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.

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Cheers,

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.
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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

Ask questions​

Many postpartum women do not know all of the details after birthing their baby.  Some have told me they were not aware they had stitches down below until the 6-week check-up when the doctor wanted to make sure they were healing well!  The check-up at 6 weeks can be quick so arrive with questions. It is helpful to know about any tearing, episiotomies, tools used during the birth, etc.  These factors are all great to bear in mind as you return to exercise and daily functioning.

Another question to ask-- “Is there a pelvic health PT that you would recommend?”  They may know someone in the area or have worked with them prior.  However, do not become discouraged if they don’t have a name to offer.  A Google search for “women’s health PT” or “pelvic PT” should show professionals in the area.  Compare websites and reviews to see if the PT would be a good fit for you and your goals!​


​Pelvic Health Physical Therapy

Once you have been cleared by the doctor for “usual exercise” and intercourse, I highly suggest visiting a pelvic health or women’s health PT.  They will be able to further answer any questions about symptoms you may experience immediately postpartum and later.

A pelvic PT is specialized on evaluation and treatment of the pelvic floor musculature.  They can perform internal evaluations to test the strength and endurance of your pelvic floor, check for prolapse, address any soft tissue issues, etc.

For the evaluation, the therapist will use a gloved finger to palpate muscles internally. While a great deal of information can be gathered from an internal evaluation, it is not necessary for visiting a pelvic PT.   The therapist can then prescribe exercises to help relieve the symptoms and provide hands-on work to hips, back, sacrum and other involved areas. Your PT should be a huge help in getting you back to fitness postpartum!  Other areas they can treat and improve are bowel/bladder issues, painful sex, and pelvic pain.


Focus on healing and strength rather than weight loss

Social media and advertising may be all about “getting your body back” and fixing “mummy tummy,” but that is not the focus when you are postpartum.  The first step in returning to fitness is addressing foundational strength and continuing to heal from the pregnancy and birth.  Your body will go through so many changes in the months following your pregnancy and the timeline is different for every single woman.

Steer clear of programs that say at week 8 you do blank. It should all be self-paced and based on symptoms, your birth story, and prior activity level.  Do you need help starting out?  This was the number one question I received from women in the clinic.  “What can I do?  Where do I start?” So I developed programming to recover and rebuild your core after having a baby. Check out the THRIVE: Rebuild Bundle programming HERE.

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​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

​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, PT, DPT, CSCS

But, what if you’re an Olympic weightlifter who has a competition coming up? What if you’re a runner who loves a good 5k? What if you have a stressful job and CrossFit is your outlet to relieve that stress?

Come on, healthcare - we can do better.

If these are your goals, we want to help you get there.

Here’s 5 different ways to train around pain and decrease stress on that painful area:

1. Weight
2. Range
3. Tempo
4. Variation
5. Different Exercise

MAIN GOAL: MAKE THE LEAST CHANGES POSSIBLE TO THE MOVEMENT

Now, let’s break down each one of these using knee pain with front squats as an example.

1. Weight

• This could be as simple as decreasing the weight.
• Example: Your knee pain starts when you hit 185 in your front squat, but not at 155. Dial it back, work at 155 and build back up over time.

 

1. Range
   • Change or decrease the range of motion. We use partial range of motion all the time in rehab as way to regress a movement.
   • Example: Your knee pain occurs at the bottom position of your front squat. Limit your depth to ¾ of the range, squat to a box or med ball.

1. Tempo

• This is an incredibly underutilized variable in training. You can’t load much weight, but can still do the movement. Tempos allow you to create time under tension and strength through different ranges of the movement - whether that’s lowering, pausing, and/or raising during the movement. We call these the eccentric, isometric, and concentric phases of a muscle contraction, respectively.
• Example: Knee pain only occurs at 90 degrees. You can try utilizing isometric holds in that position for 30-45 seconds or doing a 3-2-3 count where you do a 3 second eccentric, 2 second isometric hold, and 3 second concentric movement. The options here are endless.

 

1. Variation
   • Use a different variation of the movement – you’re still training the same movement pattern (squat), but changing up where the load and stress is placed.
   • Example: Front squats bring on your knee pain, then try a back squat, box squat, goblet squat, zercher squat, or a spanish squat.

1. Different Exercise
   • Try a completely different exercise to help get the same training stimulus for that muscle.
   • Example: Instead of a squat variation to train your quadriceps (front thigh muscle), you do seated knee extensions, lunges or step ups.

Here are a few other examples for you: 

• Back pain with conventional deadlift:
  • Weight: decrease
  • Range: elevate on blocks
  • Tempo: pause
  • Variation: sumo
  • Different Exercise: glute bridges

• Foot pain with running:
  • Weight: decrease speed/intensity
  • Range: decrease running distance
  • Tempo: walk/run, interval
  • Variation: sprints, uphill running, downhill running
  • Different Exercise: cycling

• Shoulder pain with bench press:
  • Weight: decrease
  • Range: floor press
  • Tempo: 3 second eccentric
  • Variation: single arm dumbbell press
  • Different Exercise: Pushup

Here’s the overall concept:

Pain comes on --> scale back movement slightly --> train movement --> adapt --> progress difficulty --> adapt --> back to prior level --> continue training pain-free --> hit PR

I believe that any great coach or physical therapist should be able to modify and progress/regress any movement or activity.​

If you have given these methods a shot and pain continues to impact your life, then find a healthcare professional who understands your goals and doesn’t tell you to stop.

Cheers,

Dr. Ravi, PT, DPT, CSCS

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• Bend: Once you bowed forward and feel tension in your posterior chain, the next step to a proper deadlift is to bend your knees to where you can grip the bar. THE MOST IMPORTANT part of this step is that while you bend down to the bar, you maintain the tension you created previously in your posterior chain. By doing this you’ll not only keep the appropriate muscle groups activated to perform this perform this movement, but you’ll also be much more likely to have your hips in at an optimal height (not low like a squat) which will allow you to keep you shins in a vertical position. This is crucially important and is something we’ll get into more in part II of this series. ​

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• Blades: Once you’ve gripped the bar, the last phase to getting into a good set up position is to “throw your shoulder blades into your back pocket.” By doing this movement you activate your latissimus dorsi which is important for a couple of reasons:
  1. Your lats play a direct role in creating lumbar stabilization due to their connection with the low back via something called the thoracolumbar fascia
  2. By creating tension at your lats you’ll be able to keep the bar much closer to your body while standing up with the weight, protecting you lumbar spine and boosting your performance. ​

2. Get Appropriate Sleep: I cannot overstate how important it is to get appropriate sleep. You should be getting approximately 7-9 hours of sleep per night, and during the open you need to towards the higher end of that range. To find out more information on how to optimize your sleep, check out our previous blog article "Top Two Ways To Improve Your Sleep." 

3. Eat the Right Food: As the saying goes, “food is fuel for your body” and you want to be giving yourself some jet fuel to optimize your CrossFit Open performance. What this means is you need to be eating the right foods in the right proportions to restore your body’s energy levels and to give it the needed energy it needs to repair and recover. You can find more info on how to do that by checking out out previous blog, "Which Diet is Right For Me." 
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4. Staying Hydrated: You should be drinking water constantly to maintain good muscle and vascular health. The general recommendations say to drink 8 eight ounce glasses of water a day. However there are plenty more variables that go into determining the appropriate amount of water for you to drink. Click here to go to a calculator that will give you a better idea of how much water you need to stay appropriately hydrated throughout the Open.

​So, if you want to get your best possible score in this year’s Open AND decrease your risk of injury then you need to make recovery a priority. A lot of things factor into recovery periods that are outside of your control (age, genetics, training experience, etc.), but by doing what we covered in this article you will be setting yourself up for success by recovering like a pro and getting the most out of your workouts.


Thanks for reading,

Dr. Jake, PT, DPT

​In order to fully bulletproof our backs and prevent back pain from occurring, not only must we be able to move through these three planes of movement, but we must be able to strongly control our spine throughout each motion and this is where CrossFit falls short.

The world of CrossFit lives in the sagittal plane. Squats, deadlifts, snatches, burpees, kettlebell swings, muscle-ups, toes-to-bar, double-unders, Fran, Murph, Gracie, and Annie. What do all of these have in common? In all these movements and exercises your back is predominantly bending forwards and backwards, meaning in all these movements your back is moving in the sagittal plane only. There are very few movements in CrossFit that require you to challenge your back rotationally or laterally and as you’ll see below, that’s a problem.

Holding your child at your side, swinging a bat/club/racket, getting in and out of your car, serving a volleyball, opening a door, and kicking a ball. What do all of these activities have in common? These are all movements commonly found in sports and in daily routines and they all challenge your back rotationally and laterally. Not only are these multiplanar movements incredibly common, but because CrossFit doesn’t address frontal or transverse plane movements, if you aren’t doing any type of accessory training, you’re going to be weak in two-thirds of the required movement patterns, and you’re going to be at a greater chance of developing back pain.

So does this mean that Crossfit is terrible and you should stop doing all those squats, deadlifts, and other aforementioned CrossFit workouts? Absolutely not. Sagittal plane movement is crucial to our everyday lives (i.e., bending over to pick something off the floor, getting up from a chair, etc.), it just isn’t the complete picture. You’re leaving your back vulnerable to injury if you aren’t working on getting strong in the other two planes of movement. ​

The solution to this problem is simple though, you just have to take the time make sure you’re putting in the work. To get an idea of how to start training in the frontal and transverse planes, try adding in some of our favorite transverse and frontal plane strengthening exercises either before or after your next WOD. Perform 3-4 sets of each exercise to form fatigue.

Chop and Lift (multiplanar) 

At Athletes’ Potential not only do we help CrossFit athletes with low back pain all the time, but we are CrossFit athletes ourselves. We take immense pride in thoroughly understanding your sport, what it’s strengths are, and where there may be some deficits. If you’re a CrossFit athlete living in Atlanta, and you’re struggling with back pain, we’d love to help you. Give us a call at 470-355-2106 or fill out the contact request form and we’ll contact you.

Thanks for reading,​

-Dr. Jake, PT, DPT, CSCS

Often times, patients that have trouble or pain with squatting can chalk it up to mobility issues.  Ankles and hips seem to be the major culprits.  But what if mobility isn’t YOUR problem?  Even if you have an ATG (deep) squat you may still experience:

Back and/or hip pain

Hamstrings and glutes not getting stronger

Increased soreness in the inner thigh (adductors)

Plateau of performance in squat based activities

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Does this sound like you?  Keep reading.

Motor control is the process of using the neurological system to coordinate your muscles and limbs as you perform a skill.  Without motor control, we will have trouble controlling our body in space.  This can lead to undesirable positions while we are under a weighted barbell.
Unfortunately, many of us do not have ideal motor control—particularly as we add fatigue to the system. Fatigue can come in the form of heavier weight or multiple reps. How do we judge motor control from the outside?  Technique.  Form.
 
So we know you have an ATG back squat with the chest upright and feet flat.  If you add weight and that changes, you need to practice motor control. This is rewiring the system so that as we move our extremities or add weight to lifts, the form looks the same as squat without weight.  

Many times this has to do with the initiation of the squat.  It should always start with a hip hinge.  Now, some athletes who think they are hinging are simply over-extending their back.  This means they send their hips “back” by poking the pelvis back and allowing the ribs to flare up.  Rather, the space between your ribs and hip bones shouldn’t change as you hinge your hips back.
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The same pop of the pelvis back can be a problem as you get close to the bottom of the squat or start to drive back to extension. 

A great drill to test out your squat is using a PVC for 3 points on contact.  Holding the PVC against your back, you should have contact with the back of your head, midback and pelvis.  Keeping this alignment, hinge your hips back then drop into a squat.

Holding the weight in front will help you engage your deep core and stabilize your ribs and pelvis to keep the torso in the ideal position. Moving at a slow tempo is more challenging to the neurological system and will help engrain that movement pattern.  The same rules from the PVC pipe drill still apply!  ​

If you look like the woman squatting above, this is your starter plan for improving motor control and strength.  Take the time to assess your alignment and control through the movement.  Cleaning this up will decrease pain and improve your performance drastically. 

At Athletes’ Potential, we work with athletes like you every day-- those who just want to move better and those that are in pain.  If you are finally ready to feel better and improve at the gym, give us a call.  We would love to help!

Thanks for reading,

    Dr. Jackie, PT, DPT, OCS, CSCS​

Well, maybe those aren’t his exact words but since I’m actively giving up using profanity (which is very hard to do) we’ll keep this quote the way it is. We know that Jay-Z doesn’t have wrist pain but in the last CrossFit Movement and Mobility Trainer Course I taught, about half of the class had wrist issues. Usually when I informally poll the class to see what problems most people are having, back pain comes up number one. This weekend wasn’t any different until the Sunday course. Wrist issues were a plague for this group, predominately in the front rack position. So we spent a ton of time working on the wrists right? Wrong. We fixed their shoulders!

How many of you have seen big strong guys/gals that can back squat a ton of weight but when you get them to front squat their weight drastically decreases? These are typically males that used to love bro'ing out at some globe gym where everyday is bench press day. They are pretty strong but have never put in some legitimate mobility work in their lives.

                                                                   Don't be this freaking guy!

Let’s be clear on one thing: There are many reasons for why someone could have a very weak front squat compared to their back squat. In this example, however, we are going to focus on improving the front rack position and unloading the wrist. The higher you can keep your elbows during the entire range of motion of a front squat, the easier that movement will be. High elbows also allow for the wrist to be unloaded during the lift. 

How do we get those nice high elbows? By having enough shoulder flexion and lateral rotation. In coaching terms this allows us to keep our arms parallel with the ground and maintain a strong front rack position. There are multiple problems that occur when the elbows start to drop in the front rack. It’s a huge loss of force production potential but also puts the poor wrists in a terrible position. 

         A combination of these two movements at the shoulder makes up the front rack position.

​Here’s a quick test. Un-rack a decent amount of weight (75-90% of your 1RM front squat) and hold it in your front rack position like the example in the top section of the picture below. See how your wrists feel and see if you can hold it for 30-45 seconds. Now do the same test but hold the weight in the position like the athlete in the bottom of the picture below.  No wrist wraps allowed!

Which one were you able to hold longer? Which one felt more comfortable?

For the majority of athletes the first position will feel dramatically easier when holding the load. If you have terrible front rack mobility you will always end up in some variation of the dreaded lowered elbow position. This is wrecking havoc on your wrists and costing you PRs. If your wrists hurt, fix your shoulders!

Now how do we fix the shoulders? Here is an old school (2011) MWOD video of Kelly going over fixing the front rack position. If you haven’t checked out Mwod recently, you really need to. MWOD Pro is only $8 a month and has new mobility techniques to help improve your performance and resolve pain everyday. That’s about the cost of two lattes! In the words of Kelly himself, “make a better decision.”