettlebell exercises utilize eccentric muscle contractions which are the root cause of Delayed Onset Muscle Soreness (DOMS).

An eccentric muscle contraction is executed when a muscle is firing but is lengthening while tension is maintained. An example is lowering a coffee mug from your lips to the table during which the biceps and brachialis muscles elongate and control the descent of the mug. Eccentric muscle contractions are the essential ingredient for developing muscle strength. The same physics are utilized during ballistic kettlebell exercises such as the swing. Each time the kettlebell begins its travel back to the bottom of the arc of swing, your body must resist this force and control the lowering of the bell with a global eccentric muscle contraction. Bingo! Muscle soreness.

This is actually great news because not only do eccentric muscle contractions develop strong muscle fibers, the ballistic swing also requires co-contractions from complimentary muscle groups throughout your body. Co-contractions are highly efficient muscle contractions which lead to better results from exercise and thus better outcomes for your fitness, health, & wellness.

The effects of DOMS tend to peak at 48hrs and can protect your body from repeating the experience up to 6 weeks after the initial onset.

Coming up: Breaking Down The Functional Wall Squat. In my next post, I’ll expand on one of the most useful exercises which has indications for spine health, hip mechanics, injury prevention, and more.

Top 5 WORST Gym Machines and the Kettlebell Therapy Solutions (Part 2)

Continued from my previous post with video updates, Top 5 Worst Gym Machines and the Kettlebell Therapy Solutions (Part 1):

4. Roman Chair Back Extension: Theoretically strengthens the erector spinae.

The DANGER: Resisted spinal flexion while loading the spine can dangerously increases the risk of damaging the inter-vertebral discs. Damaged inter-vertebral can cause incredible pain, nerve damage, and even paralysis. In fact, this very motion is forbidden to spine patients after surgery because of how detrimental it can be to the spine.

Kettlebell Therapy: The Functional Wall Squat – The functional wall squat is a physiokinetic exercise that strategically optimizes body mechanics and spine health. The best way to strengthen the muscles of the back is to do so functionally. This is because the body is very sensitive to activity specific training effects. We typically use the erector spinae when we are lifting objects. By isolating the erector spinae on the roman chair, the body will not recruit the erector spinae and the deeper spine muscles to stabilize our vertebrae at the critical moment of lifting. The functional wall squat is a powerful physiokinetic exercise that re-trains spinal stability, lifting mechanics, and strengthens the muscles of the back, functionally.

5. Roman Chair Sit-Up: Theoretically this exercise strengthens abdominals and hip flexors.

The DANGER: The sit-up/crunching motion yields the same spinal flexion movements which increases stress forces on the spine in a similar manner to the Roman Chair Back Extensions. The spine health maxim I encourage my patients and clients to adopt is: “never change the distance between the sternum and the navel.”

Kettlebell Therapy: The prone series progression of the plank toward the bear crawls are an excellent series to strengthen not only the abdominals and hip flexors – it also strengthens the ankle stabilizers, muscles of the knee, the upper core, the chest, the shoulder girdle, the triceps, and the wrist stabilizers.

The Plank (Full Plank)

This concludes my 5 WORST Gym Machines and the Kettlebell Therapy Solutions. I will expand on all these exercises in future posts as well as their roles in Preventive Therapy.

Coming up: Delayed Onset Muscle Soreness. So many of my students and clients love telling me, “There are muscles in places I never knew!” Find out more about this phenomenon in my next post.