New Series: Performance Papers

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New Series: Performance Papers

Performance Papers is a new series that Engineered Per4mance is starting with the goal to share articles/video/etc. that we find fascinating and want to share with our audience. 

 

1. The Cost of Adaptation

Written by Pavel Tsatsouline of StrongFirst, Pavel dives into the interplay of health and performance.  If health is the goal, how should we view performance.  If performance is the goal, how should we view health?  Can they coincide together and if so how?

 

2. Mark Bell' Powercast #237

Joel Jameison is a strength and a conditioning coach that is best known for his expertise on Heart Rate Variability (HRV).  During this podcast between 12:30 - 17:30, energy expenditure is discussed in regards to weight loss.  Can your body endlessly expend energy or is there an upper limit to it?

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Fatigue and Performance

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Fatigue and Performance

Author: Billy Snyder

Training stimulus creates fatigue. The body thus adapts to this fatigue. Too little fatigue, the body doesn't care to adapt.  Too much fatigue, the body cannot adapt fast enough before more fatigue is accumulated.   How does this relate to performance/fitness?  Well, accumulated fatigue masks performance.  In order to express the highest level of performance, fatique needs to be as minimal but not so minimal that peak performance depreciates.

What is common to see, is someone start their training hard right at the beginning and accumulate huge amounts of fatigue.  When it is hard at the beginning how much can you more can you consistently progress?  Consistently is the key.  Not how fast can you progress but how consistently can you?  Unless, that fatigue is mitigated,  it's lingering can become harmful.  This can lead to overtraining.

"In his studies G. Folbort has proven that exhaustion processes stimulate restoration processes.  [Yet] very high fatigue resulting from extensive muscular work is not desirable as recovery processes will stretch out for a long time and the athlete will enter the next training session with reduced work capacity" (Vorobyev, 1977).

"Today athletes more and more take training sessions in a phase of some underrecovery. Such training better stimulates recovery functions and has a positive effect of the growth of results.  But constant training in the state of underrestoration could have dangerous consequences...chronic fatigue and overtraining" (Vorobyev, 1977).

Overtraining is when the accumulated fatigue is held on by the body for too long causing the body's ability to reduce fatigue to be impaired.  Peformance can become deteriorated for weeks, months, and possibly years, if severely overtrained.

Some signs from chronic overtraining:

  • Joint problems
  • Scar tissue development and the possible tearing of such tissue
  • Chronic Inflammation

True overtraining, however, is actually pretty rare. What most people start to experience is Overreaching.  This is the point of which fatigue accumulation gets pushed past your body's point to recover.  If volume is lowered or deloading occurs once this point has been reached, the body will adapt from the hard training while recovery occurs.  Don't push furthur anymore though. Cycle back and start the process over.

Some signs of overreaching might be:

  • Unable to maintain usual reps at a certain weight
  • Not longer sore but having dull aches
  • Unmotivated, lethargic, and struggling to meet minimum efforts (Scientific Principles of Strength Training, 2015)

How to avoid overtraining

  • Eat enough to actually sustain your level of activity.  Your body needs food to fuel workouts but to also replenish and create adaptations from the workout.
  • Sleep.  I understand people have seasons in their lives where uniterrupted and deep sleep is a privilege versus a right.  Kids can really throw a wrench into the mix.  I just want it to be understood that if someone gets 2 hours of sleep, their day's training should not be full throttle.  You would end up doing yourself more harm than good.
  • Figure out what is optimal volume for yourself.  This sounds complicated and in reality, it is.  Everyone has a different training age and history. Some people have worked up to a point of being able to tolerate a higher volume.  It takes time which is unfortunate. However, it is safer than seeing how long you can push your body's limit because at some point you will find it.

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Concussion

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Concussion

Author: Dr. Matt Zirretta

Over the last ten years “concussion” has become quiet a buzz-word, and rightly so. Concussions have been a hot topic in the media with former NFL players speaking out on the long-term negative effects and release of the Will Smith film Concussion. Terms such as “getting your bell rung” and “protect your melon” can no longer be taken lightly. Our goal at Engineered Per4mance is to improve sport performance, but more so prevent injury and ensure safety of play for our athletes. This is why we have developed an objective removal from play and return to sport concussion protocol. This will allow parents, coaches, and medical staff to make safe decisions in the best interest of the child.

The symptoms associated with concussions are well known, but currently removal from play and return to sport decisions are subjective in nature, endangering the athlete. A staggering 85% of concussions go undiagnosed. Research has shown that concussed athletes are more likely to experience another brain injury. If this second injury occurs before the first concussion heals, the athlete can experience prolonged recovery and worse long-term outcomes.

Subjective symptoms of a concussion:

We at Engineered Per4mance have developed a comprehensive concussion protocol, which includes baseline pre-season testing measurements of objective data that can be paired with subjective symptoms to make smart removal from play and return to sport decisions. In the unfortunate event that the athlete suffers a concussion, we can retest and compare results to their baseline scores to make an objective, safe return to sport decision.

Vision

Visual pathways give a widespread overview of what is happening within the brain during a concussion. Using a specialized program we capture the athlete’s reading acuity (speed and number of errors). An athlete with concussion-like symptoms will demonstrate slower reading speeds and more errors.

Balance

Balance deficits are a key symptom of concussions of any severity. Using specialized software we capture a video of the athlete’s balance in different postures (feet together, tandem, single leg stance) with eyes open and closed, which is measured on a sway map. An athlete with concussion-like symptoms will demonstrate larger deviations of sway, which will be illustrated on the sway map.

Baseline concussion tests should be preformed every six months to remain accurate as the young athlete grows. 

Contact us today to protect your athlete’s melon!

 

 

 

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Low Back Pain - Flexion Intolerance | Part I

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Low Back Pain - Flexion Intolerance | Part I

Author: Dr. Joey Glenn

Have you ever bent down to pick up your shoes and suddenly find yourself on the floor in crippling back spasm? I've heard this story too frequently. The scenario is scary and confusing to most people, especially my typical patient that is relatively active, lifting weights, running, etc and this two pound shoe just did them in. I get it, trust me. I've been there and have seen too many of you to think you're crazy. The bad news... this sucks! It hurts really bad. The good news... it is totally treatable, you're not broken and will be back very soon with proper treatment. So what is your normal course of action? Statistics show most people go to their primary physicians and wind up with pain control medication and muscle relaxers. Sound familiar? A smaller percentage of people go to a chiropractor and get frequent adjustments, often feeling great relief that seems to be transient and sometimes completely gone by the time you reach the car looking forward to that next visit. A third segment of suffering people will go straight to physical therapy often getting range of motion and baseline strength exercises to build up that core to protect your spine but again finding a long road to recovery and often transient relief. The fourth and final segment will do nothing, confining their situation to bad luck and either "walking it off" or becoming bed ridden for days, weeks or months on end, and in the worst of cases live life with "a bad back". None of these sound fun and we have created a model that defies these typical scenarios in favor of putting the responsibility and power back into the patient's hands. If the patient understands what happened, what is wrong, how to fix it, and most importantly how to avoid re-aggrevating the condition the vast majority will get better quickly and completely return to your normal activity with a perfectly healthy back. Check out our process and if you are struggling with back pain currently, desperately googling please try this out and give us a call if you can use help. 

FIRST, ASSESS

This is vital. Back pain can have many causes but statistically speaking most low back pain is discogenic, meaning the intervertebral discs between the bones in your spine could be causing the pain, in clinical terms we call this a space occupying lesion, or I'm sure you've heard of a bulged disc. We will focus on this type of pain today and more specifically flexion intolerance. If you have not been assessed and diagnosed this may not be for you. Please seek out a qualified clinician if any of these movements, exercises, or self care is painful. 

  1. Lay down on your stomach with your chin resting on your hands. Attempt to relax as much as possible. Take 10 nice relaxed breaths in this position.
  2. Prop yourself up to your elbows, almost as if your reading a book on your stomach. Relaxing in this position, allowing your hips to sag to the floor, thinking of relaxing the back and only using your arms and chest to keep you up. In this position relax for 20 slow controlled breaths. 
  3. Return your chest down to the floor and allow 10 breaths. 
  4. Prop back up to the elbows and how for 20 slow controlled breaths. Again, reminding yourself to relax as much as possible and think of hanging your back on the bones and joints, not bracing your muscles whatsoever. 
  5. Return your chest down to the floor and allow 10 breaths. 
  6. Last time, prop yourself back up and take 20 slow controlled breaths. 

So, what happened? Interpret your pain experience at this point. Did your back pain get worse? Then this is not a good starting point for you. We can help, but your back pain is not the typical flexion intolerance and would require a different assessment and treatment all together. However, if your back pain got slightly better, or maybe you had sciatica and shooting pain down your leg that now seems to be better, or at least not traveling as far down the leg (we call this centralization of pain) then this is for you. 

Why flexion hurts

In most cases what is causing your flexion intolerance is a problem with your movement. Again speaking in assumptions, most likely you are hinging at your low back instead of your hips when you bend over. The S shaped curve of your spine helps evenly distribute load throughout your back with movement. When bending forward the discs in your spine are pushed backwards. This can become an issue with bulging which threatens the sciatic nerve and CNS. Protective muscle spasms issue and you may feel locking of your low back or chronic tightness of the low back as they attempt to protect your spine and maintain that curve. You can see why focusing solely on the muscle tightness, joint position, or core engagement is not a good idea. We have to piece the entire puzzle together and treat the body. We have to simultaneously remove the protective muscle tightness, heal the disc, and improve movement quality to truly find relief of the perceived threat and get you back into action. 

 

Treatment

Remove Pain

I like to tell patients on the first visit that we need to "put a bandaid on the situation". You come to me because you're in pain, so my first priority is to remove that pain. We often begin with laser therapy (a blog post of it's own), to help speed healing, and prep the tissue for treatment. Other pain reliving modalities include ice, heat, rock tape, biofreeze, and manual therapy. All of which are utilized under indicated conditons but for you at home I would recommend trying biofreeze, ice or heat and using what seems to work best for you.

Treat the cause

Again, we are focusing on discogenic, flexion intolerant backs. In this case the method that has shown to be far superior in terms of treatment is the McKenzie Method. Robin McKenzie is a physical therapist that discovered the techniques and system used and it was entirely by accident. Follow me here... one day Dr. McKenzie was treating a patient when another walked into his clinic. As he was currently busy he asked the second patient (with discogenic, flexion intolerant pain) to go ahead into the second room and lay face down. Dr. McKenzie forgot that the table in room number 2 was in a position much like a dentists chair, so to lay face down the patient would be in a position of extension. When Dr. McKenzie finished with patient number 1 and walked into room number 2 the patient exclaimed "thanks doc, I feel so much better!". Baffled Dr. McKenzie went to work to understand the mechanism of which simply laying in extension helped to cure this patient's back pain. What he discovered is amazingly simply and effective and has been researched extensively since. Essentially when you find a directional preference (a direction of movement that causes the pain to either vanish or move out of the leg toward the low back) you then exercise and mobilize into that position, effectively pushing the disc centrally and removing the threat. The McKenzie Method is often bastardized by those that do not understand the system and simplified into an extension based system when it is actually any direction of movement as long as the pain is being centralized or abolished. Anecdotally I have seen one patient that required flexion, but this patient was post partum and had just spent 9 months leaning into extension. Anyway, back to your flexion intolerance... depending on severity and ability to perform the exercises I ask the patient to spend some time in extension, whether that means laying with a couple of pillows under the chest, on elbows, or even performing full press ups. This movement gets repeated throughout the day as often as possible. I like to tell my patients that their arms should be tired or sore the following day from performing the program. 

Remove the insulting behavior 

Education of what exactly is causing the pain is absolutely key to fixing the problem. At this acute stage flexion is not helping. So stop stretching your hamstrings, I know they feel tight but bending forward to grab your toes truly is aggravating the issue. Understanding new mechanisms to perform daily activities like tying your shoes and brushing your teeth without rounding your back may seem boring and fruitless, but if I were to do one thing with this patient this would be it! Once the healing has taken place you will tolerate some rounding of your low back, to put on your shoes of example, but moving forward we would like to optimize the quality of your movement, particularly while lifting or squatting to improve the reliance of the low back and reduce likelihood of future episodes of threat and spasm. 

 

 

...Part II

In Part II we will dive into what we do after you are out of pain but not out of the woods. This is where the magic happens. By training proper movement quality, strength, and endurance we can build a resilient low back to avoid reaggrevation of the injury and get back to the things you love to do! 

 

 

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Eat like a Caveman?

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Eat like a Caveman?

Author: Brady Burrows

Unless you’ve been living under a rock for the past few years, then you’ve probably heard of the paleo diet. Maybe you have friends who are paleo, or maybe you’ve tried it yourself. Fresh fruits and veggies, lean proteins, no processed food or grains. Sounds great, but let’s dig a little deeper. What is the paleo diet and does it work?

What is the paleo diet?

A couple of million years ago our ancestors thrived on a diet consisting of lean meats, nuts, and fresh produce. Eventually agricultural practices were developed and our hunter/gatherer diet changed to a diet high in cereal grains. (wheat, oats, corn) It is this diet shift that advocates of the paleo diet point to as the root cause of all our modern chronic diseases we see today. Robb Wolf a former research biochemist and author of New York Times Bestseller "The Paleo Solution" claims, “it is our modern diet full of refined foods, trans fats and sugar that is the root of degenerative diseases, such as obesity, heart disease, diabetes and many other chronic diseases.”  

Where did the Paleo Diet come from?

The idea behind the paleo diet was first cited in Weston Price's 1939 book titled "Nutrition and physical degeneration, a comparison of primitive and modern diets and their effects." During the 20's and early 30's, Dr. Price traveled all over the world and made detailed observations about diet and health in non-westernized countries. He found that tribes who had adopted a modern diet (heavy in grains), had declining health. Although Price made these claims in the 30's, it wasn't popularized until 2002 when Dr. Loren Cordain released his book "The Paleo Diet". This book was the first of its kind available to the public, and the paleo diet quickly became a household name. Today Cordain and Wolf are widely known for their part in popularizing the paleo diet.

Paleo diet model

  • Animals: beef, chicken, pork, turkey, bison, fish
  • Animal products: eggs and honey
  • Vegetables
  • Fruits
  • Raw nuts

When the paleo diet was first introduced things like legumes and dairy didn’t make the cut, but many paleo enthusiasts have recently added things like grass fed dairy and legumes into the mix.

Does it work?

In 2007, a study was conducted on the effects the paleo diet had on glucose tolerance in diabetic and pre-diabetic individuals. The individuals were put on either a paleo diet, or a mediterranean diet. (high in veggies and fat, moderate protein) The outcomes measured were glucose tolerance, insulin levels, weight, and waist circumference. The study was conducted for 12 weeks. At the end of the 12 weeks, participants on the paleo diet lost an average of 11 pounds and 2.2 inches around their waste, compared to the control group who lost 8.4 pounds and 1.1 inches around their waste. Furthermore, all 15 of the participants in the paleo group had normal blood sugar levels, compared to 7 of 15 in the control group. While this is just one study, I think it’s important to highlight the positive impact that the paleo diet could have on certain demographics.

Flaws of the Paleo Diet

  • Any diet that lists foods as "good" and "bad" or cuts out a certain food group is hard to follow. It leads to all or nothing type thinking, which makes it hard to stay consistent. Without consistency, you won't get the results your looking for.   
  • There isn't enough evidence yet for excluding dairy or grains. Sure, some of us may benefit from cutting back on dairy and grain consumption or even cutting it out completely. At the end of the day listen to what your body is telling you.
  • Cutting out dairy completely could lead to deficiencies in calcium. If you choose to go paleo, look into supplementing calcium.                                                

Want to go paleo? What to do next

  • Check out thepaleodiet.com The website is run by Dr. Loren Cordain, and has a ton of recipes and tips to help with your paleo lifestyle.
  • Sit down with a coach and talk about your health goals, or setbacks. We would be happy to make you a nutrition template or give you some pointers in the right direction.
  • Make small manageable changes and go from there.
  • CONSISTENCY IS KEY!!!

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Set Range Adaptations

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Set Range Adaptations

Author: Billy Snyder


In my last post we talked about rep ranges and how a a certain rep range can have different adaptations compared to another. This week we will be following up with a talk about sets.

First off, what is a set?  Very simply, a set is a group of reps.  For example, you deadlift 225 pounds for 5 moderately-hard reps.  Congratulations, you completed 1 set!  Now, the question is, how many sets can or should you do?  Simply put, it depends.

It depends on what though?  Firstly, what is your goal and where are you starting from, ie. beginner, intermediate, or elite?  How much volume can you recover from?  Are your muscles genetically more fast twitch or slow twitch?  What weights are you planning on working with in the training session and how many reps?  Are you peaking, building strength, or building muscle?

Peaking for an event, fatigue needs to low in order for fitness to be high.  Doing high volume (reps x sets) would not be the best during this time because high volume causes fatigue which we are trying to avoid.  

If on the road to build strength, the amount of sets could be on the higher or lower side depending on what week of the strength phase someone is in.

The following applies to the heavy day for the main lifts (i.e., squat, bench, deadlift, military press, etc.).  Light days may play by their own rules.  Another topic for another time.

 

Heavy Day Options

<2 sets

-Positives

-Less time needed and energy spent

-Mental preparation (specifically for strength sports)

-Negatives

-Multiple sets have been shown to produce more strength

-With low volume, some people fail to gain strength

-With low volume, less skill practice

>4 sets

-Positives

-Strength gains from neural adaptations

-Strength that lasts is built with volume

-Increased testosterone production

-Negatives

-Requires more time and energy

-Reduction in training weight

 

Beginners will generally use more sets within a single training session, unless they are using higher frequency.  Honestly, they are lacking strength and cannot tolerate the same poundage as a stronger lifter.  No need to emulate what high level strength athletes are currently doing. 

Journal your training sessions, including name of exercise, training load, sets and reps.  You can use this information to learn about yourself and what you are able to handle and recover from. Enjoy the journey.

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How to Improve Your 5-10-5 Time

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How to Improve Your 5-10-5 Time

Author: Dr. Matt Zirretta

The 5-10-5, aka the Pro Agility Drill is the method of choice to measure an athlete’s speed/quickness with change of direction. This is a drill you will see at the NFL Combine and also here at Engineered Per4mance prior to starting our sports performance training program, Alpha Athlete. The 5-10-5 is the definition of agility – The ability to accelerate, decelerate, stop, and reaccelerate.

The Test

  1. Start by straddling the middle line
  2. Explode laterally, running 5 yards right and touch the line with your hand
  3. Sprint 10 yards left and touch the line with your hand
  4. Sprint 5 yards right back to the middle line

Tips

  1. Stagger your feet. Place the foot in the direction you plan to go first slightly behind the other foot. This allows you to open your hips when exploding laterally in the initial 5-yard segment.
  2. Distribute your weight unevenly. Load the leg in the direction you plan to go first (your back foot). This allows you to save time by not having to shift your weight to get yourself moving.
  3. Gain ground on your first step. Explode laterally on your first movement by pushing off the back leg and taking a cross over step with the other. I see way too many athletes take a drop-step to get moving = wasted time.
  4. 80% speed going into first turn. The first 5-yard segment is short and quick. Not getting up to full speed might seem silly since the test is timed, but the faster you go the harder it’ll be to slow your body to change directions.
  5. Stay low.  Stay low during your turns to change directions more efficiently. The higher your center of gravity, the more difficult it’ll be to decelerate and reaccelerate. Elephant versus cheetah, who will change directions quicker?
  6. Lean inside, plant outside.  As you approach a turn you will set your inside foot with a bent knee and touch the line with the outside foot. This allows you to have weight on the inside leg, which is in the direction you will be accelerating after touching the line.
  7. Sprint THROUGH the finish. Do not pull up. Even though you only have to sprint 5 yards, think of it as 10 yards and sprint to the far line.

Clinical Insight

    Although this is a test of speed/agility it is also a test of balance when having to change directions rapidly. Most young athletes’ bodies are growing and changing, which impacts their kinesthetic sense (body awareness). Core strength is the pillar of an athlete’s stability and helps them recognize where their body is in space. “Proximal stability for distal mobility”. Incorporating core stabilization exercises and balance activities (both static and dynamic) along with speed/agility training will help decrease your 5-10-5 time.

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Rep Range Adaptations

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Rep Range Adaptations

Author: Billy Snyder

Repetitions, aka Reps.  Each rep range has their place. Knowing what the goal is allows the the plan to be devised.  In this article, we will start with rep ranges and discuss what each range has to offer.

>10 Rep (<65% 1RM)

Reps this high develop muscular endurance via slow twitch muscle fibers.  This range does a great job in building the strength of tendons due to the time under tension. Muscles move tendons, tendons move bones.  When increasing weight too fast, tendonitis can be a result because of improper preparation. This is due to your muscular strength increasing faster than your tendons capacity.  Don't chase strength, nurture it for the long haul.

7-10 Reps (65-75% 1RM)

Reps in this range allow for volume to be high.  This is great for someone who is wanting to lose weight or gain weight, because the volume (volume= reps x sets), is high.  They typically start at the beginning of a lifting cycle, because building more muscle has the opportunity to build more strength. Makes senses.  This phase also would allow someone to lean out if that was their desire. However, their eating habits have to their resemble desire.  

Working with younger athletes, most of the reps in the weight room should be done in this range.  With their training age, being so young, a hypertrophy phase would be more beneficial than a strength phase.  They get a lot more volume done so learning the movements occur faster.  Weights are light enough for technique work but also for safety.  

4-6 Reps (75-85% 1RM)

The bread and butter of strength training is within these reps.  It is the foundation for strength.   Heavy enough for muscular tension to be high but also light enough for adequate volume to be achieved.  The majority of your training should be in this zone.  By majority, I mean over 50% of your monthly volume should be in this zone.

1-3 Reps (85-100% 1RM)

Low reps with heavy weights can peak strength but are like a jet's afterburner.  It should be used sparingly and done appropriately. The strength adaptations  due to the Central Nervous System (CNS) mechanisms that regulate muscular tension, improve anaerobic energy system, and synchronize coordination of motor units to generate powerful muscular forces.   Safety is also a big concern.  If a weight is near maximal, having spotters is definitely needed.  If lifting near maximal weight is done frequently, it can have negative side effects, A big side effect is a decrease in strength, counter to our goal to build strength, due to CNS fatigue.  Normally, these reps with heavy weight are employed at the end of the cycle during a peak for a competition or test, so that fitness stays high without fatigue.  There is an exception to this, with the conjugate method, made popular by Louie Simmons of Westside Barbell.  Even with them, if you know the system, they don't break their records in training by 50 lbs.  No, they break them by 5 lbs so that their training remains optimal versus maximally.

There is a difference between testing and training.  The majority of the time, train, and test periodically.  The opposite should not be so.

In its simplistic form, to get stronger, just lift weights. Someone who begins lifting weights, will get stronger with little effort.  After a while, adaptations start to dwindle and it gets harder to have continual improvement.  To get exceptionally strong, train smart and optimally, and for goodness sake, train safely for continued growth.

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Rehab to Performance: Gymnast with wrist pain

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Rehab to Performance: Gymnast with wrist pain

Rehab to Performance is Dr. Joey's experience with different patients on the clinical side of Engineered Per4mance. In this context he will walk you through common issues he is seeing in the clinic and how to fix it in a case study format. 

Rehab to performance: Gymnast with wrist pain

This week I saw a high level gymnast presenting with wrist pain in extension. She is a young, naturally hyper mobile athlete. I'm talking hands on the floor with multi-segmented flexion and able to touch her thumb to her forearm (Bighton score of 9/9). She presents with lots of pain when doing handstands and especially with dynamic hand compression moments like pushing off the floor during tumbling routines. 

Upon functional exam she had limited overhead and horizontal adduction shoulder mobility. Diving into local testing revealed a lack of soft tissue mobility in the lats, teres major, and pec minor pulling her shoulder in an anterior and internally rotated position. She is able to express full scapular upward rotation with shoulder abduction but lacks thoracic extension. She can express full wrist dorsiflexion mobility, getting to about 70° actively and 80° passively. This is hyper-extension in the general population but in gymnastics the book is re-written. 

You can see that without full overhead mobility landing in a handstand is impossible, so she makes up for the lack of movement at the shoulder with excessive movement in the wrist. She lands in a handstand or pushes off the floor, cranking that wrist into hyper-extension causing dorsal impingement, pain, and rebound tightness in the flexor mass. 

the fix

1. Stop aggravating the injury. Our first step in any process of rehab is education the athlete about what exactly is causing the issue and how to avoid it for the time being. This particular athlete needs to avoid excessive wrist extension for the following couple of days while the inflamed tissue heals and recovers. She is also advised to stop doing stretches for the shoulders that are by passing the tight structures and simply cranking on the joint capsule, remember she has excessive ligamentous hyper mobility so we are really just perpetuating the issue with stretches like these and setting the athlete up for chronic joint instability and worst case dislocations compromising the labrum and other supporting structures. 

2. Introduce soft tissue mobility to the indicated structures, in this case the lats, teres minor, pec minor, and wrist flexor mass. My favorite techniques include simple pin and stretch and instrument assisted work. The skilled manual therapy should be left to the clinician but the session should get at those indicated structures and create measurable, immediate change. 

The patient is sent home with with self myofascial homework, a few of which are shown below. Not shown are wrist flexor mass mobs on a ball (video coming).

 

3. Address joint restriction in the thoracic spine. The lack of thoracic extension with full shoulder flexion is addressed using joint manipulation. My favorite technique for thoracic extension manipulation is an anterior adjustment but the goal can be achieved a million different ways.

4. Add baseline strength and dynamic stability training. Immediate increases in joint and soft tissue mobility will be lost relatively quickly if not followed with stability and strength training to teach the body how to use and control the new found range. Without this essential step I have seen the patient walk out of the door feeling great only to find tightness creep back up by the time they get home. Remind you of your last chiropractic or massage therapy appointment? Increasing rotator cuff strength to help control the capsular hyper mobility is achieved with an innumerable amount of instruments but I like simple so I often start with tubing. EMG studies have shown standing external rotation with thoracic rotation to be highly effective at activating the posterior cuff so we tend to start here then progress to TRX face pulls, Y's, and T's. I finish our sessions with rhythmic stabilization exercises starting with the patient supine and the shoulder at 90° flexion, progressing about 10° further into flexion after the patient can demonstrate competency, strength, and stability in each position. After approximately 110° I progress the patient to half kneeling at 110° and continue up to 180° and finally to standing. At this point the patient can demonstrate full overhead mobility and dynamic stability in a standing position. The last step would be to get the patient inverted (as she will do in her sport) and assure full overhead shoulder mobility is achieved with no wrist pain. 

 

In conclusion I will see this patient once per week for the next month working on the above outlined treatment plan and expect her to be able to achieve a pain free handstand within the month assuming we avoid all insulting behavior along the way, which is often a tall order with this population and emphases the importance of PREhabilitation. If you are a gymnast and experiencing wrist pain reach out to us. If you are clinician and have questions or comments please drop them below or shoot me an email.

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Supplement 101

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Supplement 101

Author: Brady Burrows

If you have ever visited your local GNC or supplement superstore then you have been bombarded with claims that “this pill will knockout fat”, or “this drink will pack on muscle”. Well I’m sorry to tell you, but there’s no magic weight loss pill. While nothing will help a bad diet or poor workout regimen, proper supplementation can help fill gaps in your nutrition. So without further ado, here’s my list of supplements that give you the most bang for your buck.

1. Whey Protein

Protein is essential for muscle growth and recovery, and not getting enough will definitely hinder your results. There are many different kinds of proteins but whey comes in at the top. It is a fast digesting protein that breaks down and gets to your muscles quickly. Making it ideal for right after a workout or waking up. Benefits of whey include, increased muscle mass, increased protein synthesis and faster recovery.

How to take it

I recommend getting .8-1 gram of protein per pound of body weight a day. (ex. 200lb person = 160-200 grams of protein a day) I’m not saying to drink all of your protein, but supplementing whey will make it much easier to reach those numbers.

2. Creatine

Creatine is naturally occurring in your body and found in red meats and oily fish. Your body takes the creatine and turns it to creatine phosphate. Which plays a big role in ATP production, your muscles main source of energy.  Benefits of creatine include, increased muscle mass and strength, increased endurance, increased power output and faster recovery. Multiple studies have shown that creatine was able to show a 12-20% improvement in strength and a 12-26% increase in power output.

How to take it and side effects

The daily recommended dose of creatine is anywhere between 3-5 grams depending on body weight. While some companies recommend a loading phase no research has proven this. You may have heard over the years that creatine is bad for your kidneys, but this is simply not true in otherwise healthy individuals. In fact, creatine is one of the most widely studied supplements on the market and no research has shown creatine to have any negative effects.

3. Fish Oil

Fish Oil is a common term to describe two different kinds of omega 3 fatty acids, Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA). The benefits of supplementing fish oil are endless, and work best when the ratio of omega 3 and omega 6 fatty acids are equal. Omega 6 fatty acids are high in a typical diet of red meats and eggs, so supplementing with fish oil will help to balance that ratio. Fish oil has been shown to reduce triglyceride levels by 15-30% in overall healthy people, increase your bodies fat oxidation (percent of energy being taken from fat tissue), and in one study was showed to help with muscle soreness after exercise. Furthermore, it has been shown to have a multitude of benefits on the overall health of your brain. Results of those studies showed an improvement in memory, a decrease in anxiety, and reduced reaction times.

How to take and side effects

The American Heart Association recommends taking one gram of fish oil a day for general health, but that number could be adjusted depending on your diet again aiming for a balancing of the omega ratio. 

 

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Rehab to Performance: Weekend warrior with knee pain

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Rehab to Performance: Weekend warrior with knee pain

Rehab to Performance is Dr. Joey's experience with different patients on the clinical side of Engineered Per4mance. In this context he will walk you through common issues he is seeing in the clinic and how to fix it in a case study format. 

Rehab to Performance: Weekend Warrior with Knee Pain

This week we will discuss a patient that presents with a very common complaint of knee pain. This weekend warrior belongs to the local YMCA and is attending the "body pump" class at least twice per week. I'm not entirely sure what the class entails but he reports doing plenty of lunges and loaded squatting. He is super active otherwise going on hikes, enjoys running, and recently returned from a vacation in Colorado beat up from an accident down the alpine slide. He presents with knee pain that he describes as tugging and nagging pain on the base of the patella near the patellar tendon but often just lateral to it. He reports walking without pain but when he goes for runs it always acts up a couple miles in and he will pay for the run for a couple of days. 

After comprehensive orthopedic testing it is clear his knee is structurally sound and no passive movement could reproduce the pain experience. The functional exam is where it always gets interesting. With knee presentations like this I like to do a single leg depth squat to evaluate dynamic hip strength controlling the knee, but also limitations in mobility at the ankle and hip. What do you see?

 

If you answered KNEES COLLAPSING you would be correct. Every competent strength coach and clinician in the world can tell you we want to avoid this position especially while working under load. Where the exceptional coach shines is in the correction. "Knees out" just doesn't resonate with most people. It makes sense but the athlete knows they shouldn't be in this position, they might not have the ability to prevent it. 

 

The Fix

1. Stop the aggravating behavior.  I am the last person to tell someone to stop exercising, instead we suggest some alternatives. Right now we will build a "rehab" protocol to work for the next couple of days. For the following week we want to unload the squat and lunges done in class and focus on quality movement first. Having someone to watch the movements is instrumental. 

2. Normalize pelvic positioningA study published in the American Journal of Sports Medicine shows us someone presenting with anterior pelvic tilt of just 10° can contribute to a decrease of 6-9° of hip internal rotation and, intuitively, if the pelvis is anteriorly tilted the hip flexors tend to become hypertonic as they stay in a shortened position limiting hip extension. The thomas test and ascension drop test (pictured below) clearly demonstrate an anterior pelvic tilt positioning. In the ascension drop test, if the pelvis was in a neutral position the idea is that the femoral head would clear the acetbaular rim and the knees would be able to drop to touch the table. As demonstrated below the knees are well above the table indicating the pelvis is tilted anteriorly and the femoral head is running into a boney block at the acetabular rim. Fixing this is one of our "party tricks" because it doesn't take many passes of soft tissue work or reps of an exercise, as soon as the pelvis is back at neutral you clear space, the knees drop, and the patient can conceptualize exactly what is happening.  My preferred approach to normalizing pelvic positioning is a plethora of exercises by Postural Restoration Institute. I typically start with the "all four belly lift" or "90/90 hip lift". 

3. Normalize soft tissue ROM.  Next we attack the indicated tissue elasticity dysfunction. In this case I used Active Muscle Pumping to the hip rotators in both directions targeting the lateral rotator group, glute max, min, and finally the piriformis. A few passes here tends to clear up the left over range we are looking for. 

4. Introduce core-lower quarter control exercise to improve dynamic control of the hip and knee. Starting with Kolar dying bug against the wall as pattern assistance, clam shells, and progressing to standing mini-band monster walk sequences and kettle bell suitcase carries

5. Return to functional exercise. At this point the patient has no more pain experience and is demonstrating baseline levels of strength and control in all planes of motion. We can now safely move back to functional exercises that he enjoys including bodyweight supported squatting and lunging with PNF valgus input at first, and progressing back to the loaded movement. 

6. Maximize functional stability with plyometric control. We didn't get to this phase due to resolution of pain but if I were to see the patient further this is where the treatment plan would lead starting with jump squats, diagonal squats, and agility ladder/banana step drills asking the patient to dynamically control the core and lower quarter in a reactionary environment. 

7. Build power by adding triple extension exercises including Kettelbell swings, and olympic lift pulls/variants. This is where our practice shines as we have the ability to move patients directly into functional performance and fitness training within the facility and with direct collaboration of clinicians and performance specialists. 

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Tactical Strength Challenge

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Tactical Strength Challenge

The Tactical Strength Challenge (TSC) is upon us. This event, put on through StrongFirst, started as a way to help test workplace performance for military  and law enforcement operators, but soon became a great way to test any level of training.

The TSC is made up of three tests. 

  • The three attempt max deadlift (tests absolute strength)
  • Pull-ups for max reps or Flexed Arm Hang for time (tests bodyweight relative strength)
  • Kettlebell snatches for max reps within 5 minutes (tests cardiovascular endurance)

There are different divisions which are based on male or female, pull-up or flexed arm hang, and weight used for the kettlebell snatches. 

For those who would like to partake in this event but are worried about snatching with a kettlebell and pull-ups, no worries.  The Saturday 9am and Wednesday 6:30pm classes will become a TSC prep class.  In this class we will be specifically learning and training for these events.  I also ask that you look at what division you would like to compete in and let me know that way we can plan specifically for you.

If you would like to join us on Saturday October 1, 2016 for some fun and test your own abilities, sign up here and show up Saturday August 6th for the first TSC prep class. Also, please let us know ahead of time, that you have signed up before .  If you have questions about this event, please look here or you can ask Joey and I.

 

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Calories are King!

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Calories are King!

There are many diets that promise weight loss, even the Twinkie Diet. The Ketogenic diet has been a diet popularized by many for it's ability to increase body fat loss in comparison to other diets.  In this very recent study, it was shown that a Ketogenic Diet (KD) slowed fat loss, increased protein utilization, and increased muscle loss. However, the biggest take away from the study was that in a hypocaloric diet (reduced calories comparative to baseline), whether high carb or low carb, weight loss occurred. To expand further on this concept, Dr. Mike Israetel in The Renaissance Diet notes, 

The more carbs that are consumed, especially on a hypocaloric diet, the more energy there is for training, the more insulin there is for anabolic stimulus, and the more glycogen there is for future intense training, recovery, and anabolism. 

In the video below, Dr. Mike Israetel goes over KD and how it relates to an athlete's performance and recovery. Carbohydrates greatly increase performance and recovery.

Could there a purpose for a KD?  For sure.  It has been shown that a high fat, extremely low to zero carbs has helped reduce tumor sizes and reduce seizures in people with epilepsy.  

Understanding calorie intake is fundamental in your eating habits. We have to learn to add and subtract before we try our hand at integrals and differential equations. To lose weight, maintain, or gain weight is about the amount of calories taken in.  If you eat "clean" but gain weight or can't lose weight, don't blame the foods, blame the amount.

 

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Shoulder popping and grinding

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Shoulder popping and grinding

Popping and grinding isn't normal. Some crepitus may never go away but it should be a warning sign of dysfunctional movement or instability. Often the popping and grinding noise is accompanied with a deep achy feeling in the front top or back of the shoulder and is frequently diagnosed as scapular dyskinesia. 

Scapular dyskinesia is also referred to as SICK scapula. The acronym refers to the physical findings often presented:

  • Scapular malposition
  • Inferior medial border prominence
  • Coracoid pain and malposition
  • Dyskinesia of scapular movement. 

Yeah, they reached a bit with the K but you get the point. 

QUICK ANATOMY REVIEW

The shoulder joint is a complicated one. It is a ball sitting in a shallow socket, often described as a golf ball on a tee. The ligaments, glenoid labrum, and rotator cuff musculature help support the joint but even with all of these supporting structures accounted for, the majority of shoulder injuries or pain can be attributed to a loss of stability. 

SUBJECTIVE FINDINGS

Patients with scapular dyskinesia often complain of grinding at the shoulder blade, pain in the front of the shoulder or both. Often the patient also presents with pain and tightness in the chest musculature. This finding is usually indicative of chronically shortened positioning with the shoulders rounded and inhibited antagonists. 

STATIC FINDINGS

As you look at a patient with scapular dyskinesia it is helpful to notice the resting position on the thorax but keep in mind the magic really happens during movement, so be careful about just treating what you see statically. Often dyskinesia is associated with a prominent inferior angle of the scapula. This finding can indicate excessive upward scapular rotation and anterior tilt, or excessive thoracic kyphosis. Also, it can be helpful just to look at the two scapula and determine symmetry. A qualified clinician should be able to deduce which muscles are tight, or which are inhibited leading to the scapula sitting in an asymmetrical resting position. 

DYNAMIC FINDINGS

Dyskensia! Imagine that. Simply put, you will see abnormal movement. To know what abnormal is you need to know what normal is and normal shoulder movement is very hard to nail down, so seek a qualified clinician for this part. Easy things to spot are no scapular movement as the arms elevate overhead, or excessive winging in the same movement. 

TREATMENT

A qualified clinician should help you deduce exactly which muscles need work as manual therapy is often the first stage of treatment. Using a proper movement assessment (SFMA for example) this clinician should also be able to point to specific movement dysfunction outside of the shoulder that may be playing a roll in altered shoulder movement including the neck, thoracic spine, and frequently the opposite hip! After manual therapy is used to help down regulate tight muscles and facilitate those that are weak we jump straight to therapeutic exercises. Beginning with classic push up plus and rotator cuff isometrics is a solid start, but the exercises need to progress to promote functional stability about the joint. My personal all time favorite shoulder stability exercise in such a population is rhythmic stabilization drills. Often I will begin with the patient supine with the shoulder at 90° (as in the video below), progressing to half kneeling, then elevating the shoulder, and finally to standing until the patient is able to stabilize in standing with full arm elevation and no pain. This takes work on the patients part but it will help build that strong stabile shoulder. 

In summary, no, grinding and popping generally is abnormal and pain most definitely is abnormal. If you are feeling this sensation in your shoulders or have been diagnosed with SICK scapula reach out! We would love to help you get back pain free movement!

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Pregnancy pains?

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Pregnancy pains?

Being pregnant looks miserable. My wife is currently pregnant with number 2 AND 3, and I have to say this time around is taking its toll. Our bodies are amazing things but I am convinced the female body is an absolute work of magic. The pregnant female body releases a potion of hormones to seamlessly allow the body to stretch and conform as the new addition is developing (a whole other wonder entirely). As many of you know, this incredible change comes with some aches and pains. As many of you don't know, a chiropractic performance therapist is uniquely qualified to help during this sometimes, helpless period. Your obstetrician generally has very limited options for prescribing medical treatment during this sensitive time in baby development, which presents a great opportunity for sports chiropractors. I specify sports chiropractic because generally an audible adjustment as you might be used to isn't, in my opinion, the best way to treat a prenatal patient. As a sports doc we have education and experience in techniques that have been shown to provide fantastic outcomes in such patients. Here are a few common musculoskeletal conditions that pregnant patients commonly present with and how we help:

PUBIC PAIN

Let's just get the awkward elephant in the room out of the way immediately. This can be absolutely paralyzing pain for some prenatal patients and many are hesitant to see anyone about the condition because of the intimate areas involved. Remember that incredible concoction of hormones I spoke about a minute ago? Well they reach the pubic symphysis as well. The process is vital when giving birth, allowing the pelvic bowl to stretch and fit a little one through the birth canal but during pregnancy the constant stretching on the symphysis can cause inflammation and exquisite pain. 

HOW WE HELP

Often the adductor musculature is found to be hypertonic. With all the relaxing of ligaments and stretching of joints, excessively tight muscles pulling in the same direction surely doesn't help. Using myofascial release, massage,  Active Release Technique, or Graston we can reduce neural drive and successfully relax the muscles. We then treat the joints. When adjusting patients I typically use a more common technique but with prenatal patients I have found activator adjustments to the SI joint (in the back) and superior pubic rami (in the front) to help relieve tension and pain. I finish the treatment with Rock Tape application to help support the growing belly and take as much stress off of the symphysis as possible. Home remedies include using an ice pack just before bed and simple exercises (PRI based) to help keep the joint aligned on your own. 

 

Rib Pain

A complaint of pain just at the diaphragm and lower ribs is very common among the pregnant population. As the weight of the abdomen pulls on the obliques (which attach to the ribs) it is not uncommon to experience pain with twisting and deep inhalation. 

How we help

Chiropractic adjustments of there ribs and thoracic spine go along way in pain relief for this type of ailment, but stopping there would be a mistake. Myofasical release using Graston technique is extremely beneficial and not contraindicated with this population. Often after just one treatment in a matter of minutes the patient will find relief with deep breaths and walking. Per usual, I follow the treatment up with Rock Tape application following the ribs and often the myofascial sling to support the musculature. 

 

Swelling in limbs

Swelling is often noticed in the second trimester of pregnancy and can progress through the third as the child grows. If left untreated swelling can disrupt nerve activity and lead to numbness or tingling in the limbs. 

How we help

Swelling in an extremity is easily managed using a NormaTech Pulse Recovery System, and manual therapy on the lower limbs to promote muscle contraction and lymphatic pumping, effectively pushing effusion back toward the heart. Rock Tape application can also be used to lift the skin and provide more subcutaneous space for lymphatic drainage. 

 

Low Back Pain

Probably the most common complaint in prenatal patients that we see is low back pain. After all, that is typically what chiropractors are known to treat. As the belly grows and weight is disproportionately on the front end, we tend to lean backward to keep our center of gravity. This works until it doesn't and the joints in the back of the spine become weary, and the muscles surrounding these joints guard.

How we help

To treat this condition we start with myofascial work on the indicated muscles. Active Release Technique and Graston technique is a go-to for fast relief. Joint adjustment using the Activator is typically helpful. Again, a supporting Rock Tape application helps the patient support the new weight in a more neutral posture, and finally showing the patient exactly how to handle the weight as you grow is instrumental in a pain free pregnancy. 

 

If you are pregnant and experiencing any discomfort, please reach out. We are happy to help. 

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Heal Faster with Laser Therapy

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Heal Faster with Laser Therapy

At Engineered Per4mance we understand your urgency in getting out of pain and back to that active lifestyle you lead, which is why when a treatment modality comes along that promises everything from faster healing times, decreased pain symptoms, improved microcirculation, and decreased swelling we jump! Not to say we don't keep rational and scour the research (because we did, and it's there), but we wasted no time and let me explain why and how this adjunct to our treatment will help you get back in action even faster. 

What is it?

The laser unit looks and feels like a laser pointer on steroids. You will see a red dot on the treatment area and feel a "warm glow." It's not too hot but you will feel it, in fact its quite soothing. The chemical reaction is called photobiomodulation, but because that word is the worst let me try to explain what it means. The light emitted from the laser travels deep into your tissue where it effects tiny organelles within each and every cell called mitochondria. How's that for a biology class flashback? If you weren't sleeping or playing snake on your calculator you'll remember the mitochondria are responsible for power production. They are where the electron transport chain is housed and produces ATP, which is essentially the cellular unit of energy. Further, the light stimulates the cellular production of nitrogen oxide (NO).  These chemical cellular events have a huge impact on your injury status and healing time! So if you want to strangle me for having read that paragraph and just want to know why this matters to you read on...

What does it do?

  1. Decrease healing time. This should be enough to convince you its worth trying in its own right. The increased ATP production allows cells more energy to repair and regenerate injured tissue.
  2. neuropathic pain alleviation
  3. strength loss attenuation after strength training
  4. treatment of myofascial pain

Why Laser Therapy?

  1. great alternative to surgery and medicine
  2. no side effects.
  3. consistent results
  4. endorsed by major medical institutions - American physical therapy association, world health organization, international association for the study of pain, lancet medical journal.

Simply put, the laser is a fantastic adjunct to our chiropractic performance therapy at Engineered Per4mance. It speeds the healing process in addition to our myofascial work, joint manipulation and exercise prescription. This is our recipe to getting back to a pain free active lifestyle. If you are struggling with a nagging injury or know someone who is, give us a call at 515-964-2322 or shoot us a message here!

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Quickly improve your ankle mobility

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Quickly improve your ankle mobility

Ankle mobility is a prerequisite for so many movements in our athletic pursuits as in a squat and clean, or in our daily life like sitting on the toilet, or standing from the floor. I doubt you think about your ankle mobility much, unless you are restricted, even then you may only notice you're developing plantar fasciitis or knee pain. A skilled clinician will bring you back to the true source of the problem.

We intuitively know limited range of motion at the ankle can lead to unstable knees, or hip pain further up the kinetic chain. Research backs this thought process showing limited range of motion at the ankle influencing knee kinematics most often leading to knee valgus collapse and potentially petellofemoral pain during the squat and single leg squat performance. If I can't convince you that you need sufficient range of motion to perform squats what about landing? This study shows greater ROM at the ankle associated with smaller ground reaction forces during landing and reduced ACL injury risk! I'm speaking your language here, no matter who you are. You do squat, you do jump, you do need sufficient ankle range of motion. 

Quick story time... while working as an athletic trainer for high school athletics in San Jose I would often be asked to tape ankles. In fact it was basically the entire job. Football, basketball, rugby, you name it. The athletes would line up at my table to get taped. When I was starting out I welcomed the practice and taped everyone happily but as I became more aware I was learning that the tighter I locked down the ankle, the higher the occurrence of knee injuries became. I started asking each kid "Do you want me to tape your ankle because you have an injury, or because it looks cool?" You would be surprised how many would admit to it being purely aesthetic. In that case I would use their own tape and make it "look cool" without changing the kinematics of the joint. Look good, play good, am I right? But I digress, back to gaining that range of motion and ditching the roll of tape. 

  1. FIRST ASSESS IT. Here is a quick assessment you can do on yourself. Make sure the motion is all coming from the ankle and the heel is keeping contact with the ground. 

2. THEN FIX IT. This part is easy. The key is consistency and making this practice a daily habit. If you are spending 5 minutes a day doing ankle mobs but a solid 8 hours in your high heels for work, guess which one wins? I always start with self-myofascial release for the calf and foot. My favorite tools here are the trigger point stick and nano, but you could use anything including a lacrosse ball. Simply roll out the bottom of your feet and back of your leg. Don't forget the gastroc crosses the knee, so you need to go just above the knee all the way down around the ankle to the toes. 

Next stretch. These are a few of my favorite stretches for the calf. Again, the gastroc crosses the knee so the first stretch I recommend keeping the leg straight, however the soleus (the other muscle in the calf) does not. To isolate this muscle bend the knee and repeat. 

Finally add in your ankle mobility drills. I'm sure you've seen a million of these on the inter webs. It seems to be a hot topic but jumping straight to these drills wouldn't be the best idea. Follow the progression. I love this drill shown by Eric Cressey. Try it out and skip to step three (reassess), if you have not regained your mobility try the following drill shown by me which is slightly more aggressive combining MWM in various positions. 

3. REASSESS. Have you gained that precious mobility? If you have any  new range, "lock it in" by using it! Using the new found ROM will show your nervous system that you have the range and can control it, so squat, jump, move! If you are still missing some range you may just need a skilled clinician to do some more specific myofascial work using a plethora of tools and techniques including IASTM, compression floss, ART, or the like. 

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Straight Wrists for Strength

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Straight Wrists for Strength

Have you ever found yourself feeling pain in the wrists while doing pushups or pressing?  Do you feel like you are not as strong in those movements?  If you have nothing medically wrong with your wrists, it could just be how you position your wrist itself. 

A strong grip found with a straight wrist translates tension up into the shoulder creating a much more stable shoulder thus allowing more strength to be demonstrated.  If the wrist is bent, the weight starts to control your elbow and shoulder position.  If the wrist is straight, more tension can be created and your position now has a better chance to control the weight.  

In the kettlebell press and bench press, a bent wrist places the elbow in front of the weight's center of mass reducing the amount of strength that can be demonstrated.  This is due to the lever arm created between the load and the wrist. I understand why people do this with kettlebells because it reduces the pressure caused by the kettlebell off the forearm.  However, this over time will start to impact the elbow possibly causing medial epicondylitis or golfer's elbow.  Having a straight wrist with the kettlebell just takes some time desensitize the area.   Build up slowly, it will pay off. 

But what about pushups when your wrists are already extended? How can you perform them without putting all the pressure on the wrists and loosing your strength?  Spread and grip with your fingers.  In the first picture below, my fingers are touching each other with no tension in my palm.  No pain, but I feel as if I am just balancing on my wrists.  In the second picture, my fingers are spread and I'm trying to palm the floor like a basketball.   It feels as if my hands are cemented into the floor, strong and sturdy.

Try this out with your presses and pushups and find out how much sturdier it feels.  Until next time.

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The meal plan from the Gods

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The meal plan from the Gods

Why from the Gods? Because Dr. John Berardi is my nutrition God. This guy has his Ph.D in nutrition and repeatedly puts out the most comprehensive and informative content. Nutrition is notoriously the hardest thing to nail down when attempting to change your body composition and Dr. Berardi makes it as simple as possible. I'm done convincing you, I just simply want to repost the most recent blog and infographic that he and his team at Percision Nutrition made. I know that many of you struggle with cooking or building meals. Your nutrition template tells you how much protein, carbs, and fat to eat but putting it together sounds much more simple than it is. I get it. This infographic is an awesome start. Think of it as the Italian mother you don't have teaching your 10 year old self how to build a meal (This happens right?). My generation seemed to be too busy to learn, or maybe we weren't taught, but we are never too old to learn to cook for ourselves. After all, that seems to be one of the most basic survival skills isn't it? If you don't know how to put together a proper meal than you can't cook, but if it doesn't taste good you won't eat it.

Just follow the link, read the blog, print and tape the infographic on your fridge and fake it until you make it. Watch your goals become more attainable and your families health improve. As always reach out with any questions. This should make following your template easier, but if you are having trouble seeing the connection please let me know. I would be happy to pretend to be your Italian mother. 

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Want a bigger bench?

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Want a bigger bench?

People tend to overlook learning the technique of the big compound movements being the squat, bench and deadlift.  I can understand why this happens because these movements are some of the hardest movements to learn.  But this microwave approach of instant gratification and trying to had more weight to the bar as quickly as we can is what leads to compensation of our body eventually leading to us stalling in gaining strength or worse, injury.  Learning these movements correctly will not happen over night and it takes deliberate thought in the execution.   Go about strength training and learning as the slow cooker approach.  It needs time.  Master slow before fast and take the time to appreciate the technique.

Looking at the set up of the person below, specifically the arch or lack of, we notice that his chest is sunken, shoulders elevated and forward and his back is flat on the bench.  In this posture, a lot of stress would be placed on the front of his shoulders.  This is not good, because if he moved through the movement, he would try to bench with mostly his shoulders.   Something that might be okay at the moment but not down the road.  In the bench, setup is extremely important and if done correctly, the execution becomes rather simple.

A lot goes into getting a good set up.  In this post, let us talk about arching the back.  First of, arching the back is not damaging as long as someone does not already have a pre-existing condition.   Once again, this is why our athletes get screened.  Secondly, when I teach the bench press, I teach it by focusing on arching the upper back. Yes, the low back will extend but the focus is on the upper back.  It doesn't make sense to talk about foot position, leg drive, or elbow position when one can't even set the shoulders first.  

The exercise that I use to create the set up position is a combination of a Scap Shrug and Kelso Shrug.  Grabbing a set of gymnastic rings with straight arms and leaning back with a long body, the person will flex at the hips, letting their scapula elevate and protract (photo 1).  This is a stretch as well as a teaching of bad position for the bench press.  Please do not bench this way.  We then reverse the movement with keeping the arms straight, elbows locked by retracting/pinching the scapulas back, and depressing them down towards the glutes.  The upper arms should feel like they are being sucked into their sockets. If done correctly,  the chest should be lifted towards the ceiling, a cramp should occur in the mid and upper back, and a long neck should result.  

I never said it would be comfortable and it won't if done correctly.  Enjoy the tension.   The benefits of doing this type of arch is that it places your torso in more of a decline angle which is stronger.  It pre-stretches the pecs so that the contractions will result in higher tension, and it places the shoulder back into a safer position.  Disclaimer:  This type of setup is only for the bench press.  In the pushup or overhead press, we are wanting our scapula for move around our ribcage.  In the bench, we are pinning our scapulas together and on the bench itself.   This creates a more stable platform to push from when handling the heaviest weights in this position.

In the images above, an arch is more clearly seen.  Shoulders are pulled back, chest is higher with less wrinkles in the shirt, and shoulders are away from the ears.  This is how the setup should look as well as being maintained during the movement itself.   Do not lose the shoulders.  If the position is impossible to get into or hold, it could be a strength issue or a mobility issue. 

Give it a try in your next bench session and see how it feels.

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