TRAIN OUT PAIN

Weekend Winner: "The 3 A's of Awesome"

2012-01-27T08:56:00.000-05:00

DVD REVIEW: Womens Sprinting: Therapeutic Considerations for Speed and Power Development

2012-01-26T15:30:00.000-05:00

Last night I watched the DVD: Women's Sprinting: Therapeutic Considerations for Speed and Power Development."

It was a presentation by Track and Field coach Kebba Tolbert coach for Texas El Paso. He has trained some pretty fast track athletes. I'm just going to list some of my take away points. For only 25 dollars, I thought it was actually a pretty good buy. It's an interesting perspective hearing a coach talk about the high value they put on therapy and the important clues he looks for.

Hamstring issues in his sprinters, he always checks the psoas first, piriformis second, adductors third, quads last. Usually it is not the hamstring. Levitt's old law, he who treats the site of pain is lost!

Peroneals that are tight kill the elasticity of the athlete. Probably the most important take away point for myself.

Athletes need to drink a gallon of water a day. Dehydration can kill an athlete. (not literally) Most don't even come close to this. Those that do, bounce back from injury up to 50% faster.

Deep lateral rotators are tight, the foot will land externally rotated. This will transmit tension either into the back or into the hamstrings.

When the quadratus lumborum is healthy you will see a nice oscillation/undulation in sprinters. When they are tight, you won't.

He did a lot of drills, not for warm up or sprint mechanics, but to see how the athlete is moving. I found this very interesting. One drill he performed was the slow backwards walk with hip extension to evaluate the psoas. I will try to make a video of this in the future.

All in all, a pretty nice little resource.

Stay Strong as You Age

2012-01-24T11:40:00.000-05:00

Here is about as cool of a photo that I've come across in terms of showing what you can do with staying strong and active as you age. I've talked before about carrying muscle into your later years is your Health Insurance Policy. Stay strong. It would be very cool to see this study with a weight lifter.

Monday Motivation: 100m USAIN BOLT SLOW MOTION ART OF SPRINTING

2012-01-23T09:42:00.000-05:00

The Concept of Punctum Fixum

2012-01-20T08:52:00.000-05:00

Weak muscles can be the bane of many movement problems and the cause of much dysfunction in athletes and patients alike.

Punctum Fixum refers to the ability of a muscle to have a solid attachment. In reading through Rehabilitation of the Spine, by Dr. Craig Liebenson, the example given is the forearm flexors. The forearm flexors must be stabilized by the muscles that stabilize the elbow, and the elbow in sequential fashion by the shoulder girdle. So if that is weak, you may have weak wrist flexors.

In my own practice here in Grand Rapids, I often see the VMO (vastus medialis oblique) not have the strength it may need. Checking the attachment at the adductor magnus revealed the adductor was short/tight. Release the adductor, the VMO magically contracts strongly again.

Take home message, just because a muscle is weak, doesn't mean there is something wrong with the muscle in and of itself. Check the chain.

Gut Health Article in Wall Street Journal

2012-01-19T10:19:00.000-05:00

Here is a link to a great article that appeared in the Wall Street Journal. "A Gut Check for Many Ailments." Each year we are learning more and more about the health importance of the "gut." They are linking more and more issues that deal with mental problems that appear to have a link with gut problems.

This past month the article states they have just discovered a certain bacterium, Sutterella, that appears to be part of the problem in digastric issues found with Autistic children. Studying the gut is leading to new ways research is being pursued for Parkinson's and for Depression. Interesting stuff.

Continuing Education for CSCS

2012-01-17T22:09:00.000-05:00

Never stop learning is one of the more important concepts to grasp when looking at your career or job. To be able to grasp that what you learned a few years ago, won't be good enough, in a few years, will keep you from getting in a rut. Lately, it seems every concept or product, has a learning or certification that goes along with it. What to do?

Continuing education is a slippery slope. There are certain credentials that have meaning, for instance your professional licence. There are others that may or may not mean anything to you or the population that you work with. I had debated whether to get recredentialed in my CSCS certification for awhile. Lately, many strength coaches have been letting that cert slide away. In the end I decided to recert for the following two year cycle.

I think the reasoning was because I still enjoy going to strength coaching clinics, that I may or may not commit to doing without it. There are some discrepancies that show up with recertification that I find a bit off putting. For instance, buying a seminar in Boston, flight out to Boston, hotel in Boston, sitting and learning for a whole weekend is the same as buying a 2 twenty minute quizzes online.

In the end, a certification, doesn't really mean a whole lot. But, it can be a clue that whoever holds it, may indeed have some interest on the subject and has taken a few extra steps in time and money to pursue it.

Monday Motivation: ''I have a dream''

2012-01-16T09:06:00.000-05:00

Weekend Winner: History of American Diet by Stephan Guyenet

2012-01-13T12:57:00.000-05:00

I love TEDx. This is a great talk about the history of the American Diet and how it has evolved from technology to marketing. The information at the end about artificial flavoring is pretty awesome.

Article on Performance Enhancement for Magazine

2012-01-12T21:39:00.000-05:00

Here is an article I wrote that was published I think in Bare Essentials Magazine. Yea, I didn't know they cared for this type of information either! Enjoy.

"Training and Recovery of the Bobsled Athlete"

Preactivation with Heavy Squats Increases Sprint Performance

2012-01-10T08:59:00.000-05:00

Charles Poliquin put up an article that I found interesting the other day. "Increase Sprint Performance with Heavy Weight Complex." In it he references this research study, about 4rm squat 9 minutes before a 100 meter sprint.

They had two groups, both ran their first 100 meter sprint, then the second sprint had a changing variable. The second sprint came 9 minutes later. The variable group performed a 4 rep max parallel back squat before the second sprint. There was on average a .19 improvement in time. Pretty significant.

It appears that performing a 4rm squat followed by enough time to recover, improves the ability to sprint over short distance. It would be interesting to see if this is something that could be used on Elite sprinters for improvement.

Monday Motivation: "Destiny"

2012-01-09T08:52:00.000-05:00

The Triceps and Implications for Shoulder Health

2012-01-05T23:12:00.000-05:00

For the past few months I have been working on a small theory with the triceps muscles. I see a lot of shoulder type injuries in my office here in Grand Rapids. Everything from frozen shoulder, rotator cuff inhibition, labral surgeries and impingement's. One thing I've started to notice is that the long head of the triceps is weak and under developed and that the medial head has adhesion's.

Let's review a little anatomy. The triceps brachii has three parts, hence the tri. The bicep has two parts, hence bi. Want bigger arms, do triceps work, 2/3 of your arm is triceps. The triceps is made up of the lateral, medial and long head. The lateral head, most outward portion, gives the famous horseshoe shape seen on people. The medial portion is in the middle, and lies underneath the other two. These two portions attach from the humerus into the ulna. The last portion is the long head, you guessed it, the longest of the triceps. It's the most medial. What makes this muscle different is that its origin is actually into the scapulae. All three will extend the elbow, but the long head will actually adduct the arm in a similar fashion as the latissimus dorsi.

So back to my observations. After doing soft tissue work to the medial head, it usually brings a feeling of lightness to the shoulder or elbow joint. I am starting to view this muscle as an upper body shock absorber, in the same fashion the vastus lateralis is a shock absorber for the lower body. (This is why triceps strength is big time important for mountain bikers!)

Now in people that don't have shoulder issues, but do lots of overhead work, pressing, or throwing or the patients/athletes that bounce back quicker, the long head seems more well developed. The long head may have fascial anatomy with the teres minor muscle. It is considered part of the deep arm line in anatomy trains research. Having strong connections with the rhomboid muscle. Functionally, the long head works to keep the under part of the shoulder joint stable. It works to prevent displacement of the humeral head down and back.

The long head will not work in simple pressing exercises. It is actually pretty dormant in standard pressing and overhead work. The long head needs to be stretched to get a full workout. Its secondary function as a humeral adductor allows it to get good work in with doing back work. To isolate the long head, doing an exercise such as a skull crusher with combined pullover type movement, has proven to be effective.

Here is Arnold doing a famous bodybuilder pose. The under hang is the development of the long head. I would bet that Arnold didn't have many shoulder problems!

Pain and Pain Free Manual Therapy Paradigms

2012-01-03T22:01:00.000-05:00

Last night I had my first baby class. My wife and I are expecting our first kid in April. One of the topics covered were pain, fear and tension. It got me thinking about how this triangle represents well the manual therapy and coaching paradigm. The picture up top diagrams two sets of paradigms The top, shows how fear brings tension, tension brings pain, pain brings more fear.

Now, the second triangle shows how knowledge leads to intervention, intervention leads to being pain free and pain free often brings more knowledge. Now as a coach or manual therapist our role is to bring knowledge to the patient or athlete. The intervention is what happens, whether it's and adjustment, soft tissue work or homework of foam rolling.

Probably the most important aspect of this triangle pain free paradigm is the Knowledge. Knowledge can be things such as "Hurt does not equal Harm." Just because it hurts does not mean you're damaging anatomy, can be a powerful affirmation. Explaining what exactly Degenerative Disc Disease is and what it is not. Learning how to breath correctly and what it can do. Why sitting is bringing about the low back pain.

One of the big things that was covered in the baby class was breathing. Again, this thought process aplys greatly to the manual therapy and coaching world. Proper breathing is a great example to use. Tension, brings less oxygen to the muscles. Less oxygen leads to more pain in the soft tissue. Faulty breathing can also lead to decreased thoracic mobility. Knowledge. Intervention (practice belly breathing), Pain Free,less pain in the Scalenes as an example of the Pain Free Paradigm.

Monday Motivation: Go Get It

2012-01-02T09:52:00.000-05:00

Inspirational -

2012 Is Here: What to Keep, What to Change

2012-01-01T11:56:00.000-05:00

Every year you are probably bombarded with suggestions for new years resolutions. Why so fatalistic? Didn't we get anything right in 2011? What about thinking of things we did well and maintaining them!

So my suggestion is start there! List the good stuff, the stuff you're proud of, the stuff you got right and want to continue to do. Be specific. Don't say I will continue to drink water. I will continue to drink 100oz of water. I will continue to do three 20min workouts per week.

Now if there is something you want to change, apply the 3 rules for successful transformation.
1. Find out where you are. If you want to lose weight. How much do you weigh? Body fat percentage? If you want to eat more vegetables, how much are you eating now? What type?

2. Pick one or two and go for it. Listing 10-15 may sound great, but change is hard, so pick out one or two and prioritize them. Anything is possible, just not everything at once!

3. Reverse engineer your goal. List specifically where you want to be and start working backwards to your present state. Be very specific. Smaller steps, perhaps 5-10 mini-goals that lead you from your goal to where you are now. This makes Rule number 1 very important. Be honest with yourself and where you are.

Here's to a(nother) great year. 2012.

Feed Your Brain and Your Mitochondria

2011-12-30T13:24:00.000-05:00

Big thanks to Brian owner at CrossFit 616 here in Grand Rapids for sharing this with me on facebook. Take the time to listen to this video. Pretty awesome!

Balancing Plantarflexion And Dorsiflexion for Better Running

2011-12-29T16:54:00.000-05:00

Magnesium Deficiency with Prilosec and Other Medications

2011-12-27T18:27:00.000-05:00

Magnesium is an essential vitamin for over 300 functions in the human body. 300! It has been estimated that up to 70% of people are magnesium deficient.

GERD (gastro-esophageal reflux disease) heart burn, ulcers or anything involving excessive acid in the stomach is also a frequent problem in today's society. The treatment for choice of many doctors is to prescribe something like Prilosec. These heart burn medications cause a magnesium deficiency. If you were already low, this can really cause some issues. Everything from severe leg cramps, to not being able to convert the food you eat into energy, can be a symptom of this deficiency.

Make sure the magnesium supplement you chose is high quality. There is always a second word behind the magnesium, such as Magnesium Glycinate or Citrate. They should always end in -ate. I recommend THIS to my patients.

Some common foods that can be added to the diets are dark leafy green vegetables and nuts. But, I recommend up to 400mg a day. That would be hard to get through diet alone.

Monday Motivation: PAIN IS TEMPORARY

2011-12-26T10:26:00.000-05:00

I could listen to the "Hip Hop Preacher," speak often. Get ready for the last week of 2011.

Understanding the High Ankle Sprain

2011-12-21T09:11:00.000-05:00

If you watched Monday Night Football, you saw the repercussions of a high ankle sprain on Steelers quarterback Ben Roethlisberger.

Almost everyone at one point or another has suffered from a "normal" ankle sprain. This injury is typically an inversion sprain where the outside of the ankle bends towards the ground. The anterior talofibular ligament is the ligament often injured. The pain will be right around the actual ankle joint.

A high ankle sprain is often called a syndesmotic ankle sprain as the injury is to structures that are much higher up, the syndesmotic ligament. This is the ligament between the tibia and fibula and is often painful higher up then just the actual ankle mortise joint.

A good test with this type of injury is to squeeze the calf muscles. If this ligament is injured there will often be pain with this. Passive dorsiflexion and passive external rotation of the foot will also often be painful. While an athlete with an inversion ankle sprain may return in a week or two, because the high ankle sprain is much deeper, it may require twice as long for this to heal enough to play on.

This year in the NFL, there have been a few high profile cases. Adrian Peterson, a very talented running back, missed 2-3 weeks. This past Monday night Ben Roethlisberger, QB for Pittsburgh, was hobbling pretty badly with a high ankle sprain.

Conservative treatment is usually the wrought taken. Immobilization in a boot, ice, and rest are the required ingredients. While soft tissue work may be helpful to the peroneal muscles, because the syndesomotic ligament is inside, manual therapy is marginally effective.

Adrenal Fatigue and Knee Pain

2011-12-20T08:46:00.000-05:00

One of the things I have always checked, but have been finding more and more recently, is bilateral tender points on the inside knee. Find your Pes Anserine insertion. This is on the inside tibia. This is the common insertion for your Sartorious, Gracillis and Semitendinosis. Follow the muscles up about two inches and press in. If both sides are painful, it may be a clue that you have stressed adrenal glands.

How have you been sleeping? Has your sugar or caffeine intake been higher then normal? Have you had a craving for more high starch type carbohydrates. These questions will all be clues for potential adrenal fatigue or stress.

A few things to eliminate to help with an Adrenal Stressed Diagnosis. Make sure both arches are not collapsing, so both tibia's are not internally rotating. I usually check to make sure both Tibialis Posterior muscles aren't tight and painful as well. This will help eliminate a biomechanical cause.

What I have found as effective treatment is supplementing with Vitamin C, 3000mg for 10-14 days. If they are open to taking it, Rhodeola Rhosea as well. Eliminating the sugar for the same two week time period and trying for naps and earlier bed time if possible. Usually in two weeks time, the knee pain is gone.

Monday Motivation: PEOPLE ARE AWESOME (DON'S VERSION)

2011-12-19T09:44:00.000-05:00

Inverted Row with Miniband

2011-12-16T14:11:00.001-05:00

A nice addition to the inverted row is to use a small mini band around your wrists. As you pull up, pull out. You will get more external rotator activity and post. deltoid.

YouTube Video

- Posted using BlogPress from my iPhone

Drink Water or Don't Lift Those Weights

2011-12-15T08:59:00.000-05:00

I am always harping about hydration. In fact, 2011, if it had a theme, was hydrate. One of my goals for people in pain, is to bring hydration levels up. Dehydrated tissue carries inflammation more and in my experience more prone to adhesion's from repetitive activity.

I recently came across a STUDY, that showed that when you lift weights in a dehydrated state, the catabolic hormones cortisol and noradrenaline go up and ability to do work goes down. Testosterone levels are also lower. Catabolic hormones break down tissue, usually anabolic (build up) hormones are the result of weight lifting.

So you break down tissue and can't do as much work in a dehydrated state. DRINK UP!