Monday, February 27, 2017

Basics of the Lymphatic System

Post schedule for the next 5 weeks;
  • We are starting a new series for Mondays diving into the topic of the lymphatic system (immune), lymphatic pathologies, and compression (its uses and how it relates to these body systems)!  Along with these Monday posts, Wednesday will now be based on some product reviews from our blog partners/sponsors, and Friday will be a new series of posts dedicated to the Crossfit Open Workouts with Tips and Strategies on how to approach them and perform your best!  Make sure to pay attention to the Friday posts for GIVEAWAYS courtesy of our blog sponsors!
  • -
  • CONGRATULATIONS to the winners of our RockTape 17.1 Open Workout Giveaway!
    • Brittany Swaim -  RockTape Hat and Rock Sauce Chill!
    • Nick Hawkins -  RockTape T Shirt and RockTape!

First lets talk about the lymphatic system, in terms of structure and function to better understand the pathology associated with it ( discussed in the next post!) and how compression (sleeves, pumps, shorts etc) can help get rid of swelling.

The lymphatic system is a one way system of tubules that drain inter-cellular spaces into lymphatic capillaries, then into lymphatic trunks, then into lymphatic ducts, then into subclavian veins that then drains back into blood.  Lymphatics are located everywhere in the body except the CNS, finger nails, hair, bone or the cornea.  Larger lymphatic vessels contain valves comparable to valves of veins.  These valves prevent backflow of lymph within the vessels, especially those of the extremities and assure normal lymph flow toward the thoracic cavity.  Lymph nodes exist at intervals and sperficial clusters of them are present in high number at the cervical area, axillary area, and inguinal area.

Lymph Nodes act to:
  • Filter (bacteria, metastases)
  • Product lymphocytes (which produce antibodies for immune system)
  • Produce phagocytes (which ingest bacteria)
Lymph nodes filter and purify lymph before the fluid reaches the venous system.  Fixed macrophages in walls of the lymphatics engulf debris or pathogens that are in the lymph as it passes through.  Other antigens stimulate lymphocyte activity, that kicks off the immune response.  Lymph nodes provide an early warning system for infection and trigger activity in the macrophages nd the lymphocytes in neighboring lymph nodes.  Certain foreign substances may be permanently stored in lymph nodes, such as such as silica and coal dust particles.  Bacteria, viruses and dead cell debris are stored here and named "friendly" or "unfriendly".  If "unfriendly" it triggers an immune response to take care of and eliminate the problem.

Friday, February 24, 2017

Scaled Open Series: Workout 17.1 Tips - Presented by RockTape


WORKOUT 17.1 is.....

For time:
10 DB snatches
15 burpee box jump-overs
20 DB snatches
15 burpee box jump-overs
30 DB snatches
15 burpee box jump-overs
40 DB snatches
15 burpee box jump-overs
50 DB snatches
15 burpee box jump-overs
Time cap: 20 minutes

Scaled: (Ages 16-54)
Men use 35-lb. dumbbell and 20-in. box, step-ups OK
Women use 20-lb. dumbbell and 20-in. box, step-ups OK

Strategy and Tips for doing 17.1 Scaled:

- This is going to be a rough one, and its for time (or if you reach the time cap which ever comes first!). First lets look at the movements:
We all were warned there were going to be dumbbells in the open this year and we open with it as the first movement, the dumbbell snatch. In one movement you lift the DB from the ground while simultaneously dropping under it low enough till you are able to catch it with elbow locked out and stand upright with the DB held overhead with hips and knees locked out.  This is a really good exercise for strengthening the lateral stabilizers of your core. You must alternate the reps between right and left arm (set of 10 = 5 left arm and 5 right arm).  Men use 35lbs, Women 20lbs

The Burpee Box Jump is, quite simply, diabolical. As if a Burpee isn’t bad enough, now we have to jump up on a box instead of simply elevating high enough to slip a credit card under our Nano’s. From a standing position drop in whatever way you wish such that you end up on the ground with both your chest and thighs in contact with the earth. Get up and do a box jump, 20in, both feet on the box and over the other side. Step down and start again.  I’ll say it again: step down from each box jump.

The structure of the workout alternates movements with an ascending rep scheme for the DB snatches, coupled with a fixed number of burpee box jumps each round. 

I believe the key to this workout is consistency through out each movement.  Pick a pace from the start that allows you to cycle through the dumbbell snatches efficiently, even taking a breath after each rep.  Same thing goes for the burpee box jumps, in your head use a tempo to where you drop down, take a breath, get back up (you do not need to do a strict push up, snaking back up with the least amount of effort from your shoulders is ideal so save yourself for the snatches) jump on the box, take a breath, STEP DOWN.  There is no need to jump off the box in the scaled division of this workout.  Since box step ups are allowed, if you believe at any point in the workout you think you may switch from box jumps to step ups, my suggestion is you might as well start with step ups in the first place as it will help your pacing, then in the last round switch to box jumps to let it all loose and finish up.  After the first set of burpee box jumps, were back to more of the same DB Snatches with 10 more added each round.  However, I believe it does not matter what the rep count is or what round you are on that the goal on the snatches is that your last round should be as consistent in speed and form as you were in the first round.  With this movement consistency and efficiency = speed.  Then if you want to make up time at any point in the workout (I would recommend saving that for the last round or 2) you can always do faster burpees.

In terms of warm up I would strongly suggest using a voodoo band pre workout on your ankles, calves, and knees. Also, use a peanut mobility ball on your midback (t spine) to open it up and allow your shoulders to receive in a better position.  To do this roll around with a ball on each side of your spine and move your arms up and down over yours head (mobilizing in the planned movement pattern), and spend time where the spine feels the most stiff (2-5 minutes total).  Finally, I would use a banded shoulder distraction (youtube this) on each shoulder for about 2 minutes to help with any impingement that may affect your ability to go overhead 75 times with each arm during the workout.

Post workout I love a good ice bath haha!

With this open announcement we will be giving away a FREE RockTape Tshirt, Rock Sauce Chill, RockTape Hat, and RockTape KTape courtesy of RockTape (check the Blog Partners Page to follow the referral link to get your own gear 😉)  

To be entered to win you must COMPLETE THE FOLLOWING:
  • Post your open score in the comments (you do not have to do it scaled to qualify for the giveaway!!, along with where you did the workout.
  • Subscribe to the blog at the bottom of the page.
  • Receive your FREE Gear! (Winner will be chosen with the Monday post, so check back to claim!)

Thursday, February 23, 2017

CrossFit Open Scaled Post Series

The CrossFit Open season is upon us and it is time to start a new series dedicated to those completing the Open in the scaled division!  Each of the next 5 weeks on Friday I will be posting what the workout is for the scaled division and offer my tips and strategies to boost your performance!  Thanks to our blog partners each week we will be giving away some prizes for those that submit their scores in the comments below.

Some tips to start before we even get to the workout:

  • Make sure you do not try to over haul your routines just because this is a competitive environment.  Warm up the same, eat the same, go about your day the same, and have a strategy before you start the workout.  Now is not the time to make changes, that is something you can tinker with in the off season.  With everything the same, now you can look at and analyze the game plan below, now its time to execute it.  Don't worry about what others do, worry about what's in your control and follow the plan.  Then with a minute or 2 left throw away the plan and go for it!

Wednesday, February 22, 2017

WOD Wednesday #8

"Tabata This!"

Tabata Row

Rest 1 minute
Tabata Squat
Rest 1 minute
Tabata Pull-up
Rest 1 minute
Tabata Push-up
Rest 1 minute
Tabata Sit-up

The Tabata interval is 20 seconds of work followed by 10 seconds of rest for 8 intervals.
Tabata score is the least number of reps performed in any of the eight intervals. Unit for the row is "calories".

5 Tabata intervals of, in order, Rowing (for calories), Squats, Pull-ups, Push-ups, and Sit-ups. The WOD takes 24:00 (5 X 4:00 + 1:00 Rest between exercises). Let’s start by defining both a Tabata Interval and Tabata scoring. A key part of the Tabata principle is that fitness can be measured not only by how much work you do, but also by how well you can maintain a particular level of output. Each Tabata interval comprises 8 cycles of 0:20 (20 seconds) of exercise and 0:10 of rest. A complete interval is therefore 4:00 long. Your score at the end of the 8 rounds is the LOWEST number of reps (or calories) performed in any one 0:20 segment. For example, if you record PU of 8-8-8-8-8-8-8-2 your score is 2.

Your score for “Tabata This” is the sum of your LOWEST scores in each 4:00 segment. It is NOT the total number of reps you performed in the WOD. You do all 8 0:20 on/0:10 off segments of each exercise before you move on to the next movement (i.e. all 8 rows before you start your squats). There is 1:00 of rest between each exercise. Row for calories. On a Concept 2 Rower set the computer to record Calories. Row for 0:20, then rest for 0:10. Record the number of calories you rowed in those 20 seconds. Do this a total of 8 times.

Monday, February 20, 2017

Social Media Tips From My 1st Gym Internship

This excerpt is from a graded journal that was assigned in my undergrad internship exercise science class ~ 2011. It is old but relevant and shares first hand experience on how I started using social media (facebook) to better directly advertise to prospective clients and members. My use of social media has grown since then and I will post more tips and ideas as time goes on so keep checking back!

Another psychological and business concept I have learned is how people respond to different marketing tools. Before I started this internship, my supervisors use of social media was next to nothing, only posting about once a week. This lack of activity gave members no reason to follow our pages or to stay informed. Soon after, I made a suggestion to my supervisor that I should be given editing powers on the social media pages and that I could help post more gym related content. However, I soon realized that posting more doesn't guarantee more member activity, the key was interaction.

The gym's budget for putting advertisements (events, promotions, etc) in the news paper was about $600 a year. This budget only allowed us about 3-4 different ads so we had to pick wisely about what items needed the most promotion. Having a few weeks experience with our facebook page and seeing data of page views, posts, activity etc, I noticed the same half dozen people "sharing" our posts to all of their friends. This would get our weekly information out to a couple hundred but that doesn't match what the news paper can reach. After more thought of how to use social media to reach into the thousands to make it a more reliable marketing tool, and to save money I needed more shares.

People love the word "free" and will take advantage of anything that might earn them something of value. I used this fact to induce a reward system to our posts. Now whenever something important, events, or promotion is posted we set a minimum number of required "shares". If that number is met we give away a free tshirt randomly to one of the people who shared. After trying this out I identified several benefits of this then putting ads in the paper. First, the people sharing where typically members of the gym so they were sharing to their own friends who are perfect candidates for new members. Second, it was way more cost efficient since shirts cost us only $8 to be made, so we can give away 2 shirts a month and still come below ad budget. Third, you can see the data of activity of the post, views and the interaction of the members , with the news paper you cannot. Finally, having more tshirts out circulating in our town it is like having a walking billboard every time someone wears them.

- TJ

Friday, February 17, 2017

RECIPE: Roasted Vegetables with Bacon


Serves: 6

8 Slices of Bacon
3 Sweet Potatos
2 Beets
2 Squash
2 Zucchini
1lb Boccoli Florets
1/4 cup olive oil
1 TBsp of garlic Salt
1 TBS Garlic and Sriracha Seasoning
1 tsp Salt
2 tsp pepper
Per Serving (based on 6)

Preheat oven to 450º
Cover a sheet pan with aluminum foil
Place half of the bacon on the aluminum foil so that you cover as much of the pan as possible
Put in oven while you cut up veggies – about 7-8 minutes
Cut up all the veggies and place in a bowl
Season liberally with garlic salt, Garlic Sriracha, salt, and pepper
Place lid on bowl and shake to mix together
Pour olive oil on the veggies
Place all the veggies on top of the ½ cooked bacon
Place the other half of the bacon on top of the veggies in rows
Bake at 450º for 20-25 min or until the top layer of bacon is crisp

Wednesday, February 15, 2017

WOD Wednesday #7

Power clean 3-3-3-3-3 reps

I forgot to talk about the hook grip before! It’s meant to increase your ability to hold on to the bar while lifting. Place fingers 5, 4, and 3 around the bar, and then your thumb. Cover your thumb with your index finger. Feels weird, huh? You’ll get used to it.

With your hands grasping the bar set your back (straighten your lower back, maintaining the lordotic curve), bend your knees slightly, and then rapidly rise up by extending your legs, then opening your hips, then shrugging your shoulders up toward your ears, and only then bending your elbows and pulling yourself under the bar so that it lands in the front rack position, your lower body in a ¼ squat. Stand up with your elbows elevated in front of the bar. As you shrug you may also incorporate the “catapult” by bumping the bar with your upper thighs, launching it on its way rackward.

We are using the 3-3-3-3-3 format in which you are attempting to achieve a 3-Rep max for the Power Clean. This means that in each 3-Rep set you are not letting go of the bar until the completion of the final rep. After you warm up you do 5 sets of 3-reps, each with a greater load than the previous set. Aim for a PR (Personal Record) in set #4; this gives you a second chance if you miss the first time, or having succeeded gives you a bonus set.

As before, if you are very new to heavy lifting of any kind you have no business going for any kind or PR whatsoever. Use today to drill the Power Clean technique using lighter weights or even just a PVC pipe. Take this as an opportunity to get some coaching.

Monday, February 13, 2017

PT Modalities - UltraSound

Terminology and Properties of Ultrasound:
Ultrasound is a type of sound wave with a frequency of greater than 20,000 cycles per second.  Therapeutic US's frequency (Hz) is above audible sound (16 - 20,000hz).  When waves are generated in rapid succession molecules are jostled to a fro by the alternating phases of the waves.  The energy that these waves produce is passed through the patients tissues.  US needs a medium for conduction, or must have matter to vibrate.

Transducer:  the part of the US unit that contains the crystal (quartz) which converts electrical energy into sound.

Power; Amount of accoustic energy per unit time, measured in wats.
Intensity: Power per unit area of the sound head
Beam Nonuniformity Ratio (BNR); informs the clinician of what the highest intensity would be within the beam for any give transducer. (BNR greater than 6:1 has risk of giving "hotspots")

Continuous: the set intensity remains the same throughout the entire treatment session
Pulsed:  The delivery is pulsed on and off throughout the treatment time

Sequence and Sensations of Ultrasound in Treatment Plan:
  • US may be used first to take advantage of its pain relieving effects. 
  • Stretch should be done immediately after US, due to ability to increase tissue length - Optimal is within 8-10min of treatment or during treatment
  • Do not use with ice, however you may use ice at the very end of treatment.
  • During continuous US, gentle warmth should be felt within a few minutes.  
  • Units with high BNR, often get superficial heating, so pt may not feel sensation at all.
  • Pulsed US is SUB Sensory = no feeling
  • Abnormal sensations
    • Deep ache from periosteal heating = lower the intensity
    • Superficial burning, itching, prickling

Penetration of Ultrasound:
On average, skin, blood vessels, and muscle absorb relatively little US.  Tissues with high cartilage absorb more US ie: Bone, Cartilage, and Tendon.

Biophysical Effects of Ultrasound:

  • Tissue temperatures rise.  This rise is caused by cavitation, or pulsation of bubbles in tissue fluid.  This is more likely to occur with 1MHz US.  Clinically dense tissues retain more heat than vascular tissues.
  • Diminish pain perception
  • Slows nerve conduction
  • Raises metabolism rate
  • Increases blood flow
  • Assists in resolution of swelling
  • Stimulates immune system
  • Increases soft tissue extensibility
  • Reaches deeper than superficial heat -  1MHz used to heat tissue up to 5cm deep;  3 MHz used to heat tissue 1-2cm deep.  
  • 3MHz US heats quicker than 1 MHz US; about 3 - 4 times greater increase thus you should use a lower intensity with application of 3 MHz.
Non- Thermal:
  • Changes in cell function, effects occur at cell membrane with micromassage, acoustic streaming (or fluid movement in sound field) and cavitation.
  • Clinically facilitates tissue repair
  • Increases cell membrane and vascular wall permeability
  • Increases Cellular activity
  • Increases capillary density and improves blood flow
  • Increases protein synthesis for wound healing
  • Stimulate histamine release, serotonin release from blood platelet, chemtatic agents and growth factors from macrophages, formation of new blood capillaries to accelerate healing.
  • Direct realignment of collagen fibers to increase stretchability of tissues.
  • Increases collagen content to increase tensile strength of tissues
  • Increase motor and sensory nerve conduction to reduce pain.

When doing US to the back or neck, some clinicians pick up the transducer when crossing the midline. Actually, bone in a normal vertebra prevents sound from getting to the area of the spinal cord, except if the patient has had a laminectomy or spina bifida.  The brain is similarly protected by bone, cannot be reached by US. Therefore, cross midline with transducer quickly or treat 1 side, then the other.

Adverse Effects:
  • Most common is burning with high intensity, continuous US
  • Risk of burn increased in areas of impaired circulation or sensation.  Thus, keep the sound head moving, reduce intensity over superficial bone.  Use patients complaints of discomfort as a guide to reduce intensity.

Friday, February 10, 2017

PT Pathologies - Congestive Heart Failure

Congestive heart failure is diagnosed over 650,000 times per year, affecting a total of 6 million Americans.  CHF is a condition where the heart is weak and is not pumping enough blood out to the body. Many things can cause CHF like heart attacks, cardiomyopathy, and conditions that could possibly overwork the heart.  Some signs and symptoms would include congested lungs, fluid and water retention, fatigue, dizziness, weakness, tachycardia, and irregular heart beats.  CHF can happen during the diastolic phase, systolic phase or both.

Physical therapy can be beneficial to people suffering from congestive heart failure.  These patients would be weak (maybe have some muscular atrophy) from lying in a hospital bed.  The goals for physical therapy would be gaining strength and endurance, increasing blood flow, and improve overall function.  Some different types of training could be done with free weights such as dumbbells or resistances bands.  Interval training on a stationary bike or walking treadmill would be ideal for increasing endurance as tolerated.  The therapist needs to be aware of symptoms like coughing leg swelling, confusion, and hypotension.  If these occur the patient needs to stop therapy and rest until vitals return to normal.  While PT may help a patient with their symptoms it will not cure this disease.

Wednesday, February 8, 2017

WOD Wednesday #6

4 rounds, each for time of:
800-meter run
Rest as needed between efforts.

Today we run. A single, simple exercise.  4 rounds, each for time, of “Run 800 Meters”, with a rest between each run sufficient to recover and run again. This is a RUN, not a jog. This implies a nearly full-on effort to go fast. To run that 800M in as little time as possible. Remember, “functional movements performed at relatively high intensity.” 800M is roughly 2 times around a standard high school track. Most tracks have starting points marked on them to help you out. If my math is correct 800M is ~0.485 Miles on a treadmill if you don’t have access to a track or need to run indoors. If you do run on a treadmill you should add in 1-2 degrees of elevation to more closely approximate the effort of running outside.

Saturday, February 4, 2017

Theological Bioethics Midterm #2

Post #2 finishing my theological bioethics midterm topic from my last year of undergrad.

Yes, people in need of health care deserve it even if they do not have insurance due to the fact that it is a health professionals duty to promote the dignity of human life. The right of life is not bought with money or insurance, but it is something that we are all born with and given to us from God. The emphasis when dealing with a patient should be on doing the right thing, regardless of their financial position (Lebacqz 84). This focus on the right thing to do results in increased clarity about the true nature of ethical dilemmas. Understanding this is important, especially when we often forget it is the powerful who wrote history and consider what medicine is normal, and available to what people (Lebacqz 85).

We are all humans made in the likeness of God. We should have a preferential option for serving the poor, not because they matter more, but because they matter equally, and since they have less we should help them more and share the wealth of life. If we are all inherently equal it would make sense to allow everyone to have equal access to health care as it would be the right thing to do. Lastly it is important to consider the poor which provides more democratic attentiveness and improves the community narrative (Lebacqz 86-87) getting more people involved, healthy and able to contribute.

With reference to the Hauerwas article on this topic, the patient/doctor relationship should be a covenant. This mean a non-abandonment for anyone regardless of health or financial position since there is an imbalance or sense of vulnerability between the patient and doctor. The doctor needs to show compassion, or suffer with the patient in order to configure the relation and help eliminate the hopelessness. Doctors, nurses, chaplains and others are the bridge between the world of the ill and the world of the healthy. Their activity as physicians should be of commitment like Job's comforters, for those who need it regardless of their health or financial situation (Hauerwas 72, 80). The deepest thing we can do for something is never to abandon them especially those at a most vulnerable place in their life.

Wednesday, February 1, 2017

WOD Wednesday #5

For Time:

75 Snatches (75/55lb)

The Snatch is simply the most elegant movement one can perform with a barbell. Think of it as the golf swing of Weightlifting—there are just as many moving parts that must occur in a precise and timely sequence in both. In the Snatch a barbell is moved from the ground to overhead in a single movement without stopping at any point in the journey. “Power” means that the bar reaches a point over your head with your arms fully extended and locked out while your legs are in no more than a ¼ squat. The rep is completed when you stand straight up with the bar held overhead. You do 75 Power Snatches with a 75lb. bar (55 for women), starting your stopwatch before rep #1 and hitting “Stop” at the top of rep #75. If you’ve done the Snatch previously you can go ahead and do this, but I strongly suggest you use an empty bar (45 or 35lb.) and start from the “Hang” position. A common refrain is that you shouldn’t do Weightlifting exercises for high reps. This brings up the hard part of this WOD: you should do each rep with the goal of doing a perfect Snatch. You are training today, and grooving form should take priority over a fast time, especially if you are new to these kind of workouts. Go for it.