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Thursday, May 31, 2018

Friday Food: Sun Butter, Banana & Chia Seed Toast

Simple yet amazing looking.  This is a simple spin on toast but one that can add some health to your breakfast.  Also very easy to make and can take it on the go if you need to.

Ingredients:

  • 1 slice 100% Whole Wheat Bread
  • 1 Tbsp. Sunbather
  • 1/2 Medium Banana, sliced
  • 1/2 Tsp. Chia Seeds

The Game Plan:

  1. Toast the bread and spread the sunbather over the top
  2. Place banana slices over the sun butter and top it off with chia seeds.
  3. Enjoy (yep, that easy)



Source: The Skinny Fork (worth checking out)

The Problems of Early Sports Specialization


Introduction: 
PSA: Sorry for the hiatus, got a little caught up in finishing my semester. But, let's take it back to a tweet from just after this year's NFL Draft that this article idea stems from (right). Although I wasn't surprised that most of these guys were multi-sport athletes in high school, 91% is amazing. People hear in the news about the Antonio Gates and Tony Gonzalez, college basketball players turned NFL superstars, but people may forget that a lot of the professional athletes (if not most) used to grow up playing all kinds of sports and developing a multitude of skills.

In today's age of sport where AAU, travel baseball, and 7 on 7 football dominate and compete for each other's time, the adults manning these competitions may need to step back and analyze what will benefit the kids the most and if these events are helping or hurting not only sports but the athletes themselves. Let's first define sport specialization as playing/training only one specific sport all year long for multiple years starting at a young age. More statistics about specialized and pro-athletes? Sure! High school athletes (who did not go on to play professional or in college) in 2017 specialized 2 years earlier than their college and professional predecessors; challenging the notion that to be an elite athlete requires one to specialize in one sport at a young age (Buckley et al., 2017). Let's dive into the bulk of why kids don't need to specialize in a selected sport at such young age (or maybe more importantly why parents don't need to specialize their kids in a certain sport) to become an "elite athlete" and the risks of said sport specialization on their physical and mental development.

What's the gamble?
First of all, 98% of the population will "go pro in something other than sports" as the NCAA commercial used to say. So, whether you're a chance-taker or a gambler, the odds are in no one's favor and the consideration of sports specialization may be illogical.

Origin of Specialization: 
Where does this idea of specialization come from? In 1993, K. Anders Ericsson (1993) published an article stating that it takes 10,000 hours of practice to become an expert at that said skill and voila the "10,000 Hour Rule" made its way into sports performance, and unfortunately youth sports. Let's just debunk this right away, training 10,000 hours is not an indicator of becoming an elite athlete. This rule fails to incorporate the adolescent body undergoing rapid changes leading to potential injury risks. In essence it is just a constant high-volume, intense, one-dimensional training strategy that is incorporated into youth training. That doesn't sound very safe, does it?

Physical and Motor Development:
In regard to youth physical development, sport specialization has been researched to limit the variation of motor development and decrease involvement in activities that promote lifelong fitness and well-being (Normand, Wolfe, Peak, 2017). Specifically, motor learning in youth (<15 years old) occurs through the continual process of trial and error, task variability, and building and refining new motor programs (pre-movement processing in the brain that enables/helps you perform tasks) in multiple environments. Therefore, the combination of multiple tasks (sports) in different environments (playing surfaces and activities) and trial and error (learning new sports/drills) seems to be the best route to developing motor learning in the youth. The development of multiple refined motor programs and overall improved motor development may be a cause for an increased overall athletic ability. Physically, sport specialization has been linked to the controversial term "overuse training". Is overuse training real/not real in adults/athletes? Probably depends who you are reading or what 'bro' you ask at the gym; but, that's for another discussion. Is this a problem for kids? YES, we need to worry about this constant training due to their rapid growth and constant muscular, neurological, and hormonal changes. A lack of recovery or periodization of training can negatively impact the development of these features. Fast-forward years and years to kids that did or did not specialize and relate it to injury: Researchers discovered that from a group of NBA first round draft picks from 2008 to 2015, those who were multi-sport athletes in high-school played in a greater percentage of total games, were less likely to sustain a major injury during their career and a played in the NBA longer (Rugg, Kadoor, Feeley, & Pandya, 2018) . Although this does not prove cause-effect, the demographic evidence indicates that sport-specialization may lead to a higher injury risk, whether it happens as a kid or later on in their careers.

Mental Development:
Sport specialization has also been found to be detrimental to psychological health in youth athletes as well. No, I don't believe in giving everyone a participation award, but I do believe research and when youth athletes specialize (especially if it is a parental decision), there is an added stress to become an "elite player" leading to higher rates of attrition and inappropriate expectations often defined by parents. Again, not everyone should get a medal, but I think parents adding illogical stress to children's lives at such a young age is wrong and ill-advised.

Conclusion:
In multi-sport participation, athletes will develop a surplus of skills not otherwise learned training for one sport, train different muscle patterns, decrease 'burnout', and honestly probably have more fun.
Overall, choosing to specialize, or not specialize, in a youth sport is up to the individual at hand and each situation is unique, obviously. However, all parents, coaches, and especially the athletes should be informed at the risks of not only injury but development of skill, strength, and power as well as  overall training periodization to prevent overuse. Youth sports should be fun for the athletes, let them be active, boost some adrenaline, be happy, and appreciate what sports can give back. Let kids be kids. 





Wednesday, May 30, 2018

Study Spotlight: Hamstring Injuries-Extent of MRI Detected Edema and the Time to Return to Play

By: Joel Luedke


Hamstring injuries are among the most common soft tissue injuries one can suffer during sports.  It can also be one of the most frustrating ones to suffer as well.  There has been a lot of discussion around return to play protocols for hamstring injuries and what they should look like based on the grade of injury.  Often the grading occurs based on MRI and what is seen and the extent of damage incurred.  This study took a look at how the information based on MRI corresponded with return to play.


What They Did:
This was a retrospective study that took at look grade 1 hamstring injuries in 22 professional soccer players.  The MRI technique used was a 1.5 T MRI.  The parameters that were looked at were craniocaudal length, percentage of cross-sectional area, and volume.

What They Found:
The researchers used return to play (RTP) as the outcome measure.  When the statistics were run there was no measures from the MRI that corresponded to the length of the RTP.  Based on these results the researchers found that the extent of MRI edema in hamstring injuries did not have prognostic value.

What It All Means:
While the results show there isn't a correlation between the edema seen on MRI and RTP timeline that doesn't mean we should do away with all MRIs in the evaluation of hamstring injuries.  This information can still be extremely valuable but we shouldn't come to rely on it.  In the world of sports medicine often times more information is good information but we can't get so caught up in it that we don't take into account everything we are seeing in the day to day rehab and treatment process.

Depending on your work setting or training goals this can also be good information in that you don't have to get a MRI in order to have a quick and successful return to play protocol.  There is still a lot of evidence that just seeing how you move through a step by step progression that is gradual you can still have extremely good results when it comes to getting back to full health.

Limitations:
Due to the retrospective nature of this study there RTP protocols and decision making could be substantially different which could hamper the outcome.  Also due to only have 22 people included in the study it it hard to say this is statically significant.  Still interesting none the less.

Monday, May 28, 2018

Mobility Monday: Muscle Stiffness & Athlete Mobility


A lot of times some simple mobility work is all that you need to help your body bounce back and start feeling better.  Working on some of the major areas can really help get sore knees and shoulders to feel better.  Taking some strides in these areas is the first step to really helping your body feel the difference.  Give it a try.


Things It Helps:
-General Muscle Soreness
-Increased Mobility
-Reduced Areas of Chronic Pain


Monday, May 21, 2018

Mobility Monday: Full Knee Range of Motion Part II


In a continuation from our post last week (Full Knee Range of Motion) this is the second part of looking at how to make sure that you can get full range of motion through your knees.  Again, while the major motions of the knee, flexion and extension, are extremely important to have and maintain there are smaller and more subtle motions of the knee that are just as important.


This video helps show you how to get access to some of those more subtle motions and to help get them moving.  Check them out.

What It Helps:
-Generalized Knee Pain
-Post Op (way out, 8-12 weeks)
-Patella Femoral Pain


Wednesday, May 16, 2018

Study Spotlight: Manual Therapy in Pain and Function w/ Plantar Fasciitis

By: Joel Luedke

Plantar fascia pain affects a lot of people throughout the year and when it does, it really does.  The treatment of it can also be extremely long and frustrating and so we took a look at a review study that tries to shine more light on interventions that could help out.

What They Did: 

This is a review study that look through a lot of studies and dwindled them down to looking at seven randomized control trials (RCTs).  From these studies the researchers took a look at what parts of these studies looking at plantar facia pain and function improved those issues with the most efficiency.


What They Found:
There were a lot of variables to look at when they broke down these studies and overall found that most interventions can be helpful when it comes to treating plantar fascia pain.  When the interventions were looked at closer they shown that the inclusion of manual therapy (MT) which included working on ankle joint motion as well as working on the soft tissue around the ankle (ex. calves, foot, etc)

What It All Means:
The great part of this study is that it shows that you can help benefit your plantar fascia pain by utilizing manual therapy.  That is good news but also comes with a lot of "it depends".  The application of the manual therapy both in the technique and the timing is extremely important when it comes the treatment of plantar fascia issues.

While it may feel good to get after the plantar surface tissue it is very easy to overdo it.  You want to be careful that when doing soft tissue work on these areas that you are actually creating 'controlled damage' to the tissue and you have to make sure that you don't over stress the tissue as you can create more problems then you're trying to solve.  It is always an option to work the soft tissue around the painful area.  That could include the other part of the foot (forefoot) or all the way up through the calf.

Bottom line: utilize manual therapy but use caution when doing so. It appears it'll help in the long run treating plantar fascia issues.

Limitations:
Due to this being a review paper is is extremely hard to control for things even if you are looking at randomized controlled trials.  That makes it so it isn't a perfect study in terms of controlling all the variables so we do have to take that into consideration.  Also it is hard to standardize manual therapy with clinicians, especially when it goes across many studies.

Source: Fraser, J. Does manual therapy improve pain and function in patients with plantar fasciitis?  A systematic review.

Monday, May 14, 2018

Mobility Monday: Full Knee Range of Motion


We have shared this video before but as we were going through more things to help out some patients in our daily job we stumbled upon it again and wanted to share it.


Having full ranges of motion through your knee can help solve a lot of problems.  When we think about that ROM we often think about how much the knee can bend and while that is important we want to also make sure we maintain the ability to full extend the knee as well.  

If you've got sore achy knees, definitely start here.

What It Helps:
-Knee ROM
-Creating missing end ranges you might not have even known about
-Improving mobility to help ankles and hips.

Thursday, May 10, 2018

Friday Food: Stuffed Peppers

We tried a different version at our house the other night and they were extremely good.  We did some searching and found another option we thought we be extremely tasty and enjoyable and this is what we came up with.  We will definitely be giving this option a try as well.

Ingredients:

  • 1 pound ground beef
  • 1/2 cup uncooked long grain white rice
  • 1 cup water
  • 6 green bell peppers
  • 2 (8oz) cans tomato sauce
  • 1 tbsp Worcestershire sauce
  • 1/4 tsp garlic powder
  • 1/4 tsp onion powder
  • Salt and pepper to taste
  • 1 tsp Italian seasoning
The Game Plan:
  1. Preheat oven to 350degF
  2. Place the rice and water in a saucepan, and bring to a boil.  Reduce heat, cover and cook 20 minutes.  In a skillet over medium heat, cook the beef until evenly browned.
  3. Remove and discard the tops, seeds, and membranes of the bell peppers.  Arrange peppers in a baking dish with the hollowed sides facing upward (Slice the bottoms of the peppers if necessary so that they will stand upright.)
  4. In a bowl, mix the browned beef, cooked rice, 1 can tomato sauce, Worcestershire sauce, garlic powder, onion powder, salt, and pepper.  Spoon an equal amount of the mixture into each hallowed pepper. Mix the remaining tomato sauce and Italian seasoning in a bowl, and pour over the stuffed peppers.
  5. Bake 1 hour in the preheated oven, basting with sauce every 15 minutes, until the pepper are tender
Recipe Source: Allrecipes.com

Ep. 47: Runners Recovery Tips-Clinically Pressed

We had the distinct honor of teaming up with Coulee Health and O'Brien Physical Therapy to help out at the Grandad's Half Marathon in La Crosse, WI.  During our time providing post race soft tissue treatments we seemed to have a lot of reoccurring themes that we would talk about with all of the runners.  Well since we were there we figured why not create a short episode and lay down some ideas to help aide in recovery. 
Without getting to far into the details in this episode we do outline a lot of the 'simple' things we think you can implement into your recovery strategy to get ready for the next race or just get back and get ready for your next round of training.  Check them out and see what you can apply to your recovery strategy.



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Wednesday, May 9, 2018

Study Spotlight: How Much Protein Can the Body Use in a Single Serving for Muscle Building?

By: Joel Luedke


Rumors and myths start seemingly for no reason other than one person says it and then it spreads like wild fire.  The debate of how much protein your body can handle from a meal/serving has long been thought to be only 20g but is that truly the case?  Many people have argued this and suggested higher but the sciences wasn't always there to back it up.  This article breaks it down.


What They Did:
Brad Schoenfeld is always on the front end of muscle building and protein research.  He did a full review of what the evidence says plus a lot of anecdotal evidence an dire leading the way and coming soon.

What They Found:
The thought has always been anything above 20-25g of protein a meal was not absorbed and would be oxidized for energy or excreted out of to he body.  It is hard to make that generalization when we start taking a look at what you might be combining your protein consumption with and also when we take a look at some proteins that digest slower.

The data shows that while consuming more than 20g of protein in a serving does increase amino acid oxidation that is not the fate of all the additional AAs consumed. Some of that extra then goes to tissue building purposes.  Based on the current literature to maximize your ability to stay anabolic (muscle building) you should consume 0.4 g/kg/meal across at least 4 meals a day.   At max you should be looking at 2.2 g/kg/day

What It All Means: 
Bottom line-eat as much protein as you need/want to.  No longer do you need to look at caping your protein intake at 20-25g/per meal (depending on weight).  Even if you 'over-consume' protein and put in way more in a serving your body can still reap the benefits of muscle building.  The other thing to look at in the recommendations is that you need to take a look at the 4 times per day.


It seems to be the secret to building muscle isn't always in the timing (a story for another post) or necessarily how much protein you're putting in it is the fact that you keep eating and keep in an anabolic state.  That means constant and consistent consumption of protein and making sure you're nutrition is staying up throughout the day.  Find out more below.


Limitations:
This study was a review which is always good to have go back but makes things very difficult to control.  That can bring about questions in the evidence and while not always the 'strongest' evidence it is good to have people who take the step back and summarize all that has been found.  Not bad evidence, just a different way to look at it.

Resource: How Much Protein can the body use in a single meal for muscle-building?  Implications for daily protein distribution-Brad Schoenfeld & Albert Aragon

Sunday, May 6, 2018

Mobility Monday: Ankle Impingement


When your ankle doesn't move properly and through an entire range of motion it can throw a lot of things out of sync.  Restriction in ankle dorsiflexion can limit your ability to get into a full motion during a squat.  If you're tight and limited in motion you can really mess up your running mechanics and do everything you can to work around it to keep running even though in the long run it can be detrimental.  Give these ideas a try to get your ankle moving again.


Things It Helps:
-Ankle Pain
-Restricted ROM in the Ankle
-Improving Squat Mechanics

Thursday, May 3, 2018

Friday Food: Grilled Sweet Potato Nachos

Nachos are a big hit at our house and while we enjoy them we often rationalize how "healthy" they might be for us (maybe a little delusional but it happens).  So in a quest to see if we could do something better when it comes to our enjoyment of nachos we came across this option.  See what you think.


Ingredients:

The Nachos

  • 2 large sweet potatoes
  • 1 tbsp olive oil
  • 1 tsp each chili powder and cumin
  • 1 14oz can refried black beans
  • 1 cup frozen sweet corn
  • 3 oz. multigrain tortilla chips (enough for a layer)
  • Chopped cilantro for topping
  • Crumbled Cotija cheese for topping
The Cheese Sauce
  • 1/2 tsp butter
  • 1 large clove garlic, minced
  • 1 1/2 cups milk
  • 2 tbsp flour
  • 1/4 tsp salt-more to taste
  • 1/2 cup shredded cheese of choice

The Game Plan: 

  1. Sweet Potatoes: Turn on grill on to medium high heat.  Wash the sweet potatoes and pierce with a fork.  Wrap the sweet potatoes in a paper bowl and microwave on high for 4 minutes. When cool enough to handle, cut sweet potatoes into wedges and toss with the olive oil, chili powder, and cumin (+salt to taste).  Transfer sweet potatoes to the hot grill and grill for a few minutes on each side until roast and delicious.
  2. Nacho Assembly: Meanwhile, heat the refried beans on the stove or in the microwave until warmed through and roast the corn in a dry nonstick skillet until golden brown.  On a large platter, arrange the chips in a single layer.  Top with the sweet potatoes wedges, black beans, and corn.
  3. Cheese Sauce: melt the butter in a small saucepan.  Add the garlic and sauce for 1-2 minutes.  Add 3/4 cup milk and hat until simmering.  Whisk the remaining 3/4 cup milk with the flour; add to the saucepan and stir until smooth and thick.  Remove form heat and whisk in the salt and the cheese until melted.  Drizzle the cheese sauce over the nachos and top with cilantro and Cotija cheese.



Source: PinchofYum.com

Tuesday, May 1, 2018

In the End, It's All Relative

By: Joel Luedke

Right or wrong it appears to be the trend that you need something 'new' and shocking in order to make a change in your life (or sell someone a change).  A specific point of view has to be exactly that, specific.  Whether that comes to what you need to eat or avoid eating in order to lose weight, the specific type of exercises you need to complete in order to get the body you want, according to many there is only ONE way.

It seems a 'jack-of-all-trades' mentality has been pushed back along with having to take everything in context to the relative situation we may find ourselves in.  This discussion is to touch base on some of the more common things we see when it comes people potentially taking things to an extreme on either end of the spectrum and where that can get you in trouble.

Gatorade as "Health" Drink
Is Gatorade the best sports drink for you?  We could have that argument.  Is it the worst thing ever for you?  We can also have that argument.  After attending a conference that was around Gatorade and everything they present to the industry it got me thinking and wondering what really is "The Good, The Bad, The Ugly" of Gatorade.

Gatorade has a very specific purpose (the sports drink) and that is for rehydrating during long workouts and especially in hot temperatures.  That is where the electrolytes and carbs/sugar come into benefit. 

It is not nearly as good for you when you start consuming it on a daily basis as something to sip on and why it is not a 'health' drink.  This distinction is important but can be lost in the context of marketing and ads.  Use it how it is directed.

Lifting Weights and Getting "Bulky"
This misconception is all too common.  There are a large amount of factors that contribute to if you are going to add muscle mass and 'get bulky' when it comes to lifting.  Just picking up the weights and lifting for a week isn't really one of them.

In order to get a significant amount of hypertrophy (muscle growth) you will need to have a significant stimulus and that will lead to a lot of hard work in the gym and often times heavier weights than you think.  Get a solid lift in 3x/week but keeping the weights out of the 75-82%-ish range for 8-12 reps will lead to a great workout but often not a lot of hypertrophy.  It's all on what your goals are.


You have to EAT and a lot.  Even in athletes we work with that want to get bigger we find that they are constantly under eating (Video: How to Eat Like an Athlete) and that leads to less gains then they like.  It takes a tremendous amount of fuel to get anabolic and get muscle to grow.  If you're not in that range of calorie consumption you can most likely rest at ease that you are still getting benefits without the adding bulk.


Cardio and Losing Weight/Fat
We will never shame anyone for wanting to do cardio if that is your preferred mode of exercise. You do you and keep on going.  We do caution though that long slow cardio might not be the most optimal way to lose weight/fat.  While yes you can burn calories and that can help your metabolic rate, there are more efficient ways to trip down.

Implementing HIIT (high intensity interval training) on your favorite cardio machine has been shown to have great results when it comes to this area in just a fraction of the time.  Try going for a short burst of time on followed by a little longer off (ex. 10/20 on/off) and extend or shorten either time as necessary for what you can handle.

Weight lifting is also an area that could really benefit that attainment of your fat/weight loss goal.  Muscle is your most metabolically tissue and the more you have, the more you can burn.  See some ideas in the weightlifting section above.


We wanted to not get too lengthy with this post but if you have other ones we'd love to hear them and have a great discussion.

At the end of the day it is finding that 'happy medium' that gets you the results you are looking for and how your body best responds.  For as identical as we are via DNA the way our bodies respond to different stimuli is wide ranging.  We need to look how to fit what we are doing to the person and what they are wanting to accomplish and not always trying to force the person to fit the mold of what we have set up.