 [Credit: San Francisco Chronicles] Did you know that 70-85% of ACL injuries are typically non-contact? Or, that female athletes have a greater risk of ACL injury compared to males playing similar sports? It seems like every week you hear about another athlete who tears their ACL. In the NFL, 36 season-ending ACL injuries have been reported this year. Three took place this past Sunday, including a non-contact ACL injury by 49er’s QB Jimmy Garoppolo.  [Credit: Fox Sports] What’s even worse is when it comes from a celebration… A contact ACL injury seems to justify itself more so than a non-contact ACL injury. These season-ending injuries can have a huge impact on an athlete. Not only is it a long and costly process, but it can take a toll on you as an individual from a physical and mental standpoint. Take it from someone who has had two ACL injuries himself. I’ve even talked to parents who keep their kids out of sports due to the risk of an ACL tear. After my first ACL injury, my mom begged me to stop playing football and cheer my team on from the stands…HA! Love you Mom, but no way was that happening. I had to come back to play my senior year and it was 100% worth it. My second ACL tear was non-contact and didn’t come until six years later – which has fueled me on a path to help those who have suffered this same injury. So……Can ACL injuries be prevented? Prevented? Not really. Reduced? Definitely. Prevention means that we can stop something from happening, which means we can predict it. We’re not quite there yet. Reduction means we are making it smaller or less in amount, degree, or size. We have proof of this. For simplicity's sake, you will still see prevention and reduction used interchangeably, but keep in mind what we discussed above. A powerful research study came out this year by Webster et al. 2018 - Meta-Analysis of Meta- Analyses of Anterior Cruciate Ligament Injury Reduction Training Programs. It conclusively shows that 50% of all ACL injuries and 67% of non-contact ACL injuries in females can be reduced with the simple implementation of 2-3x per week of injury reduction/prevention programs.  [Credit: Woodcreek Soccer] Some important components of these programs are: Dynamic Warm-Ups Foundational Strength Proprioceptive Training Plyometric and Power Development Acceleration/Deceleration, Multi-directional Sport-Specific Training In later posts, we will break down these different components of a well-designed injury prevention program. At Athletes’ Potential, we design and implement these programs often to help our athletes, whether you’re someone who has had their first surgery or an unsuccessful rehab experience. It is our goal for the athletes we work with to return to their sport not only physically prepared, but mentally as well. Please feel free to reach out to our Docs if you have any questions. Cheers, Dr. Ravi
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 Whether you’ve never stepped into a gym or are a diehard fitness enthusiast, chances are you’ve attempted a pull-up. That’s a good thing! It’s hard to argue an exercise that is more foundational to upper body strength than the pull-up. That being said, for how much I love this exercise and think it is something everyone should be doing (or at least a type of modification), I treat patients all the time in the clinic with shoulder pain related to the pull-up. Whether it be mobility issues, strength, or poor technique, there are a number of reasons why your shoulder can hurt during or after pull-ups and this article is the first of a two-part series that will teach you how to keep hitting your pull-ups pain-free! Part 1: Mobility First and foremost, let’s take a look at what exactly is happening at the shoulder joint while doing a pull-up. When you raise your arms over your head to get in the starting position for this exercise, your shoulder joint has to do a combination of two movements: flexion and external rotation. If you're limited in any of these two ranges of motion your body will make compensations to get your arm in position, which will eventually set you up for a higher risk of injury. Think of it this way: If your car tires are out of alignment, nothing will happen right away, but eventually there is going to be uneven tread wear and you’ll end up blowing a tire sooner than later. The same can be said for your shoulder if you're lacking requisite mobility with either shoulder flexion or external rotation. The videos below are great ways to test if you have enough shoulder range of motion, as well a favorite drill of ours to improve any range that needs work. 1. Flexion  (Shoulder Flexion Self-Assessment (Performed by Norcal Strength and Conditioning)
(Banded Overhead Opener)
(Thoracic Spine Opener)
2. External Rotation  (Shoulder External Rotation Self-Assessment - Performed by Michael Carroll)
(Chest Opener)
(Front Rack Opener)
To recap, if you have shoulder pain while doing pull-ups, or want to prevent pain from coming, the first place to start is to make sure you have enough shoulder flexion and external rotation to perform the exercise without compensation. Be on the lookout for Part II of this blog post which will dive into the common mechanical flaws and strength imbalances that can lead to shoulder problems with the pull-up. If you’re in the Atlanta area and are interested in working with a unique professional that can help you optimize your health in all of these areas, we need to talk. Being proactive and staying on top of your health will help you avoid serious health problems down the road. Submit a contact request by clicking the button below and we’ll get you set up with one of our Doctors for a free 15-minute phone consult. Thanks for reading,
Dr. Jacob  We’ve all seen the outliers: People who are in their 70s, 80s and 90s that just look like they’ve aged better than everyone else. Not only do they seem physically healthier, but they’re mentally very sharp. Early on in my career as a physical therapist, I had the opportunity to work with one such man. His name was Charlie and he owned a mechanic shop in New Braunfels, Texas. When I saw him, he was 85 and was coming in because of some hip pain. I was blown away by how physically active and quick-witted he was. He still worked full time in his mechanic shop with his two sons. The main reason for him coming in was that his hip pain was limiting him when it came to climbing into his deer stand. To make him even more impressive, he was on no medications. He had never had a significant health issue and lived independently. If you’ve been around people in their 80s, being on no medications is incredibly rare in its own right. I ended up working with Charlie for a few months and every time I saw him I picked his brain on life and how he was so healthy and active at his age. Over the course of our time I picked up 4 Key Habits that had contributed to his remarkable physical and mental health at his age. If you want to age like Charlie, stick to these four habits: Habit 1: Move a lot Charlie never did one day of structured exercise in his entire life, except when he was in the Army early in his life. What Charlie did a lot of was move. He started his mechanic shop in his 30s and had been doing that pretty much everyday for 50 years. This is a physical job to say the least, so he had a lot of movement built into his day. He also was a big believer in walking. He would walk 3-5 miles every morning with his dog. You don’t have to exercise much if at all when you move and are active all day long. Habit 2: Have something to wake up for I thought this was a really interesting piece of advice he gave me. He gave me this nugget of advice as he was describing the new computer software they were using for his mechanic shop. In his mid 80s, he was learning a new software program to help his shop run more efficiently. He was so excited about the changes they expected to see with this new change. What I found out was that he loved what he did. He was obsessed with cars and making them run better. He had done what very few people every accomplish. He had matched up his interest in live with how he made his living. He got up early everyday so he could be at his shop to open up and greet the first customer. Constantly trying to improve and having something worth waking up early for really resonated with me. Think about how many people hate their jobs. The internal stress created with hating what you do, yet having to go and do that everyday is significant. Charlie was onto something and it was one of the big reasons for his long term health. Habit 3: Eat like you have Type I Diabetes Charlie’s wife had died about 10 years before I met him. She was born with Type I Diabetes and had lived an incredibly long life for someone born in the early 1900s with Type I Diabetes. Charlie credited the way his wife had the family eat to much of his health. Because his wife had to be very strict about what she ate, the entire family just ate the way she did. There were two big nutrition components to how he ate. First, he ate minimal to no sugar besides fruit. Black coffee instead of with creamer, banana on his oatmeal instead of brown sugar and he never ate desserts. Second, eat nothing white. Charlie explained that his wife would have big insulin spikes when she would eat white bread, rice, or even drink milk. Recent studies have shown that a cup of milk causes the same insulin response in the body that eating a piece of white bread does. He and his wife just figured this out by tracking her insulin response to food. Other than that he ate pretty much whatever he wanted. He was a big fan of the brisket from Rudy’s BBQ which was right down the road from our clinic. He was also an avid hunter and would eat a lot of venison as well. Habit 4: Go to sleep early Charlie swore that going to sleep early was important. To put this in context, he usually got to his shop around 7am and they didn’t open for business until 8am. He would get up around 5am every morning to take his dog on a walk before going into his shop. He would usually go to be by 8:30/9:00pm. That meant he usually was getting about 8 hours of sleep per night. We all know sleep is important. Often one of the most difficult parts of sleep for people is actually getting to sleep at a decent time. Follow Charlie’s advice and start waking up earlier. You do that for a week or two and I’m sure you’ll be ready to go to be once it’s 9:00 or 10:00pm. I know these 4 habits seem simple, and they are. Your health doesn’t have to be complex. There’s also no magic supplement you can take that will give you longevity like Charlie. In an age of Bird Scooters, Amazon delivering your groceries, and having an app for everything, don’t forget the basics. Move often, have something you're excited to wake up for, sleep and eat well. If you’re in the Atlanta area and are interested in working with a unique professional that can help you optimize your health in all of these areas, we need to talk. Being proactive and staying on top of your health will help you avoid serious health problems down the road. Submit a contact request by clicking the button below and we’ll get you set up with one of our Doctors for a free 15-minute phone consult. Remember: If you have a body, you’re an athlete! Thanks for reading, Danny |
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