Monday, October 17, 2016

Tradition Vs Nostalgia

Tradition is often defined as the "transmission of custom or beliefs from one generation to the next." 

Nostalgia is often defined as "sentimental affection or longing for the things or time from the past. "

I believe we often blur nostalgia for tradition.  We look back on a few things through a hazy lens and remember something as tradition.  In the same way that coaches and therapists could look at a method and confuse it with a principle.  We start to blur them, instead of remembering nostalgia for what it is and for what it is not.

Here is an example that I think illustrates the cost of tradition and nostalgia.  Growing up playing football in high school and college one big tradition was the use of two a days.  In college it's often 3 a days.  That's two practises a day, usually separated by lunch.  Two a days often consisted of skills, plays and hitting and then whatever random conditioning drill the coach thought up.  Lunch. Nap.  Then repeat the morning all over again.  For two weeks.  Most players entered two a days at the peak of strength/speed and conditioning.  You just spent three months doing nothing but lifting, running, pass catching and agility work.  You are in amazing shape.  Most started the season, weaker, slower and perhaps nicked up.

This is where nostalgia butts heads with tradition.  Football coaches are usually ex football players.  They look back on what they went though (nostalgia) and think they are keeping tradition alive.  They were convinced that they are not in football shape.  So they do things like one on one hitting drills over and over, convinced it made them tougher  and in better "football shape."  Looking back on it, I realized I never really felt great again until about 3-4 weeks into the start of the football season.  I know many of my teammates felt the same way.  The strength numbers and speed numbers that you had at the start of two days, didn't return until a few weeks into the regular season.

It was interesting when a professor from another country came to watch a practice and he asked the coach why are your players beating themselves up when they have a game in two weeks.  It took an outside eye to look at a "tradition" and expose it as perhaps nostalgia...because that is what we do.  How often do we see breakthroughs come from an outside eye asking if what we are doing is chasing nostalgia or keeping a tradition.  How often are they criticized and ostracized when they do?

We have all kept that t-shirt from an event or sport that symbolized something to us.  You haven't worn it in years, you have no plans to wear it.  But you keep it.  That is nostalgia.  It's just symbolic.  It represents something to us.  When you think about it,  what you did or accomplished will never be taken away.  That memory is there.  With smart phones so prevalent now, one can have a digital memory if you wanted to.  It means something because it most likely represents a tradition or principle that you value.  In the great book " The Life Changing Magic of Tidying Up," the author asks a key question.  Does it bring you joy.  Traditions will, nostalgia won't.

I think people get into trouble when they chase nostalgia.  It leaves them depressed, they look back on an event or place and try to recreate the "happy feeling," that they remember.  If you're not careful I think it can lead to a fore longing for the past "my life isn't as fun anymore."   Instead I think they should look back on the tradition that they want to continue.  Perhaps it was nothing more then being with family and friends, an activity or place was just an excuse to get together.  The spontaneity that was enjoyed cannot be reproduced, but it doesn't need to if you don't chase it.  New memories can be created when the old ones aren't trying to be remade.

Traditions will perpetuate joy while nostalgia will often do the opposite.  Lets hope we keep our traditions and just remember nostalgia instead of the other way around.

Wednesday, September 14, 2016

Things You Will Never Regret

I was recommending a Vitamix blender to a friend awhile back and one of the phrases I found myself using was "You will never regret it."  I meant it.  Which got me thinking about other things in my life I would put this label on.  In no particular order.

1.  Vitamix blender.  It will literally change you feeding habits.  You will get ingest more fruits and vegetables into your body.  If you have kids it's a must if you can.  The price tag is steep, but I must have gone through 3 blenders at about 90 bucks each before this purchase.  

2.  Flossing.  It is one of those things that gets pushed to the side when you are tired or it is late.  But, no one ever gets done flossing and said, "that was a waste of time."  It is always a small sense of a win.

3.  Reading.  You can state that was a worthless read, but not regret reading.  The difference, you may have gotten nothing from the book or article, but you are still increasing your ability to talk, to think and relate to a subject.  Conversation about topics is a big way for people to relate.  If you deal with people everyday, just finding a landing point to talk about often leads to better interactions on the important stuff. 

4.  Showering.  You may be exhausted and feel like you will shower later.  I've never regretted jumping in the shower and coming out clean to go about my other daily tasks.  I hate not going to bed without a shower.  Hitting the sheets feeling clean, feels great. 

5.  Studying.  I can remember over studying for tests.  But, I never regretted it.  Way better to look at the answers and rattle them off thinking it is easy, then looking at questions with the scary realization that you have no idea what is going on.  

6.  Preparing for the day the night before.  It could be meals, outfits or a preloading your car.  Setting up to make tomorrow easier is never one of those things you regret.  You often find the realization that it makes life easier and much less stressful.  

7.  Giving a Genuine Compliment.  Sometimes it can be awkward to give someone a compliment.   Not that fake stuff that comes off as just part of the social norm.  A genuine compliment.  It might even feel weird to do, but you won't regret it.  It will probably make someones day.  

8.  Learning.  Anything.  You will never regret knowing more.  For the longest time growing up, I was the kid that wanted to know why I needed to know this, this is going to be useless for my life.  This doesn't have anything to do with what I want to do.  This is wasting my time.  Looking back, learning does a few things.  It widens your window in which you see the world.  (like reading)  The more you learn about various topics the quicker you start to see patterns that perhaps will help with the topic that does matter in your career.  Learning helps you learn better.  The more you learn the more capacity you are building to learn more.  

9.  Eating Better.  That can mean whatever you need it to be.  We can all agree a diet of pizza and fries isn't healthy.  But, we may all disagree on what healthy means.  Either way, choosing what you feel is healthy over what we all will agree on is junk is never regretted. You won't wake up the next day and lament, "why did I eat that salad yesterday!"

10.  Saving money.  I'm going to put this in the category, because you may regret not purchasing something, but you never regret saving money.  At the end of the year, no one says, I wish I had spent more.  There is to much in my savings account.  

Thinking about this stuff hopefully you realize your own unique "no regrets" and it perpetuates more action in using them.  How about you?  What are some things you have never regretted? 

Friday, August 5, 2016

"Wake Up Drills" or Be Activated

The last few months in clinic have brought in some, if I can borrow the new Netflix title, "Stranger Things."  I have had at least 4 people have extremely hard falls that actually fixed chronic pain.  This was musculoskeletal pain that had been present for over 2 years.  One gentlemen had disc pain and was recommend surgery from his orthopedist.

Hard fall on a hip that took all the pain away and stated felt stronger then ever.  Another hard fall directly on a knee that shoved the hip up.  Again, took all pain away in the hip.  (knee was sore for a few weeks ) Lower back pain that went away after a hard fall down stairs onto the butt.  (I've actually had this happen 3x now in the last 7 years)  One had some serious disc pain for about a 6 month period and was in PT.  They all stated they had shot of pain, layed on the ground wondering if they broke something, slowly got up and realized the pain wasn't there.  All felt stronger after the incident immediately.

From a chiropractic stand point I don't believe there was an "out of alignment" joint.  To have that kind of need for that force would suggest a joint that was very misaligned to the point of limping or horrid movement.  One hip I can verify moved extremely well.  (I understand my bias on this and while I could be wrong I'm trying to think of other possibilities.)

For the sake of argument, if it was misaligned, I at this point in my thinking/career, wouldn't feel ethically comfortable putting the amount of force they experienced into 60+ year old hips.   Nor do I think I could actually generate that type of force.

So what happened? 

I don't really know.  If a joint moves like a joint, doesn't have abnormal tension in any of the prescribed motions what's left?  Proprioception of the joint and strength of the muscle is the only things I can come up with.  While I am a big believer in strengthening muscles/movements.  I haven't found that to be that effective with people that have had chronic pain that the joint moves well.  So for me, that eliminated this option.  That leaves proprioception of the joint.  How well the individual can find and use the joint.  This comes back to old school "muscle testing."

I've blogged before about how I don't think we are muscle testing but testing proprioceptive awareness of that movement in that position.  Movement variability even states that every successive test you are most likely not even testing the same fibers and that their is a ton of bias on the practitioners part.   But, my personal bias still thinks we should be able to lock a joint in in all planes of motion without much effort.  (not clutching the table, holding your breath, squeezing your jaw)

This question of what happened with these patients lead me to think about performance and if this could be done at a lower level.  (not having to take a huge fall to make a change.)  After much debate, I decided to take Douglass Heels Be Activated course.  I went with an open but skeptic brain.  I probably asked 5-6 people that had taken the course before their thoughts and opinions.  Really looking for a reason not to go.  All spoke highly.  What made up my mind was the number of strength coaches implementing it into their programming and all stating that the soft tissue injuries have come down.

I've found for me, the most useful tools in therapy from high class strength and conditioning coaches.  The elite use it first and it trickles down.

It was held at the Spot Athletics in Columbus, OH.  (side note...kudos Columbus, you guys have solid 3rd wave coffee scene.)  The owner JL Holdsworth a super respected guy in the strength coaching industry.  The teachers for the weekend were Cal Dietz and Chris Korfist.  Cal is the Strength coach for the University of Minnesota and has been using it with his athletes for over 3 years.  Chris is track coach and been doing it for over 6 years and has worked with Douglass for the full 6 years.  So it was great to learn from guys using it daily with real athletes.  It was equally awesome to be in a room with some pretty respected strength coaches from all over the country.

Without going into the details, it's getting muscles to fire stronger.  When JL spoke of the term "wake up" drills it clicked for me.  By the way JL, if your reading this I'm stealing that phrase!  If you believe in corrective exercises for your patients or athletes, then you can't argue with a wake up drill if it gets the muscle to fire stronger, or have better awareness, or have better proprioception in that area.  (terminology can vary)

Wake up drills make sense to me.  Can you fire the muscle/movement without a compensation pattern.  It's in the compensation pattern that many injuries can possibly be explained.  In my way of thinking it can be easily implemented into a warm up routine.  Just like many injuries can be mitigated with a great warm up, something most athletes fail at, perhaps this will be a way to increase the benefit of the warm up.

Perhaps the falls were just a jolt into the nervous system that globally stimulated the sympathetic nervous system and then a huge parasympathetic release when they realized they were ok.  Perhaps the falls literally "woke up" the muscles around the area.  A figurative defibrillator to the muscle/movement.

Friday, July 15, 2016

Loading and Unloading the Body

The more I work on patients and athletes the more I kind of view therapy as learning what to load and what to unload and how to manage it.  Load can be another view of stress.  When you stress a muscle or joint you are asking it to bear the burden, "to bear the load."  When you are unloading the muscle or joint or area, you are taking away stress from the muscle or joint.  I think most pain in a muscle or joint is that to much stress/load is being applied to the muscle or joint.

I think a lot of therapy and therapist are good at unloading a joint or muscle.  I think therapy as a whole has done a very bad job of loading tissue.  I think most therapists are afraid to properly load tissue.  Without loading the body, no progress can truly be made.  Even acute injuries, if you understand the injury mechanism can be loaded for faster recovery.

An example would be a hamstring tear that occurred on a Friday, the athlete may be able to do slow dribbles on a Saturday. A few things are happening.  First, the hamstring is still involved.  There is a neural competency that is making the muscle stay active, but at such a slow speed as to not aggravate the injury.  Second, we are increasing blood flow, paramount for healing.  Third, we are beginning the slow process of keeping the skill set of sprinting ingrained.  Finally, we are giving the athlete active part in the recovery process.  This isn't passive, only relying on the therapist.  I think this may be as important as all of it combined.  Passive treatment can lead to woe is me, victim mentality.  When the athlete stays involved from the onset, an injury can be just something to overcome.

This doesn't even going into all the different workouts that may be able to be done upper body.  Perhaps even riding a bike slowly could be done right off the bat.  

Chronic problems need even more direct approach.  Lower back pain isn't about just unloading the stress from the back or hip.  It's about finding what needs to loaded to ultimately unload the lower back from that stress.  A runner that comes in with knee pain after 5 miles, most likely needs to learn to load the hip better, not unload the painful area.

Years ago Gray Cook came up with the "Joint by Joint" approach.  Essentially, alternating joints have different components of mobility and stability.  Mobile big toe, stable mid foot, mobile ankle, stable knee, mobile hip, stable lumbar, mobile thoracic, stable cervical, mobile upper cervical, stable elbow, mobile wrist.  

I think there is a general "Load and Unload" approach.  I think most people will agree that the joint by joint approach is correct it doesn't mean the hip at times won't need to be more stable in certain individuals.  I think the load/unload approach is even more general.  Just what I see that is more common.  

Muscles to unload (destress)          Muscles to Load (Stress)
abductor hallucis                               extensor hallucis
medial soleus                                    lateral gastroc/ tibialis anterior
vastus laterals                                   rectus femoris (end range)  
psoas                                                 lower ab and external obliques
adductor magnus                              glute max
semimem/semitendinosis                 biceps femoris
TFL area                                           glute med/min
lumbar erectors                                 lumbar multifidi
thoracic erectors                               latissimus dorsi 
pec sternal                                         pec clavicular
anterior delt                                      posterior delt
levator scapula                                  upper trap/lower trap
rhomboid                                          serratus anterior/ mid trap
brachialis                                          biceps 
forearm flexors                                 forearm extensors (end range)
triceps lateral/medial                        triceps long head
SCM                                                 deep cervical flexors

This is probably very similar to what you will find on what is phasic and what is tonic.  But, it's just my way of viewing what are some common patterns that I see.

The key point to understand is to figure out ways to start loading the tissue and get better at loading it, not just address the unloading of tissue.   This approach can work for all forms of scenarios.  How much load or work can a patient assimilate in one treatment?  How much load or work can you athlete handle in a workout.  What is the deload strategy?

We can view exercise as a global load on the human body and something like a desk job as unloading the human body.  This has to be brought into balance or the human body will not remain healthy.  When astronauts go to space, special measures must be taken as their bodies immediately start losing bone and muscle mass as gravity (load) is no longer upon them.  How much can we load an older individual to keep their bone mass healthy?

I often ask the question, what stretches or exercises have you done that makes you feel better or worse.  You will be surprised how often the patient has the answers, but doesn't realize it.  "I feel horrible every time I stretch my hamstrings, but I love doing lunges." Again, their giving clues as to how their body likes to loaded.  As a therapist when you start looking at the issue your patients or athletes are dealing with, start looking for a way to load them to unload them.  In my opinion this will bring longer lasting results.

Wednesday, July 6, 2016

Reframing for Resiliency

Over the last several months I've been practicing the concept of reframing.  Some times I'm successful and sometimes I'm not.  Reframing is taking the situation you are dealing with and trying to look at it from a new perspective.  It doesn't change the situation.  It changes how you are going to react to it.

Create a different viewpoint.

My biggest downfall in terms of attitude is easily my viewpoint on time.  My time, or what I consider my time.  The concept that this thing or person gets this time, this task gets this amount of time and oh yea, this chunk of time is MINE.  Free to do with it whatever I want.

Life has a way of eating up that time occasionally.   Life chores, kids, owning a business, friends, family all have at moments eaten up "my time."  When it did, I would get angry, bitter, annoyed.  The gamut.  It was a weakness.

There is a quote by Henry Rollins that really got me thinking and looking at this more intently.

Time is not yours.  No one is actually promised time.  How many people have left this world to early thinking that they had more time?

Memento Mori may indeed be cliche.  But it is true.  We are all mortal.  No one is promised more time, another opportunity.  Time is a gift.  This is how I  reframed "my time" to build resiliency in myself.  I am better at what was a weakness.

I hate mowing the lawn.  It is a life chore to me.  It is not going away.  Once a week, I had to suck it up and just do it.  Again, it was something that I felt was robbing me of "my time."  How to reframe it?  It seems silly, but I threw on a weight vest and considered it aerobic work.  All of a sudden something I hated, became something I somewhat enjoyed.  Nothing changed but how I dealt with a life task, reframed.

Thanks to Stu Mcmillan, Sprint Coach at Altis, for his posts and conversation this past week about resiliency.  (Check out his instagram posts under @Fingermash, they are worth the follow)  He states that resiliency is a skill, like any other that can be trained.  It's his posts and conversation that got me thinking that reframing is a way to build a skill to to improve resiliency.

I think learning to reframe things is key.  Most people would consider resiliency to be getting up when you get knocked down.  For athletes, its bouncing back after an injury, a bad race, a unfair call.  Its reframing a disappointing performance.  It can also mean not letting a great performance deter you from the further work that needs to get done.

This past week at US Olympic trials I got to see great performances and disappointing ones.  I got to see Olympic dreams dashed because of someone elses error.  Imagine 4 years of work for a dream, gone because someone tripped you!

I have no idea if these athletes will show resiliency.  I do believe if these athletes will be successful, they must show resiliency through reframing.

The more often we practice reframing the easier and easier it will get, just like training a muscle.  The more you do it, the easier it will work.  The more it will get engrained in your psyche.

I write this in an airport waiting to catch my last flight home.  I was supposed to be home yesterday.  Storms, closed airports, crew switches and closed airports had different plans.  I'll eventually make it back to Grand Rapids, just not on the time I had planned.  I had to do some major reframing for me to not blow a gasket.  It sucked sure, but it gave me some time to read, write, listen to some podcast, and music.    Four things I enjoy.  Would I rather be home?  Yes, but that wasn't an option.

Don't begrudge the time you are in because it didn't work out, be grateful you have life time to deal with it.  

Sunday, May 29, 2016

The Modern World Versus The Long View

The definition of taking the long view is thinking about (taking action) in terms of its effects on the future instead of the present.  The long view can be also be intertwined with the concept of discipline.
Discipline to me is the ability to give up the ease of the moment for something greater in the future.
Long view recognizes what it is you could potentially be/have/do.  Discipline is allowing you to navigate each day to stay on the course.

I think about the importance of installing a long view mentality in my kids in a world that is more and more instant gratification.  I wonder how often the ability to have things instantly starts to erode patience and if it starts to chip away the ability to grind towards a goal.

Long view is so important for health.  The discipline to do the simple, boring things day in and day out.  Anything that changes health quickly is usually a drug.  Medicine is designed to work quickly.  Thankfully!  We don't want to wait 4 weeks to find out if this antibiotic is working.  But, realize, medicine (outside of some life threatening conditions)  isn't designed for long term use.

If it acts quick, it isn't sustainable.  If it's not sustainable, it's not a great choice when it comes to the long view.  Restricted calories and drinking nothing but 2 shakes a day may indeed lose you that 20 pounds you are looking for.  But, that isn't sustainable and when it ends there is usually a very strong rebound effect.

We are told that eating fiber is great for us, but there isn't that instant gratification that come from doing it.  The difference may not show up for months and months down the road.  That is where discipline comes in to do it day in and day out.

This leads to the final piece of the puzzle, trust.  You have to trust the process.  Trust that the long view is worth it.  If trust isn't there, discipline will wain.  Instant gratification will start to win.  Trust can come from repeated failures that what you have done didn't work.  It can come from seeing what someone else has done and following the steps.  It can come from seeing others failures and successes.  The trust has to be real.

I see people every day that have either kept themselves active or inactive in clinic.  The difference in their quality of life when they get to their 60's and 70's is mind blowing.  My last visit to ALTIS I started thinking about this when I was watching the sprinters working on the acceleration for the 100m.

The 100m is a technical race.  There is a very important phase called acceleration coming out of the blocks.  It takes discipline to gradually build into the speed to accelerate smoothly to have energy for top end speed later in the race.  The athlete must trust the process and not rush it.  You don't get a medal for being first at 50 meters.  You have to have the long view of running your race to win at the end.

 I often ask myself the question, will the me that is exactly one year older from me currently, be glad that I started doing this every day today?  If the answer is yes, I have a long view goal.  Take the long view with your health.  Don't fall for the modern world myth that health can be achieved quickly.  Discipline day in and day out.  Trust that the journey is indeed better that way

Wednesday, May 11, 2016

Random Monthly Thoughts and Recaps

Things To Watch:

I really enjoyed the documentary Barkley Marathons.  It's about a very odd 100 mile inspired by a prison break.  There has been 10 finishers in 25 years.  You get to meet the odd and interesting man that puts on the race and the equally impressive and interesting people that feel drawn to compete in it.  Available on Netflix.

I have a fascination with the world of medicinal mushrooms.  The more I read or watch on it, the more I get interested in it.  I've enjoyed the products from Four Sigmatic foods and they are putting out some really cool youtube interviews.  Very informative.

Things to Read:

Probably the newest voice I've been reading is Scott Adams.  He is the creator of the comic Dilbert and has a really interesting blog.   Through his blog, I bought his book.  How to Fail at Almost Everything and Still Win Big.   I'm really enjoying it.

Things to Do:
I've made a variation of this windmill a staple in my every day training.  It really makes the hips/lower back play nice together.  Will Chung showed me a variation of this, but this is a solid tutorial.

Things I'm Thinking about:

I know (believe) at the root of all injury is a cause.  There is no such thing as bad luck.  The last time I was in AZ working with some Olympic Sprinters through the organization ALTIS, one of the sprinters I was working with pulled her hamstring.  Everything seemed to look well for a competition and yet, she still was injured racing.  I can't stop thinking about there an answer?  Is there something that could have been seen that I didn't see.

Whats the significance of mono vs biarticular muscles.  Should they be trained differently?  Perhaps biarticular only trained isometrically.  Mono articular trained for endurance?  Frans Bosch has me thinking perhaps?

Lessons to be learned:

The things or attitude that brought you success in one arena may be a hindrance in another.  One very awesome patient is a lawyer that is also a runner.  The tenacity and hard work and just the mindset that I'll do whatever it takes to do well and succeed is often recipe for injury when it comes to a training plan.  Rest was seen as weakness almost.  Push, push, push till you get the result you want.  The problem is that training doesn't respond like that.  A different mindset is needed if recovery from injury is to happen.

Things I'm Playing Around With:

I'm trying to get in 60-75 grams of fiber per day from 8-12 real pieces of fruit and vegetables.  I've never actually eaten them consistently.  Going to do this for a few months and get my blood work redone to see how it looks.

Friday, April 22, 2016

Clinical Neurodynamics: Lumbar Foramen Mechanics and Implications for Nerve Root Health

If you read my last blog post you know that I recently attended the Clinical Neurodynamics course with Michael Shacklock.  One of the most interesting bits of discussion was his research and findings with lumbar foramen biomechanics and it's relationship to the lumbar nerve root.  I've asked permission from him to write this blog post as this is part of the course and he has graciously permitted this.

For the longest time we assumed the foramen in the lumbar spine was doing what the disc did.  This is no longer the case.  The therapy approach Mckenzie has a large component of extension to drive the disc forward.  This has been shown in MRI to be true.  But for the disc to be driven forward, the posterior annulus must essentially spread or get larger to help drive the nucleus forward.  So as this spreads, the foramen actually gets smaller.

So, going forward also does the exact opposite.  As the spine bends into flexion the discs nucleus is pushed back.  The annulus gets smaller.  The foramen increases in size.  A larger foramen is created.  With the larger foramen comes 5 positive and tested outcomes.

1.  The foramen area increases between 15-40%
2.  Pressure on the nerve decreases 30-40%
3.  Size of the nerve root increases.  (from the reduction of the pressure)
4.  Electrophysiology of the nerve improves.  Strength of the contraction is better.
5.  Pain has decreased.    

Essentially the lumbar nerve roots and lumbar discs have opposite biomechanics.  This doesn't mean the Mckenzie approach is wrong.  It just means different techniques for different times  It shows how some approaches such as PRI with their flexion based activities in my opinion give relief to some peoples back pain.

It reinforces to me some very important concepts like Functional Range Conditionings approach to having segmental control of the lumbar spine.  How can you ultimately take pressure of a nerve root if you can't flex the lumbar spine segmentally?

They are showing that the same spine in a standing MRI with disc bulges go away essentially to the point you can't tell the disc has a bulge when the individual goes into flexion.  This doesn't mean flex a disc patient that is in pain.  What it does mean is perhaps the person that has fear based apprehensions to flexion because of a prognosis of disc bulge can be reeducated.

Again, there are some really important points to take away on how to use different movements at different times.  Assess what you want to happen and use movement to help facilitate the right healing environment the body needs at the time.

Thanks again to Michael Shacklock for letting me share this.  I can't recommend Clinical Neurodynamics enough for health practitioners out there.

Tuesday, April 5, 2016

Clinical Neurodynamics Course Review

The last 4-5 years I've pretty much realized what I want from a seminar.  I want to learn something.  I want to be able to go back to my clinic and use the information right away.  I want it to spark some type of further learning.  I'm pretty happy when I get 2 out of 3.

I recently took Clinical Neurodynamics Upper and Lower with Michael Shacklock.  This course fulfilled 3 out of 3 in my wants.  I had read the book years ago and found it to be quite interesting and had tried to incorporate some of the info into my evaluation process when I deemed it necessary.  This is a very well taught course.  He has a great teaching style and I became much better at evaluating normal vs abnormal neural tension.  There is no substitute with having the author himself give you hands on on how to do a test.  There are very subtle nuances to really do the neural tests optimally.  This is something that is hard to get from a book.  The learning of how to regress/progress each neural test for treatment is invaluable in my opinion.    

I've found that great courses are able to be incorporated with whatever technique or approach you use in practice.  In fact, as I was sitting their listening I was able to see how several techniques I have an interest in are actually saying or doing some similar thought process without knowing it.  So in a way, it helped my philosophy on my approach to practice.  

It's interesting how martial arts and stuff like Scott Sonnens IntuFLow or Pavels Mobility looks very similar to some neurodynamic upper body techniques.  

This was the first I've heard of how disc and nerve root have opposite mechanics.  This was fascinating to me.  Extension of the spine opens up disc, but closes on the nerve root and vice versa.  Perhaps this is why some Flexion based PRI exercises have helped many back pain patients.  I will be devoting a separate blog post on the lumbar foramen biomechanics, so stay tuned!

Realizing that lumbar nerve roots can have 7mm of movement when both legs are involved in a straight leg raise makes you see how an L5 ELDOA technique can be so useful.  

It had me realizing my lack of blood flow physiology knowledge.  Understanding all that takes place with venous and nerve interplay and how that affects swelling and performance.  There is a dose response to blood flow on a healthy nerve.  The research is there.  Getting edema off a nerve and increased oxygen will result in less fibroblast activity.  Better tissue quality.  

I was surprised I was the only Chiropractor there.  It seems this is just up a chiropractors wheel house.  This guy lives and works in Australia so you don't get a ton of shots learning from him in the states.  That is a shame.  

I would highly recommend this seminar to anyone that was thinking about it.  

Sunday, March 20, 2016

A Week With The Elite

Whenever I go on a trip or to a seminar I always look back at my notes/thoughts and write up my take aways.  Some of the stuff I publish on this blog, some I never do anything with.  A few weeks ago I spent 10 days down in Scottsdale, AZ with the professional track and field organization called ALTIS.

ALTIS is where professional track and field athletes (mostly sprinters/jumpers/throwers) come to live, train, get high level coaching and high level therapy year round.  They make a living as an athlete.  They travel the world competing on the track.  Most will be competing for their country at the Olympics (hopefully).  ALTIS isn't just for Americans.  Any country or athlete that qualifies can come train.  While I was there athletes from China, South Africa, Canada, Korea, Germany, Scotland, England, Australia, Ivory Coast and I'm sure a few others were there living and training.

First, some impressions.  There isn't magic formulas and secret workouts.  It's often assumed because someone is elite, that they do special "stuff."  In fact, if you were to write it down on paper it would be somewhat boring  "Really, this is it?"

When you step back you can see the beauty in the basics.  Mastery.  They master the basics.  They master drills, they master posture, they master the boring.  They sleep well.  Hydrate well.  Eat well.  Bring enthusiasm and joy to the workplace (track) They listen well....and do it day after day.

There aren't secrets.  Successful people and organizations don't have secrets.  In fact, ALTIS offers clinics all the time that allow coaches and therapist come and watch and learn exactly what they do.  Day in and day out.   The programming and coaching is simply smart.

I think often times athletes get injured when they or there coach over reach (over complicate) their progressions/workouts.  Probably the notion that mental toughness can be achieved by physical beat downs still exist in the college track scene.  Running to get tired.  If being tired meant you got better, I'd be world class athlete from my chasing my 2 kids around.  Smart training, done consistently.

2nd, some questions I have received.

Can someone if they work hard enough become that fast?  Quite simply, no!  To have the ability to run 9.9 in the 100m is a God given genetic talent.  Does that mean they don't have to work that hard to do it?  Absolutely not.  Just because you have the ability doesn't mean it will happen.  Years and years of training and hard work on top of unique talent is what it takes.

Is it a lot different working with elite athletes vs the average joe?  Honestly, no.  Anatomy is anatomy.  Histology is histology.  Joints move and muscles contract.  Fascia transmits.  Humans respond to load and fatigue.  The nervous system is the same.  What is different is sometimes the quality of muscle tissue.  They have taken better care of themselves.  This lends to faster recovery.  But, the same attention to detail goes into treating an average joe as goes into treating the elite sprinter.

If you had to do it all over again, would you do the same educational path?  A lot of the work I do isn't traditional chiropractic in the truest sense.  There are PT's that adjust.  I consider myself a strength coach that adjusts joints and treats connective tissue and makes everything play nice.  I doubt if I would need a Chiropractic license to do the exact stuff I do today, but I also don't think I would have been afforded the opportunities that I was presented with without it.  Catch 22.  (PS..I'm glad I went to school)

Take aways.  Start today on getting better at the basics.  Being around Olympians and Elite athletes you can't help but feel the urge to get better.  Today is the first day of Spring.  Pick something in every area of your life to improve on and commit to doing it every day.  Walk 10 minutes.  Do 50 push ups.  Read (study) for 20 min on a topic in your field.  Write a paragraph.  Eat 3 more vegetables.  Save 10 dollars.  Get 8 more minutes of sleep tonight.  Drink 2 more glasses of water.  Start becoming a master of the basics.  That is the path to an Elite life.

Monday, March 7, 2016

Don't Let Your Hobby Become A Chore

More and more I stop and ask myself why I do what I do in training and fitness.  More and more I stop and ask my patients why they are doing what they do in training and fitness.  I've decided there are good answers and there are answered that we won't call bad, but they need to be explored more.

I'm going to go back and use my 8 year old self as the filter to this question.  My 8 year old self, loved Star Wars, playing in the woods, playing with my dog Chelsea, playing baseball, building forts, reading books, climbing trees and riding bikes.  (Not to much has changed)  lol

My 8 year old self hated weeding, raking leaves, shoveling snow, hanging laundry, doing dishes, mowing the lawn.  Life Chores.  (Nothing has changed here!)

I can remember running as fast as I can for as long as I can.  Not because I was trying to prove something to someone or to myself (important point to remember) but because I liked that feeling of being utterly spent and exploring what my body could do.  If you had asked me why after I had done something like that I'm pretty I would have just said, "It was fun."

Why are you training that particular way?

I like riding my bike.  A few years ago I was talked into doing a longish ride/race/event.  Every weekend I'd go and add a chunk of time on my ride, till I was up to about 6-7 hours.  I hated it.  I really don't like riding my bike longer then 2 hours.  This wasn't fun.  It had taken a fitness activity that I had really liked and made it a life chore!

How often do we let our hobbies become life chores?  Something that becomes another check mark on our daily to do list.  No longer something that we look forward to, that pumps are body with feel good "stuff."

Why is this an important distinction?

Runner comes in banged up and injured.  "I started running to lose weight and found that I really enjoyed it."  I loved the feeling of just getting out there and forgetting the stress of my day for awhile.  I started training for a 1/2 marathon a few months ago and now my last long run I got really sore, but the plan called for me to run again and now my hip has been hurting ever since.  But, "I HAVE TO GET MY MILES IN."

This isn't a rant on smart training or listening to your body.  It's about defining your relationship to fitness and training.  If it's about proving something to you or someone,  I'm not sure you can get that from exercise or an event.  It might seem frivolous to do only stuff that is fun, but research shows exercise that is a stress, doesn't really do a whole lot for us.  In fact, I personally think it opens us up for injury and sickness.

This is a rant about protecting the stuff you love doing.  The stuff that brings genuine joy in the activity.   Guard your joy.  This is what will bring health and happiness in your fitness and training.  If your workouts have become a chore, analyze when and how it did.  Rethink your goals.  Don't get caught in the elusive trap of comparing yourself to another.  Don't get caught in the trap of letting a hobby become a chore.  Chores suck.

Sunday, February 28, 2016

Everything I Need To Know About Health I Learned from My Dog

It's been a little more then a month since I had to make the decision to put my dog Rocco to sleep.  A tumor had ruptured by his spleen and in a matter of days he went from a vibrant dog full of energy, to unable to raise up on his legs.  To say it sucked, would be an understatement.  It was a strange combination of easy/hard and to say goodbye.  You never want something you love to be in pain, so it was easy.  You don't want to lose something you love, so that was hard.  That is pretty much life.  

After a few weeks of missing him I started to think about how amazing dogs are.  There are a lot of health benefits to having a dog.  Here are a few.

Reduction in stress.  People with dogs in their lives were able to deal with stressful situations with less anger.  Lower blood pressure.  Just the act of petting a dog will lower ones blood pressure.  Increase in the feel good neurotransmitters were also measured with those that owned dogs.  Kids tend to have less asthma and allergies when they grow up with dogs.  People tend to exercise more,  dogs keep you moving.  This is less obesity and less arthritic pain episodes.  There is also a tendency to be more social when you own a dog.  This can have several trickle down effects of health as staying social is related to lots of positive health scores.  

I always enjoyed the book, "Everything I Need to Know, I Learned In Kindergarten," by Robert Fulghum.  So in honor of my late friend, I've thought about that and here is my take.

Everything I Need to Know About Health I Learned From My Dog.

1.  Wake up and Pandiculate.  Pandiculation isn't stretching, it's a way of contracting your muscles and then releasing them.  It is a way of keeping your spine healthy and we naturally do it when we yawn.  Do this every day, multiple times of day. 

2.  Drink water.  Drink lots of water.  Hydrating is important. 

3.  Go poop everyday.  You would be surprised how important this is for your health.  You literally need to get the "crap" out of your body.  Don't hold on to your waste.

4.  Play.  We don't stop playing because we grow old, we grow old because we stop playing.  There is so much truth in this.  Play games, don't just exercise, find a hobby you love doing, play at it.  

5.  Exercise.  Dogs love to walk, run, wrestle, tug of war and play fetch.  In fact, this is just what humans need.  Walking (slow endurance) wrestle and tug of war (some resistance exercise) Fetch, some faster interval workouts with small amounts of rest.

6.  Hang out with those you love.  Most of the time dogs just want to be with you.  Laying in the same room as you do whatever.  Hang out with those you find important.  

7.  Greet everyone with a wag of the tail.  Greet everyone as a potential friend.  The world would be a better place if we all did this.  

8.  Eat Good Food, but not all of it.  Rocco would eat until he was full, but wouldn't eat all the food in his bowl if he wasn't hungry.  Learn to stop eating when you are not hungry.  Just because it's on your plate, doesn't mean you need to finish it.

9.  Sleep.  Healthy dogs sleep like 12-16 hours a day.  Humans tend to not sleep enough.  Take naps, get your rest.  Sleeping is so undervalued.  Every day we realize more and more how lack of sleep is detrimental to our overall health.

10.  Lay in the sun.  When you find some sun, lay in it.  Get your Vitamin D.  Relax and Enjoy.

We rescued him around 7 years ago.  They thought he was about 3 when we did.  He had been walking the streets of Oklahoma City when he was picked up, they thought he was a Katrina Dog.  I wish he had lived longer, but am thankful he got to be a great friend to my oldest daughter Piper and got to spend a year and half with my youngest Skyler.  He will be missed, but I'm grateful for all the days of friendship and health that he taught me.  

Sunday, January 31, 2016

Mushrooms as Medicine with Paul Stamets

I could listen to Paul Stamets (One of the leading Mycology experts in the world) all day.  Super cool info.

Tuesday, January 26, 2016

Things I Don't Understand

Ever now and then I think to myself, this really doesn't make a lot of sense, I usually just move on, but I figured I would keep a list of them lately.


Ordering a Starbucks drink with room for cream, they put the lid on.  I then carry my covered drink 3 steps to the cream, take the lid off, pour in the cream and put the lid back on.  Why not just give me the drink with the lid off?  (maybe it's policy)

When a patient comes in as a new patient for you to look at something, (quite chronic) and they proceed to tell you they have a surgery scheduled for one week, but wanted to see if you could do anything.  This has happened so often, I quit keeping track.  A good rule of thumb, if you really want to avoid surgery, give yourself the same amount of time to see what can be done as the amount of time you will be in rehab.  So if you are having a shoulder surgery that requires 4 months of rehab, give yourself 4 months to see if indeed a surgery can be avoided.

People that do an exercise that they know hurts them even though they are doing it to feel better.   Every time I do the yoga twist my back is sore for days?  Why do you keep doing it?  I want my back to feel better.  Talk about an oxymoron!  This goes for every exercise.  I've had people tell me everything at some point.  Ask for an alternative, or figure out the why that exercise hurts.  But, don't keep banging your head against the wall hoping it solves your "headache."

People that tell me coffee is unhealthy.

The gap between what we know in physical education and actual school education.  There is researched well known facts, that are repeated over and over that shows direct relationship between physical activity, (gym, play, recess) and doing better in school.  Yet, it's getting systematically cut from the schools.  Ironically, these same schools are cutting it to chase better test scores.

You brush your teeth most likely 2x a day.  Your teeth can be replaced.  Dentures.  Do you want to do  But, it can be lived with.  How come no one does a musculoskeletal "cleaning" 2x a day.  Something as simple as a minute of cat/camel in the morning and evening.  You don't have the option of replacing your spine.  Your just old before your time.

People that tell me they don't like to read.  This statement is for foreign to me.  I grew up loving books and still do.  As a kid, you could travel to amazing adventures.  As an adult you can travel to amazing adventures, that you can actually plan on doing yourself!  Some books are also like the boiled down version of everything a person knows.  A person may have worked in a field for 30 years and then taken that 30 years of lessons/experience and boiled it down to 300 pages.  In a matter of hours you can download that 30 years for yourself.  Whenever I get a new book, I get a little excited and think about that scene in the Matrix where Neo downloads a new program..."I know Kung Fu."

People that expect to be good at something they have never done.  Being good at golf, doesn't make you good at swimming.  Lance Armstrong was downright mediocre as a runner, he was the best biker in the world.

Equating security for freedom.  This job has good health insurance so I'm staying at the job I hate.  That is self imprisonment.

Why my 16 month old can't sleep through the night.  Kid, give us some uninterrupted sleep.  We'd all be better off including you.

People are still smoking that are under 50 years old.  I give you an age break, because lets face it, addiction is a real thing.  I'm not going to judge that.  In the 50's and 60's they still had advertisements that it was healthy.  Presently, there is no room for misunderstanding.  It is horrible for your health.  No one thinks you look cool.  There is no possible reason to even try smoking.  Yet I still see younger people huddled in the freezing cold, puffing away their health and money.

Spending primo money on things you put on your body, clothes, lotions, shoes and looking to spend the least amount possible on the things you put in your body.

Young athletes that are looking for the keys to the kingdom, but ignore sound advice, like get 8 hours of sleep, drink lots of water and eat protein with every meal.  The next visit they are asking about some new supplement that is like 70 dollars.  You getting good sleep yet?  No, but I'm working on it. Have you ever heard of XYZ MAX PRO?  It's supposed to put on lean muscle really quick.  LOL.

I'm sure at some point I'll think of some more.

Wednesday, January 20, 2016

Random Thoughts and Notes

The human being is 2" taller in space after the 2nd day.  Stu Mcgill studies have shown that the spine hydrates the best at night with 8 hours rest.  At 6 hours we don't get enough hydration, hydration brings nutrition to the discs.  Over 8 hours and the discs get to hydrated or enlarged and if you have a back issue this will often create more back ache on waking.

Jumping rope should be part of every runner or athletes repertoire.  It teaches stiffness and relaxation.  Nice pulsing activity.

If you ask most late 30's to late 50's individuals all would say that they would love to have healthier joints and be stronger overall.  Chances are they were taught wrong (if taught at all) in weight lifting. I'm noticing a lot of people my age were taught to arch hard in the lower back when squatting.  It does provide stability, but it crushes the bones/discs.  Stable then, pay for it later.  How much would it be worth to hire great strength coaches to put into high schools and teach kids how to be strong safely?  I think the ROI 20 years down the road would be huge.  Just something I've been thinking about lately.

Strength covers a multitude of health issues.  Some health insurance companies are paying for gym memberships now, but what if there were some fitness milestones that could be hit that would reduce rates?  It seems smart for both parties.  To get life insurance a nurse had to come to my house to take blood, get my blood pressure and do a basic health screen.  So perhaps some physical ones as well?
Can you do a pull up?  How about can you get down to the ground and up again 15x in 60 seconds?
Can you walk a mile in under 20 min?  Can you carry 25% of your body weight for 40 yards?  Can you squeeze a captains of crush gripper (selected for your age group).  All of these activities have been shown to have an influence on health.  Again, this is just something I've been thinking about lately.

Stomach is a dissolver.  Small intestine is an absorber.  Colon is a transformer.  Good way to think about your digestive system.

Fish oil has been shown to help stop sarcopenia.  I think everyone should take some fish oil everyday, but this is a must for the elderly.

Tuesday, January 12, 2016

Normal Should Be Used With Caution

Reading through "The Trouble With Testosterone: And Other Essays On The Biology of The Human Predicament," By Robert Sapolsky, one chapter that has really stood out to me was about what we have learned to be "Normal."

In the early days of human dissection and anatomy, bodies were often in short supply.  A whole underground of cadaver selling developed, whether the bodies were obtained legally or not was not much of a concern.  Some dug up newly buried bodies, others were obtained by some very nefarious practices.

"Burking"  Named for William Burke who lured beggars into his home and strangled them.  He then sold the bodies to anatomists.

One very common fact was that most if not all bodies studied were poor.  Being poor brought other health issues that were unknown at the time.  Essentially the had lived a life of chronic stress.  Malnourished, worried about being killed, etc...  This chronic stress made them produce more stress hormones.  The increase in stress hormones caused their adrenal glands to enlarge.  When physicians studied these cadavers an enlarged adrenal gland was considered"normal."

When a wealthy man came into the morgue or anatomy room they presented with an "undersized" adrenal gland.  They made up a condition called Idiopathic adrenal atrophy.  This disease was wide spread in early twentieth century.  Years later they realized they were mistaken about the size of the adrenal gland and then everyone was cured.

A more serious error came in the 1930's with the Thymus gland.  Still unknown to the medical community that stress can atrophy organs, lead to some very bad outcomes.  Babies suddenly dying in their sleep were being studied,  Sudden Infant Death Syndrome. (SIDS).  We presently think now that it occurs when babies in the 3rd trimester receive less oxygen then normal and brain cells are damaged that help control respiration.  But, back then, they had no clue why babies were suddenly dying.

At the end of the 19th century a pathologist autopsied SIDS babies and non SID babies.  What he found was that SIDS babies had a much larger thymus gland.  Now we know that the non SID babies had died of chronic stressful illness that had atrophied the thymus gland.  They drew the conclusion that in SIDS, the "abnormal" large thymus gland was pressing down on the trachea causing suffocation.

By 1920 this condition had a name and it was in all the leading pediatric textbooks.  To prevent this the thymus should be irradiated to shrink it.  This advice persisted into the 1950's.  Obviously, this had no effect on SIDS, but what it did do is irradiate the gland next to it, the Thyroid gland.  This eventually lead to thousand and thousands of cases of thyroid cancer.

As you can see, mistaking normal can have tremendous consequences.  Every now and then it would be interesting, if not good practice, to reconsider what normal is to you and think about the opposite or how you could look at normal a little differently.

"What mistake are we making now, in our modern scientific ignorance, and how many people will ultimately pay for it." 
Robert Sapolsky.

Sunday, January 10, 2016

It Ain't Over Till It's Over

Profound words from Ed Dobson.  "It's not about how long you have left, it's how you spend the time you do have."

ED'S STORY It Ain't Over from Flannel Staff on Vimeo.

Saturday, January 9, 2016

Mark Twain Even Fasted!

I've been a proponent and supporter of  Intermittent fasting for a long time.  It  has a lot of research behind it for health benefits.  Fasting has long been held in great respect in cultures though out the world.  In the last 15 years it has really gained ground.  That is why I found this article in Physical Culture so interesting, it was written in 1919, about Twains writing in 1866!

This article tells the discovery of Mark Twain, the author, first exposure into Fasting.  Mark Twain's Writing on Fasting .  He was sick in bed when sailors that had been stranded at sea for 43 days were finally rescued.  They were gaunt and weak, but all made full recoveries within days.  In fact, one that had been dealing with access, had made a complete recovery.  This got Mark Twain thinking about the health benefits of total lack of food while sick.

This reminded me of another great post from The Art of Manliness about the concept of Via Negativa.  Addition by subtraction. How to improve your life by not doing something.  Instead of spending more time in the gym, you quit smoking.  You stop something in your life that produces more results then adding something to your life.

That is what fasting is.  Improving life, by taking (calories) away.  I highly recommend adding this into your life.  An easy way to start and give it a try is to stop eating at 8pm.  Don't eat again till noon.  You will have just gone 16 hours without food.  You can drink water, tea and coffee.  I think after a few times, you will find more energy, more focus and clarity and overall improvement in well being.