Thursday, November 14, 2019

PT Pathologies: Anterior Cruciate Ligament Sprain - Grade III

In the United states, ACL sprains seem to be one of the most discussed diagnoses.  A grade 3 sprain is considered to be a complete tear of the anterior cruciate ligament.  This major source of stability is located where the end of the femur meets the top of the tibia.  This ligament is in the middle of the knee and prevents the tibia from sliding in front of the femur.  There are many diverse ways to sprain an ACL, such as getting hit from the side as one would in football, overextending the knee joint and quickly stop moving or changing direction while running.

        At the time of the injury, one might hear a popping sound.  Within the next 6 hours the knee will begin to swell and pain, especially with bearing weight, will commonly occur.  To diagnose an ACL sprain, during the physical exam the doctor will check the patient's knee for swelling and tenderness.  Also, the injured knee will be moved in a variety of positions to test the patient's range of motion and function of the joint.  A physical exam can diagnose an ACL tear alone, but X-Rays, MRI's and Ultrasound may be used to determine the severity.  Three contributing factors to an ACL sprain are biomechanics, the way one's body moves, muscular imbalances, which includes females who have stronger quads than hamstrings, and finally overtraining.  Combining all three creates a very high chance that the individual could potentially be lead to an ACL injury.

        When dealing with patients who are trying to overcome an ACL sprain, it is quite common that they will be very motivated.  Typical patients are usually athletes and will work harder than other age groups to return to their sport.  If an individual grade 1 (partially stretched) sprains their ACL it is possible that the injury will progress to a Grade 3 (complete tear) with continued stress and vigorous exercise.   Treatment without surgery to repair an ACL sprain would include a specific program, use of an electrical stimulation machine to fire the quadriceps muscle, and strength.  Treatment after surgery will include icing and compression, exercises to increase patient's ability to move and strength.

        Approximately 200,000 ACL injuries occur a year and half of those patients require surgery.  Directly after surgery, Physical Therapists typically give the patient a list of home exercises.  While at the rehabilitation center, patients will be guided through weight bearing exercises and gradually will be able to walk without crutches and return to normal gait.  After this is achieved the therapist will incorporate exercises to improve balance, running and jumping.  The main goal  with this type of patient is to help them return to their sport as soon as possible but regarding all limitations.  After pain and swelling is completely gone and feelings of instability have diminished, therapists usually release their patient to return to sports and regular activity.

Monday, November 11, 2019

The Natural Way to Treat Arthritis Pain – Without Medication

There are numerous different types of arthritis that people experience – in fact, the term “arthritis” is used to describe over 100 different types of joint pain and joint disease that millions of people suffer from. Arthritis is known to affect the elderly since it becomes more apparent with age; however, it is also possible for people to experience arthritis in their early middle age.

A study published in the American Journal of Sports Medicine states that elite male athletes are at a higher risk of developing arthritis than the rest of the general public. According to the study, approximately 30% of elite male athletes who engage in contact sports will eventually develop arthritis in the knees and hips. This is because advanced athletes who participate in contact sports experience a quicker “wear and tear” on the joints, due to continuous overexertion. 

Common types of arthritis:
  • Osteoarthritis. Osteoarthritis is the most common type of arthritis. This condition develops through a reduction in joint cartilage. This typically occurs gradually, through the natural “wear and tear” of age, but it can also occur from other factors, such as continuous repetitive motions. When cartilage wears down, the bones begin to rub together, causing friction, swelling, and pain.
  • Rheumatoid arthritis. Rheumatoid arthritis, also referred to as inflammatory arthritis, is the second most common type of arthritis. This condition develops as a response from your body’s immune system. When the joints are seen as a “threat,” the immune system will attack the tissues surrounding them, causing intense inflammation. Rheumatoid arthritis is thought to be linked to genetics, so you may be at a higher risk of developing it if you have a family member with the same condition.
  • Metabolic arthritis. Gout is the most common type of metabolic arthritis, typically developed as a result of reduced kidney function. Gout causes a buildup of uric crystals in the joints of the extremities, and it is most common in the feet.


How is arthritis treated?
Many physicians prescribe medication to manage pain caused by arthritis. Your physician may prescribe NSAID pain relievers, antibiotics, corticosteroids, or antirheumatic drugs for your arthritis treatment. However, medication is not always entirely helpful.

It’s no secret that medication is easy – all you have to do is pop a pill in your mouth, chase it with water, and wait for your pain to subside. But it’s also no secret that medication can cause some nasty side effects – and, in some cases, they can become habit-forming. For example, with NSAIDs, you run the risk of blood clots, heart attack, or stroke. With corticosteroids, you run the risk of cataracts, high blood sugar levels, and bone loss. Fortunately, physical therapy is a healthier, safer, and natural way to treat arthritic aches and pains.

If you have been suffering from arthritis and you’re looking for a natural relief, call our office today. We’ll set up a treatment plan for you that’ll kick those harmful drugs to the curb!
Getting help through physical therapy:

When treating arthritic symptoms, the main goals of a physical therapist are to reduce pain, increase strength, and preserve range of motion. Just a few of the many benefits of working with a physical therapist include:
  • Stretching/exercise. Stretches and light exercises will help increase your range of motion in the affected area(s).
  • Proper posture. Maintaining a proper posture will help to reduce stress on your joints.
  • Rest. Your therapist will also recommend a schedule for rest and sleep to complement your exercises. This helps the body to heal and will hopefully reduce your amount of arthritic inflammation and pain.
  • Weight control. Your physical therapist will work with you to control your weight through exercise and diet. Controlling your weight helps to prevent added stress on weight-bearing joints.

Wednesday, November 6, 2019

WOD Wednesday #113

Complete as many rounds as possible in 15 minutes of:
400-m run
15 body-weight deadlifts




This is a high pace medium effort. We want you to scale so that you can run at a high pace, and the deadlifts are unbroken. Visualize this for today: you never stop. You might slow down a tad when approaching the bar, but there is no stop. If you manage to do this the number of rounds you get will be fine whatever it is. If you need a target, try to get as far as you can into that 7th round. No matter what, today's mantra is: always moving, always pushing. Keep in mind this: today in both movements you are just moving your body-weight. If you were to run the same distance that you deadlift, the run would be SO easy even though is the exact same weight. The difference in the perceived difficulty is not on the bio-mechanics themselves. It is simpler. In the run gravity is working in your favor, in the deadlifts it is completely against you. ... Duh! I know. This is all but a reminder that running is a technical thing, and if you learn to fall better, it becomes so much easier. Today is a good opportunity for that. Practice your technique and use the feedback of the soreness in your hammies to make sure you are pulling the leg with the right muscles.

Friday, November 1, 2019

Product Review: GymNext Flex Timer Gym Edition

Product Details
This is the timer your coaches and members have been asking for!

The GymNext Flex Timer combines a large, crystal-clear LED display with an easy to use interval timer app creating the best, most powerful gym timer ever made.

The 4.0" LED digits (same as the Rogue Echo or MDUSA No Limits timer) in blue/red are visible from hundreds of feet away and the 95db buzzer is extremely loud. With bluetooth range of over 100 feet, you aren't tethered to the clock. Move throughout the facility and easily control and setup the timer from our convenient and FREE mobile app.

You can save an unlimited number of custom workouts spanning 6 different timer modes: Standard, Round, Interval, Tabata, EMOM and Laps. Configurable prelude times, round warnings, and a 3-second segue between rounds are just the beginning of the options available to create the most customized experience ever.

The audio sync feature allows you to use a wired or bluetooth speaker to augment or replace the timer's built in buzzer. Play your music from your phone and now you can listen to your music as loud as you want. The app will automatically fade the music in and out at the end of each round so that you never miss an indicator again.

Large gyms will love the ability to link multiple timers together and have them display the same workout or run the timers separately to easily manage different workouts or heats. And the included wall brackets make mounting your clock a breeze.

For the utmost convenience, go hands-free with a Pebble timepiece or Apple Watch. You'll enjoy the natural feeling you get from initiating the timer from your wrist just like a stopwatch.

For the data lovers and elite athletes, integrate heart rate monitoring into your workouts and have your heart rate periodically or permanently display on the clock so you know how hard you're working and can set a proper pace.

When not in use for timing purposes, the Flex Timer reverts back to a 12h or 24h clock.

But there's even more...

The Flex Timer app is updated all the time unlocking new features and functionality so that your timer actually gets even better with age.


My Review:
I avoided purchasing a clock for my gym too long. Didn't think it was necessary. I was constantly using my phone timer, an app, a stop watch, or even a stop watch website on my computer.  But after using my GymNext clock I can't imagine a workout without it. It is easy to use, not a distraction, and infinite programming possibilities for any type of workout.

I like that you can set up a custom welcome message and that the timer automatically takes local time from your phone. Be aware that the timer will only connect with one phone at a time. This means that if someone was using the timer and you go to connect with your phone, you won't be able to connect. In a big gym setting this would mean you have to reboot the timer or hunt down the person who retains control.

I researched a number of cheaper alternatives but what makes this worth the price is the app. The timer easily connects to your phone and then you can create whatever type of timer you need. Plus the built in timers make it easy to quickly get started, or you can edit them if need be.
The app works flawlessly with the GymNext Flex Timer application. Connection to the timer is so simple a monkey could do it. Everytime I open the app, it connects immediately with zero lag. It's programmable to every interval training mode known to man and has loud audible beeping that can also be programmed to discretion. It does not interfere with music and once the timer is going, you can still use your phone normally as long as the app is running in the background. It connects to a heart rate monitor and can display your heart rate periodically to your discretion. This is extremely helpful especially when you're trying to maintain a certain heart rate zone.

Bottom line, this timer is outstanding in value, usability, build quality and customer service. I've contacted their friendly customer service to tell them how impressed I am with their product and you can tell they are a Just as excited as you will be once you get your hands on it.

- Very bright numbers (I actually use the reduced brightness setting)
- LOUD (I put tape over the buzzer and it is still highly audible)
- App supports any imagineable interval combination
- Kid-safe as there is no remote to play with, damage, or hide
- Robust construction with top and bottom aluminum profiles / extrusions
- Wide-range input power supply for worldwide use

No more fumbling with an awkward remote control. Competitive price superior functionality = unbelievable value. If you're on the fence about this one, do yourself a favor and pull the trigger on the purchase, you won't be disappointed.


I must say it's even more impressive than I thought! Easy to use, 110-220V global electricity support, fast connection to iPhone, ample phone-to-LED display connection range even without the need for line of sight, straightforward LED display design, clear/visible display and audible alarm for large gym. The best timer in my opinion all around. My only critiques are not being able to sync multiple phones and not being able to adjust the beep volume.

It was pretty cool to see the time update instantly once I connected my phone to the clock and when I open the app, the response is quick, accurate and makes everything so hands free. The app user interface is easy to use and quick to learn. Additionally, if I have music playing from my phone, the app automatically quiets the music for the 3-2-1 countdown and then cranks back up for the WOD. What I love about this clock is that it doesn't take time away from my workout time. I don't know it's there until I use it, and when I'm done, it's done. Goes right back to clock time until I need it again.

Order your GymNext Flex Timer!

Monday, October 28, 2019

PT Pathologies: Adhesive Capsulitis

Adhesive capsulitis, also known as frozen shoulder occurs in individuals when the connective tissue surrounding the shoulder joint, known as the shoulder capsule, becomes thickened and tight.  Stiff bands of tissue called adhesions develop.  As these adhesions form, they cause pain stiffness, and loss of motion in the shoulder.  There are two types of adhesive capsulitis, primary and secondary.  Primary AC occurs spontaneously, while secondary is the result of an underlying condition.  This pathology tends to be a more common occurrence in individuals with diabetes, thyroid issues, Parkinson's disease and heart disease.  The typical age range for individuals to experience frozen shoulder is 40-60 years and is more commonly seen in women.

Adhesive capsulitis occurs gradually and in three stages, also known as the freezing stage, frozen stage, and thawing stage.  The freezing stage can last anywhere from 6 weeks to 9 months.  This stage is characterized by a continual increase in shoulder pain and a decreased range of motion.  In particular, the patient has trouble with shoulder abduction and external rotation.  During the frozen shoulder stage patients can actually experience less pain due to even less ROM and can last from 4-6 months.  The final thawing stage, is characterized by slow improvement in shoulder range of motion.  Recovery or return to normal strength can take anywhere from 6 months to 2 years.

Physical therapy is the most common treatment for frozen shoulder.  Once the stage is identified the PT will set up a plan of care tailored to the patient.  If the patient is in the "freezing stage" the PT will assist in maintaining ROM and reducing pain.  when in the first stage, it is normal for the PT to utilize a combination of stretching and manual therapy techniques to increase ROM.  Ice and heat can be used during this time to help relax the muscles before treatment.  An individualized HEP is normally given to the patient to reduce loss of ROM.  During the frozen stage PTs will be concentrating on gaining back the lost ROM.  In this stage the PT will use more aggressive stretching techniques and manual therapy.

In Summary:

  • Occurs more in the middle aged population with females having a greater incidence than males
  • Arthrogram can assist with diagnosis by detecting decreased volume of fluid within the joint capsule
  • Range of motion restriction typically in a capsular patter (External rotation > abduction > internal rotation)

Friday, October 25, 2019

Is Arthritis Paining You? Physical Therapy Can Help

If you have arthritis, you know how debilitating it can be. It affects millions of people and is the most commonly reported chronic illness across the nation. Arthritis is a disorder of the joints that causes them to become inflamed. The inflammation causes the pain and stiffness that you feel, and it can result in a loss of movement if the joints become too inflamed. There are over 100 different types of arthritis, containing monoarthritis (where only one joint is affected) and oligoarthritis (where multiple joints are affected.) Some of the most common forms of arthritis are osteoarthritis, which develops from “wear and tear” of cartilage, and rheumatoid arthritis, which develops from overactive immune systems.


Arthritis can hinder many qualities of life – from work, to hobbies, to overall mobility. Some people are so affected by arthritis that they are unable to work and have to go on disability. Physical therapy is a safe, healthy, and effective way to treat arthritic pain.


How do I know if I have arthritis?
First and foremost, if you believe you may be suffering from arthritis, you should contact your primary care provider. He or she will provide a thorough evaluation, looking for signs of disease, such as inflammation and/or deformity. They will review your symptoms, and may administer any blood tests, urine tests, joint fluid tests, or x-rays as they deem necessary. If you are diagnosed with arthritis after these tests, your doctor will create a treatment plan for you, in relation to the location and severity of the condition. This treatment plan may include rest, exercise routines, and medications as necessary.

It is very likely that you will also be referred to a physical therapist to help guide you through your exercise routines, in order to measure progress and make sure that you are completing your physical activity in a safe and correct manner. Early diagnosis can be helpful in avoiding joint damage and disability, so it is imperative that you contact a doctor as soon as you think you may be developing arthritic symptoms.


How will physical therapy help me?
While there is unfortunately no known cure for arthritis, there are plenty of ways to help ease the pain that you may feel from it. Physical therapy is a proven aid in arthritic pain relief. It is effective and noninvasive, and in many cases, it can even eliminate the need to rely on harmful pain medication. According to the Arthritis Center at Johns Hopkins,

“Physical activity is essential to optimizing both physical and mental health and can play a vital role in the management of arthritis. Regular physical activity can keep the muscles around affected joints strong, decrease bone loss and may help control joint swelling and pain. Regular activity replenishes lubrication to the cartilage of the joint and reduces stiffness and pain. Exercise also helps to enhance energy and stamina by decreasing fatigue and improving sleep. Exercise can enhance weight loss and promote long-term weight management in those with arthritis who are overweight.”

A physical therapist will custom-tailor a treatment plan surrounding your needs, in order to increase your strength, range of motion, and mobility. This will include the affected area, as well as any surrounding areas that may contribute to the pain. For example, if your arthritis is in your knee, your physical therapist may create a treatment plan that focuses on the knee, in addition to the hips, ankles, and lower back, since all of these areas may affect the movement of the knee.

Your physical therapist will most likely suggest manual therapy, in order to improve joint and soft tissue mobilization. Your treatment plan may consist of any combination of treatment services, including ice and heat therapy, deep tissue massage, or electrical nerve stimulation. All of these treatments are passive modalities that work to reduce pain and inflammation, in addition to increasing blood flow and mobility.

Monday, October 21, 2019

Product Review: RAGE Fitness 20lb Slam Ball

Product Details:
The no bounce heavy duty rubber shell makes the Slam Ball perfect for intense slamming and throwing routines.

Strengthen your core, improve your conditioning, and increase your explosive power with one piece of equipment. Ideal for cross training, core exercises, plyometrics and cardio workouts.

  • Encased in an ultra-durable, heavy-duty rubber shell
  • Rage slam ball is high endurance impact approved and performs in ways a medicine ball cannot
  • Textured surface allows for a high quality grip even when wet
  • No bounce design proves to be ideal for various throwing and slamming routines
  • Equipped with an air valve making it possible to adjust the air capacity and overall firmness
  • 1” low bounce rating
  • 10-35 lb are 10" in diameter
  • 40-50 lb are 11" in diameter
  • 60-80 lb are 12" in diameter
  • 90-100 lb are 14" in diameter
  • Industry best 1 year warranty



Product Review:
The RAGE Fitness Slam Ball has a textured surface to provide a better grip during your workouts. The weight values (LBS) are green on a black gloss surface for easy viewing when looking for the size that you need.

Overhead medicine ball slams are great for working the entire body and for releasing some aggression, but they tend to take a toll on the medicine ball itself. Enter the RAGE Slam Ball specifically designed and tested by myself to withstand an onslaught of abuse!  Slam balls are used to enhance your workout routine by simply holding it while performing exercises. Examples of these include sit-ups, squats, lunges and overhead presses; when working with a partner you can do chest passes, overhead passes, and abdominal work through rotation variations. Slam balls can also be used for athletic training by enhancing cardiovascular endurance, increasing muscle mass and improving hand-eye coordination. Perfect for getting rid of excess energy and pent-up frustration.

Cross training is founded on innovation and variety – and our slam ball helps transform your WODS and quickly advance cross training levels, all while letting you reap all of its benefits with unprecedented ease.  Slam ball workouts tone the cardiovascular system, enhance circulation and dramatically improve your strength and endurance. By moving at a high speed, you push your body towards producing more power – and FAST.  Slam balls add a layer of resistance to exercises which traditionally rely on bodyweight. They naturally increase muscle mass and improve posture and balance, through aiding in regulating movement patterns. Simply the highest quality slam balls on the market. and backed by a industry best 1 year warranty!

Available in weight increments from 10 lbs up to 100 lbs, these rubberized, dead-bounce Slam Balls can benefit athletes of any size and skill level or for traditional medicine ball exercises, as well. I have been working with a 20lb slam ball and as a 185lb 5'11 male it presents a challenge! I would definitely not use this for wall balls but what I like about this ball is it gives a whole new meaning to Ball Slams (having a much more challenging load picking up with every rep) and long distance running carries.

This slam ball is well constructed and just slippery enough (I would prefer a slightly grippier ball, which they offer on their site) that it forces you to apply additional grip to maintain adequate control. It is an excellent tool for a near complete functional movement total body workout out. It has very little bounce which forces one back into the squat position to retrieve it for your next rep.


I have been using it now for a few weeks and its perfect. Plus I feel like this thing will be around for a long time, it feels heavy duty and well built. It's obviously a smaller diameter than the Med-balls when doing Wall Ball workouts which is the only complaint (dead bounce slam balls do not work as well as wall balls for that particular movement) plus you can't beat the price.

In conclusion:
Quality: The quality of this product is great. I have used the ball with several clients over the last month and it has been slammed from overhead over 1,000 times easily. The ball shows no sign of wear or leakage whatsoever. The ball is just as good as when it came new.

Overall any of RAGE Fitness slam balls will compete with any slam ball on the market and I would feel 100% confident using them in a commercial gym, private studio or home gym. I plan on buying more and would recommend them to anyone. Like mentioned above, my only critique remains that its use as a wall ball is possible, however not ideal.