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Become the HERO of your own HEALTH

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Don’t Blame Your Elbow: Check Your Shoulders!

1/17/2017

5 Comments

 
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.
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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. ​
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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:
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  1. Supinated (palms up) hang on pull up bar- band around my upper arm is to increase external rotation when I move my hands apart.  Be sure to ease into this one! Begin with hands slightly closer and ease your body down.  Keep your feet on the floor to control the amount of body weight through the arms.  Ideally, you will have your head between your arms, torso and pelvis straight beneath you and pelvis tucked under.   This will help with the front rack and overhead lift for weightlifters; athletes this will also help you overhead with throwing/swinging.
  2. Overhead distraction- stretching same leg back and across to take up slack in the tissues on the side of the body.  Try to keep the palm up and feel free to move the torso a bit to feel a stretch in different areas.
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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:
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  1. Heavy farmer’s carry- simply holding a relatively heavy kettlebell in one hand. Avoid leaning far to one side and allowing the kettlebell to rest on your leg.  Keep it slightly spaced.  Choose a distance and incorporate into warm ups or go until fatigue- grip gives out or form falters.​
  2. Waiter’s carry- arm and shoulder in 90/90.  As you get tired, your elbow will tend to drift outward or down so stay aware of the position.  We like to perform these as a bottoms up carry, so the bottom of the bell remains facing the ceiling throughout. Go until form fatigue!
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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.


Thanks,
​

    Dr. Jackie, PT, DPT, OCS, CSCS
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Adrenal Fatigue: What It Is and How To Stop It

1/10/2017

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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. 
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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

Lightheadedness

Lack of energy, even with adequate sleep

Reliance on caffeine- coffee, soda, energy drinks

Food cravings

Chronic pain of unknown origin
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Chronic fatigue

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.
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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?
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Any “I don’t know” or “I don’t have time” responses?  Keep reading!

Where to start?
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.
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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. Jackie, PT, DPT
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