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Training Volume & Load Management, Part 1: How Much Is Too Much?

2/28/2019

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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:

  • Flexibility, mobility, lululemon leggings, biomechanics, nutrition, national emergencies, etc.

While these factors are definitely important to consider, there’s one that gets overlooked and is quite often the culprit:

TRAINING VOLUME

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.
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(credit to Mike Israetel of Renaissance Periodization for this concept)
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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.

​
Cheers,

Dr. Ravi Patel, PT, DPT, CSCS
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Three Easy Tips to Reduce Injury During the CrossFit Open

2/21/2019

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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.

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
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5 Steps For Returning To Exercise Postpartum

1/23/2019

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  1. Start with breathing and gentle movement right away.
  2. Ask your doctor about your delivery.
  3. Schedule an evaluation with a Pelvic Health Physical Therapist.
  4. Focus on healing and strengthening rather than weight loss.
  5. Find a community for support.


Breathing

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.
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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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
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Pull-Ups and Shoulder Health: Part II

10/25/2018

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​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
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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

​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.​


Ready To Come See Us?

​Thanks for reading,

Dr. Jacob, PT, DPT, CSCS
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5 Different Ways To Train Around Pain

10/11/2018

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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:
  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.​

Ready To Come See Us?
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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Preventing Back Pain While Deadlifting, Pt. 1: The Set-Up

7/13/2018

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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.


  • Bow: Bowing forward until you feel tension in your glutes and hamstrings is the first and arguably most crucial step to setting up your deadlift. This is the hinge movement pattern referenced above and by doing this movement correctly you’re protecting  your spine by keeping it in a neutral position and putting your posterior chain (glutes and hamstrings) in optimal position to perform the deadlift. To ensure that you're “bowing” (aka hinging) correctly, check out this drill below: 
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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. ​
I'm Ready To Come See You!

​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
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Dominate The CrossFit Open

3/1/2018

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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:
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​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." 
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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.
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​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
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Bulletproofing Your Back and How CrossFit Falls Short

8/24/2017

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​“The aim of CrossFit is to forge a broad, general and inclusive fitness supported by measurable, observable and repeatable results. The program prepares trainees for any physical contingency—not only for the unknown, but for the unknowable, too. Our specialty is not specializing.”

The quote above was taken directly from CrossFit.com. It describes CrossFit’s mission, and it is undeniable that CrossFit accomplishes its mission of preparing trainees for multiple arenas of physical contingencies. The point of this article is not to argue nor neglect the many benefits associated with CrossFit training. However, even with CrossFit’s ability to program and prepare you for the many physical challenges that life may throw your way, when it comes to building a functionally strong and healthy back, there is one crucial area where CrossFit falls short: multiplanar movement.

Before we talk about how CrossFit doesn't deliver multiplanar movement, first let's look at how our spine moves throughout the day.

Whether we are going to the grocery store, playing softball, or hitting a round of golf, our backs do not move in one dimension. To perform movement efficiently and effectively, our spine must be able to move through a combination of movements in three different planes: frontal, sagittal, and transverse.
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  • Frontal Plane: splits our body into front and back halves and is where our spine bends side-to-side.
  • Sagittal Plane: splits our body into left and right halves and is where our spine bends forwards and backwards.
  • Transverse Plane: splits our body into top and and bottom halves and is where our spine rotates side-to-side.
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​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) 
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Pallof Press with shoulder flexion (transverse plane)

Single-Arm Farmers Carry (frontal plane)

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 its 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
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Why Mobility Won't Help Your Squat

5/31/2017

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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

​
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.
​

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.
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Some faults that are common with squatting will be demonstrated when the PVC pipe leaves one of the points of contact.  Below, the left picture shows a rounding of the midback that causes the PVC to leave the pelvis.  This often happens at the bottom of the squat too.  The fault on the right demonstrates over-extending the hips and changing pelvic position rather than hinging the hips.  I find this to be more common on initiation of the squat, particularly for those complaining of back pain.  If you noticed that the PVC left your body at some point, try filming yourself as you practice!
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Improving motor control takes reps and practice.  The PVC drill is great as a warm up for squats.  You could also perform tempo goblet squats (see video below). 
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!  ​
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Inside of thighs really sore after squatting?
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The large muscles running along the inside of your thighs are the adductors. They function to bring your leg closer to midline, stabilize the hip and knee, and work synergistically with glutes and external rotators (squats?!).  Going along the lines of motor control, be aware of the speed of your descent and “bouncing” out of the hole.  The squat should not be a fall to the bottom and a bounce off the calves.  You want a controlled descent; taking advantage of the stretch-shortening cycle at the bottom can be helpful but the torso alignment should still be maintained. If you are a free-faller or a bouncer, try to slow it down and control the movement.  Similar to the goblet squat, this will improve control but also strength!
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​
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Wrist Pain? Fix Your Shoulders!

8/17/2016

0 Comments

 
In the words of Jay-Z, “I’ve got 99 problems but wrist pain ain’t one.”
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. 
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         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.”

​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, PT, DPT, OCS, CSCS
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