Antibiotics Rant

You get to make choices for the health of your body everyday.  There are a few choices that can be made for the health of our planet and global health.

There is more then just healthy choices when you chose to eat grass fed beef over commercial beef.  Not only do you get all the positive nutritional aspects, you are choosing a different way of raising the cow.  You support what you want to happen in the future.  Grass fed cows are raised like they are supposed to be raised.  Grain fed cows will get sick and die.  In order not to die, they are pumped full of antibiotics.  This can then be ingested.  This can get in our groundwater.

If you have a cold, don't go and run to get an antibiotic.  Colds are viruses.  A virus is not affected by antibiotics.

If you do take an antibiotic, please Lord, finish it.  I don't know how many people have come into my office and told me that they were on an antibiotic but started to feel better, so they quit early.  This is how antibiotics become resistant.

I just read an article about how the corn worm has evolved to be resistant to the new strain of corn it was supposed to eradicated from.  Things are evolving all the time, including germs.

Here's a story that will be sure to freak you out.  A man in New Zealand died from some organism called Oxa 48.  It's resistant to every antibiotic known.  When We Lose Antibiotics.

So lets try to keep our planet from being run over by super bugs and crazy bacterial outbreaks.  I'm not ready to fight a zombie war.

Increasing Coffee Knowledge

I've been on a quest to learn as much as I can about coffee this past year or so.  I find myself enjoying it more,  the more I know.  Probably not a coincidence.  There's something cool about knowing the history of this Ethiopian Yirgacheffe coffee I'm drinking.

One of the important things to realize is how important the grind of the coffee bean becomes.  This is an article that talks about the development of a hand grinder and gives a short overview of why the grind is important.  It's all about the Grind, from NPR.

If you want to really learn, I mean really learn about the history of coffee and how it spread through out the world,  then this podcast from Joe Rogan with Peter Giuliono is a must listen/watch.  I learned a ton.  Warning,  if you have never listened to Joe Rogan, it's not for the easily offended.

Concussions and Low Testosterone

Listening to the Joe Rogan podcast with Dr. Mark Gordon I came across some really interesting information.  It seems when a person suffers a Traumatic Brain Injury there can be lasting hormonal changes that until recently have been widely unknown.  TBI can have an impact on the sensitive little Pituitary Gland.

The Pituitary Gland is and endocrine organ the size of a pea.  This gland secretes 9 hormones that regulate homeostasis.  When we have a concussion or any other type of TBI there can be a disruption to this organ and one of the side effects can be very low testosterone.  Difficulty sleeping, anger, depression, recovery problems, etc...can all be side effects.

Boxers, Football players and Military personal have shown some hormonal changes after some severe TBI incidents.  Here a link to a few abstracts from Dr. Gordon's TBI webpage.  LINK.

Here is an article discussing the discovery and ramifications of Pituitary disruption from TBI's.
Using Hormones to Heal TBI.

7 Easy and Cheap Ways to Measure Performance

One of my concrete take aways lately is the need to keep constant records.  Are you improving?
Here are 7 easy and low cost ways to measure performance and conditioning.

1.  Broad Jump:  Measure out 10 ft and keep track.  This is a great way to measure power.  If you need more then 10ft, congrats my friend, you are a beast.

2.  Single Leg Hop Test:  Same as above, but now you are only jumping and landing on one leg.

3.  Vertical Jump Test:  Set up same tape measure to 10ft.  Jump straight up against the wall.  Use chalk to mark the wall.

4.  Heart Rate in the Morning:  All smart phones these days can buy a .99 cent app and measure your daily heart rate before you get out of bed.  Extreme spikes may mean you are overtrained.

5.  Med Ball Throw From the Knees:  Measure how far you can throw a 20 lb med ball.  No steps are allowed.  Chest pass.  Doing it from the knees will help limit the lower body.

6.  Conditioning with a Heart Monitor:  Do something all out for 60 seconds.  Measure how long it takes you to get your heart rate back to lets say 120 bpm.

7.  Endurance:  How fast can you row a 1000m or bike 3000m.  Doesn't matter, just has to be done on the same piece of equipment.

Functional Range Release Palpation Review

I know you have you been hearing me talk a lot about the Functional Range Release technique in the last few months and there is a reason, this is my blog of my thoughts and interests and things that pertain to health and performance.  All of these pertain to the FRR system.

Since November I've been on a quest to capture the knowledge base of the FRR system.  I'm not a kool aid drinker usually,  but man...I've drunk this drink.  (So I guess I am a kool aid drinker...give me the grape)

One of the best surprises about the FRR system is the palpation.  There is a system to learn.  It's a system.  That is the beauty of it.  Systems can be learned and practiced.  Looking at an anatomy book and "knowing" where things are supposed to be is hit and miss.  Hence, this is why many reports say that inter and intra examiner palpation is very poor.  Palpation is a skill and it isn't taught in school.  You would be surprised how little anatomy is taught.  Palpation is always finding bony landmarks in school.  This is quite different then muscles and very different then memorizing origin and insertions.

I find myself lately just smiling on the inside (it may be weird to be smiling while palpating a gracillis/adductor longus epimysial groove) as I practice my palpation skills on patients.  There is a joy in getting better, working the FRR system.

Again, learning knew stuff is always awesome, but being able to immediately apply new information is amazing.  It's a skill you can practice daily, when you know the system.  I once had a mentor tell me it's all anatomy.  Know your anatomy and you will figure it out.  Very true statement.  But, digging deeper, I believe it is being able to feel the anatomy.

That my friends is palpation.  It opens the door to movement,  joint mechanics,  diagnosis, rehab and training.

A few cool Articles

Does the combo of Glucosamine/chondroiten and Vit C help knee arthritis?  This study seems to suggest using Navy Seals as the guinea pigs.  They were also studying the effects of this combo on DJD of the lower back.  This didn't seem to present any changes.  The abstract states that the running times never changed.  What I take away from this statement.  These dudes are insanely tough, (most likely) or somehow the motor control for running was improved.  You would think you would run faster if the knee didn't hurt!  Here is the ABSTRACT, I couldn't find the full article.  If you are taking glucosamine, which every new patient says they are, it may be prudent to add in 200mg of Vitamin C.

I thought this was a great article from the PRI people about vision and neck problems.  Some highlights is that the closer you move your face to the screen, the more the muscles of the eye and sub occipital area are forced into contractions.  They are working harder.

Keep your screen an arms length away.  Most of the screen 2/3 below eye level.  Take unfocus breaks by looking off into the distance without straining a few times an hour.  Every now and then check on your left peripheral vision.  Why left more then right?  I have no idea, I've never taken the PRI vision.  :)  PRI Vision and Computers.

Listening to Stay Alive by Jose Gonzalez  for the above reading and writing this post.

It's All About The Cells

One of the cool things about learning new methods and ideas of treatment is figuring out the WHY's.  One of the things about Functional Range Release is the idea of what you are actually influencing.  It's the cells,   the communication of cells is force.  You pushing or treating of muscles is influencing cells by an external force and things like isometrics are an internal force to the cells. This is all backed by science.  On my own I've been reading more about the biology of cells and things of that nature and found this cool video that is trying to give a visual to the working of cells.  I think it's pretty cool.  Enjoy.

How Do You Know if Your Interventions are Working?

One of the coolest things about attending a really great seminar is that it attracts awesome therapists and coaches.  This past weekend topped them all.  One of the many highlights for me, (besides the material) was getting a chance to meet Patrick Ward in person and ask a few questions.  The dude is super knowledgeable in the area of testing, energy system development and data interpretation.  

I've listened to him a few times in various media seminars and always walked away learning a lot.  One of the take aways was having measurables in your programs.  I think I found this on my mind because part of the Functional Range Release is asking yourself the question, how do you know when you are done with the treatment.  How do you know what you are doing is working?  What are you measuring?

I do a bike workout,  is it improving my fitness?  Is my overall fitness going up week to week and month to month?  Treatment wise, lets say you are working on someones hamstring, how am I judging my intervention?  Simply pain or joint function?  Just return to play?

I think this is very interesting and important questions to ask and something I believe I've done poorly in the past.

Patrick is going to be the guest speaker at the Southwest Michigan Strength Seminar on April 26th at Niles High School.   I'm looking forward to hearing him speak and seeing what else I can learn, because I'm positive it will be a lot.  Here is the link to the seminar if your interested.  He will also be speaking in Boston in May.  Southwest Michigan Seminar.  I highly recommend attending.

Random and Interesting

Everyone I think would do well to fast or intermittent fast for a day once a week.   Here is a very small explanation of what some of the benefits may be.



Here is a very cool article on why dark chocolate is good for you.  It's not just the antioxidants or polyphenols.  Dark chocolate feeds the good bacteria and this in turn is anti-inflammatory. Bring on the dark chocolate.  One of the points in the article was that combining dark chocolate with pomegranate or acai may produce even more benefit.  Dark Chocolate.


Capsiate has been shown to increase force production in mice.  Pretty cool.  Capsiate.

Nuggets of Thinking from Functional Range Release

What are you feeling for when you palpate soft tissue?

What is your goal when you are trying to treat soft tissue?  For example, how do you know when you are done withe treatment?

These are simple questions, but when you really, truly, come down to thinking about it, most practitioners won't have a direct, clear picture of their answer.

One thing I'm sure I heard several times, but finally stuck in my brain, was that soft tissue treatment is for the improvement of the range of motion the patient has.  Training/mobility work is for trying to gain more range of motion that they do not have.  This was a light bulb moment for me.   Don't confuse the two. 

This is by far the best palpation course taught anywhere.  Again, seems simple, but this isn't taught in the school I went to.  I've done a lot on my own through practice, but it's never been systematic.  Studying anatomy/knowing anatomy is different then FEELING anatomy.  It's thrilling and humbling.  I'm getting better by the hour, (thrilling)  it's 10 years since graduation and I just know now without a doubt where some muscles lie.  (humbling)

If you don't know epimysial space (I mean own it) or the answers to the first questions,  get to a course.  

Someone posted on Facebook that the testament to the quality of the course are the people taking it.  There is an amazing group of therapists here in Portland, it's cool and humbling to be apart.  

Icelandic Giants: Strongman

This is just a cool 20 minute video on strongman culture in Iceland.  It's a country I can't wait to visit one day.

Free Your Mind

Belief Check Time

I'm flying to Portland today for a seminar.  Walking to my seat I noticed the pilots going through there checks to ensure a safe flight.  Check, check...Going through check lists are a good thing.  There was a book a few years ago how checklists can actually improve the quality of life.

What kinds of things can we use checklists for?  How about a belief checklist?  What are you believing?

"What the mind can believe, the body can achieve."

Enter Roger Bannister.

Probably the most famous mind/body belief was the 4 minute mile.  People believed that this barrier couldn't be broken.  That man could not run this fast.  If he did, he would die.  Plenty had come close, but it just wasn't going to happen.  Man couldn't fly and he couldn't break the 4 minute mile.

Then one man named Roger Bannister believed it could.  He set out and trained for it while going through medical school.  He did break the 4 minute mile and it was a great accomplishment.  But, that wasn't the most important barrier broke that day.  He shattered a belief barrier.

Within a year, several people pushed through and broke the 4 minute mile.

Personally, I became interested in this mind/body connection when I experienced my own 4 second barrier. .  Coming out of college I was training to play football and one test that was always tested was the Pro Shuttle Drill.  I thought I was fairly quick running in the low 4.2's.  (Don't laugh and start mocking my belief! I hadn't been exposed to much and times at this point)

I went to a pro combine and watched a wide receiver run a 4.03, the fastest I'd ever heard of and he seemed disappointed.  I asked him what he thought he could run and he told me he had been timed in the mid 3.9's quite a few times.  My belief barrier was broken.  My mind was open.

I went back home and started training.  With in 2 months and my next combine I ran several times under 3.9 seconds.  In 2 months I had shaved almost .3 seconds.  My body was always capable of it.  I just needed to believe it.  Of course, I worked on technique.  But, without the belief, the willingness to put in the hard work, would never have happened.  Why try to do the impossible?

What are you believing?  What do you believe about your health?  Joints?  The back you claim has been hurt for 10 years.  Your 5k time.  Your weight.

Take an evening one day and think about what physical things you would like to accomplish.  What is your beliefs about it?  That's the first step.

Free Your Mind.

What Should Our Kids Be Training For?

There is an endless debate on how kids should be training these days and a big backlash against specialization.  I'll be honest,  I used to think if I had a kid, I'd Tiger Woods him/her.  Now that I have one, I'm a little more realistic and more concerned with keeping my kid healthy/happy.  I think by doing this, I'll actually be providing them a solid base to allow them to later become, if they choose, an athlete in a particular sport.

Wouldn't a kid be better served, training like this.  (even us adults)



Then Like this?  I may be biased, but I've never seen anyone get better at a sport, by getting good at an agility ladder.  No crossover.




Getting kids back to doing things like this. (even us adults)



Here is an excellent paper that talks about the cost/benefits of early specialization.  PROJECT PLAY.

What you will notice with these videos is an emphasis on getting your body to move better and more efficiently.  If you create a large base of mobility/stability at a young age, you can build a higher pyramid in terms of athletic development.  My 2 cents.

How to Spot a Quality Protein Powders

What boosts your immunity, helps you recover and speeds up metabolism?  Whey Protein!  Sounds great, but there are a lot of good ones and a lot of garbage.

Most athletes need more protein in their diets.  If you lift weights, run, do Crossfit, or generally have an active lifestyle, protein is an important recovery tool.  Very often people grab a protein bar, or a sports shake at the gas station, juice bar and think they are doing themselves a favor.

Their is HUGE difference in protein powders.  Hopefully by now you know there is a difference in a burger.  A grass fed burger is great for you.  A processed grain fed burger is not.  The grass fed beef has as much omega 3 as salmon and is anti-inflammatory.  The grain fed burger will create inflammation.  How it's created and treated is very important.

The same goes for your protein powder.  There are the powders you can buy for 40 bucks at GNC that comes in a 5lb tub.  It probably has a load of sugary carbs added in as well.  There is Muscle Milk, that adds in MCT fats to make it taste good, but comes loaded with chemicals.  Then there are the higher quality protein powders.

Cold processed, grass fed, undenatured, purified protein powders.  What exactly do all these labels mean.

Cold processed:  It means heat wasn't used to treat the whey.  Most proteins are heat processed.  This actually kills most of the immune boosting properties and some amino acids.  This is vital.  One of the greatest things about supplementing with Whey Protein is that research has proven that it boosts your immunity!  

Grass fed:  There is some debate whether this is important.  I think it is.  Start with something healthy and you end up with something healthier.  Plus, we know a grass fed cow is treated much more humanely.  It doesn't need antibiotics to stay healthy.  Environmentally this is a win.  I think this makes a healthier protein powder.  Again, this is under debate.

Undenatured:  All protein powders get denatured.  So there is no such thing as undenatured.  When a company says this, they are saying because of how they process, it's less denatured then when it's used with heat or harsh chemicals.

Purified:  Basically, this is more about the company then the actual protein.  What is in the protein is in the protein, but just as important, what isn't listed isn't in the protein.  A few years ago a bobsledder I know tested positive for a chemical and was banned from the Olympics.  Can you imagine losing your dream and 8 years of hard work, because you bought junk from GNC.

It's honestly scary, what can be legally sold.  Saw dust as packing ingredients anyone?

Whey Protein Concentrate vs Isolate:  Isolates are more isolated...get it.  More of the pure protein.  This must undergo more processing to become isolate, so some people think the concentrate is a better "purer" whey.  If the process to get to isolate follows the above process though, I think isolate is best.  This again is debatable.

There a definitely a few products now that meet the above demands.  You get what you pay for, just like a grass fed burger is more expensive then a grain fed burger.  Quality comes with a price.  But one can help boost your immunity, one can't.  I choose the PURE brand because it's met all the requirements.  21 grams of quality protein per bottle.   18 servings a bottle.

But don't get the impression this is the only company out there doing this.  Google search and you will find a few.  Mark Sisson I know right off the top of my head has a solid product.  Now you know what to look for and more importantly, the why.

Sprained Ankle Protocols

Everyone has sprained their ankle.  The stuff we do these days, is completely different then the stuff we did when I was in High School even College.

Inversion sprain.  The ankle buckles underneath you, so the outside goes into the ground, is the most common.  The old adage of ice and rest/immobilization are gone.  NSAIDS gone.  All three were commonly used.

Today, pump the swelling out of there.  Voodoo bands, or gentle upward strokes to get some swelling out.  Tissue work on the peroneal muscle groups.  This muscle must have given out to allow a sprain to happen.  Manipulating the alignment of talus/calcaneus/cuboid can help restore proper function. Keeping as much dorsiflexion as we can with drills like wall slides to keep the talus in place and keep it from traveling forward.

Keep moving.  Obviously taking care to not allow a reinjury, so nothing dynamic, uneven or unstable.  Simple drills like going up on the toes under support can be great though.

Some times extra enzymes can help in the form of supplementation, this potentially can speed up the inflammatory process.  (extra inflammation)  Inflammation is necessary to help remodel torn or injured tissue.  That is why NSAIDS are a bad thing.

If you sprain your ankle in the future, give these new protocols a whirl, they will have you up and walking much sooner.

What a Manual Therapist can Learn from a UFC Fighter

In the early 90's I can remember renting VHS tapes of what was then the Ultimate Fighter series. (I may be remembering the name wrong) Basically back then two fighters, usually with different styles, would just try to beat each other up.  No rules really.  Your best technique vs my best technique.  The Gracie name was already legendary.

A boxer vs a karate guy, karate vs tae kwon do, wrestling vs boxing.  The first I'd ever heard of ju jitsu.  What they all had in common was that they were all good at one thing.

Fast forward 20 years.  UFC is now mainstream.  What we find now is that you can't be good at one thing.  Strikers must become grapplers, grapplers must learn to box, Muay Thai must learn ju jitsu, you have to be good at everything if you want to be a champion.  You have to know all these techniques, must know when to use them, and must have strength and speed.

There is an old saying "he could beat someone with one arm tied behind his back."  Think about this for a moment.  You are taking away an advantage, but still get the win.

A patient walks into your office.  They tell you that they don't want you to use your trained technique, could you still help them?  When I first started out, I can still remember having a patient ask me if I could treat them, but they didn't want to be adjusted.  As a chiropractor, my first instinct was, "Seriously?  You know I'm a chiropractor, why are you hear then?"  My tool box was small.

These days I get that a lot.  It no longer bugs me.  In fact, I find it humbling.  Someone still thinks you can help them without having to be adjusted.  Thank you for the trust and confidence.

So I started thinking.  How big can the tool box be?

If someone took away adjustments,  could you still help?
If we take away soft tissue work?  How could you help.
If we took away corrective exercise?
If we took away proprioceptive type therapies?
If we took away coaching?

As a chiropractor I perform manual adjustments mostly, but only when I think it will help the current condition.  How many different ways can you learn to move a bone?

I perform lots of soft tissue work.  How many techniques of soft tissue work can be learned?  Are some better then others in certain situations?

I place a big emphasis on cementing in new ROM with exercise.  How many ways do you know to get a movement to work better?

Can you help a patient find the movement.  Neurokinetic and Muscle Activation technique work on just getting better motor control.  PRI breaks patterns.

Could you just use a better strength and conditioning program?  Do you know how to teach them to deadlift or squat?

Whatever type of therapist you are, can you go to the next tool in your tool box if you need to? Chances are no one will take away your chosen method,  but chances are if your tool box is large, nails will get hammers, screws will get screwdrivers and rough edges will get sandpaper.

Don't be the guy that only has a hammer, so everything becomes a nail.  He got beat up pretty bad in the 90's.  These days if you want to be a champion, you have to train hard in many disciplines.

Does the Duck Quack?

The more you read and the more you start to have definite opinions,  the more you realize some people don't share them.  The more you realize there is a heck of a lot you don't know.  The more you realize there are some things you truly think you know.

Lately, I find myself doing self checks more often then I used to.  I used to read something that was against what I thought and dismissed it or was so intrigued by it, I immediately adopted it and it became my new thing.  Yes, I was that guy.

When your new they don't teach you critical thinking.  They teach you see this, do this, then do that.  My school taught me to Xray the bone, diagnose the bone, move the bone.  Not much more then that.

You accumulate experience.  You find patterns.  You find things that you like, you find things that work.  You find things that don't work.  You find things that don't work for this, but work for that.  Over time you have a working knowledge.  You also have accumulated attachments that you may not even know.

Want to know what an attachment is?  Read something that is the opposite of what you think.  Does it make you angry?  Do you find yourself taking it personal?  Then you are probably attached to the idea.

This is not necessarily a bad thing.  What make it a bad thing, is if you stick your head in the sand and never evaluate what you do or what you think.

I think the work of Tim Ferris has really brought to light the concept of life hacks or using your own life and body as an experiment of n=1 to find what works for you.  Hey my doctor told me washing my mouth with coconut oil for 20 minutes will cure my "ailment."  Some people called BS, some people called it a miracle.  In reality just do it for a week, did it work?

I've had people tell me acupuncture research shows its BS.  Funny thing, it is one of the few things that makes my elbow feel normal.  It's one of the few things that a cancer patient tells me helps with her pain.  Placebo?  Perhaps, but what if you don't expect it to work, you want it to fail?

I had a case of groin pain for 6 months in college.  Had been to every doctor and PT.  My mom suggested a chiropractor.  I laughed and said my back was fine.  She forced me to go.  I went reluctantly.  3 days later I sprinted pain free for the first time in 6 months.  Part of me was just waiting to say "I told you so."  What an obnoxious 18 year old.

I've heard people bash the concept that you can't feel/touch the Psoas muscle.  What am I feeling day in and day out?  Have you even tried?  Are you just repeating something you heard?

I hear that palpation and general soft tissue work is redundant.  Just get in there, rub and it will all turn out the same.  Sadly, this has not been my experience.  I have continued to get better results the more I get better at feeling "stuff" and refine my anatomy palpation.

I hear muscle testing is BS.  Maybe it is how we think of it.  But when someone can't resist a movement and they should be able to, that tells me something.

A few years ago Mike Boyle came out and said he'd gotten rid of the back squat.  You should have heard the uproar!  This is a respected strength coach that had his reasons for the population of people he coached.  That my friends is people clinging to their self beliefs.  They have come to identify with an exercise.

It seems silly at first, it's just one exercise.  But we all do it with something.

I had a patient tell me isometrics don't work.  Maybe isometrics don't work the way you do them.  I gave him some Pails/Rails isometrics for a hip capsule and watched as the sweat poured off his brow. His experience with isometrics were different from mine.

I had people tell me high dose Vitamin D doesn't work.  But it did for me when I did it and when I have had patients that needed it to as well.

I've had people tell me sleep before midnight is the best.  It never worked for me.  There are a lot of things I've wanted to work and it just didn't.  Trust me I've tried.  I would have taken the placebo effect.

These days I'm starting to read and listen and learn with open ears and a filter.  If it challenges me, I ask why.  Am I taking this personal?  Does this have merit?  How can I test this?  Is this better then what I've been doing?  If it says it won't work, but it works for you consistently, whats that mean?

Two sayings come to mind.

"Absorb what is useful, discard what is not, add what is uniquely your own."  Bruce Lee

If it walks like a duck and quacks like a duck...

Diaphragm Control by Rickson Gracie

This is an unbelievable demonstration of diaphragm control from the fighter Rickson Gracie.   Notice also the amazing spinal mobility this athlete demonstrates.  Pay attention to what he says when he says about what happens when you control your diaphragm.  Very awesome.

Finally Found a Tea I Love: Green Matcha

As an espresso lover I've had an extremely hard time finding a green tea I truly enjoy ingesting.  I've done it on principle for a bit, then given it up and always try to come back to it every couple months or so after reading another article on the health wonders of green tea.

Poor something strong into a cup, drink it.  Now put water back into the cup and swish it around.  That's what green tea has always tasted like to me.  The leftover remains of an original drink.  It was like....weak...and annoying.

I like espresso.  Strong, flavorful, bold.

I had assumed that's what green tea was, the weak after taste of a real drink.  I had tried probably like 10-12 different teas: Japanese, Chinese, imperial, white, black, purple.  Tried them all.  I had even tried what I thought was machta tea before.  Never really truly enjoyed any of them.

Finally had a real green matcha tea.  Wow.  It's strong, flavorful, bold.  It's the espresso of the tea world.  Bonus, it's even healthier then the normal green tea, with more catechin polyphenols and more antioxidants.

The tea leaves are ground, so you are eating/drinking the tea leaf.  No waste.  Pure awesome.  So if you are like me and want all the crazy, researched, proven health benefits of green tea, but have found the taste weak/lacking, try matcha,  try a few.  The health benefits are unsurpassed.

A Great Visual

I wish I could give credit to whoever drew this, but I'm not sure.  I got it off a very smart therapist (Jeff Cubos) who had shared it.  Keep your bucket full.

Change of Scenery

Often a patient will be presenting with some type of dysfunction or pain and have apprehension about going on a trip/vacation that they have had planned for awhile.  It usually goes two ways, they have almost no pain or they have very little pain.

They come back and some of the old issues start to reflare or they notice them again.  What this tells me is that the vacation made them change their old habits.  They moved more or less, ran differently, changed a workout up or simply had less stress.

Pain can get engrained with certain movements that we have learned to recognize and guard.  Often times changing environments doesn't bring the stress of the "normal" and actually changes how you move.  Even slight changes are different joint positions and muscular vectors.

So if you are dealing with something and notice that it wasn't as bad on a trip or vacation.  Start to try to change up your work environment or workout routine or both.  Simple things like changing seat height, shoes, micro movement breaks, isometrics at the desk, answering the phone differently can all add up to different patterns and can hopefully bring you some relief.

A Very Informative Video on Vitamin Supplementation from Dr. Rhonda Patrick

At the end of last year, there were several attention grabbing headlines spouting the redundancy of multivitamin supplementation.  "Multivitamins are a waste of money."  "Multivitamins Don't Improve Health."

There was such a huge bandwagon of articles written about the studies that were shown to "not improve cognition or life expectancy."

This is an excellent video on why these studies were a joke.  I found Dr. Rhonda Patrick on a Joe Rogan Podcast and was impressed by her knowledge base.

What an Endurance Athlete can Learn from a Strength Athlete

Things I hear a lot.

"Doc every time I hit 10 miles I get hip pain and then knee pain,  maybe I'm not meant to run."

"Seems like I do really well for a few months and then it all starts to fall apart, maybe I'm not mean to run"

"I used to be able to do marathons without any issue, now I can only do half marathons, maybe my best days are behind me."

I get a variation of the above at least once a week.  What you will notice in all these comments is that it doesn't hurt to run, it hurts to run at a certain point.

What I don't think I've ever heard.

I squatted 315 last week, I jumped to 405 this week and hurt my back.  I must not be meant to squat.  

My plan calls for me to deadlift the most weight I've ever done this Saturday and I'm going to do it no matter what, even though I was up all night with a sick kid and I'm still very sore from my last workout.  

I don't ever take days off of lifting.  I'm pretty sure if I take more then three, I'd lose my strength and be way off my training schedule.

What to take away.

I see very often plans jump from 8 to 10 miles on the long weekend run.  For some,  this is there very first time in this training distance.  This is a jump of 20%.  No strength athlete would jump 20% in a PR lift.   Now this is a little bit of apples to oranges, but for the most part gains are incremental.  Not leaps.  There is no shame in staying at a distance until your body has adapted to it.

The body needs recovery.  This should be built into the program, but very often it is missing.  Just because there is a "back off" run, a small dip in the training program, doesn't make it recovery.  You just did less stuff.  What are you actively doing to make your tissues healthier.  Strength athletes do a pretty good job of doing things like foam rolling, mobility work, recovery shakes and rest days.

If a strength athlete plateaus in a lift, there is a weakness.  Work on the weakness.  If you can't get to 10 miles or 18 miles or whatever distance, chance are it's not your cardio respiratory system that is lacking.  So doing more cardio won't solve your problem.

Don't get locked into a program.  I know the long run is called for on a Saturday.  Sometimes your body doesn't know it's on a precise 7 day schedule.  I know your running group is meeting.  I know you have to carve out special time just to do this one day.  But again, your body doesn't care about any of that.  In the end, it's in charge.  Listen to your body.

You ran a 5k then a 10k then a 1/2.  Your definitely adapting your body to keep running.  But how about you run the 5k 3 minutes faster before you run the 10k.  Ran the 10k.  How about you run it 6 minutes faster before the 1/2.  Why would this work?  To run faster you must get stronger.  If you get stronger, chance are you won't run into some of these issues that start to block your progress.

Hip Capsule Mobility

Amazing Single Leg Progressions from Dewey Nielsen

NSAIDS are not a Recovery Tool

Yesterday a patient presented with some patellar tendonosis.  Not patellar tendonitis as was told by the her doctor or PT.  Why is this an important distinction?  The -itis is an inflammatory condition.  The -osis is a degenerative change.  She had this pain for over 3-4 months.  High School basketball player.

Treatment of choice was they wanted to do an ultrasound using NSAIDS in the ionophoresis.  Funny how certain things in life line up, I had recently received a copy of Thomas Michauds newest book "Injury Free Running."

The forward contains some pretty powerful information on NSAIDS.  They interfere with bone remodeling.  They can actually inhibit tendon repair.  So why in the world if my goal is to help the body heal a ligament or tendon that is having degenerative changes would I pump NSAIDS into the structure.   Know the histology of what you are trying to accomplish.

On a side note I'm already 1/2 way through the book.  Very solid read.  It comes with its own highlighted high points.  So it's pretty easy to gain access to the meat and potatoes of the chapters rather quickly.  You can purchase on his website.  Human Locomotion.  

NSAIDS are not a recovery tool.  They have been shown to be an arthritic accelerator for the hip and knee in runners.  Most likely you are masking pain that allows you you keep degrading your cartilage.  But, there may be some systemic issues at play as well.

Think twice next time you go to grab the "Vitamin I" as one runner I know calls it.  Realize the relief you are getting may be prolonging or even hindering your healing process.

Advice on Advancement

Listening to the sportsrehabexpert podcast last night, they were interviewing Nick Winkelman and Charlie Weingroff and they were both asked what advice they would give to someone looking to make advancement or get better in the field of strength and conditioning.

Nicks advice was more internal.  Get used to and embrace the feeling of uncertainty.  He gave an example of talking to Dan Paff, one of the greatest sprint/jump coaches of all time.  He asked Coach Paff how many days out of the year he feels like he knows what's going on.  (Has a complete handle of all the different elements that make up a successful program or situation)  This legendary coach stated 30.  That's out of 365!  It shows how much or how little there is in certainty.  My take away,  have doubts, keep searching, don't stop asking questions.

Charlie had more of an external answer.  Read 20 min every day.  Write 20 min every day.  Workout or try something you are reading about for 20 min every day.  Proud to say, I've been doing Charlies advice for quite awhile.

The combination of the two I believe, could be and is,  a powerful way to approach therapy and training. Never stop learning, take what you are learning and apply it and have doubts, they are good, they keep you sharp.

Fat Tuesday Random Rants

Fat Tuesday is here.  Here's the thing, If you are thinking of giving something up for Lent, I'm assuming you are assuming it's no good for you, but you love it so it's a sacrifice.   If you can give it up for the 40 days, don't bring it back.

Things I've heard from patients in the last few days.  "My coach has me doing a Mitochondria Workout."  Hmm...really, what exactly is that?  "It's where I don't eat anything and then ride the trainer for 45min at a decent pace, then I eat a ton of protein."  I shake my head.

"I'm heading down to see Dr. X to get some shots."  What are the shots for?  To regrow cartilage in my hip and to heal a torn labrum." Oh really?

In case you were wondering about more information on the Functional Range Conditioning or Therapy, here is a link to a podcast from Dr. Perry's Stop Chasing Pain Podcast with Dr. Andreo Spina.

A few different techniques talk about how the upper pec or clavicular head can become underused or less recruited vs the sternal head.  The clavicular head actually twists around itself as it inserts into the humerus.  The top fibers on the chest, become the bottom fibers on the arm.  A lot of this can be resolved by making sure the epimysial space between the clavicular and sternal heads are gliding correctly.   Clavicular head is more involved in flexion,  Sternal head more in extension.  Clavicular head can contribute to abduction interestingly enough.

Speaking of epimysial spaces, a very important one is the biceps femoris and the vastus lateralis.  Clearing up this area can bring a lot of help to lower extremity issues.

Motor Units not Muscles

Thomas Meyers (Anatomy Trains) was giving an answer about the gamma motor nerve system and one of his comments really is important.

"The brain doesn't organize movement through muscles, but through motor units."  This is a huge concept.  It's not about the muscles.  What can I recruit to do the action?  Its all about the motor unit.  The average being 10-100.   Motor units which is then motor control.  Motor control is the use of the neuromuscular system to activate and coordinate the use of muscles/joints in an activity or skill.

If you have never lifted weights before the first time you start to lift or even an experienced lifter with a new exercise, the rapid strength gains that happen in the first few weeks are all motor unit recruitment being trained, not true strength gains.

New stuff is being discovered all the time about motor control.  Purkinje cells and climbing fibers are no known to play a large role in learning the "correct" skill.  As an example when you swing a tennis racket and it feels good or bad.  This article, (Neurons Coordinate To Fine-Tune Motor Control) is an excellent look into some new information that is being discovered with motor control.

I believe techniques where you muscle test and have a hard time staying strong or finding the muscle are examples of the brain not being able to coordinate the motor units.  Find the block and the brain is able to coordinate easier and the test starts to be strong.

Neurokinetic and Muscle Activation (techniques I've trained in) are examples of therapies directed at improving motor unit recruitment and thus improving motor control.

A simple way of improving motor control is to slow down the movement.  One of the reasons I believe things like Tai Chi can be a great exercise.  For the more athletic population,  try a slow Turkish Get Up.  Talk about shining a light on lack of motor control.  Give it a shot and see where it gets difficult.  Train those motor units.  

A Couple New Breathing Drills from Lois Laynee

Thanks to a few Facebook friends that were attending a Respiration course, I heard of a therapist named Lois Laynee.  Looks like she teaches a course in respiration.  I further looked and found a slide presentation that is titled Restoring Breathing for a Good Nights Sleep.

On it I found a few cool exercises today.  One is to help breathing, the other to show the differences in left and in right.

Lois Breathing for one minute:

L  Lips together
O Make an O with your mouth behind your lips.
I  Inhale and Exhale only through your nose
S  Silent breathing-Plug your ears to insure you can go to silent breathing.

This is an exercise I found very helpful if you have trouble breathing through the nose.  My right side is much more difficult.  She calls it the Nodd technique.  Plug one side of your nose and then lean as far back with your neck as you can.  You are now facing the ceiling.  Keep breathing.  Recheck your normal breathing.  Keep doing this till it improves.  Do this on each side.

Diaphragm Exercise:

Stand up.  Make a fist with your right hand and place it under your left arm pit.  Squeeze your left arm while you exhale.  Remember what you feel and how it felt.  Now switch arms and repeat.  Notice the difference?

I think this is someone I will try to learn a little more from in the future.  Until then, give the nasal breathing a try, especially before bed if you can.

Preventing Spinal Buckling

For the longest time I've been preaching a stable lumbar spine and how to train it, how to brace it.  I'm not dismissing this method at all.  It should be trained.  A heavy deadlift requires it.  I've been reading Stu McGills stuff since the beginning.



As you can see from the above video, the lumbar spine is trained to be "stiff" to not allow movement to take place.  I've been doing this for years.  I still occasionally get back pain.  Len Kravitz wrote a great article about the potential mechanisms of low back pain and did a review of some McGill work.  

"Research now shows that nominal daily task, as well as strenuous ones may result in spinal buckling.  Computerized analysis of this phenomenon suggests that there is momentary reduction in neural activation to one or more of the deep intervertebral muscles, resulting in this spinal segmental buckling leading to tissue irritation or injury."

The recommendation would be to learn to stiffen all the muscles that support the lumbar vertebrae.  I now firmly believe this is only half the solution.

I was exposed to the concept of PRI (Postural Restoration Institute) last year and started incorporating the concepts of their breathing exercises.  Many people have a lumbar spine that is actually fully locked into extension.  They don't have the ability to flex the spine, even when it is rounded it is still stuck in extension.  Below is a video of Tony Gentilcore demonstrating a simple drill to do to help facilitate diaphragm breathing and unlocking extension.  Remember the spine should move.  Joints should move!



Often when one joint becomes hypo mobile, the next joint above or below becomes hyper mobile.  It's the hyper mobile one that can bring the buckling and pain.  Remember the thought is that the level that buckles is moving to much and that there is potentially reduction in neural activation to one or more of the deep intervertebral muscles that then allow this.

Neural reduction can happen when something doesn't get used.  Ever try to lift only your big toe without lifting any of your other toes?  So how do we go about increasing neural drive to the intervertebral muscles?  Enter Functional Range Conditioning.



The idea is to take just a cat/camel exercise and create intersegmental cat camel.  Every segment should be able to go into flexion and extension.  When evaluating it, often there will be a block or area that doesn't have movement and the person doesn't possess volitional control.  If this is retrained,  spinal mobility under control is achieved.  Remember anything that moves should be under your control.  The spine should move.

I've hung out on the side of stability for a long time.  To have a true preventative program with the goal of preventing spinal buckling, we need a combination of stability and mobility.