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In the words of Jay-Z, “I’ve got 99 problems but wrist pain ain’t one.”  Nice front rack Mr. Farris! 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!  Thanks to www.twinfreakscrossfit.com for the photo. 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”. Take a crack at fixing this stuff yourself first! If you're still having issues come and see us at Athletes' Potential! If you don't live in the Atlanta area, check out this out the 4 Keys To Picking The Right Physical Therapist in your area. - Danny
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 Often times, external rotation is the focus in athletic movements. When the shoulder is externally rotated, it can be packed into the back of the capsule to improve stability and congruence. It also rotates the humerus in a way that the anterior structures of the shoulder have room to move without being pinned between bones. Many of the stretches people gravitate towards for the hip involve external rotation: sitting figure 4 stretch, pigeon, etc. What is internal rotation and why do I need it? Internal rotation is one of the movements of a ball and socket joint, such as the shoulder and hip. In the shoulder, it allows you to reach behind your back and pull your wallet from your back pocket or tie your bikini behind your back. More importantly for athletes, it allows you to keep the bar close to the body during Olympic movements and arrive at the bottom of a ring dip safely. Hip internal rotation is needed for athletes for proper biomechanics during any form of a squat or while running. Without full internal rotation, you will likely have a “butt wink” or your low back will slightly round at the bottom of the squat. It is also important for runners to have full internal rotation, coupled with extension, to allow correct biomechanics in the trail leg.   During internal rotation, the ball of the joint (humeral head and femoral head) will glide posteriorly and roll anteriorly. This movement can be restricted with a tight posterior capsule or muscles around the joint. Unfortunately, many people will have issues here due to increasingly sedentary lifestyles and desk jobs. As you sit all day, the hip rarely reaches full extension, allowing the posterior capsule to become tight. This in turn decreases the posterior glide and thus decreased internal rotation. The same deal happens at the shoulder when you sit all day at the computer with terrible posture. Interestingly, hip internal rotation deficits have been correlated with low back and sacroiliac pain. It is better to start improving internal rotation now rather than trying to manage back pain! How to check internal rotation It is easiest to accurately check internal rotation of the shoulder with a buddy. Lay on your back, arm straight out to the side and elbow bent (as in the picture below). Your buddy should provide solid but comfortable pressure to the front of your shoulder to avoid it from raising off of the ground. Now move your palm down towards the ground. Ideally, you would be able to get at least a fists-width from the floor! Be sure to check both sides because noting an asymmetry is important. Also, be sure to do this same test after practicing the mobilizations below!  To check hip IR, lay on your stomach and allow your feet to drop out to the side. Again, we are looking for asymmetries and major deficits. Ideally, your leg will move about 40 degrees or roughly halfway down toward the floor.  Mobilizations to Improve Internal Rotation Below are a few mobilizations for the shoulder and hip to improve internal rotation. They are by no means an exhaustive list but merely a starting point. Bully stretch- used to mobilize the humerus into the back of the shoulder capsule, which increases internal rotation. Pec smash- nearly everyone has a tight pec minor due to the poor postures we often keep throughout the day. This muscle is located in the front of the shoulder, so if it’s tight it can easily restrict the posterior glide! Internal Rotation Stretch- start with your foot flat on the ground and the other leg crossed over. Slowly walk your foot out to the side until you feel a strong but comfortable stretch in the hip. You should feel this in the bottom leg.  Lateral Hip Opener- this does not have to be banded if you do not have access to one, you will still feel a stretch! I hope this gives you a better understanding of what internal rotation means, how we achieve it and why it is needed. More importantly, I hope these videos give you a good idea of how to begin to manage internal rotation deficits! At Athletes’ Potential we want to help every athlete remain healthy and meet goals. You don’t have to be in pain to come see us. If you find asymmetries with tests such as these or know you have movement deficits, we can help you with proper movement and self-maintenance. We also have recovery options to further augment your fitness and health. We look forward to hearing from you! Thanks for reading, Dr. Jackie If you're in Atlanta and you have questions about our Physical Therapy or if you're frustrated with your current situation, contact us and let us help you! Photos:
http://rebellion.nerdfitness.com/index.php?/topic/79212-flex-follows-the-way-of-the-iron-dragonslayer-part-1/&page=6 http://www.catalystathletics.com/article/1848/A-Different-Thought-About-Snatch-Technique-Keeping-the-Bar-C/ https://it.fotolia.com/tag/sprinter http://www.spineandsportspt.org/exercises/shld_ir_stretch_sup.php  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,
-Dr. Jackie
 Midline stabilization is heralded as the foundation of safe and successful weightlifting. But have we been ignoring a part of the “core”? The pelvic floor is a topic that tends to be avoided. Most people do not casually discuss urinary frequency over coffee or admit to their coach that they pee every time they perform double-unders. Men- if you think this one is just for the women, stick around! I only realized the prevalence of leakage after CrossFit HQ posted a video following regionals. All of these women were saying “It’s ok, I pee during workouts too. It’s normal!” Please do not confuse normal and common. Urinary incontinence may be common in certain populations, especially of heavy lifters, but it is absolutely not normal.  The pelvic floor includes a group of muscles that attach from your coccyx (tail bone) and sacrum to your pelvic ring.  These muscles are important for bowel and bladder function, organ support, and stability of the pelvis. Although pelvic floor dysfunction (PFD) was thought to be largely a problem of women, it is becoming apparent that men have similar issues. The pelvic floor may seem very foreign and uncomfortable to discuss, but when it properly functions it can improve your workouts. Here’s how: I like Mary Massery’s description of the core as a “soda-pop can”. The front of the can is the abs, the back is the multifidi, the pop top is the glottis and the bottom of the can is the pelvic floor. The core pressure is maintained by a functioning glottis and pelvic floor, with the diaphragm acting as a pressure regulator.    When you take a breath in, the diaphragm descends. This requires the pelvic floor muscles to descend and lengthen. When you exhale the diaphragm rises and the pelvic floor rises and tightens. In fit individuals, (notice I said individuals and not just women), a common pelvic floor problem is overactive muscles. Very strong back or abdominal muscles can cause increased inward pressure. It’s been shown that when your deep abdominals contract, so does your pelvic floor. Imagine squeezing the can from both sides with the pressure maintained. The bottom and top will have to withstand more pressure and bulge. If your abdominals are always squeezing in then your pelvic floor is always pushing up to withstand the pressure. It’s overworked! The diaphragm is pretty darn good at its job. If it does not work, we have a bigger issue on our hands. So often, when something’s ‘gotta give’- it’s the pelvic floor. When all of these muscles work in concert, your canister and the force it can produce is maximized. Thus, your workout improves. A conversation about breathing techniques regarding the glottis and diaphragm is essential to training the entire core. Here I am simply touching on one contribution but remember it does not work alone. Keep in mind, PFD can also manifest in ways such as pelvic pain, painful intercourse, low back pain, urinary frequency or even the dreaded butt wink. It is not just urinary incontinence. “ Pelvic floor pain is only caused by pregnancy, right?” Wrong. There has been no correlation shown between PFD and post-partum women. Sure, some moms experience issues but again, it is not normal for any population. Weakness and/or tightness of the pelvic floor can be caused by poor postural habits, extended periods of sitting, over training of the abdominals and pregnancy. Excluding pregnancy of course, men are susceptible to all of the other risk factors. “Ok, so I pee on myself at the gym and it’s not normal. What do I do to stop it?”
-Jackie References: Sapsford, Ruth R, Hodges, Paul W. Contraction of the Pelvic Floor Muscles during Abdominal Maneuvers. Physical Medicine and Rehabilitation, 2001, Vol.82(8), pp.1081-1088. Healthyplace.com Presentation at CSM 2016 by Mary Massery: referencing Massery 2005 & 2006. So you’ve been killing it at the gym over the past month. Your body is starting to adapt and your conditioning is improving. You can do twice the amount of rounds of Cindy that you could do when you first started CrossFit. All in all, you’re the man now! Until, one day you try and do some ring dips. Next thing you know, you wake up the next morning and the front of your shoulder hurts. This is the first minor set back you’ve had since starting CrossFit so you ignore it and continue to do the gym programmed workout for the next week. Your shoulder pain starts to get worse. You finally say something to your coach and they recommend some mobility techniques they saw Kelly Starrett talk about on Youtube. Another week goes by and the shoulder pain continues to get worse. You’re frustrated and finally your coach recommends that you come to see someone like me and get it checked out. By this point you’ve been inflaming your bicep tendon for a couple weeks. In all likeliness, there’s nothing wrong with your bicep tendon and it’s simply getting caught in the crossfire (now the video at the top of this blog should make sense) of scapular stability weakness and tightness in the front of your shoulder.  You’re not the only one. In fact, recently injury rates in CrossFit were studied (see reference below). The results showed that the most common injury was the shoulder; approximately 25% of all reported injuries were related to the shoulder. In my own practice I have found this to be the case as well, if not even a higher percentage. Just this week I have seen 8 new patients and 5 of them came to me for shoulder pain. Keeping shoulders healthy while training in CrossFit can be challenging for a couple reasons:
So what’s the solution? The best answer would be to get yourself checked out before starting some significant training to see if you have any obvious deficiencies. That’s like telling people to go to the dentist so they don’t get a cavity. I understand that many people don’t see the value in prevention so I won’t try and persuade you on that. The next best option is to try and go after the low hanging fruit first. In my practice I’ve found that common deficiencies can be cleaned up with as few as 5 exercises. Below are videos of exercises you can do on your own to resolve and/or stop an injury from happening. Make these part of your gym routine and your shoulders will thank you. What’s the best way to fix a shoulder injury? Not getting a shoulder injury to begin with!  If you’re in the Atlanta area and have been dealing with a CrossFit related shoulder injury for a while give us a call. We can help you get back to what you love to do faster than any medical group in the area. Don’t take our word for it, check out what everyone else has to say in their testimonials. 
“Look up when you squat, Matta!” Coach Pettis, high school football coach
Most people who played sports in high school or college have received some coaching on some basic strength movements like the bench press, squat, deadlift and power clean. In fact, thanks to programs like the Bigger Faster Stronger program, high school athletes have been doing these big compound movements for years. I remember going through this exact program when I moved to Columbus, GA as a junior in high school with our football team. The quote above is something I remember well from all of my strength coaches, but in particular one of my coaches in Columbus. He was the one that implemented using the Bigger Faster Stronger program and he would constantly yell at us to look up when we were deadlifting, power cleaning or squatting. We all got bigger, we all got faster and yes, we all got stronger. Were these changes all beneficial? Looking back it’s hard to say but I would have to say no they were not. In my opinion, we just were adding strength to dysfunction. So what’s my problem with this cue of looking up when pulling and squatting? I think it’s a cue gone wrong in many ways. I see the rationale behind not wanting the spine to be in flexion when pulling and squatting. You want the spine to be in neutral during these movements. Cueing people to look up is designed to get people out of a flexed position. More commonly, you’ll hear the coupling of two cues, 1) look up and 2) butt back. The problem is many athletes will drive excessively into extension and this can be an even bigger problem. When we drive our spine into end range extension it’s very stable. The reason it’s very stable is because the facet joints in the spine are getting pressed into each other and it’s literally a bone block that stops any more movement from occurring. As stable as this might be it’s very irritating to the spine and can even cause local spinal fractures called spondylolisthesis. These are most common in young female gymnasts and young male wrestlers. One sport has a ton of arch positions in it and typically landing in arched positions and the other teaches wrestlers to bridge/arch to stop someone from pinning you. Both of these put the spine into end range extension with load. 
Am I saying you are going to get a local spinal fracture from squatting while looking up and arching your back? No! But you sure as hell will aggravate your back by doing this. In fact, I would say 90% of the lower back injuries that I see in my practice are directly related to extension based back injuries.
We have to fix this problem through control. The control must come from engagement and strength of the anterior torso, inparticular the internal obliques (IO) and transverse abdominus (TA). These are deep anterior stabilizers of the spine and when we put ourself into an over-extended spinal position they are essentially weakened. Strength and control in this area in particular is the best way to gain lasting control of the anterior spine.
Now let’s fix it. Below are a few videos that directly work on correcting this area and getting you out of an overextended position. Add these in daily at home to reclaim some lost control and when you do squat, actively try and mimic the same muscle contraction that you get with these corrective drills as you do when you squat.
-Danny  CrossFit is polarizing. It seems like these days you either love it and it’s all you want to talk about or you hate it and you wish you could slap your friend that can’t shut up about how much he loves CrossFit. Initially, my experience with CrossFit was something that didn’t involve lululemon shorts, chalk everywhere and some specialized pack of vitamins to help me WOD harder. I was introduced to it by two Rangers at the Center for the Intrepid in San Antonio, Texas. The two guys were both CrossFit coaches that had been in blast injuries and both had lost a leg. They were both below the knee amputees and were very high level. I saw these guys doing muscle-ups as part of their WOD one morning and spoke with them after. They told me they were doing CrossFit and invited me to train with them the next morning. So the next morning, that's exactly what I did. I got through the training session and at the end eventually had to puke into a trash can. As I wiped the puke off my face, they both laughed because they had been there before and I realized I had found something pretty awesome! Back when I first started CrossFit, it was more underground and less mainstream than it is today. CrossFit has grown and evolved with it’s success over the years, as it has to (and should) do. I think you need to give credit where credit is due, however, and CrossFit at least deserves credit in these 3 areas: 1. Adults started doing Gymnastics As a parent I feel some type of movement base needs to be developed in our kids (read more here). You could use a martial art, dance or something like gymnastics. The fact that grown adults are trying to learn hands stands, hollow holds and kipping movements is phenomenal. If we can all agree that gymnastics is a great movement base for our kids, why aren’t we working on it ourselves? We absolutely should work on gymnastics skills and CrossFit made that one of the central foundations of it’s training. 2. It Saved American Weightlifting When people say the word weightlifting most people think bodybuilding. Shit, 5 years ago I was one of those people. I couldn’t have told you the difference between lifting weights and weightlifting. Through CrossFit, I’ve been exposed to a sport that involves arguably, the hardest movement in sports, the snatch. When the last summer olympics were on I looked specifically to see when weightlifting was going to be shown. The summer olympics before that all I would have cared about was swimming and track and field (because we dominate those sports! #merica). I only wish I could have gone back and started weightlifting when I was much younger. So, is it fair to say that CrossFit saved American weightlifting? Yes it is and if you don’t believe me here’s a podcast I did with Glenn Pendlay and one with Don McCauley. They both give all the credit in the world to the fact that CrossFit has made weightlifting matter again. The last bit of proof, if you even need anymore, would be the the young weightlifting phenom CJ Cummings hitting a 175kg clean and jerk (video below) at the US Nationals this month. It’s an unofficial youth world record for his weight class. Where did he get his start into the sport? At a CrossFit gym! 3. Brought Back Real Training Last week my wife and I went to see the movie Jurassic World. As we stood in line at the movie theatre in Atlanta, we had to stand next to a gym with a ton of huge glass windows. This gave us a significant amount of entertainment and helped pass the time in a relatively long line. Why was it entertaining? It was entertaining because I look back at how I used to train and I see it’s the same as what these people were doing at the gym by the theatre. Too often people go to a nice air conditioned facility, grab a towel for the off chance that they actually sweat and head straight for the elliptical. They plug their headphones in and watch Paula Dean describe why you need 4 kinds of cheese in your macaroni and cheese to really make it correctly. Thirty minutes later after having maintained their fat burning zone it’s time for some leg extensions, bicep curls and possibly some dumbell bench press if there’s time. Grab your post workout smoothie on the way out and in your mind you’re the fucking man! Training should be hard. Training should encompass large compound movements. It should get your heart rate elevated; who cares what your so called fat burning zone might be. Training should allow you to go hiking, swim with your kids, do yard work for 2 hours and run away from a dog that would love nothing more than bite your leg off. Maybe there were other people that were training in this fashion before or during the time CrossFit came around. What CrossFit did was make it mainstream. I’m glad they did and so are thousands if not millions of other people around the globe. I know this is a polarizing topic. If you have an opinion leave a comment. Thanks for reading. -Danny 
“The fear of pain is worse than pain itself” Arntz and Peters, 1995.
Back in the day when I was still active duty in the Army, I had to attend what was called a Joint Operational Deployment Course. It’s a week-long course where myself and other active duty medical providers learned how to take care of trauma related issues predominantly. It was great training and I learned a ton. I also learned I’m terrible at giving an IV. One of my colleagues was unlucky enough to have me as a partner as we learned to hook up an IV bag. To make matters worse he was deathly afraid of needles and blood. In fact I’ve been around him when he had to sit down for a few minutes after getting a routine shot otherwise he would have passed out. The process for hooking up an IV bag is pretty straight forward. Step 1: put on tourniquet. Step 2: insert needle. Step 3: attach IV clamp/bag to needle port. Step 4: take tourniquet off and open IV. Much to my friend’s dismay, I mixed up the steps and accidentally took the tourniquet off before attaching the IV bag. My partner was intentionally looking away the entire time because if he saw the needle he would pass out. As the blood started running out of his arm through the IV port I had just placed in his vein I said the worst thing I could have at the time, “Oh Shit!!”. He immediately looked at me and then at his arm which was now next to a rather large pool of blood on the table. He immediately passed out as I fumbled to attach the IV bag and stop the bleeding. He’s still very much alive and still very much afraid of needles. I reminisced with him about this event a few weeks ago when he and his family visited my family in Atlanta. Yes, I’m not the best person to call if you need and IV put in but the real question is why is this person so afraid of needles/blood and I can watch blood be drawn or even stick needles in myself without a similar response? The answer is directly related to the opening quote: The fear of pain is worse than pain itself. Maybe this person had a memorable traumatic experience with a shot when he was a kid. Maybe his mom or dad were really afraid of giving blood/needles. Maybe he had a sibling that told him how terrible it would be to get a shot just to mess with him. Either way it eventually leads to a pain experience. After a pain experience, we start catastrophizing the event, in this case shots or needles. That leads to more pain related fear and eventually avoidance of the painful event again. All of this leads to more and more perception of pain with the activity. So why am I putting this on a blog that typically talks about performance improvement and injury treatment? Because, for people that have had pain for more than a few months they have to stay away from falling into this vicious cycle. I had a patient recently that came in to see me for pain in the front of his knee. He had no explained onset except that he had tried to take up running and had to stop because his knee hurt whenever he would run. It also hurt to go up/down stairs if he led with the injured leg. He resorted to only going up stairs with his non-injured side one step at a time. This is an incredibly slow way of going up/down stairs and I’m sure he aggravated countless people that were behind him in stairwells. What’s the first thing we did? Talked about how his leg was healthy and had him start going up stairs with what he perceived to be his injured leg. We also had him start box squatting the first week. When I told him we were going to squat his face looked like I had just told him we were going to fight a grizzly bear. We had to expose him to those activities he was avoiding and afraid of. Sure he gained some strength back and that is obviously a contributing factor to him getting better. However, the biggest factor was the realization that his leg wasn’t broken, it was functional and he needed to start using it correctly again. With chronic injuries we can become very sensitized and aware of any little thing that happens in a painful area. Sometimes the best treatments are the ones that prove to our own mind that we are still functional! -Danny  June 2014 July 2015 Testosterone- 802 Testosterone- 421 HbA1c- 5.3 HbA1c- 5.7 HS CRP- 0.9 HS CRP- 2.6 Let’s face it: we live in the information age. You can find out pretty much anything by searching for it on the internet. There has also been a massive shift toward data driven decisions. I see it first hand in my business when I look at our website analytics. We even see it with things like Wodify as athletes start tracking all their workouts, strength numbers, training sessions and making training changes based off actionable data. Think of this blood panel like a snapshot of what’s happening internally. As part of the initial testing phase to work out the kinks, my wife and I both went through the process to get blood drawn and see how long it would take to get our results back. When I got my results back, I was shocked! Last June, as part of my transition out of Army, I requested some blood panel work from my Physician Assistant. I wanted to start doing a more in-depth panel of blood tests yearly just to see where I stood and to gauge my nutrition/training based off that. For me, I used that as my initial data to compare this lastest to. Here are the tests that were grossly different:  A good number more tests were performed besides these three but these were the ones that had the most noticeable changes. What does this even mean? In the past year my testosterone production had decreased by 50%. Testosterone is very important for recovery, building muscle, maintaining a lean body and many more very important tasks. According to a 1996 study by Vermeluen et. al, the average testosterone levels for someone my age (30 years old) is 617. To make matters worse, in the same study he found that the average testosterone levels of males age 75-84 was 471. Talk about kicking me while I was down! This basically shows me that there’s a decent chance my 90 year old grandfather and I have the same testosterone production at this time. Next is the change in HbA1c. This is a marker of average blood sugar levels over the past 3 months. Most of you have probably heard of diabetes. It’s basically a disorder of high blood sugar levels in the body. It can either be genetic type I or developed type II. The range for HbA1c is pretty clear. Anything below 5.7 is normal, between 5.7 and 6.4 is prediabetic and over 6.4 is full blown diabetes. My number is elevated quite a bit and it technically puts me in the prediabetic range. Lastly, was the change in my HS CRP. This is a marker of global inflammation in the body. To be clear, inflammation is not a great thing to have in the body. Increased values on this test in particular have been drawn to increased risks for cancer, heart attacks, neurologic disorders and type II diabetes. My HS CRP was elevated compared to where it was a year ago going from 0.9 to 2.6. Now, when you see these big changes in values your physician should ask you a few things. First, did you do some crazy workout that day or the day before? Did you go out with your friends the night before, end up at the Clermont Lounge and down PBRs all night? Have you had a week of really bad sleep before this test cluster? All of these things are important to know because it can give us false values. By the way, my answer to all these questions was no.  Here’s what all this means. In the past year my health, internally at least, has slowly been trending in the wrong direction. So how did all this start to go wrong? I would have to attribute it to a number of factors. First, I started a business. For any of you that have ever started a business I probably need no further explanation. For those of you that haven’t, it’s the most difficult and stress-inducing thing anyone could ever do. Not only that, but I teach for another group (MobilityWOD) and in the past 12 months, I’ve accumulated about 70,000 miles on an airplane. I also have two small kids under the age of 4 and I typically sleep an average of 5-6 hours a night.
It’s not all bad news though. Mom, if you’re reading this don’t freak out and call an ambulance for me! I’m glad I did these tests because I had been feeling fatigued and like I was recovering poorly from my training sessions for about the past 6 months. Now I have some quantifiable data to help me make changes and retest to see what’s working. Changes will be made and I will retest in about 1-3 months. All of these markers are reversible with some supplementation changes and behavior modification. I’ll write up a follow up post once I’ve done my blood testing again. It’s time to make some changes! -Danny  It’s 5am, you’re up and getting ready for work. You got 6 maybe 7 hours of sleep last night and you’re off to crush the day at the office! Coffee in hand and listening to your favorite podcast on the drive (most likely the Doc and Jock podcast). You get through your normal day and then sit in traffic for 45 minutes on the drive home (Atlanta traffic can be rough). Once you’re home it’s family time. You haven’t seen your kids or wife all day and all you want to do is hang out with them. Before you know it, it’s 7pm. Your kids are acting crazy because they don’t want to go to bed and you’re starting to get hungry. Once the kids get to bed you have a couple choices:
 I know to many of you this example may or may not resonate. This is basically my schedule 3-4 days a week. For many people lacking time is a common frustration. For me, it happens to be dictated by owning a business, having kids, enjoying spending time with my wife and creating online content like this blog post. Of all the options above I typically go with option 4 on a day like I explained. Hitting a short but intense workout before I eat dinner is an easy way for me to keep some regular training in my schedule on busy days like this. My preference for these late evening workouts after a hectic day- the kettlebell! I feel everyone should have at least one kettlebell at their house. We have two at mine, a 24kg bell and a 16kg bell. They don’t take up much room, are pretty inexpensive and they give you a ton of options when doing a training session at home. Here are a few examples training sessions I like to do that just involve one kettlebell.
As many rounds as possible in 20 minutes. 24kg bell for men and 16kb bell for women. -10 overhead swings -run 200 m -5 power clean and jerk each arm https://www.youtube.com/watch?v=bjKGrZ7-pWQ -run 200 m -10 goblet squats -run 200 m Perform 5 rounds of 3 Turkish Get Ups each side 20 russian swings 10 head cutters https://www.youtube.com/watch?v=tJA07NpN7pM Rest 1 min Every minute on the minute for 15 minutes 5 single arm KB snatches https://www.youtube.com/watch?v=g3c73NahdjU 5 burpees Complete each round as fast as possible. Throw in some midline stability work at the beginning or end and you have yourself a respectable little training session. Not only that, but in the time it would take you to drive to the gym and back, you completed a training session. You may not be headed to the CrossFit Games doing just these type of workouts alone. Chances are, if you’re reading this you aren’t going to the CrossFit Games regardless! Staying committed to regular training sessions is important for moving well, staying fit and being able to keep up with two crazy kids. -Danny |
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