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Running has been around for a long, long time… you could even make the argument that it’s been around since the beginning of time. It’s a fundamental movement that humans perform and officially became a sport all the way back in 776 B.C. when a foot face was the FIRST ever event in the FIRST Olympic games. Then, fast forward to 490 B.C when Pheidippides ran roughly 25 miles to deliver news of a victory against the Persians at the Battle of Marathon, which gave way to the marathon race being added to the first-ever international Olympics in Athens, Greece (which only 9 out 25 athletes finished!). This entire blog post could be on the history of running. It’s an integral part of being human. So we should be pretty good at it; right? Well… not really. Running related injuries are some of the most common injuries that we see in the clinic. When you look at the literature, anywhere from 36% to 57% of the running population will experience an injury every year and upwards of 75% of all running injuries can be related to overuse. That’s a lot of people who are getting injured every year. Too many. We see a lot of those people every day at Athletes’ Potential, which has allowed us to pick up on something - something that is criminally absent from running programs: Strength Training. This. Is. Huge. No matter how you try to look at it, the lack of strength training in the running community is astonishing and unwarranted. Time and time again research is proving the injury reducing and performance boosting benefits of strength training for runners, yet I still hear things like, “I don’t want to get bulky,” or, “it will slow me down,” or, “I’ll get too stiff.” All of these are based on archaic midsets and need to be changed. Nowhere in the literature are these thoughts supported and, in fact, it finds the exact opposite.
However, all that being said, strength training has to be specific to the performance goals of runners. You shouldn’t go out and try to do the exact same training program as a bodybuilder if your goal is to be able to run a marathon. Movements that are going to improve single leg loading and train in multiple planes of motion is the name of the game for runners. Below are some of my favorite exercises to do just that. Bulgarian Split Squats Single Leg Romanian Deadlifts Step Ups with Knee Drive Finish Lateral Lunges Hollow Rock Step Downs Band Resisted Side Steps If you’re dealing with an injury and looking to boost your performance as a runner, reach out with any questions. We design and implement programs to help our athletes, whether you’re someone who doesn’t know where to start or has had an unsuccessful rehab experience. It is our goal for the people we work with to return to their sport or activity performing better than they did before. Thanks for reading, Dr. Jake, PT, DPT, CSCS
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Strength and flexibility training along with skill practice are usual as we train for marathons, weightlifting competitions, tennis matches and golf tournaments. But have you ever thought about training your diaphragm? What about your pelvic floor? What if I told you there is one major key to training that many folks skip right over? Would you try it? Here is your chance. The diaphragm is a large muscle in the body with direct connections to the lumbar and thoracic spine and ribs. The pelvic floor mirrors the diaphragm- like the younger sibling that mimics the older- and has connections to the pelvis, sacrum and hip rotator musculature. What are the most common injuries and dysfunctions that WE see? Low back, SI joint and hip! “Core strength” is definitely a buzz word in the fitness industry these days. And if you ask 5 people what it means, you are likely to get 5 different answers. So first, let’s talk about the “core.” What is the core? Your core, or the “soda can," is made up of your deep abdominals in the front, back muscles in the back, pelvic floor on the bottom of diaphragm on the top. These muscles work on concert to create pressure on your midline- think a full can of soda that has not been opened. If there is weakness or dysfunction in one of these muscles, then the midline is depressurized- the can has been opened.  So as you run, lift weights, swing a tennis racket or play with your kids, this pressurized can is helping you create torque and move through space with both dynamic stability and mobility. To learn more about this system, check out my blog about pelvic floor anatomy and leaking with exercise. How can I train it? DIAPHRAGM No doubt your diaphragm works; you’re sitting here breathing right? But you can train it to be strong and more effective with your training. A great place to start is the diaphragmatic breath. Not only does this help us work towards full excursion of the diaphragm with a deep breath but it also help relax the pelvic floor. Relaxation of the pelvic floor is just as important and being able to contract it! Try the 90/90 breathing drill and see if you are able to focus on the moving the ribs cage out and up rather than shallow chest breathing. This is essential for control. To add more strength work, try blowing up a balloon in the same position and breathing pattern! PELVIC FLOOR As far as the pelvic floor goes, I am definitely a proponent of seeking assistance from a women’s health PT before starting specific strengthening programs. They can give you a better idea of what YOUR body needs- strength, endurance, relaxation. But a great place to start is imaging creating controlled amounts of tension through your pelvic floor. This can be cued for most folks as avoiding passing gas or gently stopping a stream of urine. (Don’t ever actually stop your stream of urine, this is just a cue for a gentle contraction.) So this contraction should be as intense as the activity that you are performing. Lifting a pencil would be perhaps a 2% contraction, where lifting a heavy couch might be closer to 100%. This sliding scale applies to both pelvic floor and abdominal contractions. Only as much tension as needed for the task! How does posture relate? Going back to the soda can analogy- can you picture how bad posture is equivalent to having dented and bent my soda can? Not idea for keeping that pressurized cylinder! An easy example for this is running. If you have the “grandma lean” from the hips rather than the ankles, your can is bent. These folks tend to have back issues with running, perhaps some leaking and dysfunctional breathing. Straighten up the can and breaths are less challenged and your back feels better! ,
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If you are dealing with back, hip, pelvic pain with activity try some of these strategies. This can also improve your breathing and postures/form with fitness. This merely scratches the surface but may stimulate some ideas about what is holding your training back. After you try these, if you are still having issues or questions, come see us! We love to help people like you get back to doing what they love and living a high functioning, pain-free life. Thanks for reading, Dr. Jackie, PT, DPT 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 It seems that almost every runner has experienced “plantar fasciitis” at some point. Although there are many stretches and exercises that provide short term relief, it would be best to find out why the bottom of your foot and heel continue to be painful. Sure, there are quite a few factors that could lead to this pain but what if targeting one joint in your body could change your running and decrease your pain for good? Your foot is made up of 26 bones and 33 joints. Proper biomechanics of the foot depends on the appropriate strength and mobility of these joints. The great amount of joints allows the foot to conform to the surface so we can walk in the sand at the beach but also through the grass at home. The feet are our foundation; holding all of our body weight and acting as levers to propel us forward in walking and running. It sounds really complicated- and it is- but there is one joint that tends to be overlooked that can significantly impact your foot function. It is the great toe aka the big toe. The great toe and its mobility are integral in push-off while running. The function is described by the “windlass mechanism”. Essentially, the great toe extends which will tighten the plantar fascia. The tightening of the fascia at the bottom of our foot elevates your arch and keeps the foot from collapsing so that you can effectively push off at each stride.  Without full great toe extension, it will be difficult to allow your weight to advance forward over your foot as you run. Thus, your biomechanics will change. Our body is amazing because it will change and adapt to decrease pain but sometimes these changes are not ideal for long term. Some ways your body will find to get around lack of great toe extension is running with your feet externally rotated (toes out) or taking much shorter stride lengths to decrease the pressure at the toe. Long term changes in running form can begin to effect other joints up the chain- knees, hips, back. The plantar fascia may experience more tension as the toe becomes even more stiff which then can manifest as heel, toe or general foot pain. What does your great toe extension look like? One way to check your great toe extension is in a relaxed position as in the picture below. Your foot may be resting on a surface and push your great toe up gently until you feel resistance or discomfort. Checking great toe extension in a lunge position will be more similar to running and the toe can be pushed back passively by the ground. In the photo below, notice that the left toe extends much further than the right. Ideal range of motion is about 70 degrees of extension, though some people may have more!  If you find that your great toe extension is lacking, try these self-mobilizations at home. Working on these before and/or after a run would be ideal. Spend a few minutes on each mobilization and see how your feet feel: If you have restriction, 2 min each day of this mobilization can start to chip away decreased mobility. Using a lacrosse ball, spend 2-3 min each day on the fascia at the bottom of your foot.
As I mentioned before, great toe limitations can greatly affect your biomechanics. Factors such as stride length, foot contact, hip and knee position through swing can each be altered with foot restrictions and pain. At Athletes’ Potential, we perform Run Form Analysis for our athletes to break down their form individually and change any deviations we may see. Even if you don’t have pain currently, having a professional break down your run form can be eye-opening and help prevent speed bumps in training down the road. We would love to help you stay active and get back to your training throughout the Spring and Summer! Give us a call today to schedule Run Form Analysis or a Physical Therapy appointment to stop your heel and foot pain fast: 470-355-2106. Keep checking in on our blog weekly; May is all about running! Thanks for reading, Dr. Jackie, PT, DPT, OCS, CSCS  Although your pelvic floor and your feet may seem as though they are different and non-related structures, this is not the case. The connections are fascial, neural and biomechanical. Your feet are your foundation; how they contact the ground dictates all movements at your ankle, knee and hip. Soft tissues and fascia in your feet have vast connections to the legs, hip and back. The feet and pelvic floor, despite the distance from each other, also share neural input! Fascia Fascia is the thin covering of your muscles that looks like a spider web. The posterior fascial line runs from the bottom of your feet, up the back of your legs and torso and to your head. Along the path, the fascia connects to the ischial tuberosities, or the “sit bones”. Muscles from your pelvic floor also attach here! So tension along this fascial line will directly impact your pelvic floor. Essentially, any joint the fascial line crosses and soft tissue in the area can be effected. A great place to start is the feet! Use a lacrosse ball to mobilize the fascia and tissues in the bottom on your foot and around the ankles. Nerves The nerves that are responsible for function around your pelvic floor—sphincters, PF muscles, deep hip rotators—are also responsible for the function of your intrinsic foot musculature. Signs of foot weakness may by indicative of pelvic floor weakness, and vice versa. So, strengthening the foot musculature and stimulating these nerves may help with pelvic floor function. Unfortunately, many athletes wear big, padded shoes which decreases the amount of work the foot musculature must do! Neglecting to walk around on bare feet is robbing your feet of their natural ability to stabilize and form to the surface but also decreases in amount of neural input. We suggest barefoot walking and running to increase the input through your feet and begin to re-strengthen the small foot muscles. The best way is to find a grassy area, about 50-100m in length and run repeats barefooted. Your feet will be challenged much more than when running in squishy shoes, so ease in. You will also notice that your running form is probably different (better). Heel striking when barefoot in quite painful, so the body will automatically shift to more of a midfoot strike—which is good! Biomechanics The ankles drive the movement of the whole kinetic chain- the knee, hip and pelvis and spine. Dysfunction or pain in any of these areas can be stemming from faulty foot mechanics. For example, walking with the toes pointing outwards will cause your ankle joint to perform on a slightly different axis than it was designed. This will be demanding on the ankles and all the way up the kinetic chain. The knee tends to be stuck in the middle and pushed around. The ankle dictates the movement of the lower leg and then influences the upper leg. The knee is just where these two units connect. So you will notice, we do not focus on biomechanics of the knee. The hip has a direction connection with the pelvic floor. One of the deep hip rotators, the obturator internus, connects to the pelvic floor. With this connection, the amount of hip rotation will change (increase or decrease) the tension of the pelvic floor. Putting it all together: Our feet control the movements of the joints above it. If your arch collapses (flat feet), the lower leg will rotate inward and the knee will follow. Up the chain, the thigh will also rotate inwardly which changes the tone of the pelvic floor. The angle of the knee will change with all of this, but remember it is not the driver of the dysfunctional motion, rather the passenger. Living with faulty biomechanics (however slight) can perpetuate back, hip and/or pain and dysfunction. Rather than starting with an MRI for the back or kegals for the pelvic floor, why not see if changing how you move can decrease symptoms? A simple way to put this into practice is a slight change during a body weight squat. Move your feet to a comfortable squat position. Before sending your hips back and down for a squat, screw your feet into the floor. That is, acting as though you are moving your big toes further apart but your feet are not moving. Keep the toes on the ground! This creates torque at the hip. By engaging the external rotators, you are creating tone at the pelvic floor--remember the connection? You may also notice that the arch in your foot becomes more pronounced. Hello intrinsic foot musculature! This motion is also helpful for those with hip pain, especially pinching at the front. In the photos below, my feet are not in a squat stance, but I am showing the subtle external rotation. You can see the largest differences at my knee caps and the direction they are facing. Also, notice my arches after the external rotation (bottom photo). They are higher! You can see a greater difference on my left foot. My whole foot stays in contact with the ground.   Recap: The foot and the pelvic floor have more connections than you may realize. They share fascial connections as well as neural. Taking the time to mobilize tight tissues and allow for more input with bare feet can have positive effects on hip, back and pelvic floor issues. The ankles largely drive the entire kinetic chain from the bottom up. So, taking care of the foundation of movement will be the most beneficial!
Thanks for reading, Dr. Jackie, PT, DPT, OCS, CSCS How Runners should warm up, but don't. All too often the answer is “I just run my first half mile slower and then get into my running pace.” Paula Radcliffe, one of the greatest female marathoners in English history, does a warm up for 45-50 minutes before a marathon race! That’s longer than most of us will run for our work out. So why is it that elite runners and athletes put such an emphasis on warming up and we do not? There are a few factors that can lead to the lack of using a warm up.
We’re going to try and solve these issues with the warm up and put something together that you can do in a short period of time (15 minutes) before your next run. Here’s the strategy in a nutshell: we need to get tissues opened up that can be primary limiters of running mechanics and we need to get muscles firing that need to be working for proper movement. Let’s start with opening up the tissues we need for running.  One of my favorite pre-run mobilization for runners to do is a quick pressure-based technique for the bottom of the foot. All you need is a lacrosse ball, baseball or some other type of hard ball to step on. Do not use a racquetball or a tennis ball, it’s a waste of your time because it’s not enough pressure. We want to open this area up before running because every little bit of increased ankle dorsiflexion will be a mechanical advantage for us in particular on hills. Do this technique below for 1 minute on each foot Next, we want to open up the hips, in particular hip extension. This allows us to get our leg behind us while we run without having to compromise our back to do so. This is also a huge area of emphasis because of the amount of time most of us spend sitting. When we sit we are in a hip-flexed position. When we run, we drive into the opposite range, hip extension. If you sit all day in hip flexion, your tissues get tight in that range and cause you to lose hip extension. This is essentially a hand brake that you have with your forward movement. By opening up your hip extension, it allows increased ease of movement in the running gait. Here is what you’re going to do. This stretch is called the world’s greatest stretch and it really might be! Perform this sequence twice on each side. It should take you about 1 minute to go through this sequence on each side. This gets things moving at the upper back, front of the hip and hamstring/calf. It’s really a catch all for many athletic movements but in particular running. Alright, we should have those done in about 5 minutes. On to the priming of the movement that we want to perform. I’m a big fan of working on the skill of running. That’s right, running is a skill and if you treat it that way your body will thank you and your finish times will be better. Practicing certain movement prior to running can help us ingrain good moving patterns while we are running. The first drill is a pulling drill that I use all the time with my athletes. Do 1 minute of pull drill work like Nate explains in the video. After that, run for 1 minute trying to emphasize the same exact pull feeling that you got doing the drill. The last drill will be to work on your cadence. Cadence is how many foot strikes you have in a minute. Coaches and researchers have found that having a cadence around 180 foot strikes per minute is a very efficient place to run. This allows for you to pull your foot quickly off the ground and minimize some of the elongated ground reaction force that happens with a very slow cadence. Download a free metronome app on your phone. Put the beats per minute at 90. You’ll try and have your right foot hit the ground every time it bets. This will equal 180 foot strikes per minute since you’re only counting the one side. Run for 1 minute at this cadence but try and keep a slow to moderate pace. Don’t go bananas and try to run a 4 minute mile because you’re increasing your cadence. Stride length plus high cadence is what allows us to run really fast efficiently. Shorten your stride and keep your cadence high during this drill. You should imagine you’re running on hot coals. In summary your warm up should look like this:
Don’t be surprise if you’re breathing a little harder after your warm up. That’s why it’s called a warm up! You’ve got to prime your body for what you’re about to do. This could be the single most important thing you can do to maintain your body as a runner and improve your skill of the movement. If you’re a runner, triathlete or CrossFitter that wants to improve your running or are dealing with a run-related injury let us know. We’ve literally helped thousands people with knee, foot, hip and back issues related to running. Don’t wake up every morning wondering if this is the day your knee will stop hurting when you run. There are answers out there and we can help. Contact us below if you would like to set up a free talk with one of our Doctors of Physical Therapy to see how we can help you run pain free. Thanks for reading, Dr. Danny, PT, DPT, CSCS Full disclosure, I hate to run. There, I said it and now I feel much better. I actually have more of a love/hate relationship with running. I love the science and technique of running mechanics. I’m actually fascinated by how you can squeeze more speed and efficiency out of someone that just assumes they are a bad runner. When it comes to my personal desire to go for a run, it’s just not there. I blame the Army. They kind of ruined it for me with the whole wake up early and do a forced run almost every morning. Because everyone in the Army is technically a runner, we would see a TON of running injuries. I would guess that 50-60% of what I typically saw was running related. That’s literally thousands of running related injuries that rolled through my office during my time on active duty. Now that I’m out of the Army and have a private physical therapy practice in Atlanta, I’m still seeing runners. I’ve actually developed some good relationships with a few of the bigger running groups here in Atlanta and it’s been a blast to help these athletes get better fast. Healing from an injury is great but do you know what’s cooler than that? Winning! As a runner you are competing against others when you run but for most of us we are constantly competing against yourself to get a personal record (PR) on a race. I recently had a runner come to see me for some plantar fasciitis. If you are reading this and have actually put some decent volume in training you probably cringe when you hear the words plantar fasciitis. It’s basically the kiss of death for a runner and will take you out of your sport for a long time, if not fixed.  This individual had seen everyone under the sun for this issue including, podiatry, chiropractic, massage therapy and a different physical therapy group. This problem had been going on for about a year at this point and he was obviously frustrated when he came in to see me. He was also very surprised when I told him that we had to watch him run. Can you believe that? This guy had been to multiple other medical professionals and not a single one took the time or even thought it was important to watch him run. This is crazy! What if you went to a mechanic and he didn’t actually drive your car around to see what the problem sounded like or how the car acted when it was running? That's basically what had happened to this athlete. After watching him run it was pretty obvious he ran like crap. I won’t get into all the specifics of the running mechanics in the blog but just remember my professional diagnosis was not plantar fasciitis, it was you run like crap. My prognosis was good. It was forget about your foot pain, we are going to make you faster! He was also had really bad hip mobility and tons of hip weakness. We spent the first two visits working on run form and getting some of the pain down in the calf/foot with soft tissue techniques to include Hawk Grips work and Performance Dry Needling.
Over the next two visits we re-tooled his running form even more and added in strength/mobility work for his hips. Think of your hips as the engine of movement for running. If you have poor hip strength/mobility it’s like riding your bike around on flat tires. Sure, you can still ride a bike this way but it's a hell of a lot easier to ride with with some air in the tires. Running is hard enough, don’t make it harder than it has to be. Below are the exact 3 exercises we nailed down for this athlete to do to help fix this chronic foot pain and none of them have anything to do with the foot directly. The order of completion was this. Pre-run (videos below) -Anterior Hip Mobility Opener 2 minutes per side -Band Hip Pull Throughs 2 sets just to muscle fatigue not failure -Band Hip Side Steps 2 sets just to muscle fatigue not failure This athlete typically ran 3 days per week so that’s all the strength work we added in for him. He did complete the anterior hip mobility opener 2 minutes per day regardless of if he ran or not that day. So what was the result? 4 visits over 6 weeks. 5 minute PR on his 10K time. Oh and no foot pain. If you’re having running-related problems, fix the cause of the problem not just treat the symptoms. If you’re in the Atlanta area and are a runner that has been dealing with injuries we can help. We’d love to chat for a few minutes and see if you are a good fit for what we do. Fill in the contact request below and we’ll set up a free 10-minute phone consultation with one of our Performance Physical Therapists.  Dr. Danny Matta DPT, is a Physical Therapist and Strength Coach based out of Atlanta, Ga. He teaches on the topics of movement efficiency, mobility and injury prevention internationally. He is also the Director of the Tactical division of the renowned MobilityWOD group started by Dr. Kelly Starrett DPT. Full bio here. June 2014 July 2015 Testosterone- 802 Testosterone- 421 HbA1c- 5.3 HbA1c- 5.7 HS CRP- 0.9 HS CRP- 2.6 Let’s face it: we live in the information age. You can find out pretty much anything by searching for it on the internet. There has also been a massive shift toward data driven decisions. I see it first hand in my business when I look at our website analytics. We even see it with things like Wodify as athletes start tracking all their workouts, strength numbers, training sessions and making training changes based off actionable data. Think of this blood panel like a snapshot of what’s happening internally. As part of the initial testing phase to work out the kinks, my wife and I both went through the process to get blood drawn and see how long it would take to get our results back. When I got my results back, I was shocked! Last June, as part of my transition out of Army, I requested some blood panel work from my Physician Assistant. I wanted to start doing a more in-depth panel of blood tests yearly just to see where I stood and to gauge my nutrition/training based off that. For me, I used that as my initial data to compare this lastest to. Here are the tests that were grossly different: A good number more tests were performed besides these three but these were the ones that had the most noticeable changes. What does this even mean? In the past year my testosterone production had decreased by 50%. Testosterone is very important for recovery, building muscle, maintaining a lean body and many more very important tasks. According to a 1996 study by Vermeluen et. al, the average testosterone levels for someone my age (30 years old) is 617. To make matters worse, in the same study he found that the average testosterone levels of males age 75-84 was 471. Talk about kicking me while I was down! This basically shows me that there’s a decent chance my 90 year old grandfather and I have the same testosterone production at this time. Next is the change in HbA1c. This is a marker of average blood sugar levels over the past 3 months. Most of you have probably heard of diabetes. It’s basically a disorder of high blood sugar levels in the body. It can either be genetic type I or developed type II. The range for HbA1c is pretty clear. Anything below 5.7 is normal, between 5.7 and 6.4 is prediabetic and over 6.4 is full blown diabetes. My number is elevated quite a bit and it technically puts me in the prediabetic range. Lastly, was the change in my HS CRP. This is a marker of global inflammation in the body. To be clear, inflammation is not a great thing to have in the body. Increased values on this test in particular have been drawn to increased risks for cancer, heart attacks, neurologic disorders and type II diabetes. My HS CRP was elevated compared to where it was a year ago going from 0.9 to 2.6. Now, when you see these big changes in values your physician should ask you a few things. First, did you do some crazy workout that day or the day before? Did you go out with your friends the night before, end up at the Clermont Lounge and down PBRs all night? Have you had a week of really bad sleep before this test cluster? All of these things are important to know because it can give us false values. By the way, my answer to all these questions was no. Here’s what all this means. In the past year my health, internally at least, has slowly been trending in the wrong direction. So how did all this start to go wrong? I would have to attribute it to a number of factors. First, I started a business. For any of you that have ever started a business I probably need no further explanation. For those of you that haven’t, it’s the most difficult and stress-inducing thing anyone could ever do. Not only that, but I teach for another group (MobilityWOD) and in the past 12 months, I’ve accumulated about 70,000 miles on an airplane. I also have two small kids under the age of 4 and I typically sleep an average of 5-6 hours a night.
It’s not all bad news though. Mom, if you’re reading this don’t freak out and call an ambulance for me! I’m glad I did these tests because I had been feeling fatigued and like I was recovering poorly from my training sessions for about the past 6 months. Now I have some quantifiable data to help me make changes and retest to see what’s working. Changes will be made and I will retest in about 1-3 months. All of these markers are reversible with some supplementation changes and behavior modification. I’ll write up a follow up post once I’ve done my blood testing again. It’s time to make some changes! -Dr. Danny, PT, DPT  It’s 5am, you’re up and getting ready for work. You got 6 maybe 7 hours of sleep last night and you’re off to crush the day at the office! Coffee in hand and listening to your favorite podcast on the drive (most likely the Doc and Jock podcast). You get through your normal day and then sit in traffic for 45 minutes on the drive home (Atlanta traffic can be rough). Once you’re home it’s family time. You haven’t seen your kids or wife all day and all you want to do is hang out with them. Before you know it, it’s 7pm. Your kids are acting crazy because they don’t want to go to bed and you’re starting to get hungry. Once the kids get to bed you have a couple choices:
I know to many of you this example may or may not resonate. This is basically my schedule 3-4 days a week. For many people lacking time is a common frustration. For me, it happens to be dictated by owning a business, having kids, enjoying spending time with my wife and creating online content like this blog post. Of all the options above I typically go with option 4 on a day like I explained. Hitting a short but intense workout before I eat dinner is an easy way for me to keep some regular training in my schedule on busy days like this. My preference for these late evening workouts after a hectic day- the kettlebell! I feel everyone should have at least one kettlebell at their house. We have two at mine, a 24kg bell and a 16kg bell. They don’t take up much room, are pretty inexpensive and they give you a ton of options when doing a training session at home. Here are a few examples training sessions I like to do that just involve one kettlebell.
As many rounds as possible in 20 minutes. 24kg bell for men and 16kb bell for women. -10 overhead swings -run 200 m -5 power clean and jerk each arm https://www.youtube.com/watch?v=bjKGrZ7-pWQ -run 200 m -10 goblet squats -run 200 m Perform 5 rounds of 3 Turkish Get Ups each side 20 russian swings 10 head cutters https://www.youtube.com/watch?v=tJA07NpN7pM Rest 1 min Every minute on the minute for 15 minutes 5 single arm KB snatches https://www.youtube.com/watch?v=g3c73NahdjU 5 burpees Complete each round as fast as possible. Throw in some midline stability work at the beginning or end and you have yourself a respectable little training session. Not only that, but in the time it would take you to drive to the gym and back, you completed a training session. You may not be headed to the CrossFit Games doing just these type of workouts alone. Chances are, if you’re reading this you aren’t going to the CrossFit Games regardless! Staying committed to regular training sessions is important for moving well, staying fit and being able to keep up with two crazy kids. -Dr. Danny, PT, DPT One year ago, I was sitting at a desk in an office in the Troop Medical Clinic next to the U.S. Army Airborne School at Ft. Benning. I remember my last day as a Physical Therapist in the Army. I didn’t see patients that day. I had to go around the post and make sure I was cleared to leave and was fully out processed. This requires a lot of waiting as many other soldiers are doing the same thing. Waiting in long lines affords you an incredible amount of time to think and in my case worry about the future. As I sat in the endless lines to finish my out processing from the Army, the same question kept running through my head. Am I making the right choice? I would think anyone that has started a business has had the same doubts. This same question constantly ran through my head for about the first six months after I separated from the Army. I had spent 7 years in the Army. I was literally born in the Army since my dad was a career Army officer. I grew up on military bases, I had a high and tight haircut for the majority of my life and I knew little in regards to how the civilian world differed from the military. To make things more complicated I had a family to provide for. When I left my comfortable job with great healthcare benefits it was at a time when I had a 2 year old son and a 6 month old daughter. My goal was to leave the military, move to Atlanta, Georgia, open a physical therapy practice that didn’t accept insurance and do it in a CrossFit gym!  As I write this, my plan sounds reckless. Obviously most of my friends and family thought my plan sounded crazy and they voiced their opinions/concerns to me up until the day I got out of the Army. The reality is that they were worried about me. They didn’t mean to be negative because they didn’t believe in me or what I was doing. They didn’t understand what I was doing or why I was leaving a steady paycheck and good benefits. It was hard for them to accept and their anxiety over the transition manifested itself in questioning my decisions. This is something you have to come to terms with quickly if you want to be an entrepreneur. That’s exactly what you’re becoming if you decide to open a physical therapy practice. You may be a physical therapist but above all else you are a businessman/businesswoman. Get used to people doubting you. Get used to people questioning your decisions. You have to embrace it and the faster you do it the better you will feel. Our vision is very clear at Athletes’ Potential. With a commitment to excellence we embrace our role as a cornerstone of the medical and strength and conditioning community. We strive to provide honest patient care and respect those that work with us in a way we would want our own family members to be treated. We serve others selflessly every day and aspire to become a lifelong resource to our clients, their friends and family members. Leading from the front is the only way to lead. We embody our values both in the workplace and outside of it. We strive to live long, healthy and happy lives through clean nutrition, regular training and positive relationships with our loved ones. Thank you for being a part of Athletes’ Potential during our first year in business. You are the reason we have succeeded and we appreciate your trust in us. Together we’ll make our second year even better than the first. -Dr. Danny, PT, DPT  |
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