With over 3 million registered athletes under the age of 19, soccer is one of the fastest growing youth sports in the United States, especially here in Atlanta (if you haven’t made it out to an Atlanta United game yet, put that at the top of your to-do list!). Along with its increase in popularity, youth soccer has drastically changed over the past 25 years. We are now seeing youth athletes play at higher intensity levels than ever before and, because of year round premier leagues and clubs, are doing so with less time to recover. This rise in popularity and increased physical demand is a recipe for disaster. In fact, a recent study found that from 1990 to 2014 total number of recorded injuries in youth soccer players skyrocketed by 111 percent, with the vast majority (80%) involving the musculoskeletal system.
These statistics should absolutely be eye-opening, but fear mongering is not the point of this article, quite the contrary. Youth soccer players are some of the most fun and competitive people I work with, and with some basic understanding of preventive techniques we can help stop injuries from occurring in the first place and boost performance along the way.
Lower extremity injuries are by far the most injuries I see in the clinic when working with youth soccer players. In soccer your hips are your power house and they constantly take a beating due to all the changes in directions, kicks, passes, lateral movements, and rapid accelerations and decelerations. Not surprisingly, because of these demands, the muscles around the hip are some of the most susceptible to injury (hamstrings, groin, etc).
To prevent injuries and improve the performance of your hips there are two main components you want to look at: hip mobility and hip stability.
Good hip mobility means your hips are capable of moving uninhibited and pain-free throughout their full range of motion. There are a number of directions your hip needs to have good movement in and there are many reasons your hip may be limited, but two of the most common problems I see in the clinic are limited hip internal rotation and tight hip flexors. Let’s take a look at a couple quick ways to check your out these two problem areas
The above picture shows how to check your hip internal rotation. To perform the test correctly you want to:
You are looking to get about 40-45 of hip internal rotation and if you can’t get to a minimum of 40 degrees, then the mobility drill shown below is for you.
There are a number of ways to test and see if you have limited hip flexor mobility, but a safe and simple way to do so is demonstrated in the picture below. To perform this test correctly you want to:
If the leg you’ve lowered down cannot easily touch the table of your knee has to straighten in order to get your leg to the table, then try the mobility drill below.
Any time you do a mobility drill, you’ll want to perform a re-try the testing positions we went over to see if you notice a difference. If you do notice a difference great!, you’ll want to add that mobility work to your daily routine and can be done as part of your warm-up. However, If you’re not noticing an improvement than these specific mobility drills may not be the best option for you and you might want to give us a call.
Hip stability can mean a variety of things, but for the purpose of this article hip stability means being able to load and control your hip joint throughout its available range of motion. In other words, to prevent injuries from happening, not only must you be able to move throughout an acceptable range of motion, but you must be control the forces you exert throughout that range of motion. Poor hip stability is a huge problem in youth soccer and is a main reason why you’ll have experience a soft tissue injury such as a hamstring strain or pulled groin. Below you’ll find three exercises that target specific movements commonly found in soccer and are a great addition to your warm up before a game or practice.
The goal of any injury prevention program should be to first make sure you can move through an appropriate range of motion and then to make you strong through that range. At our clinic in Decatur, GA we have successfully treated numerous youth soccer players, and when we do we make sure we arm them with the knowledge and ability to stay healthy and keep competing out on the field versus with us in the clinic. If you’re in the Atlanta area and you either play soccer or have a child who plays soccer and you’d like to learn more about how to prevent injuries or overcome an existing injury, give us a call at 470-355-2106 or fill out the contact request form below and we will be happy to contact you.
Thanks for reading,
To put it bluntly, being strong makes life easier. Humans don’t have the ability to create more muscle fibers (hyperplasia), so in order to get stronger we have to work tediously to increase the size of our existing muscle fibers (hypertrophy). According to the American Academy of Sports Medicine, gaining strength through hypertrophy takes 8-12 weeks of moderate to high intensity resistance training (>65% of your one rep max) utilizing 8-10 upper and lower body exercises at a rate 2-3 times per week.
A relatively easy formula to follow; right? Well, what happens when you are recovering from an injury and can’t safely use loads heavy enough to improve strength and size? Or when you’re an athlete who is in-season and can’t tolerate the drop in performance associated with the muscle soreness that follows heavy lifting?
Up until now those have been troubling questions for medical professionals and strength coaches alike. However, there is a new tool with over 160 peer reviewed research studies and documented success across the military, college, and professional sports arenas; something that is creating increased size and strength in as little as two weeks and is completely changing the game of how professionals approach rehab and sports performance…Personalized Blood Flow Restriction Training (PBFRT).
What is Personalized Blood Flow Restriction Training and How Does it Work?
PBFRT is the brief and intermittent use of a tourniquet in order to restrict the amount of blood flow from coming into your limb (arterial flow) while performing low-load resistance training. There are numerous types of blood flow restriction devices available, but the gold standard occlusion device is the Delphi Personal Occlusion Tourniquet. The Delphi Personal Occlusion Tourniquet the only device have FDA approval to be safely used for medical use and is essentially a modified surgical tourniquet that contains a doppler system. This doppler system allows so you read a person’s arterial flow in live time, so you know exactly how much blood you are occluding, and it will adjust its pressure automatically throughout an exercise to maintain a designated percentage of occlusion that is personalized to each individual person.
The way PBFRT works is it reduces the amount of oxygenated blood reaching a working muscle in order to trick your body into thinking it’s working at a higher intensity than it actually is. By using this form of engineered suffering you’re able to use extremely light resistance and still get the same increases in size and strength as lifting at higher intensities with heavy weight! Exactly how this happens is laid out below:
So who exactly would benefit from Personalized Blood Flow Restriction Training?
Personalized blood flow restriction training has been one of the largest advancements for injury rehabilitation and sports performance and we are so excited to offer it at our clinic in Decatur, GA. Whether you are training through a nagging injury or preparing for your next triathlon, we would love to help you achieve your performance goals. Give us a call at 470-355-2106 or fill out the contact request form below and we will be happy to contact you.
Thanks for reading,
Females are up to 7x more likely to tear their ACL playing sports than males.
Soccer and basketball are the leading sports in ACL tears.
These statistics should really make you raise your eyebrows. Studies about ACL tears showed that over 50% of female soccer players tore their ACL through their career. Why is it so prevalent? Is there something you can do to help keep your daughter’s knee healthy?
The truth of the matter is- we are very different than men, in many ways! But there are some factors that predispose females to knee injuries.
Anatomical Make-up: Female have wider hips that makes it more common for girls to be “knock-kneed”. This can lead to collapsed arches or knees caving in with jumping and cutting- a serious threat to the integrity of the ACL. Females are generally smaller than males, meaning the ACL itself will be smaller and thus more prone to injury.
More Flexible: Females tend to have hyper-mobile joints. This is sometimes called “double jointed” but can be more than that. If very flexible, each joint will allow extra movement that leads to decreased stability and usually less strength.
Less Motor Control: This goes right along with flexibility and strength, but decrease motor control means females are less likely to know how to move their body in space. There is not as much awareness about the movement at the joint, thus are more likely/able to move in extreme ranges of motion.
Hormones: After onset of menstruation, it is likely that your daughter’s performance will ebb and flow with her cycle. It is possible that in the lower performance window of her cycle, she will be more likely to sustain an injury. As preteens and teenagers grow and develop, they require adequate recovery, rest, nutrition for health. Unfortunately, this overlaps with a time when many athletes are playing their sport at every season with little rest and no time to recover.
Lack of Warm-Up: Many student-athletes are sitting 7 hours during the day then jumping on the field with little to no warm up. Group warm-ups tends to be very general and not including stability, strength and power development that they need! Coaches are often focused on skill development at this stage rather than fundamental strength and conditioning.
What can you do to decrease your daughter’s risk of an ACL tear?
If your daughter is playing sports, she is already 7x more likely than her male classmate to experience this injury. Many of the differences that contribute to ACL injuries are simply anatomical and physiological differences that we can’t alter. However, there are some variables we can control, or at least mitigate: strength and conditioning training, proper warm ups and instruction, adequate rest and nutrition for optimal performance.
If your daughter’s coach(es) are not equipped or educated to focus on strength and conditioning, get her set up with a coach that understands her needs. Especially through the younger years, encourage her to play multiple sports with different seasons and demands on her body. As much as she focuses on training and practice, instill the importance of nutrition and rest!
At Athletes’ Potential, we work with many student athletes, females and males alike! We understand the unique gender differences and biomechanical demands for performance enhancement. If you want your kid to be faster, stronger, better and less likely to sustain a season-ending injury, then give us a call!
Thanks for reading,
Which type of exercise is the best for you?
Let me start by saying that I am supporter of all fitness and physical activity. Admittedly, I tend to stick to the type of exercise I enjoy (and succeed at) and rarely step out of my comfort zone. As more “genres” of fitness become popular, I find that I get more questions from patients about which is good and which is bad. I’ve yet to find any bad kinds, it just depends on your preferences.
When choosing the best type of fitness for you it comes down to a few things:
Over the past month, I decided to step out of my comfort zone and try some new classes. I am already familiar with weightlifting, CrossFit and yoga, but there are some that I have never experienced, such as barre, pilates and TRX. I visited some local spots; I rated each of them for difficulty, ability to modify and what benefits the class will have for you. These are unofficial scales and completely biased, but here’s what I experienced:
Pilates @ Stellar Bodies Buckhead
Walking into a room of these was a bit intimidating. These are called Reformers. The platform is called the carriage. Much of the class is moving the carriage while stabilizing part of your body. For example, one leg remains still while the other pushes the carriage out and pulls it back in for a lunge. My core and hips were burning within about 2 minutes of the class starting. The high paced class and energetic music creates the beat for many of the movements.
When I needed modifications or more in-depth directions, the instructor was able to help me while still keeping the class moving. It was a great workout and I was definitely humbled by some of the other pilates peeps. Let me say, for 3 days I couldn’t cough or laugh without feeling my obliques!
Difficulty level 8/10 Ability to modify- Easy Goal- core and leg strength, muscular endurance
TRX @ Pace23
These straps are the suspension system used for all TRX classes. For nearly every movement, either your arms or your feet will be using the straps. The instructor demonstrated the movements then we would go through a complex- something like single leg squat, jump squats and wall sits- for a song or a specific rep count. My hips and legs were definitely feeling the work, but what I found as a welcomed surprise was the shoulder workout! Even when exercising the lower half, you are to keep tension in the straps. Similar to the picture, we went through a complex with rows, high rows and bicep curls. There were plenty of options for modifications and the intensity can be increased or decreased with body position.
Difficulty level 7/10 Ability to modify- Easy Goal- overall strength, muscular endurance
Barre class @ Pure Barre Decatur
This could be an inviting atmosphere for those with experience in dance. Once we got into the thick of it, it felt somewhat like a club- girl power music and low level lighting. They promised a whole body workout when I arrived, and that it was! You have a little ball, loop bands and light hand weights to use throughout the class. There are leg and shoulder specific sections but always with a core focus. Again, fast paced music that sets the count for the movements. The instructors will demonstrate and come by to help you modify. For your first couple of classes, you may have to pause and check out what your neighbor is doing!
They often use the cue to “tuck” your pelvis. Recently it has been challenged by PTs regarding that position. Here is my thought- rather than tucking past “midline”, they cue the tuck to ensure that you are not over-extending your low back (or sticking your booty out) which can happen as the core fatigues. What is not ideal, is tucking the pelvis and holding throughout the class. I confirmed this with the coach—who is coincidentally a PT student!
Difficulty level 7/10 Ability to modify- Moderate Goal- core strength, muscular endurance
There was an obvious theme with these new-to-me fitness classes: abs on fire and holding hips in an engaged position. This is definitely a contrast to my usual training of CrossFit and weightlifting where moving quickly and being explosive are the general themes.
CrossFit & HIIT Training
Known for being “for everyone,” CrossFit is easy to scale and can be applied to any population. That being said, should everyone CrossFit? I say no. Is it what you enjoy? Does it help you reach your goals? Is it sustainable? If any of these are a no, then look to other options.
If you are interested in CrossFit or high-intensity training there are many options as well. Here is Atlanta there are loads of CrossFit gyms, Irontribe, kettlebell classes, powerlifting gyms, etc.
Here are some gyms in the area that offer these type of classes:
Move Functional Fitness
Form Yoga- can’t forget the yoga!
These are a few gyms that we have had experience with and we suggest to our patients that inquire about the best fitness classes around town. My suggestion is to go and try all different types. Most of these gyms offer the first class or first week for free! Take advantage and go get some fitness!
Thanks for reading,
Before graduating with my Doctoral degree in Physical Therapy, I had the distinct privilege of completing an internship with one of the highest performing populations out there, the United States Air Force. With patients ranging from active duty fighter pilots to military retirees, I was constantly in awe of the pain and physical punishment these individuals would put themselves through to be able to perform on a daily basis. Injuries were just another part of life. Some of these patients had been dealing with weeks of shoulder pain, months of hip pain, or years of low back pain; but there was a common ground nearly all of them all shared: pain relief and improved performance from dry needling.
What Is Dry Needling?
Dry needling is a treatment approach that involves the strategic placement of a thin needle into spots known as trigger points to alleviate myofasical pain. When describing dry needling to my patients, my go-to analogy is a sniper. Using a needle to go directly into a trigger point versus my hands or instrument assisted soft tissue mobilization is like a gunman using the extreme skill and precision of a sniper to pinpoint the problem area. Several studies have demonstrated the ability of dry needling to cause immediate improvements in musculoskeletal pain by targeting these trigger points and eliciting a local twitch response. The proposed mechanisms of pain relief supported by research include:
These effects of dry needling have been demonstrated across orthopedic, neurologic, sports, and post-surgical populations to improve range of motion, pain, performance, and increase local blood flow and oxygenation to surrounding tissues.
So It's Like Acupuncture; Right?
Wrong! Well, for the most part. Both dry needling and acupuncture use a similar instrument (a needle) to perform a treatment, but the philosophies and reasoning behind why the treatment is being performed couldn’t be more different. This is similar to how both chiropractors and physical therapists perform manipulations, but the chiropractor is attempting to correct “subluxations” while the physical therapist is attempting to unlock facet joints. Some of the key differences you should know between dry needling and acupuncture are:
What Exactly Is A Trigger Point?
This is a great question, and one that I answer on a daily basis with my patients. Trigger points are characterized as the presence of nodules (or knots) in tight bands of muscle that are overly sensitive or painful to the touch. Trigger points are divided into two main groups, active or latent. An active trigger point is described as a palpable nodule that can cause local or referred pain without being touched or pressed on, and a latent trigger point is essentially the same thing only it does not cause any symptoms without being stimulated or pressed.
Several theories exist in the scientific community regarding how trigger points form and what exactly their role is in the development of pain. Some of these theories include:
If you’re experiencing pain, regardless of your fitness goals, lifestyle, or injury history, I highly recommend seeking out a physical therapist in your area who performs dry needling for an evaluation. Let me be clear though, dry needling is not a magic bullet. It is a great tool in the hands of a skilled therapist to alleviate pain that would otherwise prevent patients from performing certain movements or exercises, but it is only a part of the picture. Education on areas like strength, mobility, and posture are vital to sustain a pain-free lifestyle and to perform at an optimal level. f you’re living in Atlanta, and you’re struggling with back pain, we’d love to help you. Give us a call at 470-355-2106 or fill out the contact request form and we’ll contact you.
Thanks for reading,
“The aim of CrossFit is to forge a broad, general and inclusive fitness supported by measurable, observable and repeatable results. The program prepares trainees for any physical contingency—not only for the unknown, but for the unknowable, too. Our specialty is not specializing.”
The quote above was taken directly from CrossFit.com. It describes CrossFit’s mission, and it is undeniable that CrossFit accomplishes its mission of preparing trainees for multiple arenas of physical contingencies. The point of this article is not to argue nor neglect the many benefits associated with CrossFit training. However, even with CrossFit’s ability to program and prepare you for the many physical challenges that life may throw your way, when it comes to building a functionally strong and healthy back, there is one crucial area where CrossFit falls short: multiplanar movement.
Before we talk about how CrossFit doesn't deliver multiplanar movement, first let's look at how our spine moves throughout the day.
Whether we are going to the grocery store, playing softball, or hitting a round of golf, our backs do not move in one dimension. To perform movement efficiently and effectively, our spine must be able to move through a combination of movements in three different planes: frontal, sagittal, and transverse.
In order to fully bulletproof our backs and prevent back pain from occurring, not only must we be able to move through these three planes of movement, but we must be able to strongly control our spine throughout each motion and this is where CrossFit falls short.
The world of CrossFit lives in the sagittal plane. Squats, deadlifts, snatches, burpees, kettlebell swings, muscle-ups, toes-to-bar, double-unders, Fran, Murph, Gracie, and Annie. What do all of these have in common? In all these movements and exercises your back is predominantly bending forwards and backwards, meaning in all these movements your back is moving in the sagittal plane only. There are very few movements in CrossFit that require you to challenge your back rotationally or laterally and as you’ll see below, that’s a problem.
Holding your child at your side, swinging a bat/club/racket, getting in and out of your car, serving a volleyball, opening a door, and kicking a ball. What do all of these activities have in common? These are all movements commonly found in sports and in daily routines and they all challenge your back rotationally and laterally. Not only are these multiplanar movements incredibly common, but because CrossFit doesn’t address frontal or transverse plane movements, if you aren’t doing any type of accessory training, you’re going to be weak in two-thirds of the required movement patterns, and you’re going to be at a greater chance of developing back pain.
So does this mean that Crossfit is terrible and you should stop doing all those squats, deadlifts, and other aforementioned CrossFit workouts? Absolutely not. Sagittal plane movement is crucial to our everyday lives (i.e., bending over to pick something off the floor, getting up from a chair, etc.), it just isn’t the complete picture. You’re leaving your back vulnerable to injury if you aren’t working on getting strong in the other two planes of movement.
The solution to this problem is simple though, you just have to take the time make sure you’re putting in the work. To get an idea of how to start training in the frontal and transverse planes, try adding in some of our favorite transverse and frontal plane strengthening exercises either before or after your next WOD. Perform 3-4 sets of each exercise to form fatigue.
Chop and Lift (multiplanar)
Pallof Press with shoulder flexion (transverse plane)
Single-Arm Farmers Carry (frontal plane)
At Athletes’ Potential not only do we help CrossFit athletes with low back pain all the time, but we are CrossFit athletes ourselves. We take immense pride in thoroughly understanding your sport, what it’s strengths are, and where there may be some deficits. If you’re a CrossFit athlete living in Atlanta, and you’re struggling with back pain, we’d love to help you. Give us a call at 470-355-2106 or fill out the contact request form and we’ll contact you.
Thanks for reading,
That’s a funny cartoon, but back pain is no joke. Chronic low back pain is the leading cause of disability in the world. Throughout our lives, 80% of us will experience low back pain. So why do some recover completely while others have chronic, sometimes debilitating, back pain?
As movement specialists, we (physical therapists) often want to explain the why of pain with muscles, joints, and movement patterns. Sure, we can work on asymmetries in movement and perceived muscle weakness but for chronic pain this is only a small piece of the puzzle.
Back pain can be particularly frustrating for a few reasons. For one, imaging does not directly correlate to pain nor does it change conservative treatment strategies. Also, improvement from back pain often has ups and downs, sometimes with no indication of what causes it.
What NOT to do if you have back pain
Going straight to the orthopedic for back pain, can start a cascade of chronic back pain. Lumbar spine imaging should not be the first line of care for back pain. I see it too often- either the imaging shows something that seems “scarier” than the pain that the patient feels OR the pain is quite intense but the image shows nothing out of the ordinary. The latter tends to be the most frustrating. If there is nothing torn, bulging, ripped, degenerating (insert any other terrible descriptor here), then why the heck does my back hurt SO BADLY?
Our nervous system is extraordinary because it has the ability to adapt and change with our stimuli- inside and out. This becomes a problem when it adapts in a way that we call “central sensitization”. Essentially, the central nervous system (brain and spinal cord) becomes extra sensitive to stimuli. So something that should cause little pain, or none at all, sends serious threat signals to the brain which leads to pain.
The best analogy commonly used is the house alarm. If a burglar breaks the window in my house, I expect the alarm to sound. However, if a tree branch scrapes the window, I do not expect the alarm to sound. But with central sensitization, the alarm does go off. And this alarm is PAIN.
Check out this cool video about chronic pain. It only takes a few minutes: Explain Pain
Is it a false alarm?
Based on the healing rates for tissues in the body, we know that after a few years into back pain, the pain is not stemming from actual tissue damage. If there continues to be pain similar to the original onset, it is likely that there are some central nervous system changes.
When working through this with patients, it always starts with education so that they understand I am acknowledging that they feel the pain but also that they understand pain DOES NOT equal damage. To progress towards improved function and a pain-free active lifestyle, we focus on repetition of basic movements that may or may not be painful. The idea is to train the neurological system that simple bending over should not be threatening or painful. That being said, sometimes it is painful! In that case, I set the following rules: if the pain is low level and constant we are ok to work in that range and if pain begins to escalate throughout the movement we will take a break. But as you build resilience and confidence through the movement range, you will experience less pain and the central nervous system will lessen the threat associated with that movement.
At Athletes’ Potential, we treat a lot of back pain. A story that we hear often is that people have bounced between providers, tried more severe/invasive treatments, long term use of pain meds or anti-inflammatory drugs, etc., but still have pain! We specialize in helping people maintain a pain-free, high-level, and active lifestyle. Whether this looks like running marathons, lifting heavy weights or playing with your kids, we can help you get there. If this sounds like your past and the future you want, give us a call. We would love to help!
Thanks for reading,
We recently had a patient come in who had been dealing with low back pain for over a year. He was super active, training 5-6 days per week, but hurt his back one day simply standing up from a chair. He had seen his family practitioner periodically for steroid injections, which would provide some relief for a couple months but then end up right back to square one. Frustrated with his lingering back pain, he gave us a call and after a thorough evaluation, some manual techniques, and exercise programming, he left our office with decreased pain and improved mobility.
We see patients like this all the time here at Athletes’ Potential… which makes total sense. Back pain can happen with some with some of the most innocuous movements, and in many cases, without warning. In fact, On average 80% of Americans will experience low back pain at some point in their lives and more than a quarter of the population currently deals with low back pain on any given day.
Not only have most people had some form of back pain, but it many cases it is the result of poor movement patterns that have been abused for years causing the root of their problem to be both incredibly complex and multifactorial. Great news though! Whether you hurt your back trying to hit a new deadlift PR or simply bending over to put your kid in their car seat, there’s a profession out there, armed with years of training and knowledge, designed perfectly to help with your low back pain: Doctors of Physical Therapy.
Here are some of the reasons why you should see a doctor of physical therapy the next time you’re experiencing back pain.
Advanced Education: Physical therapists go through seven rigorous years of both academic and clinical training in order to become Doctors of Physical Therapy. We have spent seven years in school studying human anatomy and physiology, kinesiology, biomechanics, and tissue histology. In other words, we know how the body moves, how it heals, and how to optimally restore its strength and mobility in order to get you to your goals.
Multiple Treatment Options: As I mentioned earlier back pain can be pretty complex, requiring multiple different treatment options to not only alleviate your symptoms, but correct the underlying problem that caused the issue in the first place. Unlike other healthcare professionals, doctors of physical therapy have the ability to choose from multiple different tools in their toolbox. Whether this means using corrective exercises, dry needling, joint manipulations (cracking your back), soft tissue mobilizations, taping, or wrapping, a physical therapist has the ability to customize the most appropriate treatment program for you.
Patient Empowerment: More than anything else, a physical therapist's ability to educate you the patient is invaluable to your recovery. There are 168 hours in a week, at most you’ll see a physical therapist 3 times per week for an hour...that still leaves 165 hours where you’re on your own. Compliance is crucial. For true long-term changes to happen versus short-term reductions in symptoms, you have to know what you should and should not being doing, and physical therapists are second-to-none in making sure that is exactly what happens. Additionally, after you’ve had back pain once, there is a 90% chance you’ll have back pain again at some point in the future. Think of it this way, after you roll your ankle once, you’ll more than likely roll your ankle again at some point. Don’t panic though, the education and coaching you’ll receive from your physical therapist will allow you to know exactly what to do in order alleviate most future back pain exacerbations in a few days instead of weeks, months, or even years.
In review, you’re not alone in your back pain. In fact, it’s more likely than not that you’ll experience some form of back pain in your life. However, this doesn’t take away the fact that back pain can hinder your daily activities and keep you from what you enjoy most. Physical therapists are highly trained musculoskeletal experts that not only help patients alleviate their low back pain, but keep it away by empowering them to take their healthcare into their own hands.
If you’ve living in Atlanta, and you’re struggling with back pain, we’d love to help you. Give us a call at 470-355-2106, or fill out the contact request form and we’ll contact you.
Thanks for reading,
If you’re reading this blog post and you are 100% pain free, you can stop reading it right now.
Ok, we lost maybe 1% of people that actually came to this blog post. For the rest of you, here we go!
The question is this. Why are so many people in pain everyday when the resting state of the human body is supposed to be pain free?
Over the past decade, I’ve had the opportunity to work with people as a personal trainer, strength coach, and a physical therapist. One thing in common with all of these people was that every one of them had daily pain. Now, that seems obvious that someone coming to see me as a physical therapist has pain, but what about as a personal trainer or coach? As a trainer I was shocked to see the first thing we needed to do was work on getting back into some pain-free movement.
Solving chronic pain for people long term comes down to two things: Do they have enough range of motion or mobility to perform a task, and do they have enough control over that movement to be able to do it correctly?
It’s a simple answer, yet very complex at the same time.
To make matters worse we are becoming increasingly more sedentary, weaker, and life is over all just becoming easier. Think about it. You don’t even need to drive somewhere to pick up food anymore. You can literally just use Uber Eats to get a pint of ice cream from Jeni’s Ice Cream and some Pad Thai from your favorite Thai restaurant at the same time. Don’t want to go get groceries? No worries, Amazon has you covered and will deliver pretty much whatever groceries you want to your house.
So what does all this cool convenience mean to us? Less and less non-exercise based movement. Unless you have a manual labor job, you use your body far less than it’s designed to be used.
You hear people say all the time about their grandparents that “they don’t make people like they used to.” Those were some hearty Depression Era people. Well, physiologically and genetically we haven’t changed in the last 100 years. What has changed? My grandfather grew up on a farm and stopped going to school in 4th grade to help take care of that farm full time. He then spent 30 years in the Navy and did other manual jobs like a mechanic for the rest of his career after that. He lived what some would consider a hard life, but he was also lucky because he had to use his body day in and day out. He didn’t have to get to the gym and try to engineer work, he literally just worked.
Today we use things like Assault Bikes, Concept 2 Rowers, and True Form Treadmills to build a “bigger engine.” As great as it is to get cardiovascularly fit, it should just be a piece of the equation. A large portion of what we do should be non-exercise based movement. As my good friend Kelly Starrett says, “Train less and move more.”
Here’s some examples of ways to improve your movement during the day.
Standing desk- Even though you aren’t technically moving, it gives you options. You can change your stance, you can stand on one leg, you can move around easier. It’s a hell of a lot better than just sitting all day long.
Walk more- Take a couple short breaks per day and walk around. If you have business calls to make, do them walking. If you eat your lunch fast, you can get a 20-30 minute walk in during your lunch hour. Walk to work if it’s close enough. Walk to the park instead of driving the half mile it takes to get there. Walk your dog, he needs it. Just walk more. We’re the best walkers in the world.
Commute to work- If you live in a city where you can walk or ride your bike to work, that’s huge. Get some of your movement in with something you have to do anyway: be at work! Some big companies like MailChimp here in Atlanta are even incentivizing their employees to ride their bike to work. I think this is a genius idea.
Sit on the ground- Sitting on the ground is kind of uncomfortable. Because of that we have to change positions more frequently and the pressure of the ground in our muscles/fascia can be a really good thing. Get off the couch and watch Game of Thrones on the ground instead.
Hang- Find a tree limb, pull-up bar, or back of a stair case and try to hang for 2-5 minutes per day. We have some amazing shoulders and we rarely do anything overhead anymore. Hanging is a great way to get some movement in your shoulders and build some grip strength at the same time. It’s literally as easy as just grabbing something and holding on until you have to let go.
Try to engineer some more non-exercise based movement into your day and your body will feel so much better. The resting state of the human body should be pain free. If you’re in pain everyday that’s not normal. You should see someone to help alleviate pain and get a game plan together of how to keep yourself healthy long term. If you’re in the Atlanta or Decatur area, we would love to help you with this. If you’re not, seek out the help of a qualified medical professional.
The body demands movement. Either you give it what it wants or it’s going to break down on you. Try and move an extra hour a day for the next week. It may be the most important change you could make to your long-term health.
This is a common question that we are asked at Athletes’ Potential. When delving into this seemingly deep conversation with patients, it becomes quickly evident that many people do not actually understand their benefits or insurance plans. It also becomes quickly evident to the patient that the current healthcare system is not an efficient one.
The short answer to that question is… there isn’t one. In fact, when folks ask if we “take” insurance, what they are usually meaning is, "Can I pay my copay to see you?” Sure, we “take” insurance in the sense that once the deductible is reached, the visit will be covered by a varying percentage. But copays are for in-network providers. What people don’t often realize is that there is still a deductible to be met, out of pocket.
The ideal insurance plan for young, healthy individuals is one that includes an HSA or FSA. Deductibles will be higher but assuming you have low healthcare costs, you will be banking money each year.
An HSA is a health savings account. It is a savings account for money that can only be used for healthcare. Many times, a business will match the amount of money you add to your HSA each month or some percentage of it. The benefit? This money can grow throughout your career into a large sum that is not taxed. So sure, use it as a store of money for healthcare but it is likely there will be some residual.
An FSA is a flexible savings account. Similar to an HSA in that it is a pot of money for healthcare. The biggest difference is that your company will put a lump of money in it at the beginning of the year and whatever is not used in that year goes away.
Other plans- HMO, PPO, etc are also common. It is usual with these that there is a network of providers that have a special rate and are often lower costs per visit—as long as the healthcare provider that you seek out is in the network.
A deductible is the amount of money that must be paid out of pocket before insurance will cover a percentage. Some insurance plans have one deductible and some have separate in-network and out-of-network deductibles.
Example: Sally’s plan has a $2000 in-network deductible and a $4500 out-of-network deductible. She pulls her hamstring and needs PT. If she chooses an in-network provider she will pay out of pocket until she reaches $2000 then her costs are covered 100%. If she chooses an out-of-network provider she is responsible for $4500 before her costs are covered 80%.
For a mild hamstring strain, the national average for visits is 10. At the usual PT clinic, they likely want you to come in 2-3x/week for 5 weeks. This cost per session could be anywhere from $50-300 depending on what the PT does with you and how long you are there. On top of that, your PT may be treating between 2 and 5 people at a time!
Technically this company “takes your insurance” but the payment still comes from your pocket. Until you reach $2000—which likely will not be met with the treatment for the hamstring.
Transparency: At Athletes’ Potential, transparency is important to us. Unfortunately, the healthcare system makes that muddy because of the complexity of plans that leads people to think all healthcare visits are a $20 copay.
The reality is, insurance is meant to be used as a failsafe for emergencies. Just like with the car—bad accident, the insurance helps. But if you need an oil change, that’s on you! Deductibles are so high and benefits are less because healthcare is being over-used. So rather than going to the cheapest place for the cheapest oil (that you will have to change more frequently), why not use the quality shop with the quality oil?
Why should you choose us over your in-network providers?
Our visit average per plan of care is half of the national average. In the long run, you will save money.
One-on-one sessions with a Doctor of Physical Therapy who understands your lifestyle and goals. We have experience with weightlifting, running, CrossFit, sports, yoga, gymnastics, etc.
Better outcomes than your usual PT clinic.
Care from a provider who thinks outside of the box, encourages input from the patient and helps establish long term performance goals.
Complete transparency with costs and plan of care.
Dr. Danny and Dr. Jackie's views on performance improvement, injury prevention and sometimes other random thoughts.