Thursday, May 23, 2019

Trigger Point Dry Needling Part Deux

Physical therapists routinely evaluate individuals for painful "trigger points' that can result in not only pain but, also limited movement and tolerance for activity.  If these areas of muscle hypersensitivity are not identified and then addressed therapeutically, they can result in a prolonged and sometimes chronic painful condition.  The "dry needling" component is simply a means of better allowing a technique to specifically zero in on and "reset" the muscle tissue that is hypersensitive.  As the name implies, dry needling involves the use of thin needles of varying length without anything "wet" going into or out of the body.  No medications or solutions are injected and most of the time no blood exits the body as the needles are a fraction of the size typically used for injections or for drawing blood.
The targets for these needles are trigger points which are taut bands (nodules) found within muscles that can be irritable and painful with pressure or palpation's and often times result from our body's response to injury.  When activated by pressure or irritated by injury or activity, they can reproduce an individuals pain at the site of the trigger point, or even in a seemingly unrelated location of the body, which may then result in a loss of motion or a decrease in function.  Since these identified areas of hyper sensitivity are ultimately the targets for part of our treatment regimen, it makes sense that dry needling is often called trigger point dry needling (TPDN).  Trigger points and muscle dysfunction (i.e. tight muscles or muscles that are not working properly) have been recognized since the 1950s and have been something physical therapists have been trained to correct with a variety of treatment approaches.  Stretching strengthening, therapeutic ultrasound, lasers, electrical stimulation, joint mobilizations, manipulation, as well as various techniques using thumbs elbows, and or tools have all been utilized and will continue to be used to address these problems.

Dry needling for trigger points was first used in 1979 when a physician found that using injections into trigger points to alleviate pain worked regardless of the medication used.  The needle actually seemed to be the source of the pain relief.  The rationale to explain how a skillfully placed needle into a muscle can result in a significant reduction of pain isn't completely understood.  Perhaps the needle causes a very specific and localized stretch to the taut fibers within the trigger point which then results in a 'twitch' response which ultimately renders the muscle to be less sensitive to movement.  Another theory is that there may be a localized increased chemical release or 'leak' of the chemical that causes a muscle to contract which may lead to incomplete relaxation of the affected area.  The needles may be enough of an irritant to the structure that is leaking the chemical that it releases more, resulting in a localized muscle twitch.  This may then use up the excess chemical which then ultimately helps to shut off the leak leaving behind a more relaxed muscle.  No matter what the exact mechanism is for why a needle in a trigger point makes it act differently, the result is a muscle that has been reset, no longer holding unnecessary tension or acting inhibited from performing its role in helping the body move.  This reset is often compared to the Control-Alt-Delete function on a computer effectively causing it to 'forget' whatever it was causing the problem!

Monday, May 20, 2019

What about the Lunge?

In sport, athletes display a high variance of movement potential. To build athleticism, strength trainers must select exercises that improve speed, power, and strength. In traditional strength training, the squat reigns supreme for improving lower body power and strength. But what about the lunge?
Since the squat directs force vertically, the lunge takes precedence in directing force horizontally. In running sports, acceleration and change of direction are paramount. Lunging can touch on athletic components that the squat alone cannot.

Why Lunge?
In looking at the athlete’s sporting demands, we see that movement happens in large part on one leg. This unilateral movement demands the athlete to have enough strength to both produce and resist force in the sagittal, frontal, and transverse planes.
Lunging variations serve to integrate and load multiple planes of movement that help the athlete’s proprioception and timing. Further, multi-planar lunging can help safeguard problematic and injury-prone areas like the groin, hips, lower back, hamstrings, and knees.
Although strength trainers cannot ultimately prevent injuries from happening, they can provide exercises that build multiplanar hip, knee, and ankle stability to make the athlete more robust and resilient. Since tight musculature and lack of mobility often contribute to injury potential, lunging provides an inbuilt mechanism for safeguarding against these risks.

The Lunge is Foundational
An assessment of the athlete at play is vital in determining which exercises to include in their training program. It is appropriate for a tennis player or fencer to train the lunging pattern, as their sports are almost entirely based on lunging and striking movements. However, swimmers, rock climbers, and gymnasts may not need the same training volume or intensity.

Since athletes from all sports must be able to move with precision, the lunge is as prudent as it is pragmatic. If the athlete is able to comfortably cross the midline of their body during cutting, acceleration, and deceleration, their chances of injury lessen while their performance increases.
In programming for strength and athletic performance, exercise selection ultimately comes down to the primary action of the athlete. Both bilateral and unilateral movements are important for the athlete, but the application of when and why to use each is paramount.

The Squat vs. Lunge
In human evolution, the squat is more of a rest position than an exercise, but that doesn’t mean that it shouldn’t be loaded for strength and power development. When loading the body with a barbell, kettlebell, or other implement, the squat trains the lower body’s maximum force development in the vertical plane
However, the lunge is advantageous for the athlete that must make a change of direction in sport. Further, athletes with prior injuries to the knees, low back, or hips may find loading lunging patterns easier than loading squats. In order to understand the necessity of lunging, we must look at the role the feet play in the squat and lunge:

Squat: The feet remain in a fixed position. The feet do not move during the movement.

Lunge: The feet move in a stepping motion in any direction. The feet return to the starting position or to a new position.
Since moving into a squat is a downward motion of the athlete, it’s wise to see how a bilateral squat can help improve an athlete’s overall power and vertical jump. However, lunging provides a stimulus for the athlete that must make a sudden forward thrust of the body like in sprinting, cutting, or attacking an opponent.

The Lunge Improves Athletic Ability
There are several progressions that I give to my athletes when learning to lunge. In order to progress, the athlete should demonstrate precision in each movement, loaded and unloaded.

Lunging Continuum
Split Squat  > Reverse Lunge > Walking Lunge > Forward Lunge > Power Lunge

Friday, May 17, 2019


During treatments, you need to do an ongoing evaluation of length/strength of muscles, relationships of body parts. I.e., which part moves most, which least; why? Which part is tighter causing abnormal positioning? 

Resting position (normal posture) gives strong clues as to which muscles are long, which are short, since resting position is a "balance" between antagonistic muscles. We need to lengthen muscles that are too short, and shorten supporting muscles that are too long, then use them habitually in that shortened position. This will counter balance the muscles that tend to get too long. It is ineffective to merely strengthen long muscles; they must be gotten to be shorter in their "resting" position by habitual positioning.

Need train movement to be correct through practice so correct part moves, correct part STABILIZES. (practice, use wall for support, mirrors for visual alignment.

Need correct postural habits which involves all the above, i.e. exercise must become a habit
  1.  Effects - refers to physiological changes
  2. Indication - refers to an advisable, safe, recommended, prescribed treatment based upon clinical signs and symptoms.
  3. Contraindication - refers to an inadvisable, potentially unsafe, not recommended treatment based upon clinical signs and symptoms.
  4. Precautions - It is "okay" to consider this treatment with caution.  there may be potentially negative consequences. Be aware and ready to discontinue treatment based upon effects (subjective and objective) signs and symptoms that occur during the treatment.
Common Abbreviations:
  • Rx - Prescription
  • Tx - Treatment
  • Dx - Diagnosis
  • PMHx - Past Medical History
  • BID - Bi Daily (two times a day)
  • PRN - As Needed
  • THR - Total Hip Replacement
  • c/o - Complaint
  • WBAT - Weight Bearing As Tolerated
  • WOD - Workout of the Day
  • AMRAP - As Many Reps As Possible
  • EMOM - Every Minute On the Minute
  • PR - Personal Record
  • 1RM - 1 Rep Max
  • Wednesday, May 15, 2019

    WOD Wednesday #103

    5 2-minute rounds of: - 15-cal. row
    - Max strict weighted toes-to-bars

    Rest 2 minutes

    Men use 8-lb. ball for T2B
    Women use 4-lb. ball for T2B

    In this interval workout, you have to use a hip-opening movement to earn time to perform a hip-closing movement. A moderate amount of rest is provided, allowing you to push hard in each round. Select a number of calories that will allow you about 60-75 seconds on the bar, and select a toes-to-bar variation that will allow you to perform at least 8-10 reps per interval.

    Intermediate Option5 2-minute rounds of:
    - 12-cal. row
    - Max strict toes-to-bars
    Rest 2 minutes

    Beginner Option5 2-minute rounds of:
    - 10-cal. row
    - Max strict hanging knee raises
    Rest 2 minutes

    Tuesday, May 14, 2019

    Balance, Balance, Balance

    Stance is the position of the feet and legs in standing. Stance has a primary impact on balance, along with movement and surface. Stances that require a small base of support, e.g., tandem, split, single-leg, etc., are more challenging to balance. Conversely, stances that have wide bases (feet apart) are easier on balance. Below is list of standard stances, in order of increasing levels of difficulty:

    Normal: feet about shoulder width apart.

    Feet Together: feet are positioned near each other in narrow stance, heels may touch.

    Split Stance: feet arranged with one foot forward and one foot back.

    To make balancing easier, widen the frontal plane distance between feet. Narrow the distance to make it harder.

    Narrowing the sagittal plane distance will also help make balancing easier. Conversely, widening the distance between the feet will make it harder.

    Tandem Stance: one foot directly in front of the other, like standing on a narrow balance beam.

    Modify tandem stance to make balancing easier; place feet so inside border of heel touches inside border of toe on opposite foot.

    Single-Leg Stance: standing on one foot.

    For patients unable to stand on one foot, modify single-leg stance by resting the opposite foot on the ground, stool, or wall.

    Functional carryover of arrow stances includes improved ability to stand in confined areas, such as, spaces between furniture, stored items, walls, etc. Split stance postures are also common when reaching deep into a pantry or fridge. Additionally, steadiness in single-leg stance is helpful when stepping over a tub, up/down a curb, up/down stairs, etc.
    The next time you want to increase the level of difficulty for balance training, try a new stance. Modifying stances is a great way to fine tune intensity, helping to ensure proper training at the 20:20 ratio for steadiness and unsteadiness. Don’t be afraid to take a stance, try a new stance, or change stances on balance – your patients will thank you. Happy balancing!

    Wednesday, May 8, 2019

    Product Review: XTERRA Fitness AIR650 AirBike Pro

    Product Details:
    The XTERRA Fitness Airbike Pro offers a tremendous range of workout solutions – the unlimited range of air resistance provides low resistance at slow speeds to high resistance at fast speeds. Simply put, it increases resistance the harder you work, so it’s great for everyone.
    This modern take on a classic modality is one of the most popular full-body workouts available. The XTERRA Fitness Airbike Pro offers a tremendous range of workout solutions – the unlimited range of air resistance provides low resistance at slow speeds to high resistance at fast speeds. Simply put, it increases resistance the harder you work, so it’s great for everyone. Few other full body workouts are as low impact, easy to use, and burn so many calories in such a small compact design. Whether you are looking to rehab an injury, shake up your WOD (workout of the day), or cross-train for your next race, the XTERRA Fitness AIR650 Airbike Pro has you covered.
    • RESISTANCE: Smooth, unlimited air resistance provides low resistance at slow speeds and high resistance at fast speeds – user controlled and great for anything from rehab to high intensity interval training
    • DRIVE SYSTEM: Industrial grade chain drive system operates as a fixed gear (direct drive) and is extremely durable and reliable
    • CONSOLE: Performance monitor LCD display is easy to read with all your necessary information - RPM, Speed, Time, Distance, Calories, Watt, Interval Prompt, and Heart Rate. Chest strap transmitter (not included) is required for heart rate display to function.
    • PROGRAMS: Quick mode program buttons include Target Time, Target Distance, Target Calories, Target HR, Interval 20-10, Interval 10-20, and Interval Custom
    • SEAT: Performance designed seat enables maximum exercise mobility while still providing support and comfort
    • HANDLEBARS: Ergonomic handlebars are designed with multiple padded grip options and are built to take the most intense upper body workouts
    • PEDALS: Wide, low profile pedals are anti-skid with dual sided molded pegs for an excellent grip
    • FOOT PEGS: Large foot pegs are knurled for better grip, allows user to rest their feet during targeted upper-body workouts
    • ADJUSTABILITY: Seat is fully adjustable (up/down/forward/back) to provide users with a proper fit
    • FAN: 9 heavy duty steel fan blades are completely enclosed in a 27” wire steel fan housing – added benefit is the fan keeps you cool during workouts
    • FRAME: Heavy-duty steel frame is extremely stable and backed by our lifetime warranty
    • POWER: No external plug-in required, console uses 4 AA batteries (included)
    • STORAGE: Large transport wheels allow for easy transport to any room in the house
    Product Review:
    Finally, a heavy-duty exercise bike designed directly for the use of athletes to rehab patients and everyone in between. The Xterra Fitness AirBike Pro reinvents and retools nearly every component of the traditional fan bike, from the frame construction to the crank, pedals, monitor and more.
    The great thing about the Xterra Fitness Air Bike is that it can work for a beginner, a rehabbing athlete, or a seasoned pro training at the highest levels of competition—no matter their sport, body type, or ambition. While fanbikes have existed for nearly half a century, modern advances in their design and function have made them increasingly in-demand among military personnel, pro and college sports teams, competitive cyclists and sprinters, and high performance athletes from the cross-training ranks. The key: you set your own pace. The resistance adapts to your own output, and the bike’s multiple, custom seat adjustments make for a more comfortable, customized ride.
    This bike has become an essential part of my daily routine. I've actually been using fan bikes for almost two years at my local CrossFit gym and fell in love with it there. Now I have one of my own so I can use it when I want, which is just about every day.

    There's nothing quite like it. Resistance increases the faster you pedal. There is no coasting. It's a workout from the first pedal to the last. And it's super simple. Some might be put off because of this. The monitor is an upgrade over the competition with all the the important information you need to monitor your work...time, calories, MPH, watts (watts are what you should be watching's the best indicator of how much work you're actually doing).

    It also has several simple programs built in including interval training, distance, calories, and heart rate. I like the interval programs. Research shows interval training is the best for your overall well being. I've taken to doing the 10-20 (that's 10 seconds work hard and 20 seconds rest) in the morning. You go through it 8 times which is a total of 4 minutes. I burn about 50 calories in that 4 minutes and I really feel it when I'm done. If you do interval training right and push as hard as you can during the intervals, you will get to that "breathless" state where the magic happens.

    In the physical therapy world, Dual Action Air Bikes are simply smart. Wind resistance is exponential, so the harder you pedal, or push/ pull your arms, the higher the resistance becomes. This naturally provides the right workout for both a novice exerciser and an elite athlete.  You will find the bike in heart centers, physical therapies, Cross Fit gyms, NFL training rooms, and millions of homes throughout the world.
    The bike was super easy to put together. I followed along with the directions that were included  and it probably took me all of 20 minutes. There are actually very few parts for you to assemble, and it's super helpful that all the screws are already in the holes that you'll tighten them in.

    Main Points to Consider:
    -   Effective for Any Ability
    Xterra Fitness Air Bikes resistance is controlled by the user, not the machine. You can control the intensity of your workout - The harder you push, pull and pedal, the more air you're moving and the greater the resistance. Cool-down and lower your heart rate by easing the intensity of your push, pull, and pedal stroke in order to decrease the resistance and amount of air moving.
    -  Full-Body Workout
    Pushing, Pulling, and Pedaling can all be done with a Xterra Air Bike. This activates muscles in your arms, chest, back, legs, and even your core for washboard abs! Quickly burn calories with a full-body workout where you control the intensity of your exercise regimen!
    -  Comfortable and adjusts to fit various heights
    The adjustable seat allows you to adjust the seat up/down, and forward/back. Simply loosen the pop-pin and pull out to adjust the vertical distance from seat to pedal. Next, loosen the seat lever to slide the seat closer or further away from the handlebars!
    -  Easy Transport and Storage
    Simply tilt the AIR650 forward and roll away using the 2 over-sized wheels from the front stabilizer
    -  Built to Last, COMMERCIAL GRADE!
    More robust than competitor Bikes and uses more durable moving parts. Xterra Fitness Air Bikes utilize the best technology in exercise bikes for a heavy-duty piece of equipment built to withstand anything you can throw at it!

    -  Easily Measure Performance and Progress
    Competition Ready: The Xterra Fitness Air Bike comes everything you're accustomed to and more! The console measures distance, watts, speed, and calories. The Large Console Display gives users an easy way to measure performance and track progress.  Everything you need in one, easy-to-read console with the ability to setup Interval Training, Target Training, Heart-Rate Training, and more. Polar-Heart Rate Chest Belts are compatible.

    The console also allows for switching between units of measurement: Meters or Miles and measures to the tenth of a Calorie so you know your exact progress. Our console is easier to use and more accurately reads changes in speed. We've also included the ability to SET or TARGET distance, calories, and time while the console counts down from your targeted goal so you know just how much longer to work for.

    -  How does it compare to other Air Bikes?
    The Xterra Fitness AIR650 Air Bike features increased durability by using higher quality parts throughout the frame. We've reinforced weak points of other air bike models to create the most durable and robust bike on the market. The frame weighs more than comparable models which leads to more stability.

    Purchase your XTERRA Fitness AIR650 HERE

    Monday, May 6, 2019

    Ached by Lower Back Pain? Stand up Straighter with Physical Therapy

    Lower back pain is a sensation all too familiar to millions of people. This ache can hinder many aspects of your life: working, spending time with friends and family, partaking in the activities you enjoy, and even just relaxing. The World Health Organization estimates that in the United States, 149 million days of work are lost due to low back pain. It is the leading cause of inactivity among adults, and it can result in other health issues if left untreated. It is also extremely common, appearing in 60-70% of people across industrialized nations.
    If lower back pain is plaguing your everyday life, it is important that you find relief as soon as you can. For more information on how we can help get you back to a pain-free life, call our office today.
    How can physical therapy help?
    Physical therapists focus specifically on pain and injury to help their patients regain function, comfort, and mobility. Physical therapy treatments are used to alleviate pain, promote healing, and bring restored function and movement to the painful area. When you come in for a consultation, your physical therapist will provide you with an extensive evaluation, discovering what form of treatment will be best for whatever orthopedic, neurologic, or cardiovascular condition you are facing.
    Physical therapy also consists of two categorized types of treatments: passive physical therapy and active physical therapy:
    Passive physical therapy
    The purpose of passive physical therapy is to help pain become more manageable, and hopefully to alleviate it altogether. Lower back pain can be a debilitating condition, impeding your physical abilities. Because of this, physical therapists work hard to reduce pain as much as possible. Passive physical therapy can include any combination of these specialty treatments, as deemed fit by your physical therapist:
    • Massage
    • Manual therapies
    • Hydrotherapy
    • Ultrasound
    • Dry needling
    • Heat/ice packs
    • Iontophoresis
    Some of these methods are used to reduce pain and swelling, such as heat/ice packs and massage therapy. Electrical stimulation, while it sounds intimidating, is a painless treatment that delivers minuscule waves of electricity throughout your nervous system. This also helps with pain relief, and it can also help in decreasing muscle spasms, as well as encouraging your body to produce pain-relieving hormones. Hydrotherapy is an aquatic-based treatment, in which patients will perform low-intensity movements in water, thus relieving any muscle pressure they may be experiencing and allowing their joints to move freely and comfortably. These techniques are more commonly used for the treatment of lower back pain than others, although any could be prescribed based on your physical therapist’s discretion.
    Active physical therapy
    The purpose of active physical therapy is to provide exercises that the patient can do on their own in the later stages of their physical therapy treatment. Once your lower back pain has subsided enough that your physical therapist believes you are ready for active physical therapy, he or she will set up and exercise schedule specific to your needs. This can include any combination of stretching, strength training, and stability training, and it is all geared toward helping you gain back your flexibility, range of motion, and muscle strength. These exercises will help provide support to the painful area and will guide you further in your recovery process.
    What will my visits look like?
    At your initial consultation, your physical therapist will ask you several questions regarding your medical history, lifestyle, and painful area(s). This information will assist your physical therapist in creating the best treatment plan for you and your specific needs, so you can be provided with long-term results.
    After your consultation, your evaluation process will begin. Your physical therapist will examine you by assessing your posture, coordination, strength, balance, flexibility, blood pressure, and/or heart rate, depending on your pain and symptoms. This evaluation will be both manual and visual.
    When you’ve completed your thorough evaluation, your physical therapist will then create your treatment plan, beginning with passive physical therapy and leading into active physical therapy. You may also be given exercises to do at home, during your time away from treatments. This is all done in order to reduce pain, avoid further injury, and provide you with the quickest recovery time possible

    Wednesday, May 1, 2019

    Everything You Need to Know About Barbells

    Much of how a lifter classifies knurling seems to depend on what bars he/she has used and his/her barbell sport background. Perhaps someone who has a powerlifting background and lifted with a specialized powerlifting bar for years can have a different opinion of what aggressive knurling is. The best knurl grade for you will be what you are accustomed to in most instances.

    A point of marketing that has surfaced recently is the notion that clean, defined borders of knurling is somewhat indicative of higher quality. The reality of these prominent lines is that this effect can be created in such a way that compromises the steel strength of the barbell.

    Knurling is cut into the barbell with a CNC Lathe. Some lathes will require more manual handling than others. The borders of the knurling are created where the machine stops and is restarted again. A fully robotic machine can make exact adjustments during this process, whereas a barbell that is hand-crafted by a man must be reset manually. What some barbell manufacturers will do, (even with some IWF certified bars), is they’ll cut the lines after the knurling is done to create a nice, super neat border. This looks great, and internet bloggers will certainly say this “high quality” feature is a positive attribute of the barbell. The main issue is that any physical cut in to steel is an opportunity to weaken it because it creates stress points. Multiple, unnecessary stress points along the barbell shaft are detrimental to steel strength and the higher the tensile strength of the material, the greater the problem this creates.

    Many lifters will like the traditional centre knurling featured on many barbells. Some consider the extra grip they feel on the back of their t-shirt ideal because it makes the bar feel more secure when squatting. The actual purpose of the centre knurling on barbells dates back to when one-armed “odd” lifts were part of competitive weightlifting and even included in the inaugural Olympic games in the late 1800's. The one-armed snatch and the one-armed clean and jerk are only a few examples of lifts that required such knurling. You’ll notice that 15 kg barbells don’t feature a centre knurling because women were not included in weightlifting competitions until well after the one-armed lifts were phased out. For most Olympic weightlifters, the centre knurling will be an annoyance so many higher end weightlifting bars will have a recessed centre knurling for this reason. The IWF specifies the centre knurling is still a requirement for 20 kg barbells, so manufacturers produce their bars to meet this requirement.

    Barbell Finishes and Their Properties

    Here is a list of many barbell finishes and their pros and cons:

    Black Zinc: Looks Great. Wears (down) easily. Often times it is difficult to make black zinc appear to be truly black. Typically you will end up with a somewhat charcoal to chocolate finish or somewhat of a dark olive colour.

    Black Oxide: Has a matte black appearance. Black oxide is not so much a coating as it is a chemical process of turning steel black. It has very little anti-corrosive properties which means it will rust quickly if not cared for properly. It will scratch, but it does not flake off. The scratches are just a lighter or a different shade of black so they show more. Black oxide does leave the barbell with a raw steel feel without being purely raw steel.

    Bright Zinc: Looks great and classic. It can vary from very shiny, almost chrome-like in appearance to a more matte finish. Exhibits a higher resistance to corrosion than black zinc. Bright Zinc will tarnish and turn grey over time. It is considered a sacrificial coating as it oxides itself rather than the steel underneath it. It will eventually develop a patina which makes each bar have its own unique look depending on its use.

    Nickel Chrome: Looks great and classic. Chrome will scratch or chip if mistreated, but it typically lasts a lifetime. All higher end weightlifting bars are nickel chrome or hard chrome plated.

    Hard Chrome: Hard chrome is actually an industrial finish. Although it can be polished to high lustre , it will not have the aesthetics of nickel chrome. Hard Chrome has a couple of advantages over Nickel Chrome. It does actually fortify the bar and increases the overall tensile strength. It will easily last 20 years or more. The disadvantage of Hard Chrome is that it can have slight marks in it where the components are suspended by a thin wire during the electroplating. Due to Hard Chrome being so thick, even a small imperfection can be made more noticeable where the material accumulates.

    Thin Dense Chrome: It has a matte dark grey appearance that is very unique looking. It has the feel of raw steel without the rust problems of bare steel or some of the other coatings. It adds tensile strength to the barbell just like Hard Chrome does.

    Bare/Raw Steel. It looks really great and feels great... for about a week, then it will start to oxidize and rust. If you don't like oiling barbells and meticulously caring for them, or don't mind lifting a rusty bar, a raw piece of steel is ideal for you. With routine oiling, wiping perspiration from the bar after each use, and storing it in a climate controlled environment, the steel will develop a nice bronze/grey coloured patina.

    Barbell Rotation Types
    Bronze Bushings, Composite Bushings, Needle Bearings

    Composite Bushings are made from hard plastic compounds. They are actually harder than bronze and will not break down after extensive use. Over time, the spin of the bar won’t improve (like with the Oilite Bushing), it will remain consistent

    Needle bearings provide the smoothest and quickest bar rotation. There are a number of barbell varieties with either 10 or 8 needle bearings being the most common variety. We have found the quality, grade, and fit of the bearings as well of type of lubricant used has more impact on spin than total number of bearings.

    Eight (8) bearings can actually take up as much space as Ten (10) bearings, depending on size of the bearings. Bearings are available in different load ratings and widths. Higher load bearings may not spin as easily unloaded and lighter load bearings usually spin much quicker without load, such as spinning with the hand. Once the bar is loaded, there will be no discernible difference in speed of rotation. The higher load rating bearings will last longer and can absorb more impact shock. The reality of weightlifting is that the bar only turns over 180 degrees during a proper lift, and although weightlifting is fast, it's relatively slow as far as revolutions per minute (rpm). Needle bearings are really designed for super high speed applications, meaning thousands of rpm's per minute. Although weightlifting doesn’t push needle bearings to the full capacity of what they are designed to do, utilizing these bearings can still contribute to a successful lift.

    Wednesday, April 24, 2019

    WOD Wednesday #102

    Fight Gone Bad!
    3 rounds for max reps of:
    • 1 minute of wall-ball shots
    • 1 minute of sumo deadlift high pulls
    • 1 minute of box jumps
    • 1 minute of push presses
    • 1 minute of rowing (calories)
    • Rest 1 minute
    STIMULUS: Well I was kind of kidding with the gifs. But also kind of not. This, to me, is the worst it gets when it comes to CrossFit workouts. Just when you're like, "yay my arms are dead so I get to rest now" the minute is up and you're into the next thing. So look to adjust weight/height/movements so you can be constantly going through all the stations.
    GROUP: Stations work but for us if you're scaling for equipment. If you're doing 2 heats, start one on wall balls and one on sdhp so that they never run into the same bar. Burpees are what we use as a sub for rowing. 
    I'M SCALING THIS WELL IF: The 1-minute rest feels way shorter than any of the 1-minute stations.
    I'M SCALING THIS POORLY IF: Honestly, for most people, your score is under 250. Drop some weight and do more reps.

    Monday, April 22, 2019

    Product Review: Bear KompleX Knee Sleeves - 7mm

    Product Details:
    The Bear KompleX Knee Sleeves come in a pair of 2 and are available in Black, Purple, Red, Black Camo, Blue Camo, Pink Camo, and Neon Yellow Camo.

    United States Powerlifting Association (USPA) - APPROVED

    • BEAR KOMPLEX KNEE SLEEVES that will provide the best in support and compression while performing a variety of exercises including: Squats, Power Cleans, Snatches, Box Jumps, Lunges, Running, Double Unders, and more.
    • KNEE SLEEVES ARE 5mm & 7mm FOR OPTIMAL SUPPORT AND COMFORT. The sleeves fit snug for added support and compression
    • INCREASE BLOOD FLOW AND REDUCE PAIN with our sleeves. Keep your knees warm while performing a variety of movements and eliminate injury.
    • MULTIPLE SIZES AND COLORS to appeal to both men and women. Be sure to check our size chart in our images.
    **DO NOT MACHINE WASH KNEE SLEEVES. Hand wash and air dry.

    Product Review:
    These Bear KompleX 7mm Knee sleeves are a standard 7mm thickness, made of neoprene and the thickness is similar into most other knee sleeves on the market, intended to offer joint warmth, knee support, and compression based Benefits for weightlifting, powerlifting, and fitness support.

    Out of the box, the sleeves offered a high amount of support and rigidity, some of the most I have felt compared to the standard 7mm sleeves in my past. The rigidity would be beneficial for lifters looking for a very stiff knee sleeve for heavy squats, Olympic lifts, and rebounding out of lifts; however there was some flexibility for lighter movements

    The Bear KompleX 7mm knee sleeves sizing was comparable to other 7mm knee sleeves that I have reviewed as well a trained/competed in. The contoured fit allowed for a rigid yet flexible feel of the sleeve, however I do feel that a break in period would be needed with the sleeves.

    The sleeves did a good job keeping things warm and offered good support during heavier squats and snatch training. Transitioning from more WOD-based sessions in them was more noticeable, as they did have some extra stiffness and lacked flexibility

    The durability of these sleeves seems to be higher than other lighter options. The neoprene had a good stiffness, offering durability and support. The stitching was very reinforced across the seams, make me feel confident that that could hold up to many heavy and ballistic Olympic weightlifting and squat sessions

    I imagine these sleeves to be a very solid choice for lifters and athletes looking for a supportive, rigid knee sleeve that offers some (not great) flexibility. The pricing of these sleeves makes them very appealing to lifters looking for a basic sleeve to squat, lift, and do explosive full range of movements in.

    For lifters who are more specific with their needs (wanting even more support, a taller sleeve, a more flexible hybrid sleeve, etc) these may not be the best option, as the are pretty standard sleeves that may slightly offer more support in exchange for being slightly less flexible.

    Testimonial from Taylor J.
    "If you are having knee pain or just trying to hit that new PR these knee sleeves will get the job done. Once you figure out the correct size these sleeves will provide you with optimal support for any workout. 

    I personally use them for heavy lifts, lunges and squats. The variety of thickness allows you to find the perfect sleeve for your needs. The 7mm is great for helping you hit a new squat or deadlift PR, but I prefer using the thinner sleeves for lunges or running.

    They also come in a multitude of color options. It is important to note that these need to be hand washed and air dry to decrease the wear and tear of the product. This will enable you to get the longest use from them. Overall these are a great product that should be apart of anyone’s gym bag."

    Thursday, April 18, 2019

    What is Pre-hab and How Can it Help Me Recover Faster?

    It’s no secret that having physical therapy after an injury or surgery helps you recover faster. But what if there was a way to prevent an injury in the first place? Or what if there was a way to speed recovery from surgery long before you went under the knife? Pre-hab or preventative rehabilitation helps patients heal faster after surgery, speeds recovery and, in many cases, prevents injury in the first place.

    What Is Pre-hab?
    The term pre-hab is short for preventative rehabilitation. A physical therapist typically uses pre-hab in two ways. First, they can teach targeted exercises and stretches to patients who are at risk for serious injuries. Second, pre-hab is a form of physical therapy used prior to surgery to speed healing and recovery.

    Pre-hab for Injury Prevention
    Pre-hab is one of the best ways to prevent injuries in patients at risk for developing significant movement problems. Those with physically demanding jobs may find that the exercises, stretches and pain relieving techniques taught at physical therapy help them perform in their jobs. This is especially true in jobs where there are high incidences of certain injuries. This type of physical therapy typically targets areas where injury is most likely to happen. For instance, those in the military are more prone to develop foot, knee, hip, and back problems due to the rigors of training and combat. Pre-hab can mitigate many of these injuries by teaching correct lifting techniques, proper posture and effective core strengthening exercises that keep service members strong and healthy. The same can be said for construction workers, firefighters, factory workers, or other employees in highly physical occupations.

    Even pro and amateur athletes are finding that working with a physical therapist is paying off, long before an injury happens. Focusing on the areas that are stressed by everyday movement and poor habits, a physical therapist looks at your most injury-prone areas and helps you correct any problems before you get hurt. Chances are you are hunched over your computer most of the day. Working with a physical therapist can help strengthen your core and correct your posture, keeping you strong and healthy. Since an object in motion tends to stay in motion, physical therapy is also an ideal way to begin an exercise regimen. Focused on strength, mobility and balance, pre-hab can keep you injury free for life as you begin the process of getting in shape.

    Pre-hab for Better Surgical Recovery
    When it comes to going under the knife, many people fear what will come after the stitches have been sewn. This is especially true for anyone who has a total joint replacement. Faced with the risk of time in a rehabilitation hospital, many people delay joint replacement surgery out of fear of a long, difficult recovery. But doing physical therapy before surgery can reduce the odds of needing inpatient rehabilitation by 73 percent. Patients who are stronger before surgery also meet physical milestones sooner than those who do not. Within 24 hours of surgery, someone who has had a total knee replacement is expected to walk 500 to 1000 feet with the assistance of a walker. Those who work with a physical therapist before surgery are more likely to meet this demand. These patients are stronger and have better blood flow. Physical therapy also teaches them many of the movements stretches, pain relieving techniques, and strengthening exercises they will need in their recovery.

    Monday, April 15, 2019

    Product Review: Valor Fitness BD-21 Yoke

    Product Details:
    The Valor Fitness BD-21 Yoke is a versatile piece of equipment being a functional all-in-one rack.
    Featuring 2”x3” 11-gauge solid steel uprights with 41.5” of inside working space, versatile skid sled style/storage feet with 4 10” weight pegs, J-Hooks for bar support, and a weight capacity of 750lbs. Fully adjustable crossbar and pull up bar with locking popper pins and a 72” height range allows customization to any workout, from a basic yoke carry to the Zercher Carry, Zercher Squat, pull-up station, squat station, bench station, and sled training exercises. The numerous possibilities for this unit, make it an all-in-one option for a home/garage gym.
    Features/Benefits :
    • ALL-IN-ONE RACK- A functional and versatile piece of equipment can be used as a Pull-Up Station, Squat Station, Muscle-Up Station, or Bench Press Station. Allows for a variety of Sled Training exercises, a basic Yoke Carry, Zercher Carry, or Zercher Squats, making the Valor Fitness BD-21 the perfect all-in-one equipment for a home gym.
    • UNIQUE SKID SLED STYLE- Allows the user the ability to lift and smoothly slide the Yoke Rack for Sled Training exercises. Yoke Rack weights 160 lbs. by itself.
    • STORAGE PEGS- Designed with 4 (10 in. X 1.5 in.) weight pegs at the base to create storage for Valor Fitness Bumper Plates and provide added stability of the Yoke Rack when weighted down. Allows the option to add extra weight for Carries and Sled Training.
    • ADJUSTABLE - Fully adjustable Crossbar and Pull-Up Bar with locking popper pins and a 72 in. height range allows customization to any workout. Includes Safety Catches and J-Hooks on both sides of the Yoke Rack for bar storage during Bench Press and Squat Workouts. Built with a 49.5 in. X 50 in. base to allow for a 42.5 in. of working space
    • STURDY- 92 in tall, 11-Gauge solid, Steel uprights (2 in. X 3 in.) can hold up to 750 lbs. Designed for light-commercial use. 3-year warranty.
    Shipping Dimensions:
    · Size/weight: 92" x 8" x 4" / 59 lbs.
    · Size/weight: 49" x 17" x 6" / 97 lbs.
    Assembled Dimensions:
    · Size/weight: 92" x 49.5" x 49" / 150 lbs.
    Product Review:
    I’ve had my eye on the ValorPro Yoke for over a year now since building my garage gym. Back then it was initially my plan to have this yoke also serve as my rack. I am a minimalist, the sort of person who travels light and likes to keep things very sustainable.
    However I also understand the importance of having the right tool for the job, and the aggravation of NOT. And, after many attempts at conniving minimalistic ways to achieve full body strength— at one point the whole of my equipment being a sandbag, tires, and a few kettlebells.  I ultimately settled with the conventional home gym route.
    Make no mistake: this ValorPro Yoke unit can and absolutely WILL serve as an all-in-one piece of equipment for much, if not most, of the fitness community.
    However if you are a more serious hobbyist or a competitive lifter, if you plan on moving extreme weights or if you simply want the unshakable rigidity of a commercial piece of equipment, as far as a rack is concerned a full-scale power rack bolted down to the floor is the only way to go if you truly want less inconvenience and limitations while also providing utmost safety.
    But in no way does that make this yoke superfluous or unnecessary. I am absolutely in love with this thing. In fact, there are certain pieces of equipment which are worth purchasing for one exercise alone. Now that is NOT the case with this yoke, as there is just so much you can do with it. But, just as an example, I purchased a pair of top-loaded farmers handles from a different manufacturer for over $300. There’s really nothing else you can do with them besides farmers carries, but 1) farmers carries are such an exceptional movement, 2) proper implements make such a difference on the effectiveness and enjoyment of the movement, and 3) top-loaded handles are just so convenient, that it was indeed well worth the price.
    My point is, even if all I could do with this yoke were yoke-related movements (no rack capability, extra storage, etc), I would STILL buy it.
    But the versatility of the BD-21 Yoke has me stoked beyond belief. Overhead walks, traditional yoke walks, Zercher carries, prowler pushes, you name it. I have admittedly let my conditioning slip in the pursuit of strength, but I know that for optimal strength and certainly for optimal health, one must have a certain degree of conditioning. But forget sitting on a stationary bike or jumping rope. This is the alpha manner of conditioning. These movements simultaneously get you incredibly strong and assist your other lifts, unlike typical conditioning methods where you have to altogether replace time spent doing strength work for the sake of cardio. If you are limited in the amount of time you have to lift each week-- as I am-- this is a major bonus.

    The assembly is very simple and safe, and very doable by oneself. I left all of the hardware just a touch loose so that the skis and structure can settle on the uneven ground outside. I love how when you finish a walk, the skis allow the yoke to continue a few inches past you. The unit doesn’t keep sailing for several feet, nor does it stop short right where you drop it. It’s perfect.

    At 5’11” I have found the ValorPro Yoke to be plenty tall. Setting up for traditional yoke walks I have 7 or 8 empty holes above the top of the crossmember.
    I have two comments ... the side storage pins are nice, but we just hang gym belts\wrist wraps over them because the plates get bumped when squatting (if you have a shallow walkout), and the storage on the feet aren't friendly if you have a wider stance. Also the cross-member can be difficult to move up and down. The uprights want to lean. Since the sleeves on the cross-member are pretty closely toleranced, which is good, because it provides good stability for the assembled yoke, the uprights don't have to lean far to stop the cross-member from being able to slide. So forget breaking this thing down frequently by yourself to save space between workouts.

    Wednesday, April 10, 2019

    WOD Wednesday #101

    5 rounds for time of:
    1-minute handstand hold
    21 toes-to-bars

    STIMULUS: Noobs and Bros would look at this one like, “So what’s after this?” If you BS through this workout, you’ll definitely feel like it’s a glorified warmup. But these are two tough movements in the volume they’re being presented. If you take this workout “For Quality” – meaning not looking at the time, if at all, until the very end – then you’ll find a great opportunity; getting better at handstands and toes to bar transfers to a lot of other things.

    GROUP: When I did this, I used the 1:00 handstands to mean a running clock, and I did the best I could within that minute. I usually spent around 40-45 seconds out of that minute in the handstand. I’m glad I did too because I could feel myself overextending on the last two rounds. For the toes to bar, I like to use kipping in high number and not worry about hitting the actual bar, but being able to get a good rhythm and keep a good Pike position. I also used rings for them because my shoulders were feeling tight and it helped me get the legs a little higher. When scaling for a group, I’d not worry about the “to bar” part and just get the feet as high as possible with the legs straight. This helps keep the integrity of the pike position, the kipping motion, and the relative intensity, plus makes it less likely for the athletes to pull with the arms. The running clock on handstands is self-scaling; all you a-holes who have stronger shoulders than me can accumulate 1 minute. If wall/bar space is limited, split into 1-minute stations, best efforts for each exercise within the minute. Don’t worry about reps. Hit up the comments for any injury scales.

    WARMUP: 3 rounds of: Kip – prime overhead position and rhythm Squat – always needed and loosens up hips Jump rope – always needed, especially when snowy, and singles are undervalued in running skill transfer Rope climb – warm up the grip a little, we need them even though I always get complaints Hip extension – kind of a Pike position, prims hips and hamstrings

    Monday, April 8, 2019

    Why Don’t You Take My Insurance?

    Cash-based Physical Therapy is gaining a lot of interest from both clinicians and patients due to the emphasis on quality of care over the quantity of patients. This setting allows for one-on-one appointments with a doctor of physical therapy, a full 60 minutes to address all of the patients needs, and a faster and more thorough rehabilitative process.

    Unfortunately insurance creates multiple challenges for health care providers that negatively impacts patient care. First, many insurance companies require what is called pre-authorization. This means that your initial evaluation will be provided to the company and they decide whether or not care is medically necessary. Remember an insurance agent, not a health care provider, is making this decision. Next, if it is found to be medically necessary, the patient will be awarded approximately 6-8 treatments. In the insurance-based setting, this is often not enough time, there is a lapse in care, and patient regression. It’s a nasty cycle.

    After care, insurance reimburses the provider. This reimbursement is not the amount that is charged; it is often much less. Poor reimbursement leads to minimal time with the PT and increased time with the physical therapy assistant or a rehab aide. PTA’s can vary in education/experience (some are very good!), but rehab aide’s often have no education in exercise or physical therapy. This leads to poor technique with exercises or excessive use of passive modalities. That’s low quality PT, which is not worth your time or money.

    One final consideration when it comes to insurance-based physical therapy is the pressure on doctor’s to refer “in house.” How do hospitals make money? Outpatient services. When a doctor refers within his or her own network, it brings even more money in to said network. Referring “in house” isn’t necessarily a bad thing, but not everyone specializes in your specific condition or population. If you are a CrossFitter and get stuck with someone that specializes in geriatrics, it’s probably not going to pan out well. This can often result in low quality PT, which again, is not worth your time or money.

    Insurance companies are not all bad. They provide a lot of services that are of vital importance and may not be possible without their financial support. I find that it’s largely life or death situations; unfortunately, wellness does not fall into that category. Healthcare is making a huge shift from a “sickness” to a “wellness” paradigm. This is an exciting time as a clinician. Following is an outline of the top 5 reasons that a cash-based PT practice benefit the patients.

    1) Cost-effective Care

    Therapists have the extensive education and training to be neuromuscular primary care providers. For the majority of patients’ with movement deficiencies or pain, PT’s are the provider of choice. For people with high deductibles, it makes much more financial sense to seek treatment from a cash-based physical therapist.

    Insurance-based models require the PT clinic to charge very high rates in order to be reimbursed a profitable margin. Thus, those that are private pay (or are still working to meet their deductible) are required to pay these elevated rates.

    2) You’ll See The Doctor

    By the year 2020, all PT’s will have earned their doctorate in order to provide treatment. In the insurance-based world, it is common for you to be pawned off on one of the physical therapy assistants (PTA’s). Although many PTA’s are very knowledgeable, they do not have nearly the same educational requirements as a PT.

    In a cash-based practice, you are paying for a specific service, which is evaluation and treatment by a Doctor of Physical Therapy. In this setting your provider has significantly more time to focus on you and your healthcare.

    3) Accessibility

    In the state of Indiana, we have direct access for evaluation and treatment of 24 calendar days. Patient’s have a significantly shorter wait time (we can typically provide an evaluation within 48 hours) in a cash practice. Most research shows that earlier treatment correlates with improved outcomes.

    Let’s face it, there’s nothing more frustrating than going to a doctor’s appointment to just be told you need to go somewhere else. In the cash practice, we cut out the middle-man.

    4) Transparent Affordable Pricing

    Prices are right up front. Cash based practices cut out “playing the insurance game” and extra administrative costs. Often, it shocks people to hear prices of treatment because we have become accustomed to physical therapy being covered by insurance. Unfortunately, they often later find out that each visit actually had a $40 co-pay, insurance only covers 80%, or that their deductible hasn’t been met.

    When working in an insurance-based practice, I far too often saw someone end up with a $4000.00 bill after 2 months of treatment. $150 an hour no longer seems so expensive.

    5) All Patients are Welcome

    All patients, insured or uninsured, in network or out-of-network are welcome. Payment is by cash, check or charge. Patients aren’t treated in a way that satisfies their insurance company – even better: no more silly outcome forms. Patient’s are provided the care that is needed and that will lead to desired results. We are about and for the patient.

    Thursday, April 4, 2019

    PT Therapies: Positive Expiratory Pressure Therapy

    Positive Expiratory Pressure (PEP) allows air to get behind the secretions to clear them.  A mask or mouthpiece with a one way breathing valve slows exhalation, allowing pressure to keep the airways open.  A manometer determines the correct level of PEP (10-20 cms of H2O pressure)

    Breathing should be normal with slightly increased expiration.  Supplemental oxygen, or nebulized medication can be used at the same time as PEP.  Huffing or coughing is performed after use of the device.


    1. Equipment needed:
      1. PEP device with Mask or mouth piece
      2. Manometer (measuring device)
    2. Sit upright. Hold the mouth piece tightly between lips or hold the mask tightly against the face with both hands.
    3. Breathe in a normal sized breath.  Breathe out actively (but not forced) through the mask or mouthpiece.
      1. Adjust the resistance to expiration until the manometer measures 10-20cms of water pressure.
      2. When the proper resistance is reached, take 10 breaths through the PEP device at a normal rate.
      3. Exhalation should take about 3-4 seconds
    4. Perform 2-3 huffs or coughs to remove and mucus produces
    5. Pause and perform normal breathing using the lower chest with the upper chest and shoulders relaxed.
    6. Repeat the above procedure (#3-5) as needed.
    7. A treatment session should last about 20-30minutes.  The appropriate resistance of the device and the procedure used should be rechecked periodically during clinic visits or hospitilization.
    Image result for pep device
    PEP devices should be cleaned according to the manufacturer's directions or atleast washed regularly in hot, soapy water to avoid contamination.  The one-way valve should only be washed in hot water (no soap) to prevent the valve from sticking.

    Monday, April 1, 2019

    What I Learned From Injury and Rehab

    If you told 19 year-old me, that I would be a Weightlifter, Doctor of Physical Therapy, and business owner in less than 10 years, I would have laughed in your face. I had no interest in physical therapy and I couldn’t even lift my left arm. But sometimes, things happen that rock your world.

    At 19, I had turned in my ballet slippers for some Reebok Nano’s. At that point, I had been doing CrossFit for a little over a year and was OBSESSED. I had completely drank (chugged) the kool-aid. I was training about 5 days a week, was committed to a Paleo diet, and had even changed my major to Exercise Science.

    One summer morning, I went into the gym and we were doing a double TABATA.

    Girl is #killinit and next thing I know, my shoulder dislocates. It immediately popped back in and I convinced myself that I was fine. I WAS NOT FINE.

    That night, I remember being in excruciating pain; I couldn’t even move my arm. I remember checking how high I could lift it over and over again (I’m sure that was great for it). How could I overhead squat yesterday and couldn’t even lift my arm today?
    Injuries Happen

    The first lesson I learned is that, injuries happen. It’s no one’s “fault.” It doesn’t mean that CrossFit is bad or that I had a bad coach. It’s just something that happened.

    When you increase activity levels, you also increase the chances of injury. As volume and intensity of training go up, you have a greater tax on the system. Although you may have a slightly higher chance of injury, you are also significantly decreasing the likelihood of heart disease or chronic illness. So, who is really winning here?

    Injuries are simply feedback – you did something your body wasn’t prepared for and you now get to create resiliency. It’s a time that you get to focus on the areas that you were lacking. I had poor scapular motor control, weakness within my rotator cuff, and quite a bit of anterior shoulder laxity. Had these things not been present, maybe passive structures could have given my body the feedback it needed to self-correct.

    The important thing to understand is that injuries happen. My first piece of advice is to work with educated and experienced coaches; they have the ability to help you identify major problems that could predispose you to injury in the future. If you have not exercised in many years, it may also be a good idea to have a biomechanics assessment with a physical therapist; we have the ability to look at mobility and stability throughout the body. We can give you lots of tips and tricks to address the deficits you may currently have!

    You’re Not Destined to Live the Rest of Your Life Riding the Elliptical

    This may make me sounds crazy, but I literally remember thinking “Oh no, I’m gonna have to ride the elliptical for the rest of my lifeeeee.”

    During recovery, you’ll most likely have a moment where you think you’re never going to get back to normal. I remember feeling heart broken. All I wanted was to do something simple like squat again.

    Athletes have extra challenges in recovery because it feels like a huge part of their life has been taken away from them.

    I was told to completely stop CrossFit. In theory, I get it, but “stopping CrossFit” meant much more than stopping an exercise program. It challenged my ability to cope and it also took away a huge part of my social life.

    As an athlete and physical therapist, I understand that it’s important to stay connected to what you love and also, to maintain your vision for the future. I was committed to coming back stronger.

    Although I was told to “stop CrossFit,” I technically stayed away from the gym for a week, maybe. At first I just went to the gym to do some mobility work and talk to my friends. I slowly started doing exercises that didn’t involve my shoulder. Then when I couldn’t take it any longer, I figured out the best substitutes that I could.

    Today, I’m able to snatch double what I could prior to the injury. Had I not made the choice to stay connected, this likely would not be my reality.

    At the lowest lows of your recovery, remember that you just have to take one step forward every day. Maybe things won’t look exactly the same, but that could always be for the better.
    Not All PT’s Are Created Equally (And That’s a Good Thing)

    After I saw an orthopedic surgeon, we decided to go the conservative route. I had a cortisone injection and was instructed to begin physical therapy.

    I remember being relatively unimpressed with my first day of PT. We did a bunch of tests and I was given a cute little band with a sheet of boring exercises.

    I later found out that the person who evaluated me specialized in geriatrics. Geriatrics is a vital specialty… ya know, if you are treating someone of age. It’s not vital for the 19 year old that wants to do CrossFit again.

    So, my second piece of advice is to be selective when you ask for help. Don’t just take whichever therapist works the evening shift. It’s not worth your time or money if they don’t have the skills necessary to progress towards your goals.

    Personally, my purpose is to help people, like 19 year-old Cara, get back to their sport. It’s what gets me excited and it’s what keeps me up at night. I’m obsessed with this stuff.

    There’s someone out there obsessed with joint replacements, there’s someone obsessed with pediatrics, and there’s someone obsessed with wound care. Find the person that’s obsessed with you and your needs.

    Wednesday, March 27, 2019

    WOD Wednesday #100

    For time:
    9 thrusters
    1,000-m row
    15 thrusters
    1,000-m row
    21 thrusters

    Men: 65 lb.
    Women: 45 lb.

    I look at this one as a sprint, so the things I look at for limiting factors would be rack position on thrusters and distance on the rower. Dumbbells would be a good idea for a lot of people in my opinion. Now for equipment, we don't have rowers so we'll run.

    Some of our track kids might do a 1,000, but most will probably do 600 or 800. Now since we're in Michigan, so we're ready to run in anything except ice. If it's icy, we'll probably scale to running jump ropes (alternating feet and focusing on the Figure-4 Runner's Pose) and dumbbells for everyone (to save on space/barbells rolling around).

    Monday, March 25, 2019

    How to be Healthier, Stronger, and More Active

    If you are suffering from chronic pain, you know that is healthier, stronger and more active often seems unattainable. Fortunately, the key to a more active lifestyle is simpler than you think. Call our office today to find out how physical therapy can help you achieve levels of health and fitness you have only dreamed about.

    A Healthy Lifestyle is Not an Accident
    The keys to a healthy lifestyle are not a secret, but they do take work. Eating a healthy diet is something everyone can do regardless of their activity level. But physical fitness sometimes seems unattainable for people with chronic pain. Some try to mask their symptoms with anti-inflammatory or pain-relieving medications. Others simply give up on the idea that they will ever be active again. Fortunately, there is a third option. With the help of a physical therapist, it is possible to reclaim your pain-free, healthy lifestyle.

    How Physical Therapy HelpsWhether you are suffering from lingering pain after surgery or an injury or your joints aren’t what they use to be, the purpose of physical therapy is the same. A physical therapist is a movement specialist. Highly trained to diagnose problems with walking, running, bending, stretching, moving, jumping or every other physical activity, these medical professionals can pinpoint areas of improvement and create customized physical therapy treatment plans that address each patient’s unique needs. Through in-office sessions and at-home exercises, patients build endurance, improve their balance, strengthen muscles and joints, and experience pain relief without unwanted side effects.
    What to expect from your first visitYour body’s needs are unique. Instead of relying on a cookie-cutter approach to wellness, a physical therapist takes time to evaluate each individual’s pain level, movement abilities, balance requirements, and lifestyle wish list. You may be asked to perform basic movements such as sitting down, standing up, walking, lifting or other motions. Once he or she has a clear picture of what you need, your physical therapist will begin constructing a treatment plan to help relieve your pain and get you back on your feet.

    Physical therapy in a nutshellTypically, physical therapy involves three phases – pain relief, strengthening, and functional integration. A lot of people are hesitant to start physical therapy because they are afraid it will hurt. In reality, one of the main goals of physical therapy is to relieve your pain while helping you get stronger in the process. Ice, heat, ultrasound therapy, stretching and bracing are all tools in a physical therapist’s belt to help you feel better.

    Second, an active lifestyle depends on movement. That is why physical therapy targets specific movements that increase flexibility, balance, strength, and mobility. These exercises may be done in the office of a physical therapist, or many can be done on your own at home.

    Finally, being healthy is a lifestyle, not a single event. The end result of physical therapy is living the life you want, free from painful limitations. That can only happen when you apply the concepts you learn in therapy to the outside world. Your therapist will help you do just that.

    In the end, an active lifestyle is possible, even if you struggle with chronic pain. Stop waiting around to get better and take your fitness into your own hands.

    Wednesday, March 20, 2019

    WOD Wednesday #99

    21-15-9 reps for time of:
    Dumbbell clean and jerks
    Strict pull-ups
    GHD sit-ups

    Men: 35-lb. DBs
    Women: 25-lb. DBs

    STIMULUS:  With these ones, I think it’s best to have an understanding about movement standards and movement factors. Standards are universal and not made by people. Midline stability, loading order, and laws of torque are really the three to keep in mind in the weight room. Factors are things coaches add in a workout to make it difficult for an athlete to hold the standards (load, range of motion, fatigue, strategy, and volume are all man-made factors, not natural movement standards). You can keep your midline stable in a deadlift? Okay then let’s add 100 pounds to the bar. Still good? How bout 10 reps instead of 1. Still good? Now do 15 burpees as fast as you possibly can then see how your midline looks on deadlifts. Oh now it looks sloppy? Let’s downgrade one of the factors. That’s the best way to approach this one. Midline stability is probably the best standard to look at for this one. Go as smooth on c&js, as high on pull-ups, as far back on GHDs, and as fast between exercises as you can as long as you keep your midline from changing. When it does (inevitably), take a short break or decrease range of motion. This is a training workout that doesn’t necessarily have to be perfectly comparable-to in the future.

    GROUP: As with a few days ago, I think any kind of bar work is better than rings for this kind of workout for most people. I could be wrong though. Static hangs, flexed hangs, and jumping negatives can work. Actually now that I think of it, best bet might be to do stations. 3 minutes of each, then 2 minutes of each, then 1 minute of each; just count reps on the one-minute round. This can help with lack of equipment too. As for the GHD, one of our teens a few years ago designed a 10-person double-sided GHD for us. Obviously this is awesome. I’ll post some details sometime when I see GHDs up again. A static tuck hold or tuck hang would probably be a good sub. 

    INJURY: The rings could be useful if there’s an arm injury. Dumbbells are useful too – just use one arm. As for spinal stuff, I would try squats with a 5-lb. plate held out in front to sub for a GHD sit-up. Everything else should be fine.

    I’M SCALING THIS WELL IF: my abs are the limiting factor in strict pull-ups, I am breathing somewhat heavy in the second round of clean and jerks, I feel GHD sit-ups anywhere but my lower back, and I feel like I have a little more in the tank after the workout is over.

    Monday, March 18, 2019

    PT Modalities - Spinal Traction

    Effects of Spinal Traction:
    • Joint Distraction
    • Reduction of disc protrusion
    • Soft tissue stretching
    • Muscle relaxation
    • Joint Mobilization
    • Patient immobilization 

    Indications (when a therapist will use spinal traction):
    • Disc Bulge or herniation
    • Nerve Root impingement
    • Joint hypomobility
    • Subacute joint inflammation
    • Paraspinal muscle spasm

    Contraindications (when a therapist should NOT use spinal traction):
    • Where motion is contraindicated
    • With acute injury or inflammation
    • Joint hypermobility or instability
    • Peripheralization of symptoms with traction
    • uncrontrolled hypertension

    Precautions (when to be careful and monitor use of use of spinal traction)
    • Structural diseases or conditions affecting the spine (tumor, infection, rheumatoid arthritis, osteoporosis or prolonged steroid use)
    • When pressure of the belt may be hazardous (pregnancy, hiatal hernia, vascular compromise or osteoporosis)
    • Displacement of annular fragments
    • Medial disc protrusion
    • severe pain fully relieved by traction
    • claustrophobia
    • patients who cannot tolerate prone or supine position
    • disorientation
    • TMJ problems (search post TMJ disorder for more information on this pathology!)
    • Dentures.

    Adverse Effects of Spinal Traction:
    • Prior symptoms may increase by the application of lumbar traction exceeding 50% of the patient's total body weight or by the application of cervical traction exceeding 50% of the patient's head.

    Wednesday, March 13, 2019

    Product Review: Draper's Strength Heavy Duty Pull Up Bands

    Product Details:
    • Band Set Per Order. Light to heavy resistance (2-200 lbs) - To choose the best bands for your needs, check out the band tension chart in the images to the left.
    • A variety of exercises can be performed - for physical therapy, rehabilitation, pull-ups, stretching, strength training, powerlifting and etc.
    • Bands are 41" inches long and are made of high-quality latex material built to last for years.
    • These high-quality bands are very durable so you can use them for years to come.
    Why Draper’s Strength? 
    LIFETIME DURABILITY - built to last and maintain their elasticity over many years of training. The secret to extreme durability and muscle building tension is the continuous latex dipping process that creates 100's of micro layers in Draper's Strength bands.

    MULTI FUNCTIONAL - used for ankle, knees, legs, thighs & wrists. Aids in weight loss. Perfect for strength-conditioning, coordination & balance; for assistive pull-ups/chin-ups in pull up bar/pull up tower and dip station with your pull up mate, Pilates, CrossFit, P90X, Slimin6, Insanity, TurboJam, isometrics exercises, monster walks, lateral walks, goblet squats, etc.

    TOP RECOMMENDED CHOICE BY ELITE ATHLETES AND DOCTORS - For physical therapy to help in recovery from torn MCL, torn ACL, knee replacement, patella and meniscus rehab.

    PERFECT LENGTH - All bands are 41” long so you can extend them from the ground to far overhead without damaging the bands.

    safe way to train at any age and for any fitness level - beginners or experts.

    LIGHTWEIGHT AND COMPACT- perfect for traveling and for exercising anytime, anywhere.

    COST EFFECTIVE - No need for expensive exercise equipment. No need for any more exercise bands. Just switch to higher resistance or combine a few exercise bands together. 

    Product Review:
    These Draper's Strength heavy duty pull up resistance bands set is an ideal portable gym, that you can you at home, in a work place, or outside while you enjoy sunshine and pleasant wind. Each Draper's Strength band made from strong durable rubber. You can use them for many years and they will not lose their elasticity and strength. They beat molded bands in performance, strength and durability.

    Since the bands are available in different resistance levels, they can be used by any sport enthusiast or athlete of any fitness level. There is also a mechanical advantage in resistance bands that resistance is maintained through every part of the motion while many similar free weight exercises are actually non performing work during parts of the lift when movement isn't against gravity at a large enough angle.With your resistance band training, every part of both the concentric and eccentric part of the exercise has resistance, resulting in better range of motion strength and more complete stimulation, this makes it idea for physical therapy applications, rehab, and overall linear training progressions.
    This is a great investment for a start up gym! Instead of cables you can use these in many ways that a cable system can be used as well! Great for pull ups and of course to work on your explosiveness on squats, bench and dead lifts. I've seen these used for dumbbell presses as well.

    With this band hung from my pull up bar I can get more reps in and it has increased the number of unassisted pull ups I can do. I've found that the green band is pretty equal to the assistance you would receive if a buddy was helping you with your pull ups, and you can change the amount of assistance by putting your foot through the band for more assistance or just using one knee for less. 

    The thinnest, lower-resistance bands are best for pull-up assistance, general conditioning, rehabilitation, jumping, speed training, and beginner / light weight training. The smaller bands can safely raise the intensity of a weightlifting movement without adding additional weights to a bar. For the stronger lifter, they will also add considerable resistance to bicep and tricep exercises.  The mid-level bands can be used by stronger benchers, as well as for banded squats and other exercises involving the lower body, calves, quads, hamstrings, and glutes.   Bands are lightweight, no-nonsense additions to your prehab/rehab/recovery regimen. They fit easily in a gym bag pocket, make good complements to other essential mobility tools.

    The 5 pc Draper's Strength Band set comes with some attachment handles and is a nice bonus for the price which is less than $10 per band, or close to half the price of more expensive functional fitness "brands" but offer less or no difference in features and function.

    Order your Draper's Strength Bands on AMAZON HERE:

    Wednesday, March 6, 2019

    WOD Wednesday #98

    Deadlift 1-1-1-1-1 reps

    STIMULUS: One thing to note is the limited sets here. I always had trouble understanding what the major difference is between having 7 sets of 1 as the workout and 5 sets of 1. Or whatever the rep scheme. My interpretation sounds obvious, but I think the reason comes down to volume. There is probably a reason why the CrossFit gods want to hold off on the two extra sets (especially when those could be close or at our absolute max. The more time we spend there, the more room for tweaks or injury. Now full disclosure, I have not seen the next few workouts yet, but seeing max efforts like this usually give me some serious nerves for the next day. So if you’re working to the max, plan it out, hit it, then call it a day.

    GROUP: One rep maxes are tough to coach in a group for me. When I’m watching someone do sets of 3 or 5 or 7 or whatever, I can gradually see the form break down and can either correct them as they go or stop them mid-set. The 1-rep really tests to see not only how well the athletes’ movement patterns are, but how good your coaching is. If you want to let the reigns off and let the peeps life, be my guest. I think this is a great opportunity to coach the setup and fix the spinal flinch that can come from the first lift off the ground. Might not make as big of a deal in the deadlift, but a flinch in the clean could be the difference in getting a strong jump. 
    If you know your group is not ready to do max effort deadlifts, or even if you just don’t feel like it, then check back a few days and see the workout scale for the 5-3-1 deadlift day. I’d include handstands in this time as well. Also, check the last one for comments on not worrying about rep scheme. 

    INJURY: Go with the workout. If it’s back, then try something that would challenge the midline without too much moving. Tuck hold, extended plank (hold top of push-up then walk your hands as far out as possible and hold.)

    Monday, March 4, 2019

    Why You Should Be Using Different Grips

    How you grip the bar or weights makes a major difference on what muscles are activated during a workout. Changing your grip can work muscles that previously were unengaged, enhancing your workout and building muscle.

    Crushing is the action of wrapping the fingers around an object that provides resistance to your fingers bending. Your fingers are the primary exertion of force, such as when you shake someone's hand. A crushing grip is used when gripping a bar, pulling a rope, or performing a pull-up.

    Find a small or medium-sized towel and place it in a bucket of water until it is soaked. Stack your fist one on top of the other while gripping the towel with both hands. Now “wring” the towel out by twisting and squeezing the towel as hard as you can. You will know you are done when the water is back to the original height. You can use a thicker towel or fold the one you have in half to increase the resistance.

    Pinching is the action of grasping an object between the thumb and fingers. The primary pressure is exerted inward as the thumb and fingers are pulling towards each other. Pinching is not an exercise you naturally use to train in your average workouts and requires specific and intentional practice.

    One of the most common and easiest pinch grip strength exercises is a weight pinch. Simply take two plates and place them back to back. Grip the outermost edge, letting the weight hang below your hand. Hold it for at least 30 seconds.

    Support Grip:
    The support grip is when you lift with your fingers taking on most of the load— most notably, this grip is used in kettlebell work, rows, and deadlifts. It is important to note that a true support grip means that the fingers should wrap almost entirely around the bar or object in hand. An open hand support grip can be utilized by gripping a bar or object that is large enough to leave a small space between the fingers and the thumb.

    Farmer carries are a great way to increase your support strength. You are probably familiar with these if you have been in CrossFit for a long time. A great way to challenge yourself is to use a towel or a barbell grip wrap to increase the bar size, using an open hand support grip.TRY IT NOW:
    Farmer carries are a great way to increase your support strength. You are probably familiar with these if you have been in CrossFit for a long time. A great way to challenge yourself is to use a towel or a barbell grip wrap to increase the bar size, using an open hand support grip.

    So, what do you do with this information?

    Thursday, February 28, 2019

    Product Review: Titan Fitness Hefty Bench V2

    Product Details:
    Our version 2 of our Hefty Bench features our new enhanced vinyl for a unparalleled support, feel, and grip.

    Fully utilize your bench for maximum power while also reducing your chances of injury with the Titan Hefty Bench. The added width and thickness gives your back and shoulders extra support for bench pressing.

    - Extra wide 24" base ultimate stability and support.
    - Double sided gusset plates lock the bench top to the base.
    - Constructed of heavy duty 3" x 3" tubing.
    - Handle and wheels for easy movement and storage.
    - 15" Wide pad is perfect for safely hitting you max bench press.

    - Overall Length: 53"
    - Overall Width: 24"
    - Overall Height: 17"
    - Bench Length: 50"
    - Bench Width: 15"
    - Bench Thickness: 4"
    - Capacity: 1,200 LB
    - Weight: 84 LB

    Product Review:
    I’ve been a big fan of the Titan Hefty Pad since the very first time I benched on one. It’s wider, longer, thicker, denser, and more supportive than any other bench pad I’ve ever seen or used. In addition to all that it has a unique, heavy-duty  vinyl cover that prevents any slipping or sliding around on the pad; a surprisingly uncommon feature for bench pads.

    Built like a tank and the pad is a shoulder saver. I’ve been suffering from bicep tendonitis for over two years now, from playing college baseball - with this pad I’ve been able to bench 225 for reps without any pain.  Getting frustrated that my shoulder issues are holding me back I have tried a lot of things and finally tried the hefty pad, my shoulders got noticeably better. Just a couple weeks of using it my shoulders no longer hurt at night keeping me awake, like they used to. They are improving each week where benching isn't irritating them any more.
    Some may worry that with training with this wide pad when they use a competition bench it will throw them off. While the setting up is a little different, I would rather have my shoulders pain free and adjust. Last week I went to another gym and used the competition bench and my shoulders hurt at night again, but was still able to set up okay on that bench.  If you’re a young gun out there - trust me - preventative measures now will make a huge difference in your longevity - you will still want to lift at 40 - at 50 - so get the fat pad.

    The benefits of using this bench I can notice are: Promotes Scapular movement (which means it is uninhibited and eliminates AC tears), Eliminates Shoulder Hangover, Optimizes Back and Upper body Positioning,  Very little to no translational loading,  humeral wear on bicep tissue and pec tweaks are relieved, and it increases mechanic leverages.

    It's heavier than expected and overbuilt to near perfection. The upholstery inside is thick and super dense meaning that it's the opposite of cushy (if you like softer foam, this is not for you). I like it because the density or hardness adds stability when using heavy weights. The cover material is the best I have ever seen or used. It's some kind of sticky rubberized material. Once you are in position, you will never slip.

    In conclusion, This is an outstanding product. Very impressed with grip, size, width, and tank like feeling of this pad on this bench. Did bench immediately after receiving this beast of a pad in the mail and I am currently convinced I just bought a game changing piece to my ever expanding home gym.  It’s very sturdy, and versatile.  It has helped me tremendously with some issues I was having related to shoulder injury and poor shoulder mobility. I highly recommend it for any lifters with those sorts of issues.