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“Lazy” Recovery Techniques After a Hard Day

5/19/2022

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You work hard. You want to stay fit and flexible. But, it's 7pm and dishes have to be put away and damnit if you still aren’t sore and stiff from that workout two days ago. Is it possible to both rest on the couch and also do some recovery work? Wouldn’t it be nice to get a nice massage and stretch while also winding down with a TV show? Follow this blog post for a short series of my FAVORITE couch-based recovery techniques where you can both be “lazy” and effective!

First step, put on your favorite show on the TV, grab a kettlebell, and let's get to work! Don't have a kettlebell? Go get one! They last a lifetime and open up a whole new realm of possibilities with your fitness.  For example, this first massage technique:

1. The Couch Quad Massage (3-5min on each quadricep)

While sitting and starting your first show, take your kettlebell and rest it on your thigh. Use it to massage your tight quads! Search around for any stiff trigger point that you could release and just let the kettlebell rest there. Not intense enough? Angle the kettlebell so the corner of the bottom or even the handle is resting on that trigger point. 
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Now this WILL BE INTENSE but also effective. You want this to be strong but not so much that you are tensing up. You don’t even have to move the kettlebell. Just let it sit on the tender spot, relax into the trigger point release, and let the quad release!

I prefer a 35-pound kettlebell, but feel free to experiment with the size.

2. The Couch Quad Stretch (3-5min for each quadricep)
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Start by standing up into a lunge position and putting your back knee into the deep part of the couch. See this photo for an example:
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From here, squeeze your butt and push your hips forward slightly. You should feel a good quadricep stretch. If you don’t, stand up a bit taller. You may need to do this near the armrest of the couch so you can balance using your hand. This is one of my FAVORITES after a tough run or squat day. 
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3. The Couch Pigeon Stretch (3-5min for each hip)

From a sitting position, lean towards one hip and shift your opposing leg backwards as in this photo (keep your head and chest up to see the TV!)
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This one is easy to enjoy during your show! Try some deep breathing if you can while enjoying this big hip stretch. 

4. BONUS: The Couch Calf Massage (3-5min each calf)
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Grab your kettlebell or lacrosse ball, have a seat on the ground in front of your couch, and put your calf on top of your object of choice and enjoy a bit of a calf massage as seen in the photo:
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After these four “lazy” recovery techniques, you should be feeling relaxed, recovered, AND you got caught up on a favorite show of yours! 
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I hope you enjoy these techniques as much as I do. :) 

Dr Marcus PT DPT

Performance Physical Therapist
Athletes’ Potential
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When Is Imaging Appropriate?

3/18/2022

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In the physical therapy profession, imaging in the form of X-ray and MRI are regular assessments that we request and include within our patient model. Imaging is done, generally, to rule in or rule out certain conditions and to help make a medical diagnosis. Many patients believe that their physical therapist needs to see their X-ray or MRI in order to get appropriate treatment. This is often not the case! Imaging is simply another assessment in which the details therein are considered right alongside other in-clinic details, such as your squat/lunge or night-time pain, that physical therapists use to understand your biomechanics.

Physical therapists are trained to evaluate and treat people without diagnostic test results, full-stop. We do not need radiographs or MRIs to accurately assess and treat your conditions! The medical diagnoses and imaging findings are respected by the therapist, but therapists do not evaluate, prescribe exercises, or otherwise treat based on your imaging. Just as a picture of someone will not tell you a person’s story, a picture of a body part will tell a physical therapist very little about the entirety of the biomechanics of that region! 

Additionally, all kinds of “incidental findings” in asymptomatic people can be found in all areas of the body with medical imaging. These findings include disc herniations, spinal stenosis, nerve compression, arthritis, hip and shoulder labrum tears, rotator cuff tendon tears, meniscus tears, signs of inflammation and tendonitis, and others, in asymptomatic people. These types of findings are in all populations – young, old, athletic (recreational to elite level), military, musicians, dominant and non-dominant sides, etc. Below is a summary of a literature review’s findings on spinal MRIs in asymptomatic populations1. As you can see, the prevalence of these findings on MRI does increase with age, but again, these are people without symptoms. Many people are walking around with “abnormal findings” with zero pain.
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Pain and injuries are complex and experienced differently by everyone. A physical therapist relies primarily on a physical assessment and detailed history to determine the most appropriate treatment for someone. Each patient, even ones with the same image findings and medical diagnosis, will have a different physical presentation, location, quality, and intensity of symptoms, aggravating movements, physical activity history, stage in the healing process, personality, goals, etc. None of this can be gained from an X-ray or MRI, but all of it is important when treating someone.

So, when is imaging necessary? The most consistent time I send out for imaging is when the expected progression of recovery has stalled or regressed. As a doctor of physical therapy, I am very well trained in expected healing times of tissues. If timing is off for healing and has been so for some time, I request for imaging to add another assessment to the list in order to better fully understand what we are dealing with.
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Thanks for reading,
Dr. Marcus PT DPT


Reference:
  1. Brinjikji, W., et al. Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations; American Journal of Neuroradiology, April 2015, 36 (4), 811-816; DOI: https://doi.org/10.3174/ajnr.A4173
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Are Standing Desks The Answer?

3/8/2022

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“Maybe if I just buy this standing desk, things will be better!”

Does this sound like you? If so, this article is tailor-made for you.

Let's go through many of the questions one-by-one. Maybe some of these will be of help to you if you are considering a standing desk.

Question 1: “Do you think I should get a standing desk?”
Generally speaking, yes! Though my reasoning won't be what you might think. As with any tool, it’s not really about the tool, it's about the intent behind using the tool. For many, the intent of having a stand-up desk is because they have back pain and are looking to stop sitting for most of their day. For others, it’s about improving overall health and wellness by standing more, as standing burns more calories than sitting. It all depends on what your intent is! First, find out exactly why you want a standing desk and then you can figure out why one might be for you (or not!). 

Question 2: “What are the main benefits of a standing desk?”
It allows an opportunity for changing your movement patterns throughout your day.

If you were to sit or stand with “perfect posture” at work for an entire year, both would have their own set of problems. For the person who stands all day, their feet would start to really hurt; then possibly their knees or low back. Before long, they’d need to sit!

For the person who sits at work for an entire year, they eventually need to get up because their back and knees start to hurt. 

For both parties, it’s not the fact that they are standing or sitting all day in a “perfect posture,” it’s that they need an opportunity to change their position to really feel better!

A standing desk that has the option to be both in a low and high position allows for both of these individuals to either sit or stand depending on how they are feeling. The key for them is more motion throughout the day! The key benefit for a desk that goes up AND down is that you can adjust your body more throughout the day, and more varied motion throughout your day is the KEY to longevity!


Question 3: “Why shouldn’t I get a standing desk?”
  1. If the desk is not up/down adjustable and you’ll be standing for 8 hours a day without another location to work.
  2. If you think just getting a standing desk will rid you of (fill in the problem here) without doing more exercise, stretching, strengthening, etc. as well.


So, are standing desks amazing? YES! They are a great tool in the arsenal of a healthy individual. They allow for more movement throughout your day, of which is an absolute blessing! But don’t go thinking that just because you’re standing all day long, you will automatically feel much better. The key is varied motion every day, from both the office, to the yoga mat, to the gym, and to the couch!

More movement is always better. 
Ready To Come See Us?
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​Now if you’ll excuse me, I’m gonna get to my stretches after finishing this blog post.

Thanks for reading,

Dr. Marcus PT, DPT 
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Simple Sleep Hacks to Improve Your Routine

1/12/2022

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Most people have heard we need 7-9 hours of sleep every night. However, many people struggle with getting this basic sleep requirement. Difficulty sleeping can be multifactorial, but there are some simple tips and cues we can use to help us get to and stay asleep.

Caffeine consumption could be a large contributor to your inability to sleep well. Caffeine blocks a chemical in the brain called adenosine. Adenosine is a chemical that builds throughout the day, making you feel sleepy the more it accumulates. Think of your brain as an empty parking lot after you wake up. If “adenosine cars” are allowed to fill the lot, you will feel sleepy. If you fill the parking lot with “caffeine cars,” those spots will be taken and adenosine will have no places to park. This will result in you feeling more alert. The effects of caffeine peak around five hours after consumption, and last for up to 10-12 hours after consumption. 

A lot of people come into the clinic reporting they take melatonin to help them sleep. Melatonin is a hormone that helps you fall asleep. However, melatonin does not keep you asleep. If you find yourself waking up a few hours after taking a melatonin supplement, you may want to look at other ways of creating a better sleep schedule. Avoid viewing light from 11 p.m. to 4 a.m., as light inhibits the release of melatonin.

Light from the sun early in the morning can help set your circadian rhythm. The light from the sun has a different quality than light from your phone, so try not to view your phone or other electronic devices first thing in the morning. If you are trying to go to bed at an earlier time, but have a tough time falling asleep, it takes at least two to three days to reset your circadian rhythm. Do not be discouraged if it takes at least two to three days to adjust to your new wake/sleep schedule. Blue light glasses can also be good for night time, but should be avoided in the middle of the day. 

We go through multiple phases during our sleep cycle. Two of the main cycles of sleep are REM and Non REM sleep. These cycles do not occur at the same time. If we miss out on two hours of sleep by going to bed late, we will miss about half of the Non-REM sleep; if we wake up two hours early, we will miss out on half of our REM sleep. So even though we are getting six out of the eight hours we need, we will miss out of half of a certain type of sleep based on whether we are going to bed late, or waking up abnormally early. 

Big takeaways:
  1. We need eight hours of sleep for optimal physical and mental performance
  2. Avoid caffeine products 10 hours before you plan to go to sleep. 
  3. View sunlight as early in the day as possible (sunrise would be optimal).
  4. Avoid light between 11 p.m. - 4 a.m. (phone, computer, TV) 
  5. Don’t wear Blue light glasses in the middle of the day.
Ready To Come See Us?
If you are struggling with your sleep, give the above takeaways a shot! If you are still having trouble sleeping due to neck, shoulder, back pain - what have you - give us a call or hit the button above, to see how we can help you get a more restful and effective night's sleep. 

Thanks for reading,

​Dr. Sam, PT, DPT, OCS
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Are You Training for the Right Reasons?

1/6/2022

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During its more than seven years of business, Athletes’ Potential has had the opportunity to work with literally thousands of people. Through these patient experiences, we have accrued countless hours of repetition in helping people get out of pain and back to living an active and fulfilled lifestyle. We’ve worked with people with all kinds of different training backgrounds, differing life demands, and different goals for the outcome they want from their training. Through these hours of repetitions we’ve noticed some trends. 

There are certain building blocks – habits, training styles, and mindsets – that exponentially increase your ability to master your health and wellness, which yields results that are much more impactful than simply looking better when you stand in front of the mirror.  Understanding the three critical building blocks of health and wellness that we’re uncovering in this article is like a cheat code and here’s the cool part: It’s pretty simple. 

Remember though, simple does not always equal easy. 

Building Block #1: Know Your “Why”

This may seem obvious, but this is crucially important and honestly a lot harder for most people than they realize. Reason being, when we ask most people why they work out, we get responses like “to get/stay fit!” or “to be healthy,” and while we all like to look good when we’re naked, if that’s the furthest you’ve gone for discovering your “why,” you’re setting yourself up for burnout, poorer outcomes, and increasing your risk for injury. 

Instead, dig a little deeper for your true “why.” In human psychology, the term for this is intrinsic value. What creates intrinsic value is different for everyone but some common examples of intrinsic value include self-worth, community, and connection. When we relate this to our health and wellness, that’s where the real magic happens. 

For example, instead of, “I train so hard so that I can lose 20 pounds,” try this: “Nothing makes me happier than the time I have with my family. I want to maximize my presence, engagement, and capability of enjoying the activities that they enjoy doing.”  
 

It may seem like overkill, but the data is indisputable. When you direct your efforts towards intrinsic motivators vs extrinsic motivators (ex: someone telling you you look like you’ve lost weight), you’ll enjoy your time that much more when you exercise, you’ll have significantly higher success at managing your health and wellness, and you’re more likely to lose that 20 pounds anyway. ;)

Building Block #2: Simplify The Process 

There is so much noise out there. There’s so many people out there who are trying to tell you what you SHOULD do, what you SHOULDN’T do, and they really have no clue who you even are. This is nothing new though. In the 1950s, “gurus” we’re claiming the hula hoop was the key to unlocking washboard abs. In the 1960s, these same people were claiming you could shake your weight away with a vibrating belt. It’s a never-ending cycle that is myopic at best and predatorial at worst. Also, these same gurus have constant access to your attention through the device on which you’re either reading this article, is in your pocket, or is undoubtedly within arms reach. 

A beautiful benefit to understanding your true “why” from building block number one, though, is once you figure that out, it becomes infinitely easier to overlook the 18-year-old with no children or family and counting on them telling you that you if you don’t drink your warm lemon water, read 20 pages of your favorite book, and meditate for an hour before you start your day, then you’re unsuccessful in your health and wellness program. 

Obviously, being a little vicious here. I know plenty of young clinicians, coaches, and trainers who are incredible at what they do. 

My point being, managing your health and wellness can be complex and complexity leads to confusion and the opportunity for misinformation. After you do building block number one, the best way you can combat this complexity is to find an expert who will take the time to understand that your marathon training has just as much to do with being a better parent as it does with “staying in shape,” who knows that you train so hard in the gym because it’s your way of battling the high demands that work is giving you and who will set you up on an appropriate game plan.

Building Block #3: Have Fun

You could have the perfect nutrition plan, the perfect training program, and all the time in the world, but at the end of the day if you’re not enjoying what you’re doing, you’re still looking at a higher burnout rate, poorer outcomes, and increasing your risk for injury. 

Of course, not everyday is going to be rainbows and butterflies, but if you enjoy running and all you’re doing is strength training because your friend Joe told you it’s the best way to lose weight, then you’re missing a huge piece of the puzzle. Conversely, if you love strength training but all you do is running because Susan from Instagram said it’s better for your knees than squatting, you’re missing the point of spending time during the day to make yourself a healthier, happier human being. 

At the end of the day, exercise is man-made. Kind of interesting to think about; right? There’s very few absolutes and everything is adjustable to fit your body, your goals, and your intrinsic values. While squats are great, important, and everyone should be able to do them, it’s not the only way to improve your leg strength. Deadlifts are incredible, but pulling a barbell off the ground isn’t the only way to do them. 

At Athletes’ Potential, getting people out of pain is simply the start of how we impact the lives of the people who we work with on a daily basis. Once you are out of pain, not only do we have a ton of relationships with gyms in Atlanta with great coaches and training programs that we can point you towards, but we also have a number of services that provide you the opportunity to: 

  1. Build clarity around your health and wellness goals. 
  2. Be a part of a community of high-performing professionals who care about their health and wellness at the same level you do.
  3. Have a little fun in the process. 

If you’re in the Atlanta area and are interested in working with a unique professional that can help you not only get out of pain but optimize your health and wellness in all of the areas discussed in this article, we need to talk. 

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 consultation.

Thanks for reading,

Doc Jake, PT, DPT, CSCS
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The Best Way To Stick To Your Diet This Holiday Season

12/21/2021

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Candy and cocktails and pies, oh my!

​The holidays mean food. And for most people, that means all the yummy things that we tell ourselves are “bad” or off limits. So, how do we stick to our diets and double down on some ironclad willpower when we’re constantly faced with a barrage of savory, sweet, and decadent delights?

Here’s it is… the secret is out… all you have to do is… just eat. That’s it. Just eat.  

For starters, the literal definition of a diet is, “the kinds of food that a person, animal, or community habitually eats.” Knowing that, I want to get rid of the word “diet” in the context of implying that how a person normally eats isn’t okay and that one should stick to a structured approach, eliminating a group foods or only allowing certain foods at special times of the year, and only in moderation. (Of course, disregard if you have a legitimate allergy/aversion to something - like if an EpiPen would need to be involved). 

Does this mean that you must Scrooge McDuck yourself into a vault of gravy and/or chocolate in order to assert your dominance over society’s standards of health and beauty? No. I mean, you do you. Side note: If you do have a vault and are filling it with gravy and/or chocolate to surf on and dive into, please call me. However, including fruits, veggies, water, and movement into our day are great ways to keep you feeling good, physically and mentally. Now, don’t beat yourself up about it, but being mindful of what foods and actions make us feel our best is always a good idea. We just don’t need to freak out that we’re eating a cinnamon bun for breakfast and then figuring out how many burpees we’ll need to do to “burn it off.” Taking the stress out being “good” or “bad” is what’s going to allow you to enjoy your life, holidays or not. 
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​As we’ve established, for most people, the holidays are filled with fun treats and ways to relax that aren’t typically part of our daily lives year-round. So, take the time to slow down and enjoy your grandma’s famous apple pie that brings you back to a special memory. Have an extra cocktail with your dad on the front porch while making jokes that your mom would roll her eyes at. Take shots of whipped cream straight from the can while your cat, Jeff, looks at you in confusion and disgust while you stand in the soft, warm glow of the open fridge door. But enough about me… dive into whatever comfort and joy mean to you. No judgment! 

If we are constantly afraid that what we eat and how we choose to enjoy things are going to make us “bad” or ruin our waistlines (whatever that means), then I think the true meaning of the holiday season is lost. In a year, five years, 20 years, you’re not going to remember what you weighed or that you were “good” because you turned down a favorite food. You’re going to want to look back and be thankful that you created special memories, enjoyed yourself, and made more inside jokes that will annoy your loved ones for another 20 years. And your judgmental cat. Chill out, Jeff…

Thanks for reading and happy holidays,

Claire, Office Manager at Athletes' Potential

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Your Body's Most Powerful Weapon You're Not Using

12/13/2021

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Breathing. Seemingly, the most innate skill set you have as a human being. So innate that it’s used as a benchmark for being a healthy newborn and your first time taking a breath happens within the first 10 seconds you enter this world. Fast forward to adulthood and you’re breathing an average of 12 to 20 times per minute without a single thought. With all that practice, we must be pretty good at it; right? Not exactly. Stress, lifestyle choices, and mechanics all play a huge role in how we breathe, and all breath is not created equal. 

Want an example of just how easily influenced our breathing patterns are? Look no further than something called “Email Apnea.” Yeah, that’s a real term, and it’s used to describe the phenomenon of people holding their breath when they read their email. One study by Business Insider found that upwards of 80% of people actually do this and I bet if you pay attention you’ll catch yourself doing it as well. 

But who cares? It's just reading emails, and if we don’t even notice it's happening it must not be that big of a deal; right? Wrong. When we interrupt our normal breathing patterns by either not breathing or taking short shallow breaths, we’re creating a stress response in our body, and when we do this over prolonged periods of time, it can have profound consequences on our health. That’s because our brain can’t decipher between the stress of being chased by a bear and the stress of being behind for an important work deadline. To the brain, stress is stress and breathing short, shallow breaths is one of the main ways our brain interprets stress. All this to say that shallow breathing is both a cause of increased stress and a symptom of increased stress responses, creating a vicious negative feedback loop leading people to live in a chronically stressed state of mind. Here are some examples of how detrimental this can be on your health.

  • Decreased ability to fight acute illness (COVID, anyone?)
  • Increased risk of heart attacks, strokes, and other cardiovascular illnesses  
  • Decreased Cognitive Function such as memory recall 
  • Increased susceptibility to panic attacks and anxiety 
  • Chronic Pain 
  • Headaches 
 
Here’s the good news though: The negative health consequences associated with prolonged disturbances in our breath can be easily prevented with just a little awareness and some intention. Simply taking longer, deeper breaths using your diaphragm (vs your chest) has been demonstrated time and time again to prevent the effects of chronic stress. The key word here though is “longer.”

As we recently discussed on the Active Atlanta Podcast with therapist
Megan Gillsespie, a big mistake commonly made when we tell people to “take a deep breath” is they do just that! We take this huge inhale and then quickly exhale all that air back out. All the focus is on the inhale, when it should be on the exhale.


When we focus on slow, long exhales instead of long inhales only, what we start to do is upregulate our parasympathetic nervous system, which puts our body into a relaxed state. By simply increasing the durations of our exhale, we can reduce anxiety, lower blood pressure, improve sleep, decrease pain, improve concentration, and so much more. It’s a true biohack that is free, easy, and incredibly powerful. 
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So, how do you do it? Do you just take long exhales and call it a day? While not wrong, there’s a more organized and effective way of doing so and it's called “parasympathetic breathing.” You can practice this technique by lying on your back with your feet up on the wall (as demonstrated in this video) and use a 4-7-8 breathing pattern, where you inhale for 4 seconds, hold your breath for 7 seconds, and exhale for 8 seconds. Set a timer for five minutes and repeat this pattern. Try not to fall asleep in the process! Be sure to use your diaphragm instead of your chest when doing this by simply putting one hand on your stomach and another hand on your chest. When you inhale and exhale the only hand that should be moving is the one on your stomach. Once you get the hang of it, feel free to make this less formal and start implementing throughout your day, at your desk, in your car, etc. It doesn't matter where, just make it a part of your daily habits. 

At Athletes' Potential, we have a profound understanding for how the body works and how your sleep, stress management, nutrition, and movement practices all coalesce to create a healthier life. If you’re dealing with low back pain, chronic pain, recurring injuries, or a nagging injury that’s preventing you from living life at your highest capacity, give us a call or click the button below and we’ll call you!
Ready To Come See Us?

​We help people just like you every single day. Whether you’re someone who doesn’t know where to start or has had an unsuccessful rehab experience, we’re confident we can help you as well.


Thanks for reading,

Dr. Jake, PT, DPT, CSCS
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Mindful Tolerance and The Parasympathetic Nervous System - How You Can Help Yourself Get More Out Of Your Manual Therapy

12/9/2021

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As a physical therapist, my job is to interact with pain and discomfort all day long. Most people don’t come to see me when they’re feeling great! They come to see me when they are injured, sad, and without a clear path forward. They come to see me when pain is not only slowing them down, but possibly taking away something that they love, such as running or sport! The pain they feel is a warning light that is flashing bright, and every patient I’ve ever seen has needed some guidance on how to interpret the signals that their pain is trying to convey.

Seeing as every experience of pain is unique to the individual, I won’t go into specifics on these subjective experiences, as they are so varied! What I do want to share is what we now know about pain science that we didn’t know even just ten years ago, and more importantly what can we do with this knowledge of pain science! As it turns out, there are reasonably well-performed studies that support the use of short bouts of mindfulness to manage pain tolerance.(1) A huge review came out in 2020 that may be worth looking through if you have the time (see citations). Now, within my treatment room, I’ve seen tons of evidence that mindfulness helps pain tolerance! 

Any time I perform any type of manual therapy treatment -- dry needling, voodoo band application,  Graston, or cupping -- I’m very aware of my patient’s pain tolerance. It is very important that my patients be able to relax while I’m performing these techniques. I’ve seen time and time again, if a patient is not breathing deeply in a relaxed state (or at least attempting to!), the technique is less effective. 

This makes sense. In one of my favorite books on pain science, “Explain Pain,” by David Butler, the “fight or flight” system is the sympathetic nervous system. This system can be triggered by various stimuli, such as loud noises, fearful emotions, and other things that we determine as possible threats. Once this system is triggered, our muscles tense as we are getting ready to fight or run. This is the exact opposite system we want triggered when we are receiving physical therapy treatments! What we would like to trigger is the parasympathetic nervous system, as it is the system responsible for our “rest and digest” capacity. 

As a side note, if you have any interest in pain science, I’d highly recommend you purchase the book, “Explain Pain.” It has been incredibly formative in my practice and is written in an approachable, well-explained manner that can give you a great understanding of our pain system. Ok, back to the systems!

If my patients are able to tap into this parasympathetic system, their muscles relax and absorb the treatments that I am providing. So, what is the best way to access this parasympathetic system? While I wish we could access this system with a light switch, we cannot. But, the most effective way to coax it into action is through deep breathing and mindfulness. Many times, I can simply hold onto a trigger point and ask my patients to breathe deeply, and with no motion and the proper application of pressure, we work as a team to access their parasympathetic system, thereby allowing the trigger point to release more rapidly than if I were to be fighting with their sympathetic system!

So, the next time you’re on that foam roller, lacrosse ball, or receiving dry needling, do your best to breathe deeply. You’ll be accessing your parasympathetic nervous system, getting more results more rapidly, and getting yourself to where you want to be with your muscle tissue. If you have any questions on this mechanism in our body or think you would like to experience the effect that breathing and “downregulation” has on physical therapy treatments, reach out and schedule a session with me today!
Ready To Come See Us?
Thanks for reading, 

Dr. Marcus Rein PT, DPT




1. Shires, Alice, et al. “The Efficacy of Mindfulness-Based Interventions in Acute Pain: A Systematic Review and Meta-Analysis.” Pain, vol. 161, no. 8, 2020, pp. 1698–1707., https://doi.org/10.1097/j.pain.0000000000001877. 

2. Butler, David S., et al. Explain Pain. Noigroup Publications, 2019. 
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Marathon Nutrition Prep

11/23/2021

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I have recently had quite a few people training for their first full marathon! One of the most common questions I get asked is: What should I eat before and during a marathon? Well, if you are racing soon, stick to eating the same meals you eat before your long training runs. Try to remain consistent with your eating habits throughout the training process once you discover what nutrition works best for your performance. Race nutrition includes fluid intake the days leading up to the race, dinner the night before, breakfast the day of, and supplements during your run. 

Whatever you do, avoid making any drastic changes in your behavior before or during the race.
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Dinner: For dinner you want to eat good complex carbs (vegetables and grains), a medium amount of protein (fish or chicken are my go-to choices), with a small amount of high quality fat. Avoid eating high fiber foods and foods with high fat content the night before the race as they are tougher to digest and can lead to GI problems during the race (i.e. beans or lentils). Again, try to remain consistent with your eating habits and don’t try anything too different before your race (common theme).

Late Night Snack: If you have a difficult time waking up to eat an early pre-race breakfast, you can try eating a late snack. This also comes in handy if you have traveled or changed time zones for your race. Try to mimic what you would eat for breakfast the day before a race (simple carbs and a little protein).

Breakfast: Try eating breakfast at least two hours prior to the start of the race. You do not want to eat too close to the start time or you will have to continue to digest your breakfast during the race. Your breakfast should consist of mostly simple carbs (oatmeal, bagel, toast, rice) and a little protein (protein shake, egg whites, low-fat Greek yogurt), or something like Kodiak cakes (carbs + protein in one!). Again, avoid high fiber cereals and high fat foods, as these foods are harder to digest and can lead to GI problems during the race.  

Pre-Race Snack: An hour before the race you can eat some simple carbs that can easily convert to energy. Fruit with honey is a good option. Oftentimes I will make a fruit smoothie ahead of time for a pre-race snack.

Caffeine: Caffeine is a stimulant that can help with your performance during endurance races and training. If you are used to drinking coffee before your long runs, then go ahead and drink coffee before the race. Be aware that some energy gels and blocks contain caffeine, so test these products out during your long runs prior to race day! 

Caffeine can also cause GI distress, stimulate the nervous system, and lead to increased heart rate, and, if consumed in excess, can lead to increased urination. All of these issues can create problems for the endurance athlete. If you are not used to consuming caffeine, then the day of the race is not the best time to find out how you will respond. 

During the race: It is good to know what nutrition will be supplied during the race. Some races are sponsored and will have the nutrition supplements of the race sponsor out on the course. For example if they are supplying GU gels, but you are used to Honey Stinger products, then you should plan on bringing your own nutrition for during the race. A good option is to set an alarm on your watch throughout the race to prompt you to drink and eat small amounts on a regular basis. That way, you are more likely to keep on track for your nutrition goals.

One of the biggest issues I see with novice endurance runners is the lack of fluid and energy intake early in the race. It takes time for your body to digest and use the energy you consume. If you wait until you feel thirsty, or start to feel shaky from glycogen storage loss, it’s too late. So, I tell runners to drink and eat early in the race and drink before you feel thirsty. Maintaining hydration throughout the entire race with smaller but consistent amounts is easier on the stomach than trying to play catch-up with large amounts of fluids once you feel thirsty. 

After the race: You want to make sure you continue to stay hydrated. If it was an especially hot race, you may need to continue replacing your electrolytes throughout the day with a sports drink.

Make a plan, stick to the plan, and good luck racing!
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​Sam Gillespie PT, DPT
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The Risks of Youth Athletes and Strength Training: What Does the Research Say?

11/10/2021

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Countless times, I have been asked if it is safe for youth athletes to start strength training. “Aren’t there risks to their growth plates?” and “Won’t it stunt their growth?” are common concerns. It is the purpose of this article to face these questions head on and go to the research.

Growth Plate Damage Causing Stunted Growth?

The epiphyseal plate, also known as the growth plate, is a critical part of a child’s development. A properly growing epiphyseal plate ensures that the child will grow taller! So what does the evidence say about strength training and growth plate damage causing stunted growth? The American College of Sports Medicine (ACSM) concludes in a review that “...there is no evidence to suggest that resistance training has a negative impact on a youth’s growth potential.” Further studies by Dr. Avery Faigenbaum have even shown that there are possible positive effects to the growth plates from a strength training program. 

Overall Safety?

Strength training injuries are typically found in youth athletes to be strains and sprains, with occasionally a fracture. While these are unfortunate, the statistics are clear: the rate of injury with sports such as soccer, basketball, and football are much higher than the rate of injuries with strength training or weightlifting. I would strongly argue that the actual benefits of strength training for youth athletes far outweigh the risks.

So What Are The Benefits?

Injury prevention!
A 2019 review of eight studies concluded that strength programs that were properly executed and supervised actually decreased injuries for youth athletes. Not only were these programs safe for athletes, but they experienced fewer injuries after the strength and conditioning programs were completed. 

Performance improvements:
A 2016 review of 43 studies concluded that significant performance increases can be achieved through strength and conditioning for youth athletes. Increased muscle strength, vertical jump performance, linear sprint performance, agility, and sport specific performance in team sport athletes, endurance athletes, and individual athletes were all seen in youth athletes aged from 6-18. The strength and conditioning programs varied greatly according to the ages, sex, and development of the athletes, each tailored to the development capacity of the youth athlete. 

Conclusion: 
With the right coaching, a strength and conditioning program is safe, effective at decreasing injuries, and effective at increasing performance. The fears of stunted growth need to be put to rest! If you have more thoughts about youth athletes performing appropriate strength and conditioning, check out the citations below! If you’d like to discuss this further, feel free to reach out!

Marcus Rein, PT DPT

  1. Diamond, A., 2016. Physeal (Growth Plate) Injuries: What to Know and What to be Aware of in Young Athletes. ACSM'S Health & Fitness Journal, 20(6), pp.45-47.
  2. Faigenbaum, A., Kraemer, W., Cahill, B., Chandler, J., Dziados, J., Elfrink, L., Forman, E., Gaudiose, M., Micheli, L., Nitka, M. and Roberts, S., 1996. YOUTH RESISTANCE TRAINING: POSITION STATEMENT PAPER AND LITERATURE REVIEW: Position Statement. STRENGTH AND CONDITIONING JOURNAL, 18(6), p.62.
  3. Hanlon, C., Krzak, J., Prodoehl, J. and Hall, K., 2019. Effect of Injury Prevention Programs on Lower Extremity Performance in Youth Athletes: A Systematic Review. Sports Health: A Multidisciplinary Approach, 12(1), pp.12-22.
  4. Lesinski, M., Prieske, O. and Granacher, U., 2016. Effects and dose–response relationships of resistance training on physical performance in youth athletes: a systematic review and meta-analysis. British Journal of Sports Medicine, 50(13), pp.781-795.
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