Often times, patients that have trouble or pain with squatting can chalk it up to mobility issues. Ankles and hips seem to be the major culprits. But what if mobility isn’t YOUR problem? Even if you have an ATG (deep) squat you may still experience:
Back and/or hip pain
Hamstrings and glutes not getting stronger
Increased soreness in the inner thigh (adductors)
Plateau of performance in squat based activities
Does this sound like you? Keep reading.
Motor control is the process of using the neurological system to coordinate your muscles and limbs as you perform a skill. Without motor control, we will have trouble controlling our body in space. This can lead to undesirable positions while we are under a weighted barbell.
Unfortunately, many of us do not have ideal motor control—particularly as we add fatigue to the system. Fatigue can come in the form of heavier weight or multiple reps. How do we judge motor control from the outside? Technique. Form.
So we know you have an ATG back squat with the chest upright and feet flat. If you add weight and that changes, you need to practice motor control. This is rewiring the system so that as we move our extremities or add weight to lifts, the form looks the same as squat without weight.
Many times this has to do with the initiation of the squat. It should always start with a hip hinge. Now, some athletes who think they are hinging are simply over-extending their back. This means they send their hips “back” by poking the pelvis back and allowing the ribs to flare up. Rather, the space between your ribs and hip bones shouldn’t change as you hinge your hips back.
The same pop of the pelvis back can be a problem as you get close to the bottom of the squat or start to drive back to extension.
A great drill to test out your squat is using a PVC for 3 points on contact. Holding the PVC against your back, you should have contact with the back of your head, midback and pelvis. Keeping this alignment, hinge your hips back then drop into a squat.
Some faults that are common with squatting will be demonstrated when the PVC pipe leaves one of the points of contact. Below, the left picture shows a rounding of the midback that causes the PVC to leave the pelvis. This often happens at the bottom of the squat too. The fault on the right demonstrates over-extending the hips and changing pelvic position rather than hinging the hips. I find this to be more common on initiation of the squat, particularly for those complaining of back pain. If you noticed that the PVC left your body at some point, try filming yourself as you practice!
Improving motor control takes reps and practice. The PVC drill is great as a warm up for squats. You could also perform tempo goblet squats (see video below).
Holding the weight in front will help you engage your deep core and stabilize your ribs and pelvis to keep the torso in the ideal position. Moving at a slow tempo is more challenging to the neurological system and will help engrain that movement pattern. The same rules from the PVC pipe drill still apply!
Inside of thighs really sore after squatting?
The large muscles running along the inside of your thighs are the adductors. They function to bring your leg closer to midline, stabilize the hip and knee, and work synergistically with glutes and external rotators (squats?!). Going along the lines of motor control, be aware of the speed of your descent and “bouncing” out of the hole. The squat should not be a fall to the bottom and a bounce off the calves. You want a controlled descent; taking advantage of the stretch-shortening cycle at the bottom can be helpful but the torso alignment should still be maintained. If you are a free-faller or a bouncer, try to slow it down and control the movement. Similar to the goblet squat, this will improve control but also strength!
If you look like the woman squatting above, this is your starter plan for improving motor control and strength. Take the time to assess your alignment and control through the movement. Cleaning this up will decrease pain and improve your performance drastically.
At Athletes’ Potential, we work with athletes like you every day-- those who just want to move better and those that are in pain. If you are finally ready to feel better and improve at the gym, give us a call. We would love to help!
Thanks for reading,
Running is a part of the culture in the Army. You wake up early, meet at the PT field and go for a run 3-5x a week. We had formation runs where we’d run a few miles with 100 to thousands of other sounds yelling cadences. We even had runs to celebrate important battles or events in our Brigade’s history. The only problem is, most people in the Army have never actually been taught how to correctly run distance.
The statistics on running related injuries are pretty shocking. 75-80% of runners have a running related injury every year. That number bumps up to 90% when you start training for a marathon. With numbers like that you could make the case that we have a running injury epidemic in the US.
These numbers carry over to the Army and when I was active, I had an opportunity to try and solve this issue for the Brigade to which I was assigned to at Schofield Barracks.
Ironically, for someone that’s tall and skinny, I’ve never really been a naturally good distance runner. This led me to seek out a running coach when I was in Hawaii. The man I found was Ed Bugarin (Google search this guy, he’s no joke). Ed was a retired special operations soldier that trained runners and triathletes on Oahu. I spent a couple spent a couple weekends with him working on drills, cadence and getting stronger in areas I was weak.
After a month of running mechanics work, I was running faster for longer and injury-free. In particular I had resolved an issue I’d had since starting in the Army, shin splints. If you’ve never had shin splints before, they suck. It basically feels like someone is sticking a knife in the bone on the front of the lower leg.
After working with Ed, I started teaching soldiers in my Brigade how to run. I’d do this in small groups, 10-20 at a time. First, we’d video them running and break it down on an iPad in slow motion. Next we would go out and work on corrective drills and talk about pacing for longer runs. I did this literally with over 1000 soldiers in my Brigade. After all the classes I taught here’s the most important lesson I learned:
If your run form with shoes on looks like your barefoot running, you’ll be a very resilient runner.
It’s literally that simple. This is something Ed had me do on the road in front of his house until my feet bled. By the way, I do not recommend barefoot running on concrete. Cavemen didn’t run on roads! I’m a much bigger fan of running barefoot on grass.
Here’s why I think it’s so effective: When you take your shoe off and run, your foot gets to move naturally. You have 26 bones in the foot, 3 independent segments that articulate with each other and countless ligament/muscle attachments. Imagine if the Golden Gate Bridge could change shape in a split second and then return to it’s normal shape. That’s basically what your foot does. It’s an engineering marvel.
Going barefoot allows you to let your foot do it’s job. It also doesn’t give any additional support. That way we can start to rebuild the intrinsic muscles of the foot as well as toughen the skin of the bottom of the foot.
Lastly, running barefoot solves the biggest problem for most of the runners I work with- cadence. Cadence is how many steps you take in a minute. You’ve probably been told to just stride it out and try and create as long of a stride as you can. Here’s why.
Stride Length+Stride Frequency(cadence)=Run Pace
If you increase your stride length you will run faster assuming you maintain the same cadence. You’ll also significantly increase your likelihood of having shin splints, plantar fasciitis and running related knee pain.
The better solution is to increase cadence. This would cause us to shorten our stride but increase the number of steps we are taking per minute. Imagine like you’re running on hot coals and pull your feet back off the ground. This also puts the foot landing position under our body instead of way in front of our body.
The Principle of Parsimony- It is pointless to do with more what is done with less.
This is principle is based off the theory of Occam’s Razor, essentially saying the simplest solution is the best solution.
Want to increase your running efficiency, build foot strength and decrease likelihood of injury while running? If so, add in barefoot running once a week to your runs. Here’s how I like to program it:
Find a nice, flat grass field or the inside grass area of a track.
Perform 4 rounds of this:
50 meter high pull drill on the right (start video at minute 1.26 for drill)
50 meter high pull drill on the left (start video at minute 1.26 for drill)
Run 100 meters moderate pace
Put your shoes back on and focus on mimicking the feel of the barefoot run strike and cadence while running your intervals.
Run 4-8 400 meter intervals 80-85% effort.
Rest until you can perform a 7-second exhale breath before starting the next run.
Keep it simple, focus on running as a skill and you’ll be a much happier, injury-resistant runner for years to come.
It seems that almost every runner has experienced “plantar fasciitis” at some point. Although there are many stretches and exercises that provide short term relief, it would be best to find out why the bottom of your foot and heel continue to be painful. Sure, there are quite a few factors that could lead to this pain but what if targeting one joint in your body could change your running and decrease your pain for good?
Your foot is made up of 26 bones and 33 joints. Proper biomechanics of the foot depends on the appropriate strength and mobility of these joints. The great amount of joints allows the foot to conform to the surface so we can walk in the sand at the beach but also through the grass at home. The feet are our foundation; holding all of our body weight and acting as levers to propel us forward in walking and running. It sounds really complicated- and it is- but there is one joint that tends to be overlooked that can significantly impact your foot function. It is the great toe aka the big toe.
The great toe and its mobility are integral in push-off while running. The function is described by the “windlass mechanism”. Essentially, the great toe extends which will tighten the plantar fascia. The tightening of the fascia at the bottom of our foot elevates your arch and keeps the foot from collapsing so that you can effectively push off at each stride.
Without full great toe extension, it will be difficult to allow your weight to advance forward over your foot as you run. Thus, your biomechanics will change. Our body is amazing because it will change and adapt to decrease pain but sometimes these changes are not ideal for long term. Some ways your body will find to get around lack of great toe extension is running with your feet externally rotated (toes out) or taking much shorter stride lengths to decrease the pressure at the toe. Long term changes in running form can begin to effect other joints up the chain- knees, hips, back. The plantar fascia may experience more tension as the toe becomes even more stiff which then can manifest as heel, toe or general foot pain.
What does your great toe extension look like?
One way to check your great toe extension is in a relaxed position as in the picture below. Your foot may be resting on a surface and push your great toe up gently until you feel resistance or discomfort.
Checking great toe extension in a lunge position will be more similar to running and the toe can be pushed back passively by the ground. In the photo below, notice that the left toe extends much further than the right. Ideal range of motion is about 70 degrees of extension, though some people may have more!
If you find that your great toe extension is lacking, try these self-mobilizations at home. Working on these before and/or after a run would be ideal. Spend a few minutes on each mobilization and see how your feet feel:
If you have restriction, 2 min each day of this mobilization can start to chip away decreased mobility.
Using a lacrosse ball, spend 2-3 min each day on the fascia at the bottom of your foot.
As I mentioned before, great toe limitations can greatly affect your biomechanics. Factors such as stride length, foot contact, hip and knee position through swing can each be altered with foot restrictions and pain. At Athletes’ Potential, we perform Run Form Analysis for our athletes to break down their form individually and change any deviations we may see. Even if you don’t have pain currently, having a professional break down your run form can be eye-opening and help prevent speed bumps in training down the road.
We would love to help you stay active and get back to your training throughout the Spring and Summer! Give us a call today to schedule Run Form Analysis or a Physical Therapy appointment to stop your heel and foot pain fast: 470-355-2106.
Keep checking in on our blog weekly; May is all about running!
Thanks for reading,
I hate to say it but I resent our convoluted healthcare system.
We live in the greatest country in the world and yet we have such a confusing and broken health care model. I’m not here to write about my idea for a solution. I’m here to tell you how we are avoiding many of the pitfalls of our current medical model.
First, let me add some context by telling you about a recent experience my family had with a physician group.
My wife had been feeling tired for almost two years. We thought it was just the fact that we have two kids under the age of 5 and we own a business. Both of those things can be rather stressful.
We did blood work and were able to get her feeling better but it was always a short lived response.
Finally, we decided to see an internal medicine doctor and they narrowed it down to either celiac disease or small intestine bacterial overgrowth (SIBO). This was the prognosis because she had been put on antibiotics for a sinus infection around the same time she started feeling excessively tired almost two years ago.
We go to the office visit, the doctor is behind schedule and spends hardly any time with us. He gives us a couple options for testing and we decide to do a blood test to rule out celiac disease. We ask him and the front desk staff what the office visit will cost and what the blood test will cost.
They tell us they do not know.
Fast forward to 1 month later, we get a bill from the physician for $360 for the office visit. That’s $360 for a 15 minute conversation with the physician. The next day we get a bill for the blood test. Grand total for the blood test, $940. One blood test costs $940? What the hell kind of X-Men next level blood test was this?
The results of the test showed there was no celiac disease so the solution was another round of antibiotics to fix the SIBO. Great, let’s fix this thing. So we ask the doctors office how much will the antibiotics cost? They tell us they don’t know. We call the insurance company and ask what the antibiotics will cost, they tell us they don’t know.
Alright, you’ve got us by the balls, let’s just get the antibiotics and wait for another bill in the mail. The good news is, the antibiotics worked great. My wife has been feeling better than she had in years. The bad news is, the bill we got for the antibiotics was $1650.
Let’s add this all up.
One office visit = $360
One blood test= $940
One bottle of antibiotics= $1650
Grand total= $2950 plus hours of office visits and testing and phone calls with the insurance company
Here’s my general feeling throughout the entire process: Are you kidding me?
As much as the cost of everything was, that’s not the part we were mad about. It’s the complete lack of transparency in the entire process. Tell me I’m going to have to get a $1650 bottle of pills that will cause my wife to feel better and I’ll gladly pay that. Send me a bill for the same amount a month later and now you’ve got an angry consumer.
Transparency is the key. Communication is vital. This is a relationship between a patient and their medical provider. It’s no different than any other relationship.
When I opened Athletes’ Potential 3 years ago, this was a core value for us. Transparency in medical care. Why is this so rare?
If you ask me what we charge, I’ll tell you. We charge $190 for an hour long visit and it’s an absolute steal compared to the crappy healthcare you’ll get pretty much everywhere else.
-We’re always on time because we respect the value of your time.
-We’ll never send you a bill a month later for some amount of money.
-You’ll always have email access to your provider to answer any question you have because we want you to feel comfortable through the entire process.
-We treat people the way we would want our own family to be treated.
I see more and more medical providers moving this direction. It’s better for the patients, it’s better for the provider and it sets the precedence for an honest, long-term relationship.
Sadly, many of you have probably gone through the same process my wife did. This isn’t an isolated incident that we can chalk up to bad luck or chance. This is a daily occurrence in our medical system. I hope it continues to move toward a better model but in the meantime we’ll do our part with our patients.
We strive for honest, selfless service of our patients everyday. That will never change.
Warm-ups are important for a few reasons: increase tissue temperature and extensibility, increase heart rate to prep the system for intense exercise and prep specific movements that will be performed at higher speeds. Most often, people do not warm up either for lack of time or lack of knowing where to start! If you have a particular area of pain or tightness, you may want to spend more time there. Otherwise, moving through movements of the whole body is ideal.
For each of the exercises below, I will use the width of the court, going back and forth between exercises.
Try this simple yet comprehensive workout:
Jog Forward 50% max effort (width of tennis court)
Slowly back pedal (back to starting line)
Jog Forward 60% max effort
Slowly back pedal
Run forward 75% max effort
Run forward 75% max effort
Side shuffle (facing opposite way from last time)
Inchworms- moving slowly and deliberately; keep the legs as straight as possible for a good hamstring and calf stretch. Once walked out to the plank position, do a push up (can drop to knees if needed) then walk feet to hands.
Toy Soldiers- standing upright, hands out stretched in front; kick opposite foot to opposite hand; alternate feet and move forward with each repetition.
Walk on toes- just like it sounds, walk on tippy-toes with small steps.
Walk on heels- walking on heels, taking small steps.
World’s Greatest Stretch- a great warm up tool because it hits three areas that need attention for tennis players- hips, hamstrings and back! Go through ten reps of each movement then switch legs.
3-way lunge- also addresses multiple areas, particularly glutes, hamstrings, quads and adductors. Perform 6 reps in each direction per leg.
Leg swings- hold on to something stable at your side; swing leg forward and backward, letting gravity carry it back down. Also, swing to right and left. Preform 10 repetitions each direction.
Arm swings- open arms wide then swing across the front, one arm over the other until your fingers contact your back, swing back to front and cross over the opposite way. Also, swing arms up overhead and then back down past the hips. Again, allow gravity to do the movement, no forcing the range of motion! Perform 10 reps in each direction.
After this warm-up you should notice that your muscles feel warm, heart rate is up, breathing has increased and you are ready to increase the intensity of your movement. A proper warm up may decrease the likelihood of an injury and will get you ready to perform more quickly!
Good luck this tennis season! If you missed the first parts of this 4-part series, be sure to check those out. At Athletes’ Potential we help tennis players resolve pain, improve performance and prevent injury. Like what you’ve read? Give us a call!
Building a solid foundation is important for any structure. Therefore, maintaining healthy, mobile and strong feet is a foundation that athletes cannot ignore. This becomes particularly important for athletes who require agility—moving laterally, side to side, sprinting, shuffling. The problem is, we rarely focus on our feet, unless they already hurt!
I challenge you to add at least one foot mobilization or exercise into your daily routine. Your tennis game will thank you.
Ankle mobility - The ability of your ankle to dorsiflex fully (toes up) is ideal for proper biomechanics during running and cutting. Without proper length in your Achilles, injuries and tendonitis are more likely. The first step is to check your ankle mobility. The wall test is our favorite.
Place your foot a hand width from a wall (in a lunge position), with the foot in that position drive your knee toward the wall making sure that your heel stays down. Can it touch the wall? Due to the structure of the calf musculature, you may find that you lack mobility more when your knee is straight. Be sure to check out your dorsiflexion side-to-side by using a yoga strap or dog leash. If you seem to be lacking range of motion here, try these two mobility exercises:
Foot mobility and strength - The foot is very complex with 26 bones and 33 joints. It is important that the joints maintain the ability to glide on one another so that our feet can conform to uneven surfaces and absorb shock as we run and jump. Years spent in hard dress shoes, high heels and flip flops can take a toll on our feet. So when we lace up the tennis shoes and play a hard 2 hour match, the feet were not prepared! Simply being able to separate the movements of the big toe from the little toes can improve your foot mobility, strength and control.
My favorite set of exercises is Toe Yoga (video below). Try these out, you might be surprised how tough it is!
The great toe - The big toe (or great toe) may seem trivial to some but is essential for function of the foot. More specifically, the importance of great toe extension. Without mobility here, the natural mechanism of the foot is interrupted. This can lead to pain on the outside of the foot, pain of the other metatarsals (top of the foot) and recurrent plantar fascia pain. If your great toe isn’t so great and is lacking some range of motion, try these out:
As you add these to your daily routine, remember that there is no quick fix but you are taking the right steps! If you have knee or hip or back pain, you still need to start at the foundation. The biomechanics of the foot drives the whole system. Try these out for a few weeks and notice the change. You won’t be disappointed!
Thanks for reading,
Your hip and spinal rotation are the power house of each stroke. The winding-up and subsequent uncoiling of the kinetic chain allows tennis players to add velocity to their stroke. Without the ability to fully rotate the spine side-to-side, much of the torque will be dispersed down to the hips and knees or up through the shoulder and elbows. So if you have nagging aches and pains in those areas, your lack of rotation could be the issue. Let’s check out the amount of hip and thoracic rotation that you have side-to-side.
When checking internal rotation, sit on a table or box so that your feet are not in contact with the ground. Internal rotation is the motion when your foot moves outward from your body when your hips and knees are bent. We like to see 40-45 degrees, as in the picture below. Be sure that as you rotate your hip, you don’t bring your booty off the table and lean to make it go further! Limited here? Try out the mobility exercise for internal rotation. Always retest your rotation afterward so you know if the mobilization is valuable!
External rotation would be the opposite, so as if you were crossing one leg over the other the ankle resting on the thigh of the other leg. If this is tough, your external rotation may be limited. This is less common but still possible! The best mobility piece for this is the Lateral Hip Release (video below). Try it out! Remember, test- mobility- retest.
If you sit a lot throughout the day or just generally have tight hip flexors, this could impede your ability to extend your hips fully. My favorite go-to for this is the Couch Stretch (video below). Most people would benefit from spending 2 minutes in this stretch daily. It will undoubtedly add power to your strokes and serves!
The thoracic spine is specifically important for rotation due to the structure of the vertebra. If there is limited rotation in the T spine, we will tend to look for more rotation form the lumbar spine and hips. The way the lumbar vertebra are stacked on each other, rotation is very limited; thus, repeated rotation with a tight T spine can lead to low back and hip pain.
I would not be shocked to see that most tennis players will have a greater amount of rotation or more ease of rotation to their forehand side (so left rotation in right handed athlete). This is a structural change that can happen over time as muscle for rotation in one direction are recruited more frequently that muscles for rotation the opposite way. But what about the backhand? If you feel that you lose a lot of power with the backhand stroke, it could be due to a rotation restriction.
Take a look at your spinal rotation mobility to each side. Laying on your side, knees up at 90 degrees, rotate your back to the floor so that your arms make a T. The top knee should stay stacked on the bottom and both shoulder should touch the floor. If this is challenging, we modify this just a bit to an exercise working on spinal rotation throughout the whole movement: The Windmill (video below). With this variation, you can use breathing to gain a bit more range and get the shoulder closer to the floor. If you get stuck with your arm overhead and you are unable to touch the hand to the floor, then pause there, take a deep breath and on the exhale gently push into a bit more rotation.
To incorporate hip extension and thoracic rotation, I suggest adding scorpions (video below) to your mobility routine. They will also hit the shoulder with a nice stretch across the front. If you’re short on time- hit a set of 10 to each side before grabbing the racquet!
Notice that although we are adding power to your stroke, there were no strengthening specific exercises. The first step is to chip away at long standing range of motion deficits you have may have. Having proper hip range and spinal rotation will allow you to unleash your potential from the power house of the body. Once range of motion has been addressed, other areas to explore are strength and control. However, skipping the mobility piece will only allow you to layer on strength in the shortened range of motion. To be resilient, mobilize then strengthen!
Thanks for reading,
The elbow is affected so often by tennis that it was named after the sport! Tennis elbow, or lateral epicondylalgia, is pain at the outside part of the elbow. Its sibling, golfer’s elbow, is pain at the inside of the elbow. Despite the names, tennis players are susceptible to both.
Many times, the treatment will focus solely on the elbow. Decreasing inflammation, resting the muscles that insert at the painful area and strengthening can all be helpful, but what is the root of the issue? Something that can be overlooked is shoulder dysfunction causing pain down the kinetic chain. Check out the picture of the athlete serving below. The arm acts as a whip-- drawing the hand back and then unraveling with force the whips the elbow forward so the hand and racquet will follow. If the shoulder lacks the proper stability in these end ranges and with quick change of direction, the elbow takes the force.
We want our shoulders to be strong through the stroke but it starts with being strong as stabilizers. An easy go-to for shoulder stability are carry variations. Farmer's carry (see video below) and overhead carry are great places to start, then you can try a waiter’s carry. This moves the weight out front so that there is more stress to the shoulder musculature. If you try this variation with a kettlebell and hold it bottoms-up (see picture below video) it will be more challenging and work on grip strength! As you get tired, your elbow will tend to drift outward and down, so walk while stabilizing the bell only as long as you are able to keep the correct form.
Movement must be added to make it effective for the tennis player. The control of the arm to accelerate and then quickly decelerate comes from the posterior rotator cuff. Those muscles at the back of the shoulder put the brakes on the arm; without control here, again the elbow suffers but you may also feel pain in the back of the shoulder.
A very effective protocol is banded rotator cuff strengthening in multiple different angles. My two favorite are the WY Negative and the Snow Angels:
The WY negative strengthens the external rotators, demands stabilization overhead with arms straight and requires posterior cuff control as your lower slowly. No other banded exercise that I have seen is as effective and comprehensive for the tennis athlete. The best band tension to use for this exercise is 3-7#, so much lighter than you might imagine! Around 10-20 repetitions at a time is a great goal, although you may need a break or two when you first start.
Another great shoulder stability exercise is the Snow Angel. Again, with the light band and perform 10 repetitions at a time. This exercises forces you to pull back on the band and sustain tension while moving overhead and back down. Try it out!
The subscapularis is one of the rotator cuff muscles that tends to be largely ignored but can be a culprit in shoulder pain with overhead athletes. When it is tight, it will limit external rotation, or the ability to bring your arm back to serve. It can cause pain at the back of the shoulder and sometimes that back of the wrist! The easiest way to get pressure and a stretch on the muscle is with a lacrosse ball. Check out the Subscap Smash (see video below). This is a great mobilization to add your warm ups or workout routine during tennis season.
The big picture here is that elbow pain is often a secondary symptom due to a primary cause at the shoulder. Direct trauma and inflammation to the elbow itself are possible but ensuring a strong foundation at your shoulder will protect the elbow joint over the long run. Try out these mobility pieces for a week or two and note any change that you have in your performance or symptoms. If you continue to have shoulder or elbow pain, reach out to us at Athletes’ Potential. We would love to get you back on the court pain-free!
Thanks for reading,
Ready To Work With Us?
Elbow pain can be one of the most irritating and inconvenient issues. I once had a patient say that the most painful part of his day was just cutting butter for his toast in the morning.
Classically, we tend to blame the tissues at the joint—wrist extensors/flexors. Sure, the common insertion for these muscles becomes inflamed, but what causes that? I like to view the elbow similarly to the knee; it is a joint that is pushed and pulled on either side by very complex joints. The shoulders will largely influence the biomechanics of your elbow and the amount of torque that passes through the joint.
Although somewhat simplified, we could group you as either tight and immobile or mobile and bendy. Each characteristic has its own pros and cons, but the cons are where pain manifests. With decreased shoulder mobility and/or control, the elbow will take the brunt of the force when lifting weights or swinging a racquet. Shoulder stabilization and control are important for correct biomechanics of the shoulder girdle and upper extremity. Lack of control upstream, allows more movement downstream at the elbow. The repetitive, small insults at the elbow joint will eventually result in elbow pain.
Hammering away at the soft tissue around the elbow is often where athletes start when self-treating. Don’t get me wrong, a little forearm smash with a lacrosse ball or barbell is great. But if it does not improve your problems, move on! In this case, we are going to check out the shoulder.
Less mobile folks: To decrease the torque at the elbow, it would be ideal to improve both the external rotation (front rack) and flexion (overhead position) or your shoulder. Tight lats can often be the cause of the restrictions. Try these two mobility pieces:
More mobile folks: Shoulder stabilization is going to be the key for you. A simple way to start on this is kettlebell carries, all variations! Here are two simple, yet effective stabilization drills:
As always, do a movement screen/ form check first. Get a coach or super friend to watch you move and see if they notice any faults. Racquet sport athletes—if you constantly have elbow pain, check your grip size. Grips too small or too large can cause elbow issues as well. If you are a desk jockey, check out your work station and the ergonomics!
Try these mobility exercises and tips out. If you continue to have issues, come see us at Athletes’ Potential. We see elbow pain often and are able to effectively treat it with an evaluation! Keep devoting time to making your body work and feel better.
Adrenal fatigue is the inability of the adrenal glands to carry out their normal function. The kidneys produce hormones to regulate blood sugar, blood pressure, burn fat and protein and react to stress. A disruption can cause changes in metabolism, fluid and electrolyte balance, the cardiovascular system and sex drive. The adrenal glands are the main stress control of the body and thus are affected with a stressful, overworked and under nourished lifestyle.
Some common triggers or causes of adrenal fatigue are: over-exercising, high stress levels, sleep deprivation, high sugar intake, chronic illness, depression, surgery. This is not an exhaustive list by any means but you can likely identify with a few of these.
The signs and symptoms of adrenal fatigue can be slightly different with each person. Keep in mind, one or two symptoms does not suggest adrenal fatigue. Rather, a cluster of the symptoms and lifestyle factors in an otherwise healthy adult could point towards adrenal fatigue. Unfortunately, adrenal fatigue is not on the forefront of “old school docs” minds or they were never taught this in med school. Holistic medical practices, dietitians or nutritionists are more likely to recognize the symptoms and prescribe a non-medicinal approach to working back to health.
Weight gain and inability to lose it- often abdominal area
High frequency of sicknesses that tend to last longer than normal
Reduced sex drive
Lack of energy, even with adequate sleep
Reliance on caffeine- coffee, soda, energy drinks
Chronic pain of unknown origin
Obviously, we at Athletes’ Potential are not dietitians or nutritionists but we have a strong belief that input = output. We tend to treat the output side, but you could see they are directly related! So if you train 6 days per week, crave and/or eat sugary foods, sleep 4-5 hours a night and have trouble sleeping once you lay down--- your body is TIRED. As a society wrapped up in the ‘go until you drop’ mindset, it is not often that we take time to slow down and let the mind and body recover.
Take a minute to answer these questions for yourself: How many minutes each day are quiet and calm? Meaning, no phone, no TV, no conversation, no working, no cooking. After a workout or long day at work, what do you do to ensure that your body is ready to do it all again tomorrow? How do you respond when your body sends stress signals?
Any “I don’t know” or “I don’t have time” responses? Keep reading!
Where to start?
Recovery practices- If you are that athlete training 5-6x/week but have no recovery schedule, it is only a matter of time before you will have an injury or begin to experience some of the above symptoms. Recovery can look like an off day (more than once every 2 weeks), a stretching and soft tissue regimen, appropriately fueling for the training or a resource such as whole body cryotherapy. Stretching and soft tissue maintenance has always been our mantra but something you may not be familiar with is the cryotherapy. It will reduce inflammation to speed recovery, boost metabolism, decrease chronic pain, burn calories and increase norepinephrine (increase focus, attention, mood). Many of our patients with chronic sleep issues tend to have more restful nights following a few bouts of cryotherapy. This could be the game changer for you!
Nutrition- Not my area of expertise, but definitely an area of interest! A friend of ours is a Nutritional Counselor at a Holistic and Integrative Medicine clinic here in Atlanta. She shared a short blog about supplements that she suggests if you are experiencing these symptoms, found HERE. There is also a delicious recipe--- you’re welcome! A dietician or nutritionist can work with you one-on-one to talk through symptoms and which food changes could impact your health.
Meditation- Meditation doesn’t have to be some mystic, religious experience unless you want it to be. By meditation, I mean taking a small chunk of time to relax the mind, breathe and calm the body. This is a new practice for me as well! The first time I tried it, I only lasted about 30 seconds before I was thinking about something else. Now, I almost always make about 10 minutes of relaxation! Check out the app Headspace. It’s free and is directed mindfulness for 10 min each day.
Journaling- Very similar to meditation, but some people prefer journaling. For those with busy minds, taking a few minutes to write down what you are thinking about can be freeing and lighten the load swirling in your mind.
Listen to your body- Although last, it is the most important and closing thought. Listening to your body while training is paramount to all practices. If you feel fatigued, foggy headed, have various aches and pains over the body, perhaps today isn’t the day to run your 10-mile loop or try to PR a lift. Take the time to slow down and be attentive to the signals your body sends!
Thanks for reading,
Dr. Danny and Dr. Jackie's views on performance improvement, injury prevention and sometimes other random thoughts.