Sunday, December 16, 2018

Mobility Monday: Subscap Mobility

The subscapularis is the muscle of the rotator cuff group that moves your arm into internal rotation.   This muscle can also cause problems with limiting external rotation if the muscle is locked down and feeding into upper crossed syndrome.  These are a few simple mobilizations that can help loosen this area up and get you moving.

Things It Helps:
-Shoulder Pain
-Limited External Rotation
-Generalized Shoulder Tightness

Wednesday, December 12, 2018

Study Spotlight: Effect of cold vs. ice water immersion on recovery from intermittent running exercise

By: Joel Luedke

Cold water immersion (aka hoping in the cold tub) has been long used as a form of recovery in hopes of reducing soreness and coming back feeling more fresh for the next round of workouts.  The science behind its use waivers and you can pick and choose what ones fit your argument.  Does it really help soreness?  It is hard to say.  Can it help you body down regulate and set you up for enhanced recovery?  That is definitely a possibility.

This study seems to challenge all of these ideas in something new.  Find out more below.

What They Did:
This research project looked at how cold vs ice water immersion compared to a control group in 9 male team sport players.  Exercise was performed and then each group took part in a 12 minute immersion or just a control of doing nothing.  Maximal cycle performance and markers of recovery were measured before and in the 0-72 hours after exercise.

What They Found:
What they authors found is that peak power was impaired when in both the cold and ice water immersion when compared to the control.  After 72 hours of immersion the groups seemed to recoup peak power compared to control but it did take time.

What It All Means:
Based on this study it would show that doing cold or ice water after high intensity exercise would not be a good idea when it comes to trying to do repeated bouts of high intensity exercise within the following 3 days.  It shows that there could be potential to have a decrease in performance in terms of power output.  This could obviously be detrimental for games or important training sessions following major outputs of power and performance.  There is potential that after the three days you could still have your output at pre-exercise levels but you have to know if that is a risk you'd like to take.

The hard part about this study is such a small sample size.  9 isn't large (but we have to start somewhere) and that hurts how applicable you can make it across the board.  Also, as with any study, it focuses on specific tests and how people respond to certain exercises.   I think until this study is repeated and also can potentially be done on a larger scale.  Until that time, do your own trial and error and see what works best for you.

Resource: Anderson, D.  Effect of cold (14degC) vs. ice (5degC) water immersion on recovery from intermittent running exercise.  Journal of Strength and Conditioning Research. 2017.

Tuesday, December 11, 2018

Antifragility: Patient Care

Disclaimer: The concept of anti fragility is a new one to me and while not completely through the book (Antifragile-Nassim Taleb) the concept is one I've wanted to explore and try my hand at applying to my life and in doing so trying to explain it while applying it to different things in my life.  Here is the first attempt (most likely to be modified later).

The book explains that we have a full definition of 'fragile' but there is no word for the opposite.  The author introduces the concept of 'antifragile' which we have defined out of a couple quotes below.

"Antifragility is beyond resilience or robustness.  The resilient resists shocks and stays the same; the antifragile gets better.  The anti fragile loves randomness and uncertainty, which also means-crucially-a love of errors, a certain class of errors.  Antifragility has a singular property of allowing us to deal with the unknown, to do things without understanding them-and do them well."

How can this concept be applied to the practitioner (which is the focus of this post).  We can be resilient in our patient care by taking our hits if things don't go completely how we planned and we  continue on with our process and even potentially refer out.  We absorb the shock and we stay the same.  We approach every injury that seems to be the same with the same tools that we always use.  See the nail, use a hammer.  See the screw, give the hammer a try.  Obviously this ins't good for the care of the patient in the fact that every patient's issues and pain are unique to them.

This is where I think being 'antifragile' in your patient care is not only a win for the patient but a win for you, the practitioner.  If we look at the definition above we want the randomness and the uncertainty and the errors that come along wit that.  This is where we can excel and absorb the shocks that we could just past by, we use them to get better.  If there is an 'error' in diagnosis or care we learn from it immediately or it forces us to adapt in real time.  We get stronger and both entities benefit.

By maintaining an open mind you can become antifragile and accept mistakes, adapt to them and get stronger both for you and your patient.  Don't put yourself in a corner and allow that to affect you and/or your patients.

Monday, December 10, 2018

Mobility Monday: Bias, Bias, Hip Flexion and External Rotation

A lot of little changes can bring about big results when it comes to health and performance.  Focusing on biasing the hip flexion and external rotation are a couple of those things.  This video breaks down why making sure you focus on these couple of hip movements is so important and that implementing simple mobility work and stretches can be extremely beneficial.

Things It Helps: 
-Improved Squat Mechanics
-Pelvic Positioning
-Low Back Pain

Thursday, December 6, 2018

Friday Food: Slow Cooker Barbacoa

We've become a cooking shredded meats lately (pulled pork has gone well) so we decided we needed to find one that we could do with beef and this is what we came up with.  Simple, cooks all day and you can make so many different meals out just one recipe.  Try it out.


  • 4 lbs beef brisket (or beef chuck roast will also work)
  • 2 tbsp avocado oil
  • 3-4 chipotle chilis in adobo
  • 1 1/4 cups beef broth
  • 4 tsp minced garlic
  • 1 1/2 tbsp ground cumin
  • 1 tbsp dried oregano
  • 3/4 tsp salt, then more to taste
  • 1/2 tsp ground black pepper
  • 1/4 tsp ground cloves
  • 1/4 cup fresh lime juice
The Game Plan:
  1. Cut the beef into large cubes.  In a large skillet over medium high heat add the avocado oil and sear the beef on each side.  Transfer to your slow cooker.
  2. In a food processor add adobo chilis, beef broth, garlic, cumin, oregano, salt, pepper, cloves, and lime juice.  Pulse until blended and pour on top of the meat.
  3. Cook on low for 8-9 hours or high for 6 hours.  Shred the meat with two forks and turn on warm.