A very common problem we see at Athletes’ Potential is low back pain. What comes with low back pain are a lot of questions about the best ways to manage the pain when it first occurs, as well as the best ways for our athletes to rehabilitate. What I want to focus on in this blog post is how important it is to get back to gentle activity sooner rather than later when dealing with low back pain.
A Timeline of Back Pain
T0: Back pain!
You feel a sharp ache in your lower back. You may have been lifting something heavy or you may have been reaching for your shoes. Back pain can come about for a variety of reasons! Whatever the case… your back “went out.”
No matter the presence or absence of pathology (disc irritation, facet irritation, muscle strain, etc.), your brain and nervous system are going to go into overdrive trying to protect your back. This is where many people will experience a tightening sensation or spasms in their lower back. This is a normal, protective mechanism! Your brain is doing its best to shield you from further motion by tightening up all the musculature in your back.
Thank you, brain!
This phase is known as the “acute” phase of pain. Typically this lasts for a day or two. It's where pain is the worst and rest is indicated. The goal of this stage is to get the pain to stabilize. When I say “stabilize” I mean that it still might be quite painful, but you are able to do more than you previously could, such as get out of bed and do short walks, where before that was near impossible due to the rapid, sharp pain that occurs with motion.
Many athletes believe that rest is best at this phase, but many studies suggest the opposite. In a 2018 review of best practices surrounding low back pain, 6 out of 11 studies support avoiding bed rest during acute bouts of low back pain, four studies were inconclusive, and only one suggested bed rest.1
Great news! Get active as soon as you are able. At this point, it's best to work on breathing exercises, gentle core exercises such as bracing and bridges, and try to get on your feet when tolerable.
If this is unsuccessful and your high level of pain is lasting for more than three days, I would contact us at Athletes’ Potential or your PCP for further assessment and treatment.
Once the pain begins to stabilize, and you’re able to do some gentle activities as tolerated, you’ve entered the subacute phase.
T1: Less Back Pain!
You’re feeling slightly better but you’re still hesitant to do anything beyond baseline. You would like to get back to your workouts, your sport, or just simply getting into and out of a car without increased ache. This is the subacute phase and is also where physical therapy is incredibly helpful in accelerating your rehabilitation.
In lieu of physical therapy, this is where so many athletes choose one of two directions:
Luckily, we have a good bit of evidence supporting option number two. Those that choose light activity as compared to bed rest have a statistically significant improvement in their overall recovery timeline as supported by a cochrane review of the literature2.
Once again, get active. Do a light workout as tolerated. Listen to your symptoms and stay within what your body is telling you. If you want guidance, reach out! This is what Athletes’ Potential is here for!
Hopefully by day 5-10, you’ve slowly progressed back to a reasonable level of capacity.
T2: Light to Moderate Activity
Once again, this is where physical therapy at Athletes’ Potential excels!
You’re feeling better but just need a bit more guidance to push you over the edge to get back to your activity or sport.
Core stabilization, strength training, and flexibility drills are all part of this phase. This is where we can really make some quick strides in your recovery.
I won’t go into this last phase too much, as this phase isn’t the intent of this blog.
Overall, I want readers of this post to know that if they are having an acute bout of back pain, stay gently active as tolerated! Don’t go out and progress too fast, and don’t ignore your back pain. Listen to what it's telling you.
If it's slowly getting better, go do things such as walks, light exercise, and gentle stretching. And if you ever need guidance with this recovery, feel free to reach out to us at any time!
Thanks for reading,
Dr. Marcus Rein PT DPT
When we first meet our clients, the usual conversation we have surrounds pain and injury. As PT’s, we are honored to be able to work with people to help them heal their injuries. Once healed, we are also honored to be able to work with these same athletes to take them to the next level in their training. From Clinical Strength Training classes to form-checks to strength training sessions, we offer so much more than a standard PT clinic!
When we are working with these clients on performance and high-level training, questions routinely come up.
The most common questions I get regularly are about protein and they are:
“Should I take protein?”
“How much protein should I take?”
“What kind is best?”
Let's go through these questions one by one.
“Should I take protein?” Great question! What is your intent?
Typically we see two different motivations for this question:
If you are an active human (most of our clients and most likely the person reading this), the answer is an absolute and definitive YES!
Here’s an exhaustive list of all the well studied benefits of whey protein supplementation:
The only risks are if you have current or previous kidney or liver damage. If so, consult your physician prior to doing any supplementation.
“How much protein should I take?” Great! Now you want to supplement protein. How much?
A general rule that has been well verified in research is that between 0.5-1g per pound of bodyweight per day is appropriate for active individuals.
The more active and intense you are, the more likely you’ll want a higher amount of protein per day (more towards 1g/day).
My advice? Ignore the specific grams of protein when starting.
Unless you’re a bodybuilder or really enjoy the details, don’t count your grams of protein.
Start simple by having one or two scoops of protein twice every day.
DON’T WORRY ABOUT SPECIFICS WHEN STARTING. Just find small successes, then build off of those.
If you can start with a simple habit, and are finding success by doing that habit for at least a month, you can start getting curious about specific grams of protein you are intaking per day.
“What kind is best?" The most well-researched and most value-conscious (in general) as compared to meats, tofu, and beans, is whey protein.
There’s a TON of different types.
Don’t worry about that.
Simply pick one that says “whey protein” and start taking it as I described above (1-2 scoops two times per day).
If you are able to finish the first container... success! You’ve begun this journey of a thousand miles! You can build off this first step and now start looking for more specifics!
I would then look for whey proteins with low cholesterol, relatively low-calorie, and between 23-30g of protein per scoop.
My favorite is Optimum Protein (it's a big black and red bag in Costco) but there’s DOZENS of other great proteins that are cost-conscious and value-conscious.
Hopefully this has been enough to get you started with protein supplementation.
Marcus Rein, PT, DPT
So, you’ve been working hard, training hard, and enjoying life. Your body is a little achy, and dang you’ve been looking forward to a vacation for the last few months. Summer is here! You’ve got your chance to take a break from work and really, truly, relax. Or, maybe you’ve got a move coming and you know you won't be able to train as much.
So, the question arises… how little training do I have to do over a longer vacation or during a transition such as a move to a new home to maintain strength levels for my sport? For me it's soccer, but for you it may be running, tennis, basketball, or pickleball!
Let's dive into the literature.
Luckily, a fantastic review titled “Maintaining Physical Performance: The Minimal Dose of Exercise Needed to Preserve Endurance and Strength Over Time” was just published in 2021 answering this very question. Let’s look at the abstract and I’ll highlight important lines:
“Nearly every physically active person encounters periods in which the time available for exercise is limited (e.g., personal, family, or business conflicts). During such periods, the goal of physical training may be to simply maintain (rather than improve) physical performance. Similarly, certain special populations may desire to maintain performance for prolonged periods, namely athletes (during the competitive season and off-season) and military personnel (during deployment). The primary purpose of this brief, narrative review is to identify the minimal dose of exercise (i.e., frequency, volume, and intensity) needed to maintain physical performance over time. In general populations, endurance performance can be maintained for up to 15 weeks when training frequency is reduced to as little as 2 sessions per week or when exercise volume is reduced by 33–66% (as low as 13–26 minutes per session), as long as exercise intensity (exercising heart rate) is maintained. Strength and muscle size (at least in younger populations) can be maintained for up to 32 weeks with as little as 1 session of strength training per week and 1 set per exercise, as long as exercise intensity (relative load) is maintained; whereas, in older populations, maintaining muscle size may require up to 2 sessions per week and 2–3 sets per exercise, while maintaining exercise intensity. Insufficient data exists to make specific recommendations for athletes or military personnel. Our primary conclusion is that exercise intensity seems to be the key variable for maintaining physical performance over time, despite relatively large reductions in exercise frequency and volume.”1
The first time I read this, my jaw hit the floor.
What this means is that for most people, endurance can be maintained for over three months and strength can be maintained for over a half a year with relatively few sessions per week. The key metric is INTENSITY.
Strength only needs one session per week and just ONE set per exercise, as long as you’re intense and lifting your regular heavy weights. JUST ONE SET.
Endurance needs just two sessions per week, and only around 20 minutes of running, as long as you find an intense level of exertion.
I’ll keep this blog post short and sweet. Just wanted you guys to know about this amazing article and hopefully gain something from it. If you want to actually read an article this summer, make it this one, as it's pretty straight-forward. Now, go and actually enjoy a break when you need a break! Just a few INTENSE sessions a week is all you need. You’ve earned it.
Thanks for reading!
Dr. Marcus Rein PT DPT
1. Spiering, Barry A.1; Mujika, Iñigo2,3; Sharp, Marilyn A.1; Foulis, Stephen A.1 Maintaining Physical Performance: The Minimal Dose of Exercise Needed to Preserve Endurance and Strength Over Time, Journal of Strength and Conditioning Research: May 2021 - Volume 35 - Issue 5 - p 1449-1458 doi: 10.1519/JSC.0000000000003964
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.
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 you 17.4). Or is that two 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
While structured breathing work may seem simple-even silly- to some, we know that it is a powerful tool for the pregnant and postpartum woman. Deep breaths have the ability to calm the nervous system which can affect muscle tension, heart rate, and blood pressure. Additionally, the respiratory diaphragm can mobilize muscles in the pelvis and back due to anatomical connections. Muscles, including those shown in the photo below, are big players in midline stabilization and support. A great place to start is the 90/90 breathing drill (seen below). Try this out for 10-15 breaths at the end of your day.
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.
Find a community for support
Returning to group classes or running groups can be challenging because you will not be jumping right back into the level you were previously exercising. Having a group of women who understand your needs and have been or are currently at the same stage as you is tremendously beneficial. If this sounds like something you would be interested in, please join my Back to Fitness Postpartum Facebook page. We have posts nearly every day and a lot of great discussions- some serious and some silly!
Once you return to group classes, be sure that the trainer knows you are postpartum and if there are any symptoms with movements. If they offer other movement suggestions that still do not feel great, then modify further! Symptoms (leaking, pain, heaviness in the vagina) are a signal to decrease the workload by resting or modifying or both!
Getting back to fitness postpartum can be challenging but it is not impossible! With a holistic plan and support you will be able to recover and rebuild to get back to your favorite activities. If you are looking for help with learning more about postpartum fitness, the pelvic floor and how to reach your goals, then please reach out at Athletes’ Potential.
Thanks for reading,
Dr. Jackie, DPT
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, PT, DPT, CSCS
Have you ever been in the middle of a workout and feel an ache or pain? It’s completely normal if it’s something small and goes away. It’s another story if it continues to bother you or increase in pain.
Sometimes we just do too much (or too little) and it pisses off some part of our body.
You may start to realize it’s impacting the way you move and you may even avoid a particular movement that causes the pain altogether.
Often times, people see this as a sign to take some time off and rest. This may be the case in some instances, but it’s not always the best solution.
Some people go to a healthcare professional to find out what’s going on. Quite frequently, they’re told to stop that activity or exercise. We hear it all the time from new patients.
“Squats are bad for your knees.”
“Running will wreck your body.”
“Stop doing CrossFit. You’ll get hurt.”
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:
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.
Here are a few other examples for you:
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.
Dr. Ravi, PT, DPT, CSCS
On average 80% of Americans will experience low back pain at some point in their lives and more than a quarter of the population currently deals with low back pain on any given day.
Not only do most people have some form of back pain, but it many cases it is the result of poor movement patterns that have been abused for years causing the root of their problem to be both incredibly complex and multifactorial.
An exercise once thought to be dangerous (something that has been debunked by a multitude of recent studies), there is arguably no other lift that is more functional than the deadlift. The deadlift is a hinge type movement pattern, which is used every single time you bend over to pick something up off the floor, so you better be efficient with this movement. This article is Part I of a two-part series covering the common mistakes I see in the clinic and will teach you how to prevent low back pain while deadlifting.
This exercise can be moderately complex to perform correctly and the number one mistake that I see most in the clinic is a poor set up. There is a lot that goes on to get into this position but by bringing your shoelaces to the bar and remembering the “3 B’s” (Bow, Bend, Blades), most people will be able to get into a solid starting position.
So in review, to be in a good set-up position you need to “bring your shoelaces under the bar," bow until you feel tension in your posterior chain, bend your knees until you can grip the bar, and engage your shoulder blades. Doing this will get you into a good set-up position, which will protect your low back and allow you to lift bigger weight.
Thanks for reading,
Dr. Jacob, PT, DPT
The CrossFit Open is finally here. After all of the countless hours spent in the gym perfecting your craft, it’s time to see just how far you’ve come in year’s time. I’ve got some good news for you too, simply by signing up for the CrossFit Open you’ve set yourself apart from your peers as only approximately 20% of CrossFit members worldwide have the moxie to put their money where their mouth is and actually sign up for the Open.
Now that you’re here though and you’ve made it through that miserable 18.1 workout, it’s time to grind through another 4 weeks designed to push you to your absolute limit. As daunting as that sounds, there’s a secret out there that elite athletes figured out a long time ago, yet it still gets ignored by most people in the gym. Recovery.
No matter how much you train, most of your hours during the day will be spent recovering. Recovery is undoubtedly the most overlooked aspect of training. Tell me if this sounds like something you (or let’s just say somebody you know). You rush from work to get to the gym, get there barely in time to hear your coach going over the day’s workout, then after blasting through a max level workout you rack your weight, grab your keys and head out to your car to get to the responsibilities waiting for you at home. Rinse and repeat throughout the week.
I see this all the time in the gym, and quite honestly I’d be lying to you if I said I haven’t had this happen to me as well. The issue with this all-to-common scenario though is that when you do this, you are skipping out on arguably the most important aspect of any training program. If you are not recovering appropriately then you’re leaving performance on the table and setting yourself up for injury.
Elite athletes and their trainers know exactly how important it is to recover appropriately, they spend endless resources monitoring their athletes’ bodies vital signs and other physiological functions in order to objectively determine when they are ready to go full throttle. However, for those of us who don’t have the ability to measure things like heart rate variability 24/7, there are a few things you can do to optimize the speed and effectiveness of your recovery:
1. Post Workout Cool-Down: Immediately following a workout do some form of very light activity (ex: walking, light row, light bike, etc) and then take another 10-15 minutes to work on soft tissue and joint mobility. Doing these things will not only decrease the soreness you experience after workouts, but it will allow your body’s heart rate, blood pressure, and nervous system to return to baseline levels. All of which are crucial to optimizing recovery. While you should choose which soft tissue and joint mobilizations you should do based on the movements performed in the WOD, some of my favorites are listed below. Perform each drill for 2 minutes.
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."
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
Dr. Danny and staff's views on performance improvement, injury prevention, and sometimes other random thoughts.