I remember the feeling like it was yesterday. A sharp popping sensation in my back and then an odd, almost warm tingling feeling down my left leg. I knew it wasn’t good, and I should have known better.
This was my first week at an infantry brigade I had been assigned to in 2011. I was the only physical therapist assigned to a group of 3,500 soldiers. My job was to treat all injuries, teach injury prevention classes, and help with human performance optimization. I was also attached to an infantry brigade so that meant a lot of physical training and ruck marching.
On my fourth day assigned to this group, I went on a Thursday morning ruck march. For those of you that don’t know, ruck marching is basically walking around while wearing a 50-pound backpack. This morning we had gone on an 8-mile ruck march. When I finished, I dropped my rucksack (i.e heavy ass backpack) and stood around talking with the other soldiers. As I was leaving, I bent over to pick up my rucksack and that’s when I felt the pop.
I immediately knew something was wrong, but the last thing I wanted to do was get hurt in front of all my soldiers. I was the guy assigned to this group to make sure people didn’t get hurt and there I was in excruciating back pain trying to act like I was fine. I managed to make it to my car before collapsing into my seat. I drove straight to the troop medical clinic to see a fellow physical therapist friend of mine. There was no unringing this bell… the damage was already done.
Over the next six months, I did everything to help fix this back injury I had given myself. Fatigue from the ruck march followed by picking something heavy up, like an idiot, was a recipe for a pretty serious disc injury. I had what’s called an L4-L5 disc prolapse. This caused me to have a lot of numbness and weakness in the back of my left leg.
With a combination of dry needling, hip joint mobilizations, and time, my pain resolved in about six months. It took me roughly another six months before I could get back into deadlifting heavy. 12 months of rehab/recovery from picking up a rucksack wrong. As much as this wasn’t fun, I’m glad it happened to me, and here’s why.
I learned a lot about why I had this back injury in the first place and was able to correct those issues. This injury lead me down the path of better understanding complex movements. I became obsessed with treating my own back and developing protocols to help other people with their back injury. Lastly, I can relate to anyone I see with a back injury on a much deeper level than someone who’s never hurt their back.
I also got to see first hand that disc injuries do heal. Even when I was in school, the thought process was that a disc injury wouldn’t heal. I have an MRI from one month after the injury and three years after the injury. The MRI from one month post injury shows a significant disc prolapse that’s pressing on a nerve. The MRI from three years post injury looks completely normal. The body heals on the inside just as it does when you get a cut on your skin. It fills in, heals, and you have a scar as a reminder of the thing that happened.
Dealing with a disc injury can be extremely frustrating. Here’s my advice to you if you’re currently dealing with one from my own experience and from all of the back injuries I’ve seen:
I hope this helps and I hope you realize that you can heal. Your body is incredible and often times it just needs time and the right approach to do so.
If you’re in the Atlanta area and are currently dealing with a back injury, we need to talk. We’ve helped thousands of people in Atlanta get back to a pain-free, active life, and we can help you as well.
Click the “Get Started” button below, leave us your information and one of our team members will reach out to find out if you’re an ideal fit for what we do.
Thanks so much for reading,
June 6th, 2014 was a hot day in Columbus, GA. That’s pretty normal for Columbus in June and I remember this day well because it was the last day of my service in the U.S. Army. I had spent the past seven years on active duty, either in school or serving as a Physical Therapist on an Army post. I’ve never had more mixed feelings of excitement, nervousness, joy, and fear at the same time. I remember giving my final out processing packet to a Sergeant that I had only spoken to once or twice. He asked me what I was going to do and I told him I was starting a Physical Therapy practice in a gym in Atlanta. His responded with, “Hmm, that sounds interesting. Good luck with that, sir,” and then he was back to filing the huge stack of other packets he had on his desk.
If I learned anything while I was in the Army, it’s that you’re not as special as you think you are. You don’t deserve special treatment, and you have to earn respect from others. Respect comes from being remarkable at what you do.
My goal for Athletes’ Potential was to create an environment that was remarkable - a level of healthcare quality and true attention to the patients that was, and in many cases is, still missing. June 9th, 2014 was the first day I actually saw a patient at Athletes’ Potential. His name was Sam, and he was a defense contractor that had driven in from Alabama to work with me. We had a lot to work on due to his years in the military and police departments. I worked with him for three hours straight that day. At the end of the visit, he paid me and what he did next surprised me. He gave me a big bear hug and thanked me for being the first healthcare professional that had actually listened to him and taught him how to take care of himself.
At this point, I had been a Physical Therapist for years and I never had a response like this from a patient. That day, I knew Athletes’ Potential was going to be different. It was going to change a lot of people’s lives and it was going to be worth all the hard work we had to put in.
Ashley and I like to think of Athletes’ Potential as our third kid. Our kids obviously come first, but our business is something very special to us. It’s allowed us to help thousands of people in the Atlanta area and live an incredible life.
Over the past five years, I’ve learned a lot of lessons about business, healthcare, and developing meaningful relationships with people. If you’re reading this, I know I’m basically fighting for your attention against Instagram, Netflix, and HBO. That’s some steep competition, so I’m going to keep this relatively short by highlighting the 5 Most Important Lessons I’ve learned over the past five years.
1. Make decisions based on how you would want your family treated.
Zig Ziglar once said, “You can have everything in life you want, if you will just help enough other people get what they want.”
Helping others achieve their health and wellness goals is one of the core pillars at Athletes’ Potential. This also doesn’t always mean we are the right people to help individuals reaching out to us.
I remember seeing a patient about six months into starting Athletes’ Potential. She came to see me for some shoulder pain she was having. Within 10 minutes of talking to her, it was obvious that this shoulder pain did not sound like it was musculoskeletal. In particular, she had recently changed some medication she was on around the same time her shoulder started hurting.
I ended up taking her through an exam and it reaffirmed the fact that I didn’t think she actually had a shoulder problem.
I told her she needed to go back to her doctor because I thought she was having a reaction to this medication change. We ended up spending about 30-40 minutes together, and she left a little confused but happy to hear her shoulder was fine.
This is the first time I had to decide if a visit like this warranted a charge. I decided it didn’t since I couldn’t directly help her and she wasn’t appropriate for my skill set. She was pretty surprised that I refused to charge her for the visit and that I followed up directly with her physician about what I found.
Two weeks later, she emailed me to let me know her shoulder felt fine now. Her doctor switched her to a different medication and everything was fine. She was also emailing me to let me know she was setting up an appointment for her husband to get some help with his chronic lower back pain.
Years later we still get the occasional person referred from her and it’s because of a decision I made the day of her visit to focus on long-term decision making.
I didn’t do it in hopes that she would send someone else our way. I did it because it’s what I hope someone else would do if my mom went to see them for a similar issue. We make decisions based on how we would treat our family and because of that we have been able to develop an incredible level of trust with our patients.
2. Comparison is the thief of joy.
This is a quote credited to Teddy Roosevelt and it’s spot on. This applies to basically any element of our life.
For me, early on in business, I struggled with comparing our business to others. If you’re competitive at all, you probably struggle with comparing yourself to others as well. Over the past few years, I’ve realized that this is an utter waste of time.
For me to sit here and try to figure out who has more patient visits per month, who has more traffic to their site, or who’s using a new app on their website, is a waste of time.
The same can be said with anyone comparing themselves to others in their personal life. We can sit there and look at a friend, sibling, neighbor, or colleague and compare any number of variables. It’s so easy to do this now with social media and our kids have to deal with this on a level that many of us never had to when we were growing up.
Nothing but wasted time and stress comes from comparing ourselves to others. My advice is to focus on what you can change and that’s yourself. I look back five years ago and barely recognize myself. I didn’t know shit about business, being a parent, or developing meaningful relationships in life. I’m better in all of these areas today, but I’m nowhere near what I need to be.
This is a good thing and it’s one of our human superpowers. We can make a conscious decision to improve, progress, and work on ourselves. The more you focus on working on yourself and the less you compare yourself to others, the better off you will be five years from now.
3. Show up and listen.
According to the Journal of General Internal Medicine, the average doctor listens for 11 seconds before interrupting their patients.
I know many of you have been there. You show up to your visit 15 minutes early to fill out a ridiculous amount of paperwork. Next, you sit there and wait. They finally call you back 30 minutes after your appointment time and bring you to a small treatment office. You proceed to wait there for another 30 minutes while counting the cotton balls in a jar since you have no cell phone service in the building. Finally, your doctor shows up. You are so excited to finally get out what’s worrying you and they stop you dead in your tracks by interrupting you. You barely get any time to explain what’s going on and within 10 minutes the doctor is out the door. You’ve been at the facility for 90 minutes and are lucky if you get 10 minutes of facetime with the doc.
This scenario is all too common and it’s the exact opposite of how we wanted to set up Athletes’ Potential.
There are a lot of things you can’t control in life but being on time is one of them. When you are late you are showing others that you value your time more than their time. This is not ok and it’s one of the reasons we work so hard to keep everything functioning on schedule even when we are very busy.
The other common frustration is a lack of time with the doc. This is the primary reason we have our visits set up for 60 minutes per visit. In particular, this allows our patients to explain to us in great detail what’s going on. Half of the time we barely do anything else but talk the first visit because of how important that information is toward making the right long-term decision.
There’s a reason why people pay behavioral health specialists and psychologists $200 an hour to listen to them and have a conversation. This is incredibly healthy and you have to verbalize your frustrations/fears. When you’ve been dealing with pain for five years, you’re going to be frustrated.
We are here to listen, support, and help you achieve the long-term change you want.
4. Focus on the whole person not just the injury.
Early on when I was a new Physical Therapist, I would ask patients, “So how’s your __________ (insert injured area) feeling today?”
Now my line of questioning is, “So, how are YOU feeling today?”
In the last five years in particular, I’ve learned a lot about dealing with people. There are so many factors in people’s lives that can directly affect how they feel and the decisions they make. This is why we focus on 4 Core Areas of health/wellness no matter what type of injury we are dealing with.
Those 4 areas are:
Look, your back might hurt, but if you’re sleeping four hours a night and living off coffee, you’re going to have a really tough time healing. Too often, other variables in health/wellness are missed because of tunnel vision we get on the injury bringing someone in to see us.
You cannot fix a problem in isolation unless you have ruled out the other contributing factors from the four areas listed above.
I recently saw a prior patient who came back with an unexplained hip injury. He had pain in the front of his hip and it hurt so bad he had to use his arms to help get his leg in and out of his car.
When he came in to see me, we spent 80% of the time talking about mindfulness work for stress management and how to improve sleep.
To give some context, he had just switched jobs and he was getting crushed at work. He also has two young kids at home and one wasn’t sleeping so well recently. This was taking a toll on his sleep as well as increasing stressors in his life. He had also been so busy he barely had worked out over the prior four weeks.
He left that day with some homework exercises we wanted him to do, and, more importantly, a game plan of how to optimize sleep and deal with stressors.
He came back a week later and his pain was completely gone. We barely touched his hip but all of his hip pain had resolved. This isn’t voodoo. It’s how the human body is designed. Pain in many ways is like a check engine light turning on in your car. It’s telling you something is wrong. Other variables can have very strong effects on how you feel and how you heal. They must be addressed and improved.
The goal for most people we work with is to lead a healthy life, stay active and maintain strong relationships with their loved ones. In order to do that you have to do an at least decent job with your sleep, nutrition, stress management, and movement.
5. Surround yourself with amazing people.
Easily my favorite thing about Athletes’ Potential has been the people that I’ve met along the way. I love meeting people and learning not just about what injury they have, but about their lives in general.
As soon as you shut up and start listening to people tell their story, you realize just how interesting seemingly normal people can be. We are so lucky to be able to work with the amazing people we call our athletes.
Here’s a snapshot of some of the awesome people we’ve worked with:
When we say, “If you have a body you’re an athlete,” we mean it. The human body is amazing and we get to see it uses for so many cool things.
Being around amazing people also applies to our entire staff. I’ve never been around a more selfless and dedicated group of people. They show up everyday to help our athletes achieve their goals. Our staff are not a group of employees. We are a family and I hope that is apparent to people who come to see us.
I can’t imagine doing anything else. I’m so proud of our team and what they’ve accomplished in the past five years. I’m not sure what the next five years holds for us, but I can promise you we will continue to serve our community to the best of our abilities.
If you're reading this and you’ve worked with us, I just want to say thank you. If it wasn’t for you, there wouldn’t be an Athletes’ Potential.
If you’re reading this and you’re a Physical Therapist thinking about starting your own practice, I hope this encourages you. This decision could very well change your life in many ways going forward.
If you’ve made it this far, thank you for your time and attention. I know that’s a very rare and valuable thing. At least for the last few minutes, I have beaten HBO, but I think the final season of Game of Thrones will have the last laugh.
Thank you for reading. Thank you for being a part of our world in some way. Most importantly, thank you for taking a chance on a company with an odd name for a physical therapy practice that is trying to do things differently.
Danny Matta, PT, DPT, OCS, CSCS
We’ve all seen the outliers: People who are in their 70's, 80's and 90's that just look like they’ve aged better than everyone else.
Not only do they seem physically healthier, but they’re mentally very sharp.
Early on in my career as a physical therapist, I had the opportunity to work with one such man. His name was Charlie and he owned a mechanic shop in New Braunfels, Texas. When I saw him, he was 85 and was coming in because of some hip pain.
I was blown away by how physically active and quick-witted he was. He still worked full time in his mechanic shop with his two sons. The main reason for him coming in was that his hip pain was limiting him when it came to climbing into his deer stand.
To make him even more impressive, he was on zero medications; he had never had a significant health issue; and lived independently. If you’ve been around people in their 80's, being on zero medications is incredibly rare in its own right.
I ended up working with Charlie for a few months and every time I saw him I picked his brain on life and how he was so healthy and active at his age.
Over the course of our time, I picked up 4 Key Habits that had contributed to his remarkable physical and mental health at his age. If you want to age like Charlie, stick to these four habits:
Habit 1: Move a lot
Charlie never did one day of structured exercise in his entire life, except when he was in the Army early in his life. Moving is what Charlie did best. He started his mechanic shop in his 30's and had been doing that pretty much everyday for 50 years.
This is a physical job to say the least, so he had a lot of movement built into his day. He also was a big believer in walking. He would walk 3-5 miles every morning with his dog.
You don’t have to exercise much, if at all, when you move and are active all day long.
Habit 2: Have something to wake up for
I thought this was a really interesting piece of advice he gave me. He gave me this nugget of advice as he was describing the new computer software they were using for his mechanic shop.
In his mid-80's, he was learning a new software program to help his shop run more efficiently. He was so excited about the changes they expected to see with this new upgrade.
What I found out was that he loved what he did. He was obsessed with cars and making them run better. He had done what very few people every accomplish: he had matched up his interest in life with how he made his living.
He got up early everyday so he could be at his shop to open up and greet the first customer. What really resonated with me was Charlie's ability to constantly try to improve and his drive to wake up early and seize the day.
Think about how many people hate their jobs. The internal stress created with hating what you do, yet having to go and do that everyday is significant. Charlie was onto something and it was one of the big reasons for his long term health.
Habit 3: Eat like you have Type I Diabetes
Charlie’s wife had died about 10 years before I met him. She was born with Type I Diabetes and had lived an incredibly long life for someone born in the early 1900's with Type I Diabetes.
Charlie credited the way his wife had the family eat to much of his own health. Because his wife had to be very strict about what she ate, the entire family just ate the way she did.
There were two big nutrition components to how he ate:
First, he ate minimal to no sugar besides fruit. He chose black coffee, a banana on his oatmeal instead of brown sugar and he never ate desserts.
Second, eat nothing white. Charlie explained that his wife would have big insulin spikes when she would eat white bread, rice, or even drink milk. Recent studies have shown that a cup of milk causes the same insulin response in the body that eating a piece of white bread does. He and his wife just figured this out by tracking her insulin response to food.
Other than that he ate pretty much whatever he wanted. He was a big fan of the brisket from Rudy’s BBQ, which was right down the road from our clinic. He was also an avid hunter and would eat a lot of venison as well.
Habit 4: Go to sleep early
Charlie swore that going to sleep early was important. To put this in context, he usually got to his shop around 7am and they didn’t open for business until 8am. He would get up around 5am every morning to take his dog on a walk before going into his shop. He would usually go to bed by 9:00pm. That meant he usually was getting about 8 hours of sleep per night.
We all know sleep is important. Often one of the most difficult parts of sleep for people is actually getting to sleep at a decent time. Follow Charlie’s advice and start waking up earlier. You do that for a week or two and I’m sure you’ll be ready to go to be once it’s 9:00 or 10:00pm.
I know these 4 habits seem simple, and they are. Your health doesn’t have to be complex. There’s also no magic supplement you can take that will give you longevity like Charlie.
In an age of Bird Scooters, Amazon delivering your groceries, and having an app for everything, don’t forget the basics.
Move often, have something you're excited to wake up for, sleep and eat well.
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.
Remember: If you have a body, you’re an athlete!
Thanks for reading,
Dr. Danny, PT, DPT, OCS, CSCS
At some point you were probably a young athlete with aspirations of playing a sport in college or even professionally.
Think back to that time and answer this question as your 15-year-old self.
Would you rather run faster or be less likely to get hurt?
If you were anything like me at a 15-year-old kid, an injury was probably the last thing you cared about. When we’re 15 we are bulletproof. We’re borderline superheroes with mega amounts of hormones flowing through our system that help us grow, recover, and have tons of energy. If you had tried to sell me on injury prevention program, I would have laughed at you and walked away (yes I was a little jerk at 15).
Now, let’s talk about development of speed. If you had asked me at 15 if I wanted to be faster, I would have been all ears. I once spent 6 weeks doing a program to improve my vertical jump when I was 16 years old. My family was living in an apartment in Columbus, Georgia at the time. We had a storage garage in the apartment complex. I would go there everyday over the summer and do different plyometric jumping exercises onto a metal ladder because I didn’t have a box to jump on. I wanted the glory of being able to jump higher, run faster and being an overall better athlete.
Here’s the interesting part about performance improvement and injury prevention. If done correctly, performance improvement and injury prevention are the same exact thing.
Let’s take the example of a 15-year-old female soccer player for this next example. Let’s say that every time she lands or changes direction her knee caves in. This is a strong indicator that this athlete has an increased likelihood of having an ACL tear.
To correct this we can improve landing mechanics, hip strength, foot and ankle control and general body positioning awareness. To do so, this athlete would need to complete a structured program to develop these weaknesses in her athletic movement.
Now on the other hand, an athlete that has knee collapse when they cut will also be slower and less efficient. So, if we take this same athlete through a structured program to decrease their ACL injury risk, they also get faster. This means they will win more ball challenges. They will be able to jump higher and change direction faster. They will become an overall better mover and athlete on the field.
The program is not the hard part. Buy in from the athlete is where the real magic is. If you can get a 15-year-old athlete(tough sell) to buy in on your program, you win.
Buy in is a concept of getting our athletes to do what we want. It’s phrasing things correctly to gain the trust of that athlete. WIth trust comes effort and with effort comes results.
It’s sort of like when I want my 5-year-old son to do something. I could ask him to clean his room and it’s likely that he will do it. Now, if I ask him to clean his room and tell him I’m timing him to see how fast he can do it, I get a much better result. One step further, if I tell him I’m timing him and his sister is cleaning her room at the same time, we now have competition. Competition between kids can be a gold mine of buy in.
If you’re reading this and you have an adolescent kid playing a sport in the Decatur, Georgia area, we need to talk. We see countless youth athletes from sports like soccer, lacrosse, swimming, baseball, football, golf and even ultimate frisbee! Each one of these athletes comes to us because of an injury. Almost all of these athletes lacked basic movement coordination that lead to the injury.
It’s hard to get your kids to listen to you. You can tell them all day to do exercises to decrease their likelihood of injury. It’s very unlikely they will take action and implement what you tell them.
Send them to Athletes’ Potential and we delve into how to improve their performance on the field. We use a unique a proprietary athlete assessment to isolate where the strength and movement limitations are. We get them strong, moving well and winning more. One really nice side effect to all of this is….they become significantly less likely to have an injury.
Now it’s your turn to make a decision. Do you wait for your youth athlete to get hurt or do you proactively get them checked out? The decision is yours and time starts now.
Give us a call at 470-355-2106 or request to chat with one of our Doctors for free by clicking on the link below.
Thanks for reading,
- Dr. Danny, PT, DPT
“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.
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)
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
If you’re reading this blog post and you are 100% pain free, you can stop reading it right now.
Ok, we lost maybe 1% of people that actually came to this blog post. For the rest of you, here we go!
The question is this: Why are so many people in pain everyday when the resting state of the human body is supposed to be pain free?
Over the past decade, I’ve had the opportunity to work with people as a personal trainer, strength coach, and a physical therapist. One thing in common with all of these people was that every one of them had daily pain. Now, that seems obvious that someone coming to see me as a physical therapist has pain, but what about as a personal trainer or coach? As a trainer I was shocked to see the first thing we needed to do was work on getting back into some pain-free movement.
Solving chronic pain for people long term comes down to two things: Do they have enough range of motion or mobility to perform a task, and do they have enough control over that movement to be able to do it correctly?
It’s a simple answer, yet very complex at the same time.
To make matters worse we are becoming increasingly more sedentary, weaker, and life is over all just becoming easier. Think about it. You don’t even need to drive somewhere to pick up food anymore. You can literally just use Uber Eats to get a pint of ice cream from Jeni’s Ice Cream and some Pad Thai from your favorite Thai restaurant at the same time. Don’t want to go get groceries? No worries, Amazon has you covered and will deliver pretty much whatever groceries you want to your house.
So what does all this cool convenience mean to us? Less and less non-exercise based movement. Unless you have a manual labor job, you use your body far less than it’s designed to be used.
You hear people say all the time about their grandparents that “they don’t make people like they used to.” Those were some hearty Depression Era people. Well, physiologically and genetically we haven’t changed in the last 100 years. What has changed? My grandfather grew up on a farm and stopped going to school in 4th grade to help take care of that farm full time. He then spent 30 years in the Navy and did other manual jobs like a mechanic for the rest of his career after that. He lived what some would consider a hard life, but he was also lucky because he had to use his body day in and day out. He didn’t have to get to the gym and try to engineer work, he literally just worked.
Today we use things like Assault Bikes, Concept 2 Rowers, and True Form Treadmills to build a “bigger engine.” As great as it is to get cardiovascularly fit, it should just be a piece of the equation. A large portion of what we do should be non-exercise based movement. As my good friend Kelly Starrett says, “Train less and move more.”
Here’s some examples of ways to improve your movement during the day.
Standing desk- Even though you aren’t technically moving, it gives you options. You can change your stance, you can stand on one leg, you can move around easier. It’s a hell of a lot better than just sitting all day long.
Walk more- Take a couple short breaks per day and walk around. If you have business calls to make, do them walking. If you eat your lunch fast, you can get a 20-30 minute walk in during your lunch hour. Walk to work if it’s close enough. Walk to the park instead of driving the half mile it takes to get there. Walk your dog, he needs it. Just walk more. We’re the best walkers in the world.
Commute to work- If you live in a city where you can walk or ride your bike to work, that’s huge. Get some of your movement in with something you have to do anyway: be at work! Some big companies like MailChimp here in Atlanta are even incentivizing their employees to ride their bike to work. I think this is a genius idea.
Sit on the ground- Sitting on the ground is kind of uncomfortable. Because of that we have to change positions more frequently and the pressure of the ground in our muscles/fascia can be a really good thing. Get off the couch and watch Game of Thrones on the ground instead.
Hang- Find a tree limb, pull-up bar, or back of a stair case and try to hang for 2-5 minutes per day. We have some amazing shoulders and we rarely do anything overhead anymore. Hanging is a great way to get some movement in your shoulders and build some grip strength at the same time. It’s literally as easy as just grabbing something and holding on until you have to let go.
Try to engineer some more non-exercise based movement into your day and your body will feel so much better. The resting state of the human body should be pain free. If you’re in pain everyday that’s not normal. You should see someone to help alleviate pain and get a game plan together of how to keep yourself healthy long term. If you’re in the Atlanta or Decatur area, we would love to help you with this. If you’re not, seek out the help of a qualified medical professional.
The body demands movement. Either you give it what it wants or it’s going to break down on you. Try and move an extra hour a day for the next week. It may be the most important change you could make to your long-term health.
-Dr. Danny, PT, DPT, OCS, CSCS
This is a common question that we are asked at Athletes’ Potential. When delving into this seemingly deep conversation with patients, it becomes quickly evident that many people do not actually understand their benefits or insurance plans. It also becomes quickly evident to the patient that the current healthcare system is not an efficient one.
The short answer to that question is… there isn’t one. In fact, when folks ask if we “take” insurance, what they are usually meaning is, "Can I pay my copay to see you?” Sure, we “take” insurance in the sense that once the deductible is reached, the visit will be covered by a varying percentage. But copays are for in-network providers. What people don’t often realize is that there is still a deductible to be met, out of pocket.
The ideal insurance plan for young, healthy individuals is one that includes an HSA or FSA. Deductibles will be higher but assuming you have low healthcare costs, you will be banking money each year.
An HSA is a health savings account. It is a savings account for money that can only be used for healthcare. Many times, a business will match the amount of money you add to your HSA each month or some percentage of it. The benefit? This money can grow throughout your career into a large sum that is not taxed. So sure, use it as a store of money for healthcare but it is likely there will be some residual.
An FSA is a flexible savings account. Similar to an HSA in that it is a pot of money for healthcare. The biggest difference is that your company will put a lump of money in it at the beginning of the year and whatever is not used in that year goes away.
Other plans- HMO, PPO, etc are also common. It is usual with these that there is a network of providers that have a special rate and are often lower costs per visit—as long as the healthcare provider that you seek out is in the network.
A deductible is the amount of money that must be paid out of pocket before insurance will cover a percentage. Some insurance plans have one deductible and some have separate in-network and out-of-network deductibles.
Example: Sally’s plan has a $2000 in-network deductible and a $4500 out-of-network deductible. She pulls her hamstring and needs PT. If she chooses an in-network provider she will pay out of pocket until she reaches $2000 then her costs are covered 100%. If she chooses an out-of-network provider she is responsible for $4500 before her costs are covered 80%.
For a mild hamstring strain, the national average for visits is 10. At the usual PT clinic, they likely want you to come in 2-3x/week for 5 weeks. This cost per session could be anywhere from $50-300 depending on what the PT does with you and how long you are there. On top of that, your PT may be treating between 2 and 5 people at a time!
Technically this company “takes your insurance” but the payment still comes from your pocket. Until you reach $2000—which likely will not be met with the treatment for the hamstring.
Transparency: At Athletes’ Potential, transparency is important to us. Unfortunately, the healthcare system makes that muddy because of the complexity of plans that leads people to think all healthcare visits are a $20 copay.
The reality is, insurance is meant to be used as a failsafe for emergencies. Just like with the car—bad accident, the insurance helps. But if you need an oil change, that’s on you! Deductibles are so high and benefits are less because healthcare is being over-used. So rather than going to the cheapest place for the cheapest oil (that you will have to change more frequently), why not use the quality shop with the quality oil?
Why should you choose us over your in-network providers?
Our visit average per plan of care is half of the national average. In the long run, you will save money.
One-on-one sessions with a Doctor of Physical Therapy who understands your lifestyle and goals. We have experience with weightlifting, running, CrossFit, sports, yoga, gymnastics, etc.
Better outcomes than your usual PT clinic.
Care from a provider who thinks outside of the box, encourages input from the patient and helps establish long term performance goals.
Complete transparency with costs and plan of care.
Dr. Danny, PT, DPT, OCS, CSCS
Running is a part of the culture in the Army. You wake up early, meet at the PT field and go for a run 3-5x a week. We had formation runs where we’d run a few miles with 100 to thousands of other sounds yelling cadences. We even had runs to celebrate important battles or events in our Brigade’s history. The only problem is, most people in the Army have never actually been taught how to correctly run distance.
The statistics on running related injuries are pretty shocking. 75-80% of runners have a running related injury every year. That number bumps up to 90% when you start training for a marathon. With numbers like that you could make the case that we have a running injury epidemic in the US.
These numbers carry over to the Army and when I was active, I had an opportunity to try and solve this issue for the Brigade to which I was assigned to at Schofield Barracks.
Ironically, for someone that’s tall and skinny, I’ve never really been a naturally good distance runner. This led me to seek out a running coach when I was in Hawaii. The man I found was Ed Bugarin (Google search this guy, he’s no joke). Ed was a retired special operations soldier that trained runners and triathletes on Oahu. I spent a couple spent a couple weekends with him working on drills, cadence and getting stronger in areas I was weak.
After a month of running mechanics work, I was running faster for longer and injury-free. In particular I had resolved an issue I’d had since starting in the Army, shin splints. If you’ve never had shin splints before, they suck. It basically feels like someone is sticking a knife in the bone on the front of the lower leg.
After working with Ed, I started teaching soldiers in my Brigade how to run. I’d do this in small groups, 10-20 at a time. First, we’d video them running and break it down on an iPad in slow motion. Next we would go out and work on corrective drills and talk about pacing for longer runs. I did this literally with over 1000 soldiers in my Brigade. After all the classes I taught here’s the most important lesson I learned:
If your run form with shoes on looks like your barefoot running, you’ll be a very resilient runner.
It’s literally that simple. This is something Ed had me do on the road in front of his house until my feet bled. By the way, I do not recommend barefoot running on concrete. Cavemen didn’t run on roads! I’m a much bigger fan of running barefoot on grass.
Here’s why I think it’s so effective: When you take your shoe off and run, your foot gets to move naturally. You have 26 bones in the foot, 3 independent segments that articulate with each other and countless ligament/muscle attachments. Imagine if the Golden Gate Bridge could change shape in a split second and then return to it’s normal shape. That’s basically what your foot does. It’s an engineering marvel.
Going barefoot allows you to let your foot do it’s job. It also doesn’t give any additional support. That way we can start to rebuild the intrinsic muscles of the foot as well as toughen the skin of the bottom of the foot.
Lastly, running barefoot solves the biggest problem for most of the runners I work with- cadence. Cadence is how many steps you take in a minute. You’ve probably been told to just stride it out and try and create as long of a stride as you can. Here’s why.
Stride Length+Stride Frequency(cadence)=Run Pace
If you increase your stride length you will run faster assuming you maintain the same cadence. You’ll also significantly increase your likelihood of having shin splints, plantar fasciitis and running related knee pain.
The better solution is to increase cadence. This would cause us to shorten our stride but increase the number of steps we are taking per minute. Imagine like you’re running on hot coals and pull your feet back off the ground. This also puts the foot landing position under our body instead of way in front of our body.
The Principle of Parsimony- It is pointless to do with more what is done with less.
This is principle is based off the theory of Occam’s Razor, essentially saying the simplest solution is the best solution.
Want to increase your running efficiency, build foot strength and decrease likelihood of injury while running? If so, add in barefoot running once a week to your runs. Here’s how I like to program it:
Find a nice, flat grass field or the inside grass area of a track.
Perform 4 rounds of this:
50 meter high pull drill on the right (start video at minute 1.26 for drill)
50 meter high pull drill on the left (start video at minute 1.26 for drill)
Run 100 meters moderate pace
Put your shoes back on and focus on mimicking the feel of the barefoot run strike and cadence while running your intervals.
Run 4-8 400 meter intervals 80-85% effort.
Rest until you can perform a 7-second exhale breath before starting the next run.
Keep it simple, focus on running as a skill and you’ll be a much happier, injury-resistant runner for years to come.
-Dr. Danny, PT, DPT, OCS, CSCS
I hate to say it but I resent our convoluted healthcare system.
We live in the greatest country in the world and yet we have such a confusing and broken health care model. I’m not here to write about my idea for a solution. I’m here to tell you how we are avoiding many of the pitfalls of our current medical model.
First, let me add some context by telling you about a recent experience my family had with a physician group.
My wife had been feeling tired for almost two years. We thought it was just the fact that we have two kids under the age of 5 and we own a business. Both of those things can be rather stressful.
We did blood work and were able to get her feeling better but it was always a short lived response.
Finally, we decided to see an internal medicine doctor and they narrowed it down to either celiac disease or small intestine bacterial overgrowth (SIBO). This was the prognosis because she had been put on antibiotics for a sinus infection around the same time she started feeling excessively tired almost two years ago.
We go to the office visit, the doctor is behind schedule and spends hardly any time with us. He gives us a couple options for testing and we decide to do a blood test to rule out celiac disease. We ask him and the front desk staff what the office visit will cost and what the blood test will cost.
They tell us they do not know.
Fast forward to 1 month later, we get a bill from the physician for $360 for the office visit. That’s $360 for a 15 minute conversation with the physician. The next day we get a bill for the blood test. Grand total for the blood test, $940. One blood test costs $940? What the hell kind of X-Men next level blood test was this?
The results of the test showed there was no celiac disease so the solution was another round of antibiotics to fix the SIBO. Great, let’s fix this thing. So we ask the doctors office how much will the antibiotics cost? They tell us they don’t know. We call the insurance company and ask what the antibiotics will cost, they tell us they don’t know.
Alright, you’ve got us by the balls, let’s just get the antibiotics and wait for another bill in the mail. The good news is, the antibiotics worked great. My wife has been feeling better than she had in years. The bad news is, the bill we got for the antibiotics was $1650.
Let’s add this all up.
One office visit = $360
One blood test= $940
One bottle of antibiotics= $1650
Grand total= $2950 plus hours of office visits and testing and phone calls with the insurance company
Here’s my general feeling throughout the entire process: Are you kidding me?
As much as the cost of everything was, that’s not the part we were mad about. It’s the complete lack of transparency in the entire process. Tell me I’m going to have to get a $1650 bottle of pills that will cause my wife to feel better and I’ll gladly pay that. Send me a bill for the same amount a month later and now you’ve got an angry consumer.
Transparency is the key. Communication is vital. This is a relationship between a patient and their medical provider. It’s no different than any other relationship.
When I opened Athletes’ Potential 3 years ago, this was a core value for us. Transparency in medical care. Why is this so rare?
If you ask me what we charge, I’ll tell you. We charge $190 for an hour long visit and it’s an absolute steal compared to the crappy healthcare you’ll get pretty much everywhere else.
-We’re always on time because we respect the value of your time.
-We’ll never send you a bill a month later for some amount of money.
-You’ll always have email access to your provider to answer any question you have because we want you to feel comfortable through the entire process.
-We treat people the way we would want our own family to be treated.
I see more and more medical providers moving this direction. It’s better for the patients, it’s better for the provider and it sets the precedence for an honest, long-term relationship.
Sadly, many of you have probably gone through the same process my wife did. This isn’t an isolated incident that we can chalk up to bad luck or chance. This is a daily occurrence in our medical system. I hope it continues to move toward a better model but in the meantime we’ll do our part with our patients.
We strive for honest, selfless service of our patients everyday. That will never change.
-Dr. Danny, PT, DPT, OCS, CSCS
One of my patients woke up the other day with pain that started on one side of her lower back and radiated down her hip, hamstring and into the side of calf. She told me this while I was making pancakes on Saturday morning for our kids. My wife is my number one patient so I’m writing this blog post for her. I know that many of you suffer from some degree of pain radiating down a leg as well. My goal with this blog post is to teach you a few simple strategies to ease these symptoms.
Let’s start by defining sciatica. It’s actually an umbrella term describing pain that radiates along the course of the sciatic nerve. The sciatic nerve is a huge nerve that starts in the lower back. It comes together and courses down the hip, through the hamstring and then branches into two other nerves at the height of the knee. If you’ve ever sat on something hard like a wallet for too long on one side, you may have experienced some short term sciatica.
What sciatica is and what causes sciatica are two separate things. Sciatica itself is the pain/irritation you feel down the leg. The cause of sciatica can be a number of different things.
First, it could be coming from your lower back. This could be due to a bad disc herniation, poor movement at the small joints in the lower back, lack of mobility in the hip and even prolonged positional pressure like sitting on a plane to Australia.
Because of the many varying causes for sciatica, my goal is to give you a number of different self-management options. We’ll cover three different areas where you could improve and ease much of the sciatica that you do experience.
These areas are:
Step 1: Easing sciatica issues by getting out of positions that cause increased symptoms
This seems blatantly obvious to most people. The reality is that many people stay in pain producing positions for extended periods of time.
For instance, let’s take a traditional office-based job. Sciatica can be irritated with prolonged sitting, especially in a very flexed position. This puts the lower back into a flexed or rounded position. Because of this forward flexed position, the discs (think shock absorbers) of the lower back had additional stress placed on them throughout the day.
Take a look at the picture below. This shows the amount of pressure on the discs of the lower back in different positions. You can see that sitting in a forward flexed position increases the amount of pressure on the discs by 85% compared to standing. Even sitting in a good position increases the pressure by 40%.
What this shows us is your best option is to stand more, if possible. Even better, stand up and walk around more. Walking is like spraying WD-40 on the joints of the lower back and hips. Getting a standing desk is a good option for most people. They are becoming much more common in workplaces and even in schools. Stand Up Kids is a great reference for some of the other health benefits to getting a stand up desk.
If you are stuck sitting at a desk and you notice your back feels better when you stand, a lumbar roll may be a good option for you. These are firm rolls that are placed at the height of the lower back. They block the user into a more upright sitting position and deter much of the slouching that we see when people sit at a desk all day. You can also make yourself one of these pretty easily. Just get a gym towel, roll it up tight and duct tape around the roll. That’s it. It may not look as cool but it works.
Step 2: Easing sciatica issues by adding in self-mobility work to muscles in the lower back and hips
Let’s go over two areas you can start working on daily to help ease pain down the leg. For all of these areas our dosage is this: perform them twice a day, two minutes each technique per side. For all three techniques it should take you about 8-10 minutes with transitioning from one exercise to the next.
The first muscle is the quadratus lumborum. We’ll just call this muscle the QL because the actual muscle name sounds like a Harry Potter spell. The QL is a muscle that is one either side of the lower back and connects from the rib to the lower back to the pelvis. This muscle can refer pain down into the back of the hip region and is notorious for being irritated in people who sit all day or lack strength in their trunk.
The second muscle is actual a group of muscles. We call it the lateral hip complex but it includes fibers from the gluteus maximus, gluteus minimus, gluteus medius and deep rotators like the piriformis. These muscles, in particular the piriformis get blamed for much of the sciatica people experience. We’ll catch a little bit of all of these muscles with this one technique.
Step 3: Working on improving control of the lower back and hips
This step is often the one that people skip over. This is especially true if someone gets pain relief with some of the mobility techniques or a passive treatment like dry needling or massage. Controlling your own body is massively important. I love the saying, “Strength is never a weakness,” and it’s true in this case. Here are two techniques to get some control back in the right areas.
The first thing we want to do is account for a huge area of dysfunction in almost every patient I see. That area is breathing! I know, you’re obviously breathing if you’re alive and reading this article. Just because you’re breathing doesn’t mean that you haven’t started doing it in a compensated way. We take an astounding 20,000 breaths per day. Many of us who have had issues with sciatica or lower back pain tend to breath in a dysfunctional pattern.
The main dysfunctional pattern I see in my patients is chest breathing. These are the individuals that just raise their rib cage and shoulders every time they breath. What they neglect to use is the diaphragm to initiate the breath movement. This can happen for a number of reasons but for the purpose of this article let’s just leave it as something we want to try to correct.
Below is a breathing exercise you can start using to correct this problem. Try and get 5-8 minutes of this breathing drill in per day. You can break it up into 1-2 minute bouts or get the whole 5-8 minutes in at once if you want.
The last exercise you can add in is to help develop some control in extension between your lower back and hips. This is an exercise called the banded bird dog and it requires a significant amount of stability/control. It also connects the hip with the shoulder on the opposite side. This is very important because we function so much in rotational patterns. Think about throwing a ball. If you’re throwing with your right arm then your plan leg is your left leg.
This diagonal control is very important for the lower back and controlling torque through the spine. Getting strong in this pattern is one of the best ways to create long term function and decrease the likelihood of sciatica issues.
Try and do 3 sets to form fatigue with as much rest in between sets as you need. Form fatigue is when you can’t perform a perfect repetition anymore.
If you’re like me you probably read the highlighted bullet points and then you’ll read this last paragraph (I call it efficient reading!). Let’s go ahead and summarize everything and make sure we’re clear on what to do.
First, get out of positions that cause sciatica. Move to a standing desk if possible and if not get up and move around as much as you can. Next, start working on mobility to areas that can be problematic for sciatica. This includes the QL and the lateral hip. Last, start getting some control back in your hips and lower back. Control and strength in these areas will be a huge benefit to you in any physical activity you chose to do.
Give this stuff a try for a week or two. If you feel like you’re not making progress or are ready to get some one on one help, we can help. We help people just like you get back to running, golf, tennis, CrossFit and cycling without sciatic pain. Check out our testimonials pain to see what others have to say about the work we do. Stop avoiding activities because of pain, get some help and get back out there.
- Dr. Danny, PT, DPT, OCS, CSCS
Dr. Danny and staff's views on performance improvement, injury prevention, and sometimes other random thoughts.