With the CrossFit Open upon us and beach bod season approaching, people will be fitnessing. A LOT. With this, comes the opportunity for injuries to sneak up and leaving performance on the table.
People typically blame certain factors for an injury or lack of performance:
While these factors are definitely important to consider, there’s one that gets overlooked and is quite often the culprit:
I had a patient come in a month ago who was dealing with foot and ankle pain. It has been on and off for months, and she decided to get it checked out due to a recent exacerbation. She’s a ½ marathon runner who also does Orange Theory a few times a week. She was starting to increase her mileage for her ½ marathon coming up. I think you know where this is going…
Before trying to change up her running mechanics, change her shoes or blaming it on “overpronation,” we had a conversation about her training volume. I asked her how her running mileage and volume been. In this discussion, she said she went from 3 miles to 6 miles within a weeks time. BINGO. She was confused as she had previously ran this much mileage in the past, BUT... it’s been a couple months.
I also asked her about the first time she ever dealt with this same issue – she said she couldn’t really think of why it initially started – “maybe running form or my shoes?”. I asked her when she started Orange Theory – lightbulb went off. BINGO again.
Let me be clear – there’s nothing wrong with her doing both running and Orange Theory. There is when your body is not prepared for the demand of these tasks. This was and is a volume issue, and if you’re reading this, think back to a previous non-contact injury and see if you can attribute any other factors playing into that specific injury – moreso volume in this case.
Now, mobility, biomechanics, strength, etc., all play roles into whether we are operating as optimally as possible from a performance standpoint. For this patient, we did work on strength in certain areas and tweaked some things from a running standpoint, but the big component of her rehab was starting at a volume she could tolerate without pain or just a little, and progress forward from there.
Training volume falls under the umbrella of Load Management (coming in Part 2) and is a big reason why injuries occur.
Some common methods of measuring training volume include counting the number of sets to failure, the volume load (sets x reps x weight), distance, number of sprints, etc.
Here are some terms to understand:
Maintenance Volume (MV) – How much volume you need to maintain your gains
Minimum Effective Dose (MED) – Smallest amount of stimulus needed to drive positive adaptation. If we are below this threshold, then there will be no adaptation.
Maximum Adaptive Volume (MAV) – Here we are training at our optimal range of volume that we can adapt to and recover appropriately to drive optimal performance
Maximum Recoverable Volume (MRV) – This is the absolute maximum volume that your body can handle and recovery from. Sometimes it’s necessary to pass this threshold from time to time, called overreaching, in order to elicit greater adaptations. Important point here is to make sure it is not often and that deloads are accompanying this high accumulation of volume to allow for supercompensation (the point of overreaching to get the training effect you want – improved strength, power, speed, etc.). When this is not appropriately monitored or constantly overreached without recovery, you open the door for injuries to occur and performance to suffer.
(credit to Mike Israetel of Renaissance Periodization for this concept)
The way this is laid out is that you start with your MED, progress to MAV, then MRV to overreach. However, notice that you don’t dance with MRV often, nor do you want to.
Overtime, your MRV will increase, meaning you’ll get stronger and develop more work capacity, as long as you intelligently handle your training volume.
A good rule of thumb is The 10% Rule - While there can be some variability here, staying within a 10% increase from the previous week tends to work well for a lot of people. It pushes that threshold in a progressive manner and allows appropriate recovery from the increased demand on the body.
Next week, in Part 2, we’ll take a deeper dive into load management and training volume, explore exactly what this concept means, and how to practically apply it to yourself or athletes you work with.
Dr. Ravi Patel, PT, DPT, CSCS
It’s baaaaack. The largest fitness competition on Earth, the CrossFit Open, is finally here. Maybe you’ve trained all year for this, maybe you’re still new to CrossFit and are curious about all the excitement. Maybe you’re a seasoned vet, maybe this is your first Open you’ve ever participated in. Regardless of your CrossFit background, your fitness will be tested, your mental toughness will be challenged, and you will certainly have a blast working through these workouts with your crew at your local CrossFit affiliate.
That being said though, this is typically a time where we start seeing an uptick in the people we see coming in for CrossFit related injuries. Having an athletic background, where I had to personally sit out multiple seasons due to injuries, I speak from experience when I tell you there is nothing worse than working all year towards a goal/competition/test and not being able to perform at an optimal level, if at all, because of an injury. And, look, I get it. There is inherently an increased risk of injury when you're pushing yourself in a competitive environment. However, there are some very important things you can do to minimize this risk and allow you to perform your best. Let’s take a look at the three easy things you can do:
#1 Don’t Be Reckless
This is huge and something I see year after year. If you’re a CrossFit coach, or even just an observant CrossFit athlete, I’m sure you’ve seen what I’m about to explain...You’ve worked all year to create movement patterns that are both safe and effective. You know the importance of good, quality movement. However, throw in the element of an international competition and it seems like all these lessons about technique go out the window.
For example, last year’s first Open workout (18.1) consisted of three movements: toe-to-bar, dumbbell clean and jerks and rowing. Can you guess what type of injury we saw coming into our clinic after this workout? If you said back pain, you’re correct. But why? Well, with this workout people were trying to perform as many rounds as possible for 20 minutes. To get better scores people weren’t maintaining core control for a solid hollow position with their toes-to-bar, they stopped getting full hip and knee extension for optimal power production during the drive portion of the clean and jerks, and/or they started to over-extend during the rowing component. All of these create situations that are destined to increase stress on your low back. Keep in mind that this was just the first workout! Now you’re either completely unable to participate in the other workouts or will not be performing at an optimal level because you’re trying to grind through an injury.
#2: Protect Your Sleep
There are four main pillars of health care that we look at with every patient who walks in the door at Athletes’ Potential: Movement, Stress, Sleep, and Nutrition. Sleep is easily on of the biggest problems that we see out of these pillars. And check this out, Sleep affects everything you do and everything you do is positively affected by quality sleep. Good, quality sleep literally improves everything: every marker on a blood panel, weight management, sport performance and recovery, productivity, and numerous types of disease management. The list goes on and on, yet the percentage of sleep deprived Americans, particularly in Urban areas, continues to rise at an alarming rate. In fact, the U.S Centers for Disease Control and Prevention reports that more than 30% of Americans are sleep deprived getting fewer than 6 hours of sleep per night.
If you’re not getting enough sleep, you’re not giving your body a chance to recover. If you’re not recovering appropriately then you're leaving yourself at risk for injury and decreased performance. So bottom line, create an optimal sleeping environment, protect your night time routine, and get some good quality sleep sleep.
For more info on how to optimize your sleep. Check out this article we wrote.
#3: Maintain Perspective
This comes full circle with tip #1. For those of you trying to make it on to regionals, those extra few reps I mentioned could be the difference in making the cut vs staying home. However, for the vast majority of athletes competing in the CrossFit Open this is not reality. You all have careers, kids you need to take care of, and numerous other responsibilities that you need to keep rocking with once you leave the gym. Is bouncing off the top of your head to get an extra rep or two really going to mean that much if by doing so now you can’t look over your shoulder while driving? (yes this is a real scenario that we’ve worked on at our clinic...I’m looking at your 17.4). Or is that 2 position jump on the leaderboard really all the important if now you can’t bend over to pick up your kids?
Crossfit is meant to be a competitive, fun and challenging way to make all aspects of life outside the gym a little easier. This time of year is huge for all CrossFit athletes and it is truly impressive to see the physical accomplishments and PR’s that happen every single year in the Open. However, the Open isn’t an excuse to throw all safety out the window but it isn’t something you should be afraid of either. Following these three easy tips will ensure that you have a great time, reduce your risk of injury, and maybe even hit a PR or two.
Thanks for reading.
Dr Jake, DPT, CSCS, CF-L1
Recently, I had the opportunity to present to a local soccer club and their coaches on injury risk and reduction for the sport of soccer. In order to understand this, a “Needs Analysis” must be done. A Needs Analysis is a two-part analysis breaking down the sport into two components:
Today, our primary focus will be on evaluating the sport itself. This can be further broken down into:
Movement & Physiological Analysis
Soccer is a very lower-body dominant sport involving the hip, knee and ankle joints and muscle groups including the quadriceps, glutes, hamstrings and calves. A soccer athlete must be able to run, jump, accelerate, decelerate, land, cut, kick, pass, head, shuffle, tackle – all while handling a ball and avoiding defenders. Oh, they also need the ability to sprint and jog throughout the duration of a 90+ minute game. Now, you’re talking about a dynamic athlete with a sound aerobic and anaerobic energy system. That’s A LOT.
Here’s a more thorough breakdown:
Sports injuries are inevitable. It comes with playing sports – exposure already puts you more at risk. You cannot prevent sports injuries, but you can help mitigate and reduce the risk of them happening – especially ones that are non-contact or overuse in nature.
Here’s a breakdown of the most common injuries in soccer:
A study done in 2017 by Khodaee et al. tracked detailed information on injury rates among high school soccer players over a 10-year period (2005 – 2014). You can see those below broken down by gender and injury diagnosis.
Muscle strain, ligament sprain and concussions are highest as expected.
What’s most interesting is the girls’ ligament sprain – very high for both practice and competition as compared to the boys’ group. Females are 2-5 times more likely to tear their ACL than males in a similar sport. There are a lot of factors that play into this and nothing is definitive. We do know that strength and neuromuscular control are big modifiable factors from an injury risk standpoint.
In another study from 2015, Waldén and company analyzed 39 videos for movements related to non-contact ACL injuries in professional soccer players. They found that pressing, kicking, and heading were the 3 most common movements in relation to ACL injuries.
Heading (check that right leg in D - ouch)
Cool, so now what do we do with all of this? Make some superhuman soccer athletes.
Have a plan in place to address these different components. It’s important to create a program for these athletes to develop these athletic characteristics – i.e. lower body strength, power, repeated sprint ability, cardiovascular endurance, change of direction and reactive agilities. Injuries happen all the time in soccer, but if we know what joints and muscles are most at risk, then we can better prepare these tissues to withstand the stress of the sport and build more resilient and robust athletes.
Dr. Ravi, DPT
Baechle, Thomas R., and Roger W. Earle. Essentials of Strength Training and Conditioning. Champaign, IL: Human Kinetics, 2016. Print.
Turner, E., Munro, A. G., & Comfort, P. (2013). Female Soccer: Part 1—A Needs Analysis. Strength & Conditioning Journal, 35(1), 51-57.
Coming at you with the the final part of our two-part series for ensuring healthy shoulders while improving your pull-ups. In this part we’re talking about how to develop appropriate strength in the appropriate areas. For those of you who missed it, part one is super important and I highly recommend reading that before moving on with part two. For those of you who are caught up, let’s get after it.
Part II: Strength
In any training program, it’s important to make sure your movements are balanced and that your shoulders are working in multiple directions (ex: vertical pulling, horizontal pushing, horizontal pulling, etc). The pull-up is an excellent example of a vertical pull strengthening exercise. With most pulling exercises, your body is primarily moving through two movements: elbow flexion and shoulder extension. This means your primary shoulder extension (latissimus dorsi, teres minor, post delt) and primary elbow flexion (biceps brachii, and brachialis and brachioradialis) muscle groups need to work synergistically to perform this movement appropriately.
Unfortunately this synergistic relationship isn’t normally the case. More often than not I find that people way over utilize elbow flexion and underutilize shoulder extension. When this happens bad things happen and those bad things usually end up manifesting themselves as pain along the front of the shoulder. As you can tell in the picture above, the long of of your biceps tendon crosses the shoulder joint and when you rely too much on elbow flexion with pulling based exercises, you can end up agitating that tendon, which leads to shoulder pain.
I see the aforementioned situation happen all the time in athletes who do a lot of kipping pull-ups vs strict pull-ups, specifically in those who don’t have the requisite strength to perform consecutive strict pull-ups but are repping out 15+ kipping pull-ups at a time. Now I’m not saying kipping pull-ups are bad or that you shouldn’t do them, but kipping pull-ups should be an expression of strength, not a way to avoid a weakness.
To ensure you’re not overusing your biceps while doing the pull-up you want to have strong, engaged lats (latissimus dorsi). To make sure this is the case, check out our top 3 exercises below for improving shoulder lat strength and control.
Drill #1: Active Hangs
This drill is an all time favorite of mine for a couple of reasons. First, it allows you to feel how your lats should be contracting while you are going a pull up. Second, it allows you to strengthen your shoulders in a vulnerable/weak position. You’re only as strong as your weakest link and being strong in a weak position is a great way to prevent injuries.
Drill #2: Lat Pull Over
This one is a great example of “killing two birds with one stone” because not only are you able to improve lat strength with this drill, but because of the long eccentric phase (muscle contracting while lengthening) of this drill, it’s also a great way to improve shoulder mobility.
Drill #3: Single Arm Banded Lat Pull Downs
Breaking up a bilateral movement (using both arms) into a unilateral movement (using one arm) is a highly underutilized training modality that allows to balance out weaknesses. Plus, as an added bonus, you’re able to perform a vertical pulling drill at a slightly different angle which, as we talked about above, is how you train for healthy shoulders.
If you have shoulder pain while doing pull-ups, or want to prevent pain from coming, this two-part post is a great place to start. Ensuring appropriate mobility and then building appropriate strength is a common occurrence in the rehab world.
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, DPT
Let’s recap from last week:
Your ankles drive the squat bus and your knees are along for the ride. Unfortunately, the hip is often overlooked when pain or dysfunction with squats occurs. Strengthening targeted to the hip will improve knee position during the squat. If it hurts your knees to squat, it is likely a faulty movement pattern causing the issue.
When there is pain, do not push through. Jane Fonda might have said “no pain, no gain” during her abs, buns & thighs workout but this does not apply. The feeling of an ice pick jabbed in your knee cap is not normal. Pain with a back squat does not mean you can’t squat at all! Try these first:
I eluded to different flavors of squats in the last post. Is high bar back squat bothering the knees today? Try a low bar position, front rack or squat to a box. There are so many options! It is nearly as exciting as picking a flavor of ice cream.
Check out Noel showing us some variations of squats! Pay attention to her ankle and shin positions.
High Bar Back Squat a.k.a Traditional Back Squat
The bar rests across the top of the upper trap, on the shoulders. Throughout the movement, the torso remains upright. With this set up, the knees tend to move more forward than in other squat variations so adequate ankle mobility is essential!
Remember, those with significant ankle mobility issues will have trouble maintaining the upright torso and may try to sidestep the issue by turning the toes out wide. Another squat flavor will allow you to move in less compromising patterns while still gaining strength. Don’t forget to work on ankle mobility every day!
The bar rests across the front of your shoulder, elbows are high and in front. The torso is the most upright in this squat flavor to keep the barbell over the midfoot. Again, ankle mobility is key here!
For those who do not have glaring mobility restrictions, the front squat is a great exercise to carry over for the clean.
Low Bar Back Squat
The feet are in a wider stance than for the traditional squat. The bar rests lower across your shoulders, elbows are back and high to help create a shelf for the barbell. The torso maintains more of a forward inclination to keep the barbell over the midfoot.
This flavor of squat decreases the torque at the knees by allowing the tibia, or the shin, to remain more vertical. (Go back and look at her shin-to-foot angle in the traditional squat and compare!) More torque is placed at the hip, so the hammies and glutes are targeted. If you feel a pinching at the front of the hip, vary your squat width and work on that hip flexion mobility!
The feet are in a wider stance, similar to the low bar set up. The bar rests across your back in either high bar or low bar position. A sturdy box is behind the lower legs. The hips are allowed to travel further posteriorly during this movement which allows the tibia to remain vertical.
The box squat is great for all athletes to include in their workouts. It is helpful when just learning how to squat or trying different foot positions. After a knee or ankle injury, it is a good way to decrease torque at the knee and demand on the ankle joint. Box squats are also used for power athletes as it has been shown to increase the rate of force development, or explosive strength, more than other squat flavors.
Each of the squat flavors has something different to offer for your health and athletic development. If you are recovering from an injury or lack mobility in the hips or ankles, there is still a flavor for you! Grab an empty barbell and try each of the variations. Don’t be afraid to vary your stance width. Start with a taller box and gradually work your way down as you get comfortable.
Taking a video of yourself moving is the cheapest and quickest way to find faults and underlying mobility issues. Once you work through each squat flavor, you will have a better idea of which mobility drills to introduce daily. Get your squat moving correctly and cut out that knee pain! After all, it’s not your knees’ fault!
Thanks for reading!
Swinton P, Lloyd R, Koegh J, Agouris I, Stewart A. The biomechanical comparison of the traditional squat, powerlifting squat, and box squat Journal of Strength and Conditioning Research. 2012;26(7):1805-1816.
Simply put, no. Squatting, specifically deep squatting, is actually beneficial for your muscles and tendons. If you simply wanted to know the answer to the question, that is the abridged version. But those “why” people (it’s ok, I am one too!) should continue reading.
Research tells us:
The Knee, the Middle Child
In my experience, the knee joint seems to be the most baffling to folks. So much emphasis is put on knee position during workouts that other (more important, in my opinion) joints are virtually ignored. It may be more beneficial to understand this joint if you view it as the middle child.
The ankle is like the oldest child. It sets the scene for how the other joints are allowed to act. If the older child is rebellious and does not behave as expected, the middle and youngest child will imitate the older sibling. Without the proper ankle mobility and foot strength, who cares what your knee and hip joints can do? The foundation for these multijoint movements is already the weakest link.
The hip joint is the youngest child. By this point, the parents are exhausted from the rebellious older child who influenced the middle child into its rebellious ways. The youngest child can get away with anything. Our hip joint is a large, strong joint complex that should be the prime mover during squats. Unfortunately we get so focused on the knees and ankles that we overlook the hips and allow them to “run free”. This presents in the form of decreased pelvic control during large movements like the squat.
Finally, the knee joint is the middle child of the family. It gets pushed and pulled by its siblings but never has a moment when it’s all about the knees. During foundational weightlifting movements, the knees never work alone. They are guided by their neighbors.
So what does this mean? The ankles are the steering wheel. If you do not have sufficient mobility in your ankle joint, your knees are predisposed to faulty movement patterns. But it’s not your knees fault!!
Sad stick man on the right does not have great ankle mobility which causes his femur, the thigh, to be pushed backward. From this position the torso has nowhere to go but forward if he wants to remain standing. Throw a barbell in the front rack and the stress in concentrated on the knees, low back and upper body. With a barbell on the back rack, it will be harder to maintain spinal alignment, particularly in the bottom of the squat. This is often the position athletes attain when their hips raise well before their knees begin to straighten in a squat.
I don’t know what to do with my knees!
“Knees out!” is one of the most over-coached cues. Sure, it is a quick and easy fix in the middle of the workout but it is important that athletes understand what this means. If your knees are crashing in during a workout, the weakness is at your hip. A weak gluteus medius is often the culprit but it has an accomplice! If your hammies and glutes are weak and you attempt a heavy squat, your adductors are going to kick in to assist with hip extension. But the primary motion of these muscles is hip adduction, or knees together. Thus, crashing ensues. So strengthen your hip muscles and your knee position will improve.
If squatting is not bad for my knees, why do they hurt?
Undoubtedly, this will be the next question. There are several reasons that your knees may hurt during a squat. Some irreversible arthritis or previous injuries may be contributing but even these populations should be able to return to pain-free squatting. They just may need to try a different flavor than the traditional back squat.
Essentially, squatting is not bad for the knees but it is how you are squatting!
Do I squat through the pain?
No! Our body is very good at letting us know when something is not right. Now, I am not referring to muscle fatigue pain but true pain. If the back squat is causing knee pain today, try another variation. There are plenty of flavors of squats that can be used for training while you work on mobility or strength deficits. Be sure to look out for my next article about finding the best squat flavor to suit you!
Moral of the story: squatting, even below parallel, is not bad for your knees. The squat is a fundamental movement pattern that all humans should be able to attain. If pain arises from this movement, remember it is how you are moving. Decrease the weight, video yourself performing a squat and pay attention to which muscle groups are doing the work. If you continue to have pain, contact us at Athletes’ Potential so we can watch you move and delve deeper into your individual movement patterns! Most importantly,
Thanks for reading,
Hi, I’m Dr. Danny Matta DPT. I’m a Physical Therapist/Strength Coach and I’m the founder of Athletes’ Potential. Our company helps people just like you live higher quality, higher performance lives. That could be running your first 10K, competing in the CrossFit Games or getting rid of that lingering back pain so you can start getting back in shape! Dry needling is a technique we use frequently. I hope you have a better understanding of what it is after this article. Please email us if you have any other questions and we’d be glad to answer them for you.
When I was in the Army as a Physical Therapist, I remember first hearing about dry needling and thinking how crazy it sounded. I remember thinking PTs that were doing dry needling were searching for some kind of voodoo treatment that only had placebo effects. I actively stayed away from learning it because at the time I was a new graduate that thought I knew everything and was going to set the world on fire by getting everyone better.
Well, things changed one morning when I wrecked my back after a ruck march training session. I hurt my back so bad I could barely drive home and had to cancel all my patients that day. I threw everything at it that I knew and even enlisted the help of a few of my colleagues. Six months later, my back still hurt to pull weight from the ground, back squat or run (that was literally 80% of my training at the time!).
About that same time, a new physical therapist named Dr. Emmanuel Easterling moved to where I was stationed. Dr. E, as we called him, was a certified dry needling ninja. I reluctantly let him perform his voodoo on my back and I'm so glad that I did!
Within 2 days of Dr. E dry needling my back for the first time, I was running with no back pain. After the second time he did it, about a week later, I was squatting and deadlifting again. That was it- I was hooked and not only did I drink the Kool-Aid but I chugged it! I dove into dry needling head first and learned as much about it as possible.
So what does this technique do and why is it so effective? That’s a great question and the answer is we don’t fully know. Frankly, medicine is constantly evolving and we are always using our best evidence/knowledge at that time. Dry needling is the same way so as I answer this, understand there is probably way more to this than we even know.
First, dry needling involves placing small needles into strategic spots in the muscles. These spots were recognized and mapped out by a physician named Dr. Janet Travell, MD. She was an incredibly smart lady and was even John F. Kennedy’s personal physician during his presidency. Did you know he had chronic back pain? Yep, and what did she use to alleviate the back pain? You got it- dry needling!
The points Dr. Travell mapped were called trigger points. This trigger points in the muscle actually refer pain, not just where the “knots” in the muscle are, but to other areas of the body. Here’s an example of a trigger point in the upper trap. The X is where the trigger points are typically found. The dotted red areas are where the trigger points refer pain. Have pain on the inside of your shoulder blade? It could be just an irritated trigger point in your upper trap that dry needling would help fix really fast!
So how does a needle in a muscle cause pain to resolve quickly? There are a few theories on why this happens and I like to explain it in terms most of us understand: Think of a trigger point like a glitch in your computer. Something isn’t working right and it’s causing other things to have issues as well. What fixes most computer problems? You got it- the restart!
Dry needling is like the restart for the musculoskeletal system. If we have a irritated trigger point and we put a needle in it, it resets. This reset occurs at the muscle with what’s called the wash out effect. This basically means that a needle in a muscle causes increased blood flow to the area. Increased blood flow causes increased oxygen/healthy blood to shunt to the area. Local inflammation/stagnant fluid gets “washed out” by this effect.
There has also been evidence to support the theory that dry needling has a strong effect on the nervous system. Basically, placing a needle in a trigger point causes local opioids (our bodies own natural painkillers) to be released. This also causes a positive pain relieving effect on the spinal cord. This means we can get a local and central pain relieving effect from this technique.
Yes, most people are sore for a day. It feels like you worked out hard and the muscle is fatigued. In addition, you have to perform self-treatment work to really get the best benefit from dry needling. Picking the right home exercises and doing the right technique is where the magic is.
If you’ve been struggling with an injury or pain that’s stopping you from the activities you love, this might be a very effective treatment option for you.
You have a choice. You don’t have to wake up every morning and hope that this is the day your shoulder/back/neck or whatever areas stops hurting. It’s sad how many people are in pain daily. It stops them from playing with their kids, walking 18 holes in golf, staying in shape and living overall happier lives.
If you’re in the Atlanta area and you’d like to talk with one of our Doctors of Physical Therapy to find out if our approach is right for you, contact us. We’ll set up a free 10-minute phone consultation at your convenience.
Thanks for reading.
It’s the day after Christmas and as my wife and I break down the endless boxes that my kids' toys came in, I had some time to reflect on this past year. I’ve learned a lot of lessons this year and since we all have such short attention spans these days, I will share this with you in bullet point format!
1. Age is just a number.
If you didn’t know your age, how old would you say you are? How old do you feel? I turned 30 this year and supposedly that means it’s all downhill from there. I disagree with that, I feel like I’m just hitting my prime. Age is just a number, don’t pay attention to it.
2. Treat your body better than your car.
Because of the nature of my practice I get some very successful people as patients. Many of these clients have the newest German luxury, badass cars that’s detailed and shiny as could be. The car is taken care of as if it’s going to need to be show-ready at anytime.
Many of us treat our vehicles better than our own bodies. Listen people, you can get tons of different vehicles in your lifetime but you only get one body. That means treat it with respect. Put good food in your body. Exercise and perform some basic maintenance. That means you either do some body maintenance on yourself or go see someone to get a massage, do some dry needling or some whole body cryotherapy.
You can either put the work in now or pay the price when you’re body breaks down on you.
3. You can’t appreciate how comfortable you are unless you are uncomfortable sometimes.I read a book this year that I really enjoyed called Living With A SEAL by Jesse Itzler. I recommend you all read it. It’s a short read, hilarious and the message really resonated with me. In the book, the SEAL Jesse hires to train with him makes him sleep in a wooden chair all night. His rationale was he was too comfortable. He wanted him to experience something uncomfortable so he could appreciate what he had.
Push your body, expose yourself to uncomfortable things and have a better appreciation for how comfortable our lives really are.
4. Embrace the cold.
For the past few months I’ve been exposing myself to cold immersion work. I’ve done things like cold showers, whole body cryotherapy, ice baths and running in cold temperatures in shorts and no shirt.
I was inspired by a man named Wim Hof who is called the Iceman. He believes that cold exposure and breath control is the way to unlock our human potential.
I have to say, I hate being cold. It’s such a mental hurdle to step into a cold shower or get in an ice bath. Once you do it, it’s so cold it literally takes your breath away. This is where the magic happens. If you can expose yourself to something cold enough to take your breath away and then control your breathing, you’re in charge again. You are overriding your body’s fear mechanism.
This has been one of the coolest things I’ve learned in the past year. You might be standing in a whole body cryotherapy tube that’s -200 degrees but in your mind it can be 75 degrees and sunny!
5. You need to actually warm up before training.
I know, this sounds crazy right? Actually warming up before doing a workout- what a creative idea! Here’s the reality: very few people actually warm up before training. Some gyms run people through a structured warm up but some leave it up to the athletes to warm themselves up. I think this is too important to be left up to chance.
Take your athletes through a thorough warm up specific to the training for that day. 3 rounds of Cindy does not count as a warm up unless you are doing Cindy!
This could very well be the most important injury prevention tool you have as a strength coach, use it!
6. Your diaphragm is the second largest muscle in your body, use it.
Most of us take somewhere around 15,000- 20,000 breaths in a day. That’s a ton of breaths and you can live a long, happy life breathing like crap. If you’re an athlete you’re missing out on a golden opportunity if you aren’t working on your breathing.
I’m talking better endurance, better spinal stability and stronger lifts. I’m not selling you snake oil. Learn how to control your diaphragm along with the structures that connect into it and you will be a better athlete.
7. Everyone is deficient in Vitamin D.
Well maybe not everyone, but basically everyone who’s blood work I looked at this year was deficient in Vitamin D. Get your Vitamin D 25-hydroxy tested. Optimal values should be in the 50-80 ng/mL range.
8. Everyone should be taking a probiotic.
Probiotics have been main stream ever since Jamie Lee Curtis became the spokesperson for the probiotic yogurt, Activia. Well, in the past few years more and more research has been done on gut health, gut bacteria and the link between poor gut health and neurologic disease. A probiotic is an easy way to make sure you’re getting healthy gut bacteria. You can also throw in some fermented foods like pickles, greek yogurt with live cultures, kombucha tea and kimchi. Adding a probiotic into my daily diet has had the best health effects on me than anything else I’ve done this year.
Check out the great conversation we had about functional medicine for more info on this.
You’ve got to get high quality sleep. It’s so important for so many body functions. In the worlds of Dr. Kirk Parsley (check out our podcast with him if you haven’t listened yet) “Good sleep is the most anabolic thing you can do for your body.” Get 7.5-8.5 hours ideally. Make sure the room is pitch black and cold.
10. Do something to utilize all that time you put in at the gym.
Play a sport again. It doesn’t have to consume your life like when you were in high school and college. Pick something and start utilizing all that great training you put in at the gym. Go out there and dominate some overweight frat boys and guys with dad bods. You’re a fucking stud, go dominate!
I was challenged earlier this year by one of my patients. She bet me that I couldn’t make it 3 minutes without thinking about something. I took the bet and lost. I made it about 20 seconds into my 3 minutes of mindfulness meditation before I started thinking about my to do list. Add in just 3 minutes of mindfulness meditation everyday. If you don’t have 3 minutes to work on your own mental mindset then you have bigger problems.
12. Do or do not. There is no try.
Yes, I stole this from Yoda. We’ve been re-watching all of the Star Wars movies with my 4 year old son. He told me that I didn’t know the power of the dark side the other day. I think we’ve created a Star Wars maniac.
What this means for you is stop telling other people and yourself that you’re going to do something. Stop putting things off until tomorrow. Tomorrow is a magical place where nothing ever happens! Whatever it is that you’ve been holding off on, do it this year. Run that marathon, do that triathlon, start that business you’ve been thinking about, ask that cute girl at your CrossFit gym out on a date. Stop procrastinating, just do it already.
13. Earn your carbs
This is something I got from my friend and podcast co-host, Joe Szymanek. I love his philosophy of earning your carbs. Carbs are great! In fact, you could argue that it’s the most delicious macronutrient.
Too many carbs, along with poor intake timing and a sedentary lifestyle will turn you into a fat lazy person with type II diabetes. Timing your carb intake around your training session will help you recovery and have more energy. You’ve gotta earn your carbs.
14. A pyramid is only as tall as it’s base.
This is something that Louie Simmons has famously said. What he means by this is you have to build a strong athletic base if you want to build a serious athlete.
If you can’t control your own spine under load, do you think you’ll be squatting 1000 pounds? That’s what people that go to work with Louie Simmons do on a regular basis. They work on their base constantly so they can build a taller pyramid.
You have to prioritize the fundamentals and doing the non-sexy auxiliary work. Think reverse hyper, hollow to arch progressions, single leg deadlifts and good mornings. This stuff is just as important as doing metabolic conditioning.
15. Listen to podcasts
I might be slightly bias because I have a podcast but it’s the truth, podcasts are the best. It’s completely free and you can learn some amazing things by listening to podcasts. I can tell you without a doubt my business and my professional skill set have improved because of listening to podcasts. Try it on your commute to work. Just think, if you’re sitting in your car for an hour a day, 5 days a week and you listen to a podcast 50 weeks out of the year, you’ll listen to 250 hours of content a year. That’s a lot of information! If you don’t know where to start, check out Doc and Jock first.
Thanks for being a part of the Athletes’ Potential family in 2015. Have a great 2016!
Get Our Report 5 Movements To Bulletproof Your Back and start off the new year right!
August 2010, I remember it like it was yesterday. My family and I flew to San Antonio, I was in my dress blues and very excited to have finally graduated from the most difficult academic course I had ever studied. I graduated from the U.S Army Baylor DPT program and was ready to change the world.
I arrived at my first job as the Assistant Chief of the Schofield Barracks PT Clinic (that’s in Hawaii; not a bad military assignment). After a few months of grinding out a fairly high volume patient load, I began looking for opportunities to get out the clinic. One of these opportunities was to help teach new program called the Advanced Tactical Athlete Conditioning program (ATAC, currently run by a stud ATC/CSCS, Neil Santiago). It was great; I taught speed, agility, distance running techniques and some basic bodyweight training. I was also able to positively impact soldiers before they got hurt by improving their conditioning and movement quality.
A few months later I moved to the 2nd Brigade 25th Infantry Division as a Brigade Physical Therapist. I was given 100% say over what I did from a day to day basis. I immediately started setting up my schedule to teach all kinds of strength and conditioning courses. I taught courses on POSE running, basic programming, Olympic lifting, powerlifting, speed, agility, and advanced bodyweight training. I noticed a trend that the more I taught on strength and conditioning the fewer patients I would see for injuries. What an obvious conclusion, right? As the soldiers learned how to train their bodies to move more efficiently they experienced less injuries.
When we saw patients the emphasis focused on movement, retraining, and education on how to maintain an optimal body through mobility techniques. We saw our average visits per patient drop and people started taking ownership of their own rehab process. We didn’t count reps for people. We were teachers and expected our patients to do what we taught if they wanted to get better.
Fast forward 5 years and here I am writing this blog before I go teach squat mechanics at a local CrossFit gym here in Atlanta. I may not wear a uniform everyday or try to fix a bunch of broken soldiers, but I still teach those same core concepts. This really is the future of physical therapy: education. More specifically we have to teach movement education. This is a blend of strength, conditioning and what we learned in physical therapy school (diagnostic skills, primary care, manual therapy, neuro re-education). I’m going to make a bold statement... the hybrid strength coach/physical therapist model is the future of physical therapy.
Recently, a fellow PT colleague commented on a blog I wrote Four Keys to Picking the Right Physical Therapist. In her comment she summarized my post by stating if she doesn’t do CrossFit and deadlift, then she is not a good physical therapist. Although she was being sarcastic, she was offended by my post. I replied that you don’t have to do CrossFit to be a good PT but you have no excuse to not deadlift regularly. Why would anyone who understands even the basics of strength, conditioning and movement tell someone to not deadlift unless they had significant trauma that stopped them from doing so? What are you going to do, ask other people to pick up your grocery bags off the ground for you the rest of your life? Sorry lady, but you need to deadlift. The deadlift isn’t dangerous, being a physically weak person is dangerous.
This mindset must change and it starting. Physical therapists across the country are flocking to the “PhysioCoach” model. If you’re an athlete that is injured, you need to seek out a PhysioCoach Physical Therapists. Their knowledge will not only help you recover from injury but help you reach your athletic goals, whatever they may be.
I’m excited for the future of Physical Therapy and I’m looking forward to help lead the charge!
If you're in the Atlanta area and you want to work with one of these hybrid physical therapists let us know. Leave us you're information and we're contact you for a free 10 minute phone consultation to see if you're a good fit for what we do.
“Give a man a fish and he eats for a day, teach a man to fish and he eats for a lifetime.” -Unknown or was it Jin?
I recently had a patient that drove in from Orlando to work with me for two hours. He’s had lower back pain for about 5 years and it started while he was in the Army as a medic. He didn’t sustain any type of combat trauma that caused the back pain. It literally started while he was doing a workout one morning. The workout involved kettlebell swings and he felt a pop in his back toward the end of the workout.
Fast forward 5 years later, and he still has back pain. He’s tried physical therapy, chiropractic, acupuncture and even took up yoga in the quest to fix his back pain. None of these things worked so he made the 7 hour drive to Atlanta to see me (ironically driving was one of the activities that aggravated his back).
He showed up with a pretty classic presentation for back pain. Poor hip mobility, underactive posterior chain and really bad posture. We completed our evaluation and decided on a plan. First, we’d do some dry needling to the lower back and hips. This is a great technique for pain reduction. This allows us to work on things that would otherwise be painful to help regain strength and mobility.
Following a short bout of dry needling, we spent the rest of the time putting together a plan of what this individual needed to do everyday in order to fix his back pain permanently. We literally spent over an hour piecing together 5 exercises that I wanted him to do religiously.
So how did he do? Well I just got an email from him about a week ago that said he was able to sleep through the night and is virtually pain-free consistently for the first time in 5 years. We get a chance to help individuals like this all the time and in many cases help them get out of chronic pain permanently. So why did this guy have to drive from Orlando to Atlanta to see another physical therapist? The answer is that no one was teaching him, they were all just trying to fix him.
There are 168 hours in a week. Even if you went to see a physical therapist 3 times per week (the standard physical therapy prescription in many cases) that’s still 165 hours of the week that you are on your own. What are you doing in those 165 hours? Are you prioritizing sleep correctly to help with healing? Are you eating the right things and staying hydrated? Are you doing corrective exercises and mobility work? Are you getting out of bad positions as much as possible during the work day? Are you rounding your back every time you pick anything up off the ground?
Resolving long lasting and chronic problems comes down to compliance from you! It’s my job to teach you what you need to know and persuade you well enough to actually do it. If you’re dealing with a chronic issue and are sick of being in pain or avoiding certain activities, it doesn’t have to be that way. We see patients from all over the southeast just like you and they get better. They run 10k races again (the Peachtree race if you’re in Atlanta), they play with their kids without throwing their back out, they compete in local CrossFit competitions and they wake up in the morning without feeling like they have been hit by a truck.
At Athletes’ Potential we may be physical therapists but more than anything we are teachers. You have to learn how to take care of yourself. You have to be empowered with the right information to make huge long lasting changes.
If you’re in Atlanta or the southeast, for that matter we’d love to help you. Give us a call at 470-355-2106 or fill out the contact request below and we’ll talk on the phone to see if you are a good fit for what we do.
Dr. Danny and Dr. Jackie's views on performance improvement, injury prevention and sometimes other random thoughts.