Wednesday, December 11, 2013

Highlights of Dr. Emily Splichal Barefoot Science Presentation

These are a few highlights that I took note of from Dr. Emily Splichals presentation at the Okanagan Strength Seminar.   The OSS was a six part series that is available for download.  Highly recommend it.  I've learned some cool stuff from each presenter and I've only had time to go through half of the six presenters.

Dr Splichal is a Podiatrist and Fitness professional that specializes in what is called barefoot science. Training the foot for greater athletic and health performance.  

Most people think barefoot training is running barefoot.  Not correct.

Barefoot, means barefoot.  Training in a minimalist shoe, vibrams, even socks, are not the same thing.  The plantar surface can't have anything else in contact between you and the floor for that afferent feedback.  

A high arch is usually a stiffer foot, more problems with Achilles, stress fractures.  A "flat foot" is more likely to experience shin splints, knee pain. 

Strengthening the glute med over 6-8 weeks can pull the sub talar joint up 2-3 degrees.  This is the same amount that most orthotics try to correct.  

Steps to Barefoot Science
1.  Mobilize the Everters.  Everters are muscles that attach to the lateral side of the calcaneus.  Peroneal group and gastrocnemeus.  Gastrocs lateral head tends to be more tense.  Mobilization through myofascial release is more effective then stretching.  Trigger points have been shown to cause hypomobility of the joint.   Shoot for at least 5 minutes.

2.  Activate the Inverters.  Inverters are muscles that attach to the inside of foot.  Abductor hallucis, tibialis posterior and tibialias anterior.   A great activating exercise is the short foot drill.  (the short foot drill will be a foundational exercise so get good at it.)

3.  Isolate and Strengthen the Inverters.  Now this group can be strengthened.  A great exercise is placing a ball between your heels, feet pointing straight ahead, and do a calf raise.  The pressure to keep the ball in place helps to strengthen the inverters.  

4.  Strengthen toe flexors.  These are perpetually weak on most people.  These are the small intrinsic muscles, not the extrinsic or muscles that cross up into the calf.   Press the toes into the floor, whole toe, not just the distal tips.  Forward lean after the toes are pressed in.  When this gets good, do a calf raise.   Toe flexor strength correlates to vertical jump.  The old standby of toe crunches actually strengthen the already strong extrinsic toe muscles which will actually create a further strength imbalance and it creates hammer toes.

5.  Strengthen the hip rotators.  Hip rotators have an intricate relationship with the foot muscles. 

6.  Integrate everything.  Short foot, small knee bend, small amount of hip flexion.  This is the loaded position.  Several single leg exercise are now done in this position.

Following these steps should create a stronger and healthier foot, which in turn creates a stronger and healthier athlete. 

Tuesday, December 3, 2013

Functional Range Conditioning Seminar Review

Have you ever been given a book recommendation from a friend and realized just minutes into reading it that the books subject has tons of stuff you are interested in.  It takes several topics you really enjoy and weaves them into one singular piece of stand alone work.  That is what Functional Range Conditioning was like for me.

Taught by Dr. Andreo Spina, he was an excellent teacher and presents the material over the two day course in a very enjoyable way. FRC, at the heart of it, is all about mobility.  Mobility is the combination of flexibility and strength.  Mobility is the ability to keep your joints working like they should work.  So the byproduct of mobility work is joint health.  The system strengthens your joints.

Joint health.  Optimizing your joints.  Having strength in a large range of motion, not just the middle range.  Control.  FRC teaches all these things.  Creating stronger, healthier tissue.

When I was younger I wanted to squat 500 pounds and I did.  I could have cared less about how my joints  felt.  Now much older and banged up, I want joint health.  I want to do a third world squat comfortably.  I watch my daughter squat and move and realized earlier this year, that I was severely lacking.  It took me years and years of dedicated practice and struggle to be able to squat 545lb (my PR) so I know mobility won't be had overnight.  It will take work....a lot of work.

Which brings us to mobility work,  it is work!  Mobility is not just rolling around on lacrosse balls.  I was sweating and hurting(in a good way) for most of the drills.  It was a wake up call on how hard you have to work to regain lost mobility.  What Dr. Spina has created is a system that utilizes, isometrics, stretching, joint mobilizations, vector changes, eccentric exercise all rolled up into what is Functional Range Conditioning.

By then end of day one, even after having spent the previous day in the car, my hips felt amazing.   The first day back to work I started implementing a few things with a couple patients.  This should honestly be taught in most chiropractic schools, as at the core, FRC is about having healthy joints for life.  Most chiropractors goal.  I always say while learning stuff is cool, the true mark of anything substantial is if it actually gets integrated in your life whether personal or professional.  I can confidently say it will be both for me.

Tuesday, November 12, 2013

You are Eating Your Apple All Wrong!

To me, this video was pretty amazing.  I tried it out on my way home from work the other day and realized, wow, this is awesome.  It really works.  I didn't eat the whole thing, like the video guy, but instead of having the "core" left, I had the size of a nickel.

Thinking about this even further, I realized I wasn't really amazed because I got to eat 30% more apple, but because someone came up with a new way to eat an apple.  I will never eat an apple the same again.

What else in life is like this?  I never had a problem with the old way of eating an apple.  I never thought to myself, wow, I'm wasting a lot of this apple.

Is there a better way?

That way of thinking I find truly remarkable.  This is probably why a few companies stand out, for example Apple.  Ipad anyone?

Is there a better way?

Thinking of life, encompassing family, friends, work, hobbies, free time, Is there a better way?  Not talking about just more productivity either, but about looking at something differently to achieve a result that you don't even realize you are looking for.

I hope I can keep start to look at things through the lens of the question, "Is there a better way?" 

Saturday, November 9, 2013

Weekend Coffee #3: Good Reads

Grab your espresso, hunker down and enjoy a few reads that I've accumulated.  Hopefully something sparks your interest to read the full version.  Links provided.

I'm really interested and continue to try to improve on my understanding and implementation of PRI (Postural Restoration Institute) principles.   On the inside, we are not symmetrical.  In fact, we are very asymmetrical, and it is these asymmetries that create patterns in us.  This article talks about the right thoracic curvature in adults after adolescence.  (most scoliosis is right)  Should be a reason,  correct?  Right Thoracic Curve.

I'm always telling people about the importance of high quality fat in their diet.  This is just a basic article talking about those benefits.  Many Roles of Saturated Fat. 

We need to keep physical education in our kids lives.  So many things point to physical activity strengthening the relationship of kids learning.  Yet, we still seem to be slashing these activities in our public schools.  How Physical Fitness Promotes School Success.

There are some crazy bacteria resistant strains out there.  Ever have to deal with anyone struggling with GI issues, IBS or some crazy bacterial infection?  Life simply becomes a struggle to get through the day, let alone make the day worthwhile.  I recently had a patient tell me of her fecal transplant procedure and how it literally gave her life back in a matter of days!  Very amazing.  Fecal Transplant Article.

Not an article, but I thought a pretty good video interview with Dr. Alan Christianson about thyroid health on  50 minutes.  Video Interview.

Can your grip strength influence how long you live?  This study shows that low grip strength in adolescence had an influence on risk factors of suicide and cardiovascular disease.  Grip Strength.

Tuesday, November 5, 2013

Routines and Being Awesome

My wife sometimes tells me I have issues with my routines.  It's true I don't like variance when it comes to routines, but there are good reasons behind "healthy" routines.

We  know that you have a limited supply of will power.  Say no to the cookie now, it's most likely leaked out a little of your will power for later.  Hopefully, the later isn't as important.

We also know that decisions sack our energy.  The more decisions we make the more mental fatigue we accumulate.  This leads to either very ill advised decisions, or the opposite, we do nothing.  Both of these choices can lead to not so desired results.

It doesn't even half to be important decisions.  In fact, it's the small decisions that start to sap our energy, not the big ones.  So how do we combat this?


Work through the stuff that really isn't that important and create an automatic pilot for your day.

Figure out what you eat for breakfast.  Have the same thing on Monday, every Monday.  This goes for the rest of the week as well.  This goes for lunch and dinner.  Create yourself a menu.  One of the reasons I think Intermittent Fasting has become huge, besides it works, it creates a decision free morning.  You don't eat.  Talk about freeing up some mental energy.

I wear gray shorts and polo to work every day.  I never think about what I'm wearing.  The beauty of the uniform.

I lift weight every Monday and Thursday evening.  I very rarely miss them except for family obligations.  Just part of the week.

I get coffee at my favorite coffee shops on my lunch breaks Tues/Thurs.  Again, I not only enjoy this, but I no longer think whats happening for lunch today.

I have a few other things I put into automatic pilot as well, but you get the picture.  What is interesting, I often get creative thoughts or come to important decisions while I'm doing the aforementioned things.  The freed up mental energy can go to more important stuff.

So if you find yourself feeling just plain old mentally tired, set up some routines.

Make them healthy (donuts for breakfast...em no)
Make theme easy.  Creating a fresh 12 ingredient omelet for breakfast, while healthy,  sounds like so much work to me, I would never keep it in my routine.
Make them for Everything that doesn't change.   We all eat, sleep, bathroom, exercise, grocery shop, ect.
Be Awesome.   Use your extra mental energy to do the stuff well and better, that can't be in a routine.

Thursday, October 31, 2013

Turning a Bobsled Cheetah into a Marathoning Tortoise

Everyone knows the tail of the tortoise and the hare, where the slow and steady wins the race.  But, you may not know why.   Sprinters and Marathoners are a different breed. Sprinters have been blessed with fast twitch type 2 muscle fibers.  Marathoners with type 1 muscle fibers.  One can go very fast, but for very short distance.  Then they are done.  Spent up their energy.  The Marathoner can go very slow for very long periods.  There is a debate if one can switch from one fiber to another,  but realistically one that has been blessed with speed will never do great at distance races and vice versa.

In fact, if you gravitate towards speed and power or to distance activities you usually hate the other.

Running a 5k to me would be like telling me to go jump off my roof 10 times.  (my joints would feel the same) But repeat sprints up stairs, that sounds fun.

"Everyone is a genius.  But if You judge a fish by its ability to climb a tree, it will live its whole life thinking it is stupid. "  Albert Einstein

The only thing I'm trying to say, it takes a lot of hard work to get a fast athlete to compete and run slow.    Not only physically, but mentally.  Most of our past workouts as speed and power athletes never even went longer then 50-60 minutes.

So to do long runs that can reach 4-5 hours.  The body and brain are saying, "Dude, what are you doing to me?"

My good friend Lorenzo Smith is doing the NYC marathon this weekend to help raise money for some local charter schools that are trying to change inner city education in the NYC area.

Lorenzo is the definition of a Cheetah.  Sprinter for United States Military Academy (West Point)  Olympic bobsled brakemen (fastest position) for the United States in the Torino Olympics.

So through determination and probably a whole lot of discomfort.  Lorenzo will be running this weekend to raise money for the Success Academies of NYC.

Here is a link if you want to donate to help.  At the end is a pretty awesome video showing real life students talking about education.     DONATION LINK

Wednesday, October 30, 2013

Get on the Ground for some Floor Based Movement

Over the years of working in my clinic I've noticed that when a person has had a painful knee, hip or lower back, one of the things that becomes a problem for them is the ability to get down on the floor and get back up.

In fact, getting on the floor becomes a fear.  Fear perpetuates into avoidance.  Avoidance creates more difficulty for that task in the future.  In this case, the floor becomes a great obstacle.

"Always do what you are afraid to do."  Ralph Waldo Emmerson.

Most of these painful areas aren't from a major accident.  Years of abuse and avoidance has manifested in this "painful area."  I started thinking about a typical day and realized that without effort, you can indeed go a very long time with out ever getting down on the floor.

Wake up in a bed, usually several feet off the floor.  Go to the bathroom on a toilet.  Walk to the kitchen and sit at a counter or chair.  Go to work in a car.  Sit at a desk.  Drive home.  Eat dinner at a table.  Perhaps they go to the gym and workout, typically on a machine, bench, bike, elliptical, ect.  Go back to bed.  Repeat.

It takes concerted effort to physically get down on the floor.  Which is why I believe some of the best exercises are done on the ground.

Turkish get ups.  Most of the time I just try to get my patients to get to the half way point of getting their hips off the floor.  A baby get up.

Primal Rolling.  Rolling from the stomach to the back, left and right.  This is a core based exercise. Surprisingly how many people can't do this at first.

Foam Rolling.  One of the big benefits I believe with the foam roller is not only the roller but how you are on the ground moving on top of it.  Pushing and pulling using their hands and feet.

In the book "Muscles and Meridians", author Philip Beach takes it a step further and recommends some floor based postures that aren't exercises per say, but are simple postures that benefit the myofascial system.

Full Squat.  Now this is probably unrealistic for most people to be able to relax into a full squat, like a toddler.  But, when hanging onto a poll or door jam, leaning away, this becomes a very nice way to get the hips below the knees.  Not exactly a floor based posture, but if you can do a full squat with ease, You're not going to have to many mobility issues.

Sitting on the toes.  Knees on the ground, feet under your butt, with toes in extension.  Keeps mobility in your big toe.

Drinking posture.  Same as sitting with toes under the butt, but now you bend forward so that your forearms are on the floor.

Kneeling.  Same as sitting, but now the tops of the feet are flat on the floor.

Cowboy Posture.  This is a combo.  One knee in Kneeling, one knee up so the foot is flat on the ground.

Long sitting.  Sitting with legs straight out in front of you.

Cross Legged.  Sometimes this has been called sitting Indian Style.

Side Saddle. Sitting, one leg is externally rotated and bent the other leg is internally rotated, both knees are bent.

Tailors Posture.  Sitting, bottoms of the feet are pushed together and brought as close to the body as possible.  As my track coach used to shout, "Put you're soles together and give me an Amen!"

These postures should be entered with care, but can be done while watching commercials for example. The idea is to simply bring back whats called floor based living.  Those with knee pain will probably find the kneeling postures to aggressive.  I would suggest not to spend more then a minute in each posture and slowly transition form one to the next as part of your cool down from exercise or just pick a few during your evening to reclaim the floor.

Saturday, September 28, 2013

Weekend Coffee 2: Good Reads

Get your coffee and peruse the following.

I read the book "Free to Learn" last year.  This article talks about the concept and has some good points about how children are suffering from lack of play.  Couldn't agree more.  Basically to much forced learning/activities, not enough time just playing, has it's consequences. The Play Deficit. 

Speaking of consequences, the loss of mobility has more pronounced consequences then just physical health as we age.  One test that can be easily monitored for the elderly is the get up and go test.  Person sits, gets up, walks ten feet, turns around, walks back and sits back down.  Measure and record.  Don't lose your mobility. 

If that has you clenching your teeth in agreement, be careful.  The position of your jaw may influence muscle activity.  Short abstract on how jaw placement can effect knee muscular recruitment.  Knee mechanics. 

But, we are getting super freaky fine tuned if we start talking about 1mm of jaw placement.  Perhaps we are over thinking things at times.  For the runners out there, this article describes several scenarios where awesome runners overcame serious setbacks.  The body can adapt.  Sometimes we don't give it credit for being just an amazing organic organism instead of just a nuts and bolts machine.  The Running Machine Myth.

So your not going to have excuses for not being able to run, but you want to run faster! 7 myths of the 40 yard dash.  Nice article on some very common practices that coaches/athletes do in the hope to get faster.  I like how there are several tips that are proven to work and not just a list of don't do's.

With all this running, you are probably going to be breathing hard.  This is a good thing.  Strengthen up that diaphragm.  It's a muscle and when it lack endurance it may correlate to low back pain.   Very short abstract.  Diaphragm.

Have a great weekend.

Sunday, September 15, 2013

Weekend Coffee 1: Summery of Articles for the Week

I've used Evernote for a few years now.  Each use, it grows more useful for me.  Kinda like a personal storage engine.  One of the prime ways I use it is with a quick save of articles and ideas that come across during the week.

I will find an article on a blog, website, Facebook , twitter or email that interests me, but I don't have the time in the moment to read it.  So I will tag it, save it,  and come back to it when I get some time.

So these are a few from the last week or two.  Grab a cup of coffee (unstoppable coffee if you're in the know) and see if any of these reads interest you to read further.

Stretching is actually a complicated subject.  Is it good, is it bad?  Whats the best way to do it?  What is actually happening when we stretch?  This paper talks about some possible theories and refutes a few as well.   Stretching on Physther.   Conclusion from the paper that it is most likely an modified sensation by the person stretching that allows more muscle extensibility.

Using what is called Flux Based Analysis, supplements were analyzed.  This was an interesting paper as it goes into what could be the future of supplementation for human metabolism and health.  Methionine, Arginine and BCAA's seem to increase protein synthesis post exercise.  Supplement or Not to Supplement.  It talks about how perhaps using this model type 1 (slow twitch) and type 2 (fast twitch)supplementation may be used to target these fiber types.  Interesting.

Benefits of Non-Functional Training.  Basically prepping single joints for better movement.  Getting local tissue ready to handle uncertain situations.  I'm looking forward to the Functional Range Conditioning seminar I'm taking in a few months.

Vimeo has some pretty sweet videos available for free.  One is Erwan LeCorre talking about MovNat: Evolutionary Natural Fitness.  45 talking about modern health and why we are losing it.

Don't give your kids fancy shoes to run.  Old fashioned plimsoll's shoes allow kids to learn to run more naturally.  Now as an adult, don't read this and think it's best for you.  If you've worn a 2" inch athletic heel for 30 years.  You are in a different category.  Help your kid though, not become you.

Nothing really about health and fitness, just plain fascinating.  Insects show these micro gears that perhaps we will learn how to use to advance our mechanical knowledge.  Fascinating.

Copper has shown to destroy highly infectious norovirus.  Virus can live on surface such as door handles.  Hopefully this information trickles down to schools, hospitals and other public places.

Loose connective tissue in the neck may play a roll in Chronic Neck Pain.  This was just the abstract.  

Golden Arches: Human Feet.  Quick take on perhaps the foot's lateral arch is more flexible then we previously thought.

Thursday, September 12, 2013

Problem Solving: Honesty, Weakness and Priority

The foundation to a new project, goal or venture, the starting point has to be honesty.  You have to be honest at where you are at.  This can be very humbling.

Last May, working out with some buddies, I realized I did a pitiful 3 pull ups.  For someone that used to be able to do 20 pull ups with a 45lb plate attached, this was a big wake up call.  First, as always seems to be the case, excuses started rolling through my head.

 "That was 15 years ago."

"That was before all your shoulder injuries."

"That was before you elbow surgery."

"That was before you worked on people 8 hours a day."

Then after a few minutes of remembering what used to be, I just decided 3 isn't enough.  Maybe I won't be strapping weight on and ripping off sets of 20, but I certainly don't have to be where I'm at.

1.  Honesty evaluation.  Realizing I was just plain weak and realizing I had been avoiding them because they were hard for me was humbling.

2.  Accountability.  I made a bet with my training partners.  12 reps in 8 weeks or coffee was on me.  This brought a timeline.  Who likes losing bets?

3. Problem solve.  Grip strength was an issue after work.   My hands are pretty darn tired after doing manual therapy 8 hours a day.  I started to do a few sets of pull ups before work.  Nothing earth shattering there and nothing to failure.

4.  Prioritize.  I did pull ups every day.  Several times a day.  Weakness isn't overcome by once a week training.  It has to be attacked aggressively.  

5.  Do the work.  I started to do windmills with kettlebells and extra self myofacial work on my shoulder blades to help improve shoulder health.  Every day.

6.  Creativity.  Think outside the box.  I started to work on the front lever for a different stimulus and this improved my pull ups by leaps and bound.  Doing assistance work is important.

Although this formula was used for my sad pull up dilemma, you can replace the concept "pull ups" with anything  It
doesn't have to be a physical goal, just a goal.  It works every time.  This morning I did 15 pull ups before work and my shoulders haven't felt this good in years.  

Wednesday, August 21, 2013

Guts to the Brain is a Two Way Street

I was sitting on my coach feeling good one Saturday, over the course of a half hour, feeling good changes dramatically.  Next thing I know, my brain, via the Vagus nerve,  is telling my 2nd brain, the guts, to expel everything.  I mean EVERYTHING.  Found a dangerous intruder, get it out any way possible.  (there are only two ways people)

It keeps coming back to the gut, technically considered the mouth to the anus.  More neurons in the gut then the rest of the nervous system.  The Vagus nerve is the connection from the gut to the brain.  90% more signals pass from the gut to the brain, then the brain to the gut. Yes, the gut gives more information to the brain, not the other way around.  95% of Serotonin is produced in the gut.  Treating depression with drugs to upload more serotonin, not fixing the problem per say.

 More bacteria in the gut then cells in your body. 100 trillion.  500 different kinds.  Yes, there are more then just L. acidophilus.  Good and bad should be a ratio of 85-15.  If you take an antibiotic, it can't tell the difference between the two and kills them both.  Always resupply with a probiotic. Get rid of the antibiotic soap.  Just use soap.

It's not a coincidence that allergies and asthma are on the rise in today's kids.  Cesareans are partially to blame as they are on a dramatic upswing.  As the baby passes through the birth canal it takes with it some of the moms good bacteria.  Without the natural child birth, this process doesn't happen.

80% of your immunity is in your gut.  Stressed out gut.  Stressed out immune system.  Bad bacteria feast on processed foods, pasteurized foods even.  Sugar, white flour, alcohol, all stress the gut out.

One study showed that swapping gut microbes from one mouse to the next made those mice lose weight.  Gut Microbe Swap Helps Mice Shed Weight.  Don't get to excited about this yet though, It will be years before you just have to upload good bacteria to lose weight.

Another study showed that a calorie restricted diet can have a very positive effect on longevity and in changing the gut to more favorable bacteria.  This was in mice.  The calories were restricted to 30%.  That's quite drastic.  Fasting for a Healthier Gut.  Potential use for humans?  Maybe a 24 hour fast every now an then, or try Intermittent Fasting for a few months and see how your body does.

What you eat influences how you feel.  I know pretty obvious, eat lots of crap and an hour later you are sleeping or feel like junk.  But, there is also more subtle ways as well.  Eat fatty acids and your brain is wired from the gut to feel less sad.  Perhaps this is why fatty foods are a comfort food?  Fatty-Acid Induced Signals.

More research is being done on how possibly the guts microbes influence some of the brain degeneration diseases like Parkinson's and Alzheimer's.  This brings us to this article and study. Changing Gut Bacteria Through Diet Affects Brain Function.

In this study basically the women that ate probiotics showed communication from the gut to the brain and under fMRI showed cognitive changes.  This opens up doors for research into fields like chronic pain, mental and digestive disorders.

It also raises a very interesting point that if probiotics affect the brain can antibiotics do the same?  Should we be more careful in putting kids through as many antibiotics as we do if we know that its effects could be felt in the brain?

Gut flora research is still in the infancy, but already, new and exciting research is being done.  Until then,  keep that two way street between the gut and the brain working as efficiently as possible.

Friday, August 16, 2013

Why Western Marathon Times are not Improving

Reading through the book "The Sports Gene" by David Epstein, one of the points that has really stood out to me were some of the statistics about the marathon.  Going back just 50 years, the United States, England and Finland were the major long distance powers.

Presently, you would be hard pressed to find a great marathon time not run by someone from Kenya or Ethiopia.  Its as if these two countries just decided to dominate one day.  No doubt they are very talented to run the times they run for the marathon, but consider these statistics.

1983-1998 the number of US athletes that run under 2:20 marathon decreased from 227 to 35.
England dropped from 137 to 17.  Finland was a powerhouse of distance running during both World Wars and didn't qualify a single marathon athlete in the 2000 Olympics.

Now consider the same time period,  Kenya had one sub 2:20 in 1986 to 541 in 2006.

The age old debate of nature/nurture and talent/hard work comes back to rear its head.  Where do you look for answers, which is what I find very intriguing about this book.

It's hard not to make some conclusions when you see some statistics like this.  Perhaps as the rise of talent in Kenya/Ethiopia that the other countries athletes tend to pursue other events or decide not to compete at all.

That the talent for long distance dried up in these three countries.

These countries athletes got fatter and didn't want to put in the work to be an elite distance runner.

An amalgam of all three.

Negative feedback loops are a deadly thing.  A makes B worse, B makes C worse, C makes A worse.  It's a cycle.  You can try to get at one of them, but they all have to be addressed.

Perhaps that is where are distance situation is at.  As affluence improved in the US, England and Finland so did our physical weight perhaps.  The hunger and desire to put yourself through the rigors of that type of training decreased.  Other sports become better options.  You fall prey to the notion that the Kenyans and Ethiopians are way more talented, so why try.  You look around and your notions are proved correct.  You don't see anyone coming close to competitive times.  The cycle keeps repeating itself every generation to a greater extent.

What can be a negative feedback loop can also be positive.  Just flip the coin.  I have talent, look where I'm from.  My brother, friend, friend of a friend is doing it, I can do it as well.  Work extremely hard because of the belief and are rewarded.  The next generation does the same.

Both fulfill a type of self prophecy.

If 100 kids come out to race and 10 are talented and one is very talented we would say there is a 1% chance that we will find a champion.  If that champion becomes famous perhaps the next years race draws 150 kids.  Now we find 15 talented kids.  Now kids see these talented kids competing and a culture of racing becomes a new norm.  Next year 300 kids come out and we have kids that have been training for the race.  Without training, we would find 30 talented kids, perhaps with training we find 50-60.  5 kids that can become champions.  The culture of racing exists and just keeps perpetuating itself.

On the flip side, if only 50 kids come out we find 5 kids with talent.  Perhaps we don't find the champion because he just didn't show up.  Next year, you get 30 kids.  Depleted resources and enthusiasm.  The culture of racing is dying.  It keeps perpetuating itself.

Belief in both systems perpetuates the system.  My thoughts only.   Thoughts on my thoughts?

Thursday, August 1, 2013

Master the Basics and Do it Every Day

I'm a huge fan of Dan John.  He's a strength coach that has the ability to boil down the fluff and periphery to get to the important, central stuff.  Own the principles, not the methods.  Dan has many books, articles, videos, a lot for free,  all over the Internet.  I would suggest anyone interested in health and strength to take an hour or two and read his stuff and watch his videos.

One of the things that has always stuck with me is Dan's approach to the basics.  Don't get crazy reaching for the top of the pyramid if your base is not there.  The other point comes from legendary coach Dan Gable who Dan often quotes.  "If it's important, do it every day."

With that template, master the basics and if it's important, do it every day, here is my list in no particular order.

1.  Drink water.  Half your body weight in ounces.  Sport drinks don't count, tea doesn't count.  Water.  If you drink coffee or pop add another 8 ounces of water.

2.  Don't drink pop.

3.  Walk.  Try to get 15 minutes a day. Minimum.

4.  Get sunshine.  Have the actual suns rays touch your skin.

5. Get your Vitamin D levels checked twice a year.  Keep your level above 50.  1000 IU for every 25lb of body weight when supplementing.

6.  Lift weights.  Find something you like and do it 2x a week.  I don't care if it kettle bells, cross fit, powerlifting, bodybuilding or what ever is next around the corner.  The more muscle mass you carry as you age, the more healthy you will be.  Guaranteed.  Carry something, push something, pick something off the floor, pull yourself up.  (colored dumbbells do not count though.)

7.  Floss.  There is a lot of evidence for the health of your gums and the health of your heart.

8.  Wear your seat belt.  ( I stole 7,8,9 from Dan John himself)

9.  Take fish oil.  3-5 grams a day.

10.  Get rid of polyunsaturated oils.  I think this is why most people that adapt a paleo or primal or low carb diet see such improvements.  Unhealthy oils destroy your body.

11.  Be grateful.  Make a mental list or a physical one.

12.  Breath well.  Inhale with the diaphragm.  Exhale.  The ribs should move, not your shoulders.

13.  Stretch the hip flexor and then pair it with a glute activation exercise.  Your lumbar spine will thank you.

14.  Get down on the floor on your back and get back up.  Several times a day.  No particular technique needed.  I've lost track of how many patients tell me they fear getting down on the floor for how hard it will be for them to get back up.  Don't let that happen in the first place.  If you don't make it a priority, it can be weeks before you have to actually do it.  Think about that for a second.

15.  Eat some vegetables.  Think Rainbow.

16.  Master the hip hinge.  Use it.  When you bend at the hips not the back, you save your back abuse.

17.  Read.  The person that doesn't read and the person that doesn't know how, not much difference.

18.  Roll the bottoms of your feet with golf balls.  A lot of fascial lines evolve or cross the bottoms of the feet.  Next time your tired at work or after work, take a few minutes to do this and feel your energy return.

19.  Focus on getting some good fat in your diet.  MCT oil, coconut oil, grass fed butter, olive oil, fish oil, avocado, red palm oil, to name a few.

20.  Drink Green Tea.  On top of the water you are going to drink.  It's like amazing for you.

21.  Laugh.

22.  Sleep.  7-8 hours a night.  There is a lot out there these days about how to get by on less, but science doesn't seem to support that.

23.  Your own personal physical/personal goal.  Find a way to work at it every day.  If you want to write, write at least one sentence.  If you want more mobile hips, do 5 min a day of hip mobility work.  Striving towards something you want every day, builds strength and character.  Lay some ground work every day, it's the consistency that counts and makes real changes.

This is my list, I think it's hard to argue with any of them.  What do you want to add?

Tuesday, July 9, 2013

My Experiment with Gluten Free: The How and Why

There was once a lady that went and asked Gandhi to tell her young son to give up sugar.  Gandhi said to come back in a month and ask again.  The lady comes back with her son and Gandhi told the young man to give up sugar.  The lady stated, "Why did you make us wait a month for you to tell my son to give up sugar?"

Gandhi stated, "I needed to give it up myself if I was to tell your son to."

I've always remembered that story.  (I have no idea if I got the details right, but you get the point)  Lately, I've been asking more and more of my patients to try to go gluten free for a three week trial.  Granted they give me some rather large clues that it will be very helpful.  Bloated after eating, lack of solid bowel movements, brain fog feelings after eating, no energy, upset stomach.  Pretty easily identifiable stuff that at least warrants a solid 3 week trial of gluten free.

I was starting to feel a little guilty.  I had never done the trial myself.  My defense, I was pretty sure I don't have one.  But, the proof is in the testing.

So I did it.

First, there is never a perfect time.  There will always be a date in the three week trial that conflicts with your test.  I had 4th of July.  Friends and family visiting, burgers and going out to eat.  If your going to do it, just do it.  There is never a "perfect" time.

2nd.  Get some real ideas about meals and food.  Don't just think you will snack and eat and just give up pasta and bread.  Write down actual meals that you will eat and go shopping.

3rd.  Figure out the foods you normally really enjoy or crave in weak moments and find a substitute.  Those cravings will hit.  Have a plan.

4th.  Plan your meals ahead that you normally improvise on.  I eat lunch at work twice a weak.  This became a planned meal instead of on the go.

5th.  Drink tons of water.  Expect after about a week that you start to pee like crazy.  This seems to be pretty common.

6th.  Up your fats.  Get a lot of extra fat into your meals and diet.  This helps you stay full and satiated.  Bacon anyone?  Avocados, coconut oil, eggs, grass fed beef, wild fish, fish oil, sardines, ice cream (the real kind 3-4 ingredients)

7th.  Enjoy the testing.  Find new foods, new places to eat.  Order something you would normally not try.

Commit and figure it out.  I finished with a gluten meal just to see how much a difference it would make the next morning/day.

For me, it didn't do much.  I felt great the whole time, but went in feeling good and felt great the next day after my gluten binge.  In fact, I hit a PR in pull ups and trap bar deadlifts for my first half summer cycle.

If you have always had some stomach issues, extra joint pain, lethargy, unexpected low motivation, brain fog, give the 3 week gluten free trial a go and see how you respond.

Thursday, June 27, 2013

Interesting and Cool Reads

Foods you eat can have a direct impact on your skins ability to fight UV rays.  Dark chocolate flavonoids show great ability as well as green tea and tomatoes.  Instead of just slathering on sunscreen perhaps add these foods into your diet.  Chocolate as Sunscreen.

For therapists working with athletes and groin pain, make sure the diaphragm is functioning properly.  Thomas Myers has shown a direct relationship with the Pectineus muscle and the diaphragm.  Find Your Pectineus.

A very interesting paper on a potential true cause of Fibromyalgia.  The hypothesis is there is extra sensory nerve endings around shunts in the hands and feet.  Not only are they involved in temperature regulation, but in diverting blood to where it is needed the most.  Fibromyalgia patients have extra sensory nerve endings which explains why they often have sore hands and feet.  Fybromyalgia is Not All in the Head.

Circadian Rhythm is a very important piece of the puzzle when it comes to health, sleeping and hormonal issues, but this article talks about osteoarthritis and how cartilage cells actually have clocks as well.  The cartilage has peaks of temperature.  This has implications for drug use, perhaps the drugs will have stronger affect when taken at certain times.  More and more the bodies natural circadian rhythm shows strong health implications.  Body Clock linked to Osteoarthritis. 

MRI confirms that people that suffer with Restless Leg Syndrome have higher levels of Glutamate in the brain.  If confirmed will lead to different drugs already available to be used as first treatment options.  RLS and Glutamate.

Probably the coolest thing I learned is why we have an appendix.  The idea that we just have an organ that "we don't really need," has never really seemed right to me.  I had heard that it was perhaps part of the immune system.  This article talks about how it houses good bacteria and that it repopulates the intestines after heavy bouts of antibiotics or severe diarrhea.  Appendix isn't Useless.

Tuesday, June 18, 2013

Money, Athletics and Bobsled

Bobsled is in the news and surprisingly it's not Olympic year.  A recent addition to the sport, Lolo Jones of Track and Field hurdler fame,  became a bobsled athlete this past year and with this VIDEO, raised a few eye brows.  I've never talked to Lolo, but I still have a few ties into the sport and have heard that she was a hard worker and was a pretty decent push athlete.  Not quite at the level of some of the top US pushers but good enough to make the World Cup team and compete.

The recent news came from her stating she only made 741 dollars from 7 months of bobsled work.  Some people took it as complaining, some people took it as her making light of the fact that this is all you make as a bobsled athlete.  Either way bobsled is in the news!

"There is no such thing as bad publicity."

I think it's actually a good thing.  Many people make the mistake thinking these guys that win medals make a lot of money from the sport through actually competing, endorsements and medals won.  9 out of 10 of bobsled athletes for the US won't make enough to live on without going into debt.

Housing and food are provided for sure, but not much else.  Some of the top teams will receive a 2000 dollar stipend per month.  But, that is 25% of the athletes.   Flight home to see family, not covered.  Leaving the training complex for a meal not covered.

When the season ends, you are technically no longer a "member" of the US team.  Come summer, you have to pay your own way back to camp to "remake" the team.  Often this requires a hotel stay and food. Over two weeks this can easily reach 1500 dollars.  You are the best pusher in the world, guess what,  you still have to remake the team on your own dime.

As a whole, their is no monetary gain in bobsled.  There is no fame in bobsled.  You are not going to see a bobsled athlete have any type of endorsement.  Why?  It's not because they are not marketable freaky talented, smart athletes, it's because you have to be able to offer value to the company.  In the US their is no value in the sport.  It's not going to excite kids to buy shoes, or companies to buy commercial time if bobsled is even shown on TV.  You will most likely leave the sport with debt.

So whats the draw to do this?  Most every athlete at some point in their life has thought about how cool the Olympics are.  Bobsled allows that dream to be pursued.  It allows most of these athletes to continue athletic careers that would be over without it.  Very few in the US grow up thinking, I want to be a bobsled athlete.  Most come from Track or Football careers that are over.  It allows you to compete for the Untied States against some of the best athletes in the world all over the world.  That is cool.

In the end, it is a choice.  Pursue sport or go make some money.  I'm glad Lolo did what she did.  Any light that is shed on this sport is a good thing.  Maybe with a little more limelight some of these amazing athletes will be seen as marketable and be able to make a living pushing that sled down the hill in USA colors.

Friday, June 14, 2013

Leave the Dumbbells at Home

Every now and then I'll start to think about an exercise a little more intensely.  It is often after hearing a patient hurt themselves doing it.  Most of the time, it's just a quick technique analysis, minor adjustment and the exercise becomes a "good" thing again.

But, once in awhile, I think there are a few exercises to just put on the shelf and retire.  Enter the Dumbbell Curl Walk.  It seems to attract women over the age of 40.  In their hands are colorful dumbbells.  They go for walks as they do dumbbell curls and an occasional shoulder press.  While I admire the though process, lets make it harder and combine weightlifting and cardio, it's not a good idea.

Walking is a reflexive activity.  You don't think about it and no one ever taught you how to do it.  In fact,  if you slow it down and start to think about how to do it, you will most likely mess up.

Now curling a weight is not a reflexive activity.  You have to think about it.  You have to have some technique.  Don't focus and you do enough repetitions and a painful shoulder may result.

Walking is a tremendous exercise.  Everyone should do more.  Often my advice after getting adjusted is go for a brisk walk and use that spinal engine.  Curling is also a good exercise.  It's the combo that doesn't make sense.

If you want to make the walk harder, invest in a weight vest.  That's a very safe, very awesome exercise.  Like running with ankle weights, put the dumbbell curl walk in the retirement home.

Tuesday, June 4, 2013

A Random Rant on Exercises

Are squats good or bad?  Is yoga good or bad?  Is Pilates good or bad?  Will this tone my midsection?  How often do I hear questions like this?  More then I can keep count.  Frustrating yes, more so for the patient as my answer is, it depends.

Are squats good or bad,  let me see you squat.  Yes, squats how you just did them will indeed cause your knees to hurt.  Yoga gets trickier, there are so many forms of yoga that one form can be completely different than another.  Some things to consider, are there more people in the room than digits on your hand?  Unless your very good at yoga, you need someone watching you correcting your form.  Slight pressure here vs here, goes a long way.  So unless your great, get to a smaller class.  Get a teacher that makes corrections, just isn't "practicing" while you pay them. 

Pilates is a different beast all together as I think that hands on is much more important.  Constant correction to get the right muscle cues are very important.  For some reason I see a lot of messed up diaphragms on people that do Pilate's a lot.  I think they are substituting psoas/iliacus for the lower abdominal/obliques.

What gets even trickier, when an exercise can be both good and bad.  I often watch patients lunge for an evaluation.  It often times isn't pretty.  So at this point a lunge for strength correction would be a horrible idea.  You would strengthen the dysfunction.  Clearing out what you find and watch the lunge pattern become smoother and more powerful, now the lunge becomes an excellent exercise.  

So this leads to the notion "I had hip pain, did a bunch of lunges, my hip got better."  This information is passed on to family/friends.  Family/friends don't improve by doing a bunch of lunges.  Your back hurts, "do these yoga stretches and your back will feel great."  Really?  

The point of this rant was,  yes, things can be both good and bad.  Frustrating, maybe.  When in life do you want to just be a cog in a machine.  Why do you want movement to be?  You are unique, whats good for Peter, might not be good for Paul.  Find the things for you that will make improvements in your health and fitness.  

Tuesday, May 28, 2013

New Favorite Vitamix Green Drink

Seems like everyone is sharing their favorite greens drink recipe lately, so I figured I'd throw my 2 cents in.

Cup of Kale.  I tear the leaves off the stalk and throw the stalk out.  Lots of Vit K in Kale.  Some people worry about the potential for kidney stones from a lot of raw kale.  If your worried about that, substitute spinach.

1/2 a pear.  Sweetens it up

1/2 cucumber.  Silica in this veggie is good for skin/joints.

2" piece of ginger.  Awesome anti inflammatory, anti bacterial, anti viral.  Good stuff.  I like the kick it gives the drink as well.

1/4 of frozen banana.  Sweetens it up.

Teaspoon of cinnamon.  Potentially helps regulate blood sugar.

Scoop of Pure Vanilla Protein powder.  Some protein powders are better then others.  This one is up there.  Not denatured.  GMP.  No fillers or artificial ingredients.  Don't make a green drink and then dump in garbage.  Pay for a good protein powder or skip it.  20 grams of protein.  Whey is an immunity booster.

Scoop of Bulletproof collagen protein.  Great for the joints and ligaments.  I've tried others in the past that didn't taste this well.  I keep saying I'll make my own bone broth, but I procrastinate.  This serves the purpose and is great quality.  There is a lot of thinking out there that one of the increases in tendon/ligament issues in the younger generation is the lack of this in the diet.

Tablespoon of organic cacao powder.  Good magnesium content, high anti oxidant.

1/2 avocado.  Gives it an awesome creamy texture.  Good fats.

1 cup of raw milk.  If you don't have raw milk can substitute cocunut milk or almond milk.

1 cup of filtered water.

Handful of ice cubes.

Tastes great.  My kid loves it too, win and win.

Monday, May 20, 2013

Tuesday, May 14, 2013

Notes on Anterior Core Training

I recently watched Eric Cressey's presentation on the Anterior Core.  I found it very good.  One of those, wow, Internet is amazing kind of moments.  Fork over 15 bucks and get to sit and learn for 45 min from a respected leader in the field.

He opens with one comment I've come to truly appreciate.  If I can learn one thing to take back to my clinic for my patients and athletes and start implementing, it was worth it.  Give me one thing to take away that can have real value in my world.  Not conceptual.  Applicable.  I learned a few.

First, I found a nice tie in with the Postural Restoration information I had went through a few weeks ago.  Eric is very familiar with it, having taken their seminars and was actually one of the ways I first heard about PRI.  So I found a lot of practical information on how to implement the PRI principles much easier.

Get good proximally before distally.  If the core/spine aren't right, the extremities won't be either.  Get to neutral and stay neutral.  Use warm ups to work on getting flexed people into extension and those locked into extension into flexion, thus getting both to neutral.  The workout then becomes what cements the neutral spine.

Many of the modern injuries we see can all be related back to the anterior core.  Sports hernias, femoral impingement and hip labral tears can all be related back to having anterior rotated pelvis.  Excessive tension through muscles like adductor longus and rectus abdominis.  Thoracic outlet can also have roots from a dysfunctional anterior core.

A great test is have the patient supine.  Flex the hip and internally rotate the hip.  This may cause a pinching pain in many people.  Now, have them brace the abs and slightly posterior tilt the pelvis.  Retest flexion and internal rotation.  Often the pain will be gone.  It's not a hip problem, it's an anterior core problem.

He talks about another simple test to decide if your patient/athlete should even be doing overhead work.    Can you raise your arms overhead without letting the ribcage tip up in the front?  Important for all the Crossfit athletes that live overhead.

Everyone is unique.  There are many great exercises, but you may have to coach and cue one person much different then another.  Again, one may be locked in flexion, one may be locked in extension. Don't coach the exercise the same.

Anytime you lift something overhead, you are working the anterior core.  Gain length in the Lats and strength in the obliques and rectus abdominis and you will gain a much more functional anterior core.

Eric goes on to discuss exercise progressions for many different lifts and exercises.  These progressions, how to implement them and why you would, make up the heart of the presentation.  I would highly encourage anyone that works with athletes to give it a watch.  I'm sure you will walk away with one applicable nugget of information you can start to use right away.

Thursday, May 9, 2013

Review of Postural Restoration Institute Respiration Course

A few weekends ago I had the opportunity to take a Postural Restoration Institute (PRI) respiration course.  It was myself and about 7 physical therapists at the University of Michigan Pain clinic.  James Anderson was the PRI teacher.  He knew his stuff inside and out and was a great teacher, engaging and open to questions.  I had several, more on that later.

First, if your thinking on taking one, I would highly recommend it.  I study anatomy a lot and found myself learning and thinking about concepts in a new way.  As this was a respiration course the primary focus was on the diaphragm,  rib mechanics and how they influence the rest of the body.  I feel I gained great insight and better understanding to both of these anatomical concepts.  Surprisingly, none of the information about rib biomechanics are taught very well in chiropractic school.

PRI is built with the premise that the body is actually asymmetrical and that it's the sum of these asymmetrical parts working together in harmony that make us move and function well.  It's because of some of these asymmetries that we create known dysfunctional patterns that are labeled and treated in PRI.  I'm not going to get into their patterns and treatment methods, as that would take quite a lot of time, but basically the left front leg gets tight and is called an Anterior Interior Chain (AIC) which includes the diaphragm, psoas, rec femoris, TFL, vastus lateralis and biceps femoris.  Also, the right  upper arm gets tight, labeled Brachial Chain (BC) including the intercostals, deltoid, pec, Sibsons fascia, SCM, scalene and diaphragm.   Right rib hump on the back and left rib flare on the front is generally seen  (also 90% of scoliosis has this pattern)

The respiratory system is not symmetrical.  Right diaphragm is larger, thicker, has a larger central tendon, has thicker crural attachments to the lumbar spine and because of this creates a right rotated lumbar spine.  It's 1 to 1.5 vertebral levels deeper on the right and has a more dome shape on the right because it drapes over the liver.  Because of this it has better abdominal integration for opposition.  It can push better against the abs essentially.

The unique anatomy allows us to breath easier on the left and harder on the right.  So the right ribs become more locked down and the left ribs become blown out on the front.  We are a culture that is carrying dead air, we don't fully exhale.  All of this leads to dysfunctional patterns.

Some interesting anatomy.  Subclavius is the only scapular retractor on the front of the body.  When it gets tight, it can inhibit the lower trap and serratus anterior, two muscles that get inhibited a lot.  Thus, subclavius is an important muscle for respiration and shoulder function.

The diaphragm when dysfunctional actually becomes a paraspinal extensor.  If you don't use it and breath well, you will have a tight back.  Because of the described anatomy the right ribs become rotated under the scapulae.  This makes the scapula dysfunctional and will create shoulder impingement at times on the right shoulder.

One of the concepts that I have an issue with that was touched on in the seminar was the use of flexed positions in the lumbar spine to create a neutral spine.  They believe most people are locked in extension and to actually create a neutral spine, squats ect, must be done flexed.  Please reread that.  This concept attacks my paradigm.  I can understand the concept that we are both after a neutral spine.  Obviously no one is saying squat with hyper lordosis but to go the opposite and squat with a flexed spine to get to neutral, I'm not buying it yet.  I brought up McGills research and didn't really get much of a response on that, but we agreed we are after neutral.  I actually did a bunch of flexed exercises and to be honest, I had some radicular pain down my right glute and I haven't had any radicular pain in about a year and a half.  N=1 was a failure for me.  But, I don't believe I'm locked in extension.  So flexed spine for me was a flexed spine in my opinion.

The other concept that was touched on briefly was the use of an orthotic.  He pretty much came out and said if your not in a PRI orthotic all the work you are doing to solve dysfunction won't last.  Really?  I don't buy that one at all.  I'm a big believer that feet play a major role in how we move, but not that big....for everyone.  Need by need basis.  He was very down on the minimalist shoe for everyone.  I talked with a buddy doing PRI with himself and a few athletes and was told he has been doing great without the orthotic and is stronger then he has ever been.

Overall, I really enjoyed the PRI seminar. I truly believe I'm a better clinician having attended.  I'm working with diaphragms and having success with improving shoulder mechanics via the diaphragm.  They give a ton of exercises that can be used for your patients as homework.  I plan on attending more of their seminars in the future, so you can say I like their stuff.

Wednesday, May 8, 2013

Building a Circadian Rhythm Template Through Food, Light and Sleep

One of the most interesting chapters in the book "Perfect Health Diet" by Paul Jiminet was the chapter on Circadian Rhythm.  Circadian Rhythm (CR) is the bodies natural tendencies and hormonal fluctuations.  Every cell in your body has an internal clock.  The more we learn about health and fitness the more importance the roll of maintaing a healthy CR becomes.

The body is an incredible adapter.  It can adapt to anything, almost.  You can get it to run faster, jump higher and lift small cars if need be.  You can train it to run across deserts and climb mountains without oxygen.  It can thrive (not just survive) on vary diverse diets, from Inuit protein and fat to some almost pure plant based diets.  One thing we can't adapt to and probably never will, is lack of sleep and sleeping in the day time.

 Sorry 3rd shifters, but that is not normal and you are messing up your CR big time.  There are a lot of health risks involved with this.  Maintaining a healthy sleep schedule, getting sunlight in the right time and eating at the correct period are probably the biggest steps in keeping your CR healthy.

Here are some highlights from the PHD chapter to be used as guidelines for setting up your proper Circadian Rhythm.

Get sunlight on your eyes early in the morning.  Sunlight not only kick starts the CR but also we absorb Vit D more in the morning.  Sunlight has tremendous amount of blue spectrum light.  Great in the morning and day.  (not at night) Cataracts block blue light and this is one reason elderly have messed up CR.

Avoid blue light in the evening.  Just as blue light in the morning is helpful, blue light in the evening is harmful.  It will block the hormone Melatonin from being produced as much.  (almost 50% less)  Melatonin is highly important for health.  There are now filters that can be put on computer screens and ipads ect to block the blue light.

Sleep as much as you can.  There are so many studies about sleep and they all say the same thing, go long enough with limited sleep and you are going to have some health issues.  Some pretty serious.  This is something we as humans have not been able to adapt to.  Sure there are people out there that thrive on "4 hours of sleep" day in and day out, but chance are you are not them.  There are amazing outliers in everything.

This brings us to food.  Food can have a powerful influence on the CR.  Generally speaking, eat during the daylight.  Create an eight hour window to eat.  Stop about 2 hours before you go to bed.  Carbs have a powerful effect as they promote night rhythm and sleep. Carbs influence the hormone leptin, fat does not.

The hormone leptin follows a circadian rhythm.  Low in the morning and rise as the day goes on, peaking at night.  Eating carbs increases leptin levels 4-9 hours post consumption.  So to time carbs influence on leptin and your natural leptin levels, most carbs should be eaten around sunset.  So dinner.  This goes against most of the dietary advice out there.  (so it's probably right....this also has strong agreement with the Warrior Diet by Ori Hofmekler)

A few supplements that may help are Vit D in the morning, Magnesium at night and Melatonin at night.  All will have strong influence on creating optimal CR.  Light physical activity with your initial sun exposure in the morning can also be highly beneficial.

A healthy circadian rhythm is a template to allow you to do the things that are important to you.  If you are looking for a faster 5k, lose 15 pounds of fat, total elite in powerlifting or just have the energy to enjoy your grand kids, setting your Circadian Rhythm is the foundation to the person you are building.

Tuesday, April 23, 2013

Charlie Weingroff Notes from Southwest Michigan Strength Clinic

A Systemic Approach to Athletic Evaluation
"The Greatest Improvements is made by the man who works most intelligently."  Bill Bowerman.

As therapist/coaches, we have to do stuff.  Compete at something, want to get better at something.  Don't forget what it's like to want to improve and excel.  

General physical prep is where most of our efforts will be.  As human we have minimum level competencies.  Athletes have Wide level.  Have a way to measure.  Baseline can be some thing like FMS but must be bodyweight, minimally cued and modifiable.  

Evaluation principles.  1. Movement  2. Preparation  3.Sensory Systems.

Locomotion testing.  Crawl-roll-step-lunge-walk-shuffle-skip-run.  
look at simple to complex, slow to fast, closed loop to open loop.  Can measure it by time or quality of movement.  

Power is single expression.  Capacity is multiple expression.  Various jump tests can give us indicators for both power and capacity.  Energy systems (all three are doing work).  

Capacity is important as clinicians.  If you're out of shape that can contribute to fibrous tissue.  Don't have the ability to use oxygen as all.  Aerobic fitness can normalize the nervous system.  Things don't hurt as much when you have good aerobic fitness.  (this doesn't mean you have to run)  

Measure what we can measure.  Get some biomarkers.  (objectively measured as an indicator of normal biological processes)  
Examples are omega wave, heart rate in the AM, grip strength tools like hand dynometer or bottoms up kettle bell press, vertical jump.

Are you ready to train or do you need to do some low CNS activity.  Don't dump on your patient/athlete more if their already down.  

5 senses (sight, touch, taste, hear, smell)  All are CNS driven and all cause a reaction. 
Vision is underrated.  20/20 vision is no longer the best.  Elite guys are showing up as 20/10 and 20/8.  Have your athletes tested.  

2nd Talk

Understanding Joint Centration (applying DNS to rehab and training)

Control in the presence of change is stability.  Motor control and timing of tonic and phasic muscles.

Joint centration allows maximum amount of load bearing.  Balance of mobilizers and stabilizers working on a joint.  Balance of agonist/antagoinst. 

Babies and the strongest,fastest people in the world do it the same.  Joint positions.  No one teaches babies.  That is why DNS (Dynamic Neuromuscular Stabilization) is powerful stuff. 

4x4 Matrix is 4 postures and 4 variances with them.
Postures are 1.unloaded (prone, supine, on side) 2. quadruped 3. Kneeling  4. Vertical.  What can change is the following.  
1.  position 2. static vs dynamic 3. load vs no load  4.  assistance vs no assistance.

Examples.  May have poor hip centration in vertical squat, but be good in quadruped.  May give assistance to the vertical squat with a band around the knees and restore hip centration this way.

Getting the diaphragm working is a major goal.  Any of the 4x4 matrix can be used.  Powerful stuff.  Diaphragm when fully engaged will get the pelvic floor engaging as well.  Breath over the brace while lifting as McGill would say.

There is a time for bracing and a time for not.  Air squat should not have the same effort as an all out barbell squat.  Biomechanicly exactly the same, but nervous system should not be.  That's why biomechanics don't always give you all the truth.

Exercises that require all out bracing like hard style kettlebells, but perhaps should follow that up with something like Indian clubs where there is flow and big movement.  

If you train tonic muscles to be phasic muscle you are lost (I've been guilty of this)  Example Glute med is a tonic muscle, yet most exercises to challenge them are making them into phasic muscles. Clam shells/band walks.

Loss of centration when phasic muscles are forced to stabilize.  

Some interesting points that didn't really fit into the flow of my recap but I found interesting.

  Biceps can be used as a thoracic extensor with crawling.  
Taylor sits with young girls may be one of the reasons girls are predisposed to ACL injuries. (note to self, don't let my daughter sit this way)
Babies from 3-14 months development go through all phases of the Turkish Get Up.   
Deep toe flexors get active, has a very negative effect on the entire body.  Try yoga toes to walk around in.
T4-8 is an important area for mobility as it is highly proprioceptive.  
Never seen serratus anterior winging without pain resolve with push ups plus.  Put a heavy bell in their hand overhead.  Watch the winging scapula disappear.  
Brain loves extremities crossing midline, it's like candy, and their is more to PNF then just contract relax.  
Skipping in multiple planes of motion barefoot is a great for the nervous system.  Foot is loaded in multiple planes, lots of mechanoreceptors active, crossing the body is involved with things like skipping carioca.  I used to always think skipping with arm movements was a waste of time in my warm ups in college.  Now I can see the merit.  
Exercises that are crawling based don't need as much time to recover from.  Think pulling heavy ass weight as you crawl.
Everything is brain driven.  

These were most of the notes I was able to jot down.  The room we were in lost lights during the presentation so I was writing in the dark.  If you see my hand writing you would think I have an upper motor lesion, now compound that with scribbling in the dark.  Charlie is one smart dude, if you get a chance to hear him speak, definitely jump at it.  

Wednesday, April 17, 2013

Could You Eat It?

The first things people do as they try to get healthy or ensure health is to look at food.  What are you eating?   Whole foods, no chemicals, no preservatives, get rid of crummy oils, no sugar, most everyone will agree on that.

 I'm as guilty as anyone when it comes to the next part, absorption.  Your skin is the largest organ in the body.  What you put on it can matter.   In fact,  because it doesn't go through the digestion process, the body doesn't break it down.  It enters pretty much unchanged.  What you put on it can be good or bad.  

Don't think it can have that big of impact?  Men with low testosterone are often given a cream to rub on them to boost this hormone.  Think of all the baseball players busted in the past decade, most of these performance enhancement drugs were lotion or cream based.  

Enter a chemical called Parabens.  In lotion the ingredient will be "-paraben."  Used as a preservative, for the most part it doesn't even need to be there.  It has been shown to be a xenoestrogen, chemicals that can mimic some estrogenic properties.  They have shown that you can have paraben build up in the bodies tissue.  No one is saying that it increases cancer risk outright, but the question becomes why risk it.  

Most people use lotion at least once a day.  Over 5-10 years, that's a lot of chemicals that your bodies tissue is absorbing and holding on to.  There are lots of options out there now that are paraben free, in fact, many are able to be ingested if for some reason you had to.  (Not saying do this)  but there should be that level of safety when it comes to the thought process.  Could I Eat This?

We care about what we eat, lets care about what we absorb on our skin routinely.  

Wednesday, April 10, 2013

Piriformis Pain in Runners

Piriformis syndrome is a pretty common dysfunction pattern that usually presents more in women then in men.  Described literally as a pain in the butt.  It can present not only with local pain, but also a sciatic type pain as the sciatic nerve can become compressed over time when the Piriformis is tight.

Soft tissue methods directly on the Piriformis can lead to short term improvement.  The question becomes why is the Piriformis irritated or feels the need to tighten.  This is how long term improvement is achieved.

One possible answer lies in the surrounding anatomy.  Looking at where the piriformis has attachments, the lateral portion of the sacrotuberous ligament has fibrous reinforcement from it.  The sacrotuberous ligament is made up of three separate bands, medial, superior and lateral.

The sacrotuberous ligaments role is to limit nutation of the sacrum.  Further down the line, the biceps femoris muscle (lateral hamstring) has direct attachments to the sacrotuberous ligament.  The biceps femoris now is understood to contract before heel strike.  Without a strong biceps femoris, gait mechanics will be changed and Sacrum/Iliac (SI) joint dysfunction can occur.  This may lead the piriformis to tighten up to try to help stabilize the SI joint.

While one can never achieve great results with just following a cookie cutter recipe in manual therapy, recognizing patterns is always helpful.  Test for weakness in the biceps femoris next time piriformis pain presents in your patient/athlete.  For the athlete dealing with this roll out the hip rotator complex and perform some hip/hamstring Swiss ball leg curls with the feet slightly turned in to try to target the biceps a little more.  Try this everyday for two weeks and see if the pain in the butt leaves.

Tuesday, April 2, 2013

Creating Hypertrophy in Lumbar Multifidi

Eight out of ten of us will have back pain in our lives.  Chances of having low back pain are significantly higher if you have had low back pain before.  Take away, it comes around again if you don't do anything about it.

One of the main reasons in the research and therapy world is that after the first bout of acute low back pain (LBP) the lumbar multifidi start to atrophy.  Not only atrophy,  but they start to get fatty infiltration.  It can be one sided atrophy on the side of the pain as well.  So not only will we have asymmetrical function from the back, but asymmetrical form as well.

The role of the multifidi was long thought to be that of a rotator/extensor.  It is probably too short to be much of a power producer but it has a high amount of muscle spindles.  This means it sends a lot of information to the brain about position and movement.  So with atrophy we get loss of form and function and lack communication with our most important organ, the brain.  It most likely alters its relationship with another important communication system as well, connective tissue.  There has been some understanding that the multifidi also play a roll in maintaining a proper lordosis or curve to the back.

The big question then is after back pain, how do we restore hypertrophy to the multifidi?  It's been shown through EMG that although lumbar extension and things like bird dog exercises make the multifidi active, they did not produce any changes in cross sectional area.  

Finally, a study showed that holding a contraction, an isometric hold of 5 seconds, was successful in increasing cross sectional area.  In between the concentric and eccentric phase of a movement, hold the contracted position for 5 seconds.  Do not go to failure.  Also, having an upper body extremity do an isometric hold increased activity of the lumbar multifidi up to 51%.  This may be a great starting point for someone coming off acute LBP or back pain surgery.

Adjustments of the area have shown to increase the lumbar multifidi to contract and activate better.  Not only post adjustment, but one week later as well.  Before an exercise program is begun, creating better mechanics through HVLA adjustment may be the kickstart the body needs.

Friday, March 22, 2013

Notes on Gait Function with Thomas Michaud

These are some of the highlights or things I found of importance in a recent webinar I took given by Thomas Michaud.

Walking, your center of mass (COM) is highest at midstance.  Running the COM is lowest at mid stance.

Inefficiency of the Gastroc is the point where speed goes from walking to running.

Some studies done with forefoot running as a means to prevent injury were flawed as they were done with college runners that had already become midfoot strikers.

Runners that are not elite that transfer to a forefoot or minimalist type shoe show arch inner calf problems if they have a flatter arch, higher arched individuals show with more metatarsal strain/stress fracture.

Most runners are more efficient with heel strike when energy expenditure is looked at.  Around the 6 minute clip is when forefoot running becomes more efficient.

Shape of the heel is perfectly suited to absorb impact.  100lb female has a larger heel bone then a 350lb Gorilla.

Heel expands and contracts like a rubber ball.  Thin outer layer of bone and and extensive blood supply to help repair.

The heel is protected by a well designed 3/4 inch fat pad.  The fat pad is spiral chamber of sealed fat.  Fat pad is several chambers.  Outer layer is a protective cup.  The inner layer is a major shock absorber.      It quickly deforms and reforms.  Retains all its shock absorption even in cold environments.   It is made of polyunsaturated fat.

Barefoot running shows 60% deformation of heel pad.  Shoes it is 35%.  Walking is 40%.  Thinning of the heel pad is a major predictor of foot pain.

With a heel strike the Tibialis Anterior is used to handle the absorption of impact which it is well designed to do.  Midfoot strike the Tibialis Posterior is responsible for slowly lowering the heel.  Forefoot strike the Gastroc is used.  It is not well designed for this as it crosses 2 joints.  2 joint muscles are easier hurt.

Flexor Digitorum muscles are important for dampening the oscillation from bony vibrations.

Lateral Gastroc and Biceps Femoris were important for pre muscle contraction right before impact.  This is why running surface matters very little.

While glute med/min are important for hip stability, the faster you run, the more important the Glute Max becomes.

One myth is that disc act as shock absorbers.  McGill has proved that the endplates of the vertebral bodies are what absorb impact.

IT Band is an energy storer.  Hips are force producers, lower legs act like rubber bands storing and returning energy.  Prosthetic makers have started to take advantage of this key understanding.

Seems counterintuitive, but the calf muscles don't go through big lengthening, more of an isometric with the tendons going through large changes in length.  As we age, tendons get more brittle, hence we have a harder time moving fast.

Flexor Digitorum Brevis is an important muscle for maintaining arch height.  Weakness may be a important cause of plantar fasciitis.

Slow running possibly less stress on the joints then walking.

Flexor Hallucis Longus pulls the fibula head down.  This deepens the ankle mortise and helps to prevent ankle sprains.  So if dealing with an ankle sprain, mobilize fibula and strengthen FHL.

Achilles is unique as it rotates 90 degrees before attachment.  Gastroc/Soleus (GS) primary role is not one of concentric (shortening) but more isometric impulse as and anchor for the Achilles tendon and allow the Achilles to go through large ROM.

Plantaris is located between the GS.  To thin to be used for force production, now known to be loaded with mechanoreceptors.  It provides detailed information to CNS to allow the GS complex to create precise isometric impulse for proper Achilles function.

When Achilles is storing and returning energy efficiently, it reduces the load on the hip flexors.

Looking forward to reading through Thomas Michaud's latest book.  "Human Locomotion."

Tuesday, March 19, 2013

A Few Product Reviews

Here are a few of the products I've been using that I think are worth mentioning.

First up,  the Squatty Potty.  It's kind of a funny concept growing up in the United States, but many cultures still go to the bathroom using the "Third World Squat."  I first read an article about the proper way to eliminate and started looking further into it.  This is a pretty well made video.

Now I'm starting to see these recommend in a few places.  I like it and think there pretty cool.  I'm keeping mine.

Next up is the Slingshot from Marc Bell.  It essentially unloads some of your weight and supports your elbows as you bench or do push ups.  While it did do what it said it would do, allow you to complete more push ups.  I didn't really see much benefit from doing them that way.  It was strange in that I didn't get a pump in my triceps or chest from doing more push ups and after playing around with it a few days, haven't really used it to much since.

I've been doing some reading about how computer screens late at night can trick your body into not falling asleep.  Since I read a ton on my iPad at night, I looked into some options.  I forget who recommend the blue light filter from LowBlueLights, but it seems to work.  The blue rays are what causes suppression of the sleep hormone Melatonin.  My first night using it, I fell asleep while reading.  I had never done that before, but did all the time while reading hardcover books.  It's easy to remove in the daytime as well.

I had heard of the Perfect Health Diet for awhile now and finally bought the book and read through most of it.  I agree with most of it and think it's a solid way of eating.

So those are a few things I've been playing around with.  Enjoy!