Friday Food: No-Bake Chocolate Energy Bites

Anytime you can take some energy to go and not have to bake it, we think you have a winner.  We found this recipe that can give you a boost in energy and also get you a chocolate fix while you're at it.  Simple and pretty quick to make up.  Give them a try.

Ingredients:

• 1/2 cup no stir almond butter or creamy peanut butter
• 1/4 cup + 2 tbsp honey
• 1 tsp vanilla extract
• 3 tbsp unsweetened cocoa powder
• Up to 4 tsp warm water, as needed
• 1 cup old fashioned oats (raw)
• 3/4 cup toasted or raw coconut 
• 1/2 cup flaxseed meal
• 6 tbsp semi-sweet chocolate chips

Instructions:

1. In a mixing bowl, stir together almond butter, honey, vanilla and coachmen's powder.  If mixture seems to thick stir in 2 tsp warm water to thin.  Add oats, coconut, flaxseed meal and chocolate chips and stir until evenly coated.  At this post if mixture still doesn't stick well, stir up to 2 tsp water as needed.  Transfer mixture to refrigerator or freezer and chill until nearly set and easier to handle.
2. Remove from refrigerator and shape into 1-inch balls.  Store in refrigerator in an airtight container.

Source: www.cookingclass.com 

Study Spotlight: Effect of Deep and Slow Breathing on Pain Perception

The idea of the mind and the 'self' being able to control the reaction of the body has been a long held idea in many disciplines.  Recently it has become more accepted as something that needs to be integrated into general healthy living along with utilizing it for athletic performance.  The idea that the mind can control so much when it comes to the body's response to pain is key in this concept and this study takes a one way to help utilize it.

What They Did:

Subjects were placed in one of two treatment groups.  Attentive deep and slow breathing and relaxation deep and slow breathing.  These groups were trained in their breathing techniques.  For measurable outcomes skin conductance levels (indicating sympathetic tone) were measures,  thermal detection and pain threshold for cold and hot stimuli and profile of mood states were examined before and after the breathing sessions.

What They Found:

Both breathing groups appeared to have similar reductions when it came to mood states and negative feelings.  Pain thresholds increased for the relaxed ground but no significant changes were seen for the attentive group.  Mean skin conductance levels indicating sympathetic activity decreased in the relaxed group but not with the attentive deep and slow breathing group.

What It All Means:

I think there are a couple major parts to the results of this study.  The first being that we, as humans, have the capacity to control intensities in pain with our breath.  This leads to the idea that you can control so much of your body and what it's reaction is to different stimuli but utilizing your mind and controlling your nervous system.  If you haven't heard of Wim Hof I recommend finding something on him to listen to as he is one of the masters of this concept.   Just think (get it?) that you could help control your pain, potentially your healing (at least your reaction to it) and where that could take you in performance or just in daily life.

The second part of these results that I found extremely interesting was the difference being attentive vs relaxed when you are doing the deep slow breathing.  As someone who doesn't like to turn their mind off and hasn't even tried meditating this is an area I think that could be especially important with the type of fast passed world we live in.  Not only do you have to slow down and break deep you have to relax in the process in order to maximize efficiency.  

So the bottom line is: relax, take a deep and slow breath and let your body respond to that.

Source: Busch, Volker. The Effect of Deep and Slow Breathing on Pain Perception, Autonomic Activity, and Mood Processing-An Experimental Study. Psychology, Psychiatry and Brain Neuroscience Section.

Mobility Monday: Improving Shoulder Wind Up

Mobility is important when it comes to your shoulders but having the ability to create stability through your shoulders is equally important.  This video gets you deep into how to work to achieve both when it comes to your shoulder health.  Some simple things you can focus on to increase stability to help prevent injuries down the road.

Things It Helps:
-Shoulder Stability
-Increased Strength
-Improving Chronic Shoulder Pain

Friday Food: Cream of Turkey & Wild Rice Soup

How could we think about food on a day like this?  The day after and the turkey hangover is in full effect.  Along with that you always seem to have leftovers that you can't quite seem to figure out what to do with.  Here is a simple recipe to use up some of that turkey (can combine it with a roll or two) that you can have throughout the week and for a change of pace.

Ingredients:

• 1 tbsp extra-virgin olive oil
• 2 cups sliced mushrooms (about 4 oz)
• 3/4 cup chopped celery
• 3/4 cup chopped carrots
• 1/4 cup chopped shallots
• 1/4 cup all-purpose flour
• 1/4 tsp salt
• 1/4 tsp ground black pepper
• 4 cups reduced sodium chicken broth
• 1 cup quick-cooking or instant wild rice
• 3 cups shredded cooked turkey
• 1/2 cup reduced fat sour cream
• 2 tbsp chopped fresh parsley

The Game Plan: 

1. Heat oil in a large saucepan over medium heat.  Add mushrooms, celery, carrots and shallots and cook, stirring, until softened, about 5 minutes.  Add flour, salt and pepper and cook, stirring, for 2 minutes more.
2. Add broth and bring to a boil, scraping up any browned bit.  Add rice and reduce heat to a simmer.  Cover and cook until the rice is tender, 5 to 7 minutes.  Stir in turkey, sour cream and parsley and cook until heated through, about 2 minutes more.

Courtesy: www.EatingWell.com

Study Spotlight: Effect of Varying Self Myofasical Release Duration on Subsequent Athletic Performance

By: Joel Luedke

Soft myofascial release (soft tissue work/foam rolling) can be very effective for many things if it is applied properly.  It can reduce tightness/soreness, increase ROM, and potentially aid in increasing performance.  As with most things though if you do too much you could potentially get results you weren't looking for.  This Study Spotlight looks at different durations and their effects.

What They Did: 

Researching looked at ankle and knee ROM assessments using modified weight bearing and kneeling lunge.  They also tested vertical jump and pro agility performance.  All the tests were conducted before and immediately after one minute self myofascial release (SMR), five minute SMR or after a control condition.  The SMR was done on the quadriceps and triceps surae (calves) using a standardized protocol and foam roller. 

What They Found:

Overall what the researchers found was that ROM increased in the SMR either in the one minute or 5 minute group compared to control.  The also found that pro agility time improved slightly following SMR but decreased following the control or SMR of 5 minutes.  There was also a decrease in vertical jump after 5 minutes of SMR and changed little after SMR of 1 minute or the control.

What It All Means:

Foam rolling can be effective for many things but the dosing of use is very important.  Most things that can be good for you can turn very bad for you if you do too much of it.  Self myofascial release is no different.

Depending on your goals you need to roll appropriately.  If you are looking for increases in ROM that is great, go a little longer (2-5 minutes) but we would recommend not doing so before you are trying to participate or train for an important athletic event.  As the results show if you do too much work too long it can have detrimental effects on your body's ability to perform explosive tasks (vertical jump and pro agility in this case.  

That doesn't mean you can't work on a tight spot before you want to do something athletic you just need to be sure that when you do it it is short duration, less than a minute, and you then you shouldn't have to worry about decreases in performance.  Use the foam roller or other tool as you need too but be cognizant of how much, how often, based on your goals.

Source: Phillips, J.  The Effect of Varying Self-myofascial release duration on Subsequent Athletic Performance.  Board #116

Does the IT Band Really Stretch?

By: Joel Luedke

Nope, not really....Post Done.

The IT band and IT band friction syndrome is a source of a lot of frustration for both patients and clinicians alike.  Grounded in the chronic injury world is the idea that your IT band gets tight.  The syndrome that comes out of this is IT band friction syndrome.  The symptoms of this problem generally involves pain at the lateral side of the knee especially with landing during running and especially with going down hill. The patient may have pain along the lateral upper leg which is where people believe the 'tightness' comes from.

First things first, the anatomy.  The IT band is a very long, very thick, very strong tendon.  It is

NOT a muscle, therefore most traditional soft tissue work doesn't have the same effect on it as it would in a muscle belly.  The IT band originates from the tensor fascia latae (TFL), the iliac crest and the glute max.  These muscle are important to keep in mind when we talk about the soft tissue work you will want to focus on.

When we talk about how strong the IT band is, we mean really strong.  It is strong to the point that with maximum force put on it (before failure) the IT band can stretch about 0.2%.  For an example you can hang the weight of a Volkswagen from the IT band before it'll snap.  That is strong. That leads us to think that going at the IT band with different tools and stretching probably isn't going to result in promising or lasting results.

What is could really be going on with you pain?  I personally think most of the problems with your IT band are underlying.  If we were to put your leg in a relaxed position and did some digging around we would find a lot of latent (and you might already know of some active) trigger points in your lateral quad, up into your TFL and your glute max.  When we look at pain referral patterns of trigger points pioneered by Travell and Simmons the common trigger point areas of the lateral leg can settle their referred pain to the lateral knee.  The common location of pain when it comes to the IT band.

There can be pain as a result of mechanical issues at the lateral knee with a bowing in and out of the tendon as it comes across the knee.  Tightness and adhesions along the later quad can be a contributing factor but we also need to look at your running mechanics.  If you are looking at the stability in your hips when you run and notice that the knee dives in and your arch potentially flattens as your running we are setting up for this 'bowing' at your IT band to be exaggerated and cause more pain,

What to Do About It:

Targeted and effective soft tissue work for the lateral quad, TFL and glute max.  Focusing on these areas can help reduce pain and tightness along the lateral side of your upper leg.  This can help reduce the 'tightness' and pain you feel at the lateral portion of your know.

Strengthening the lateral hip musculature for general stability is also extremely important to help stabilize your hips and put your knee and foot in the best position to connect efficiently with the ground.  Running is something we learn to do innately as we grow up but we tend to change a lot unintentionally and then never return to it.  Treat your running form as a skill much like you would shooting a basketball or swinging a golf club and you'll reduce your risk of injury period.

LINK: Lateral Quad/"IT Band" Soft Tissue Work-VIDEO

LINK: Running Exercises-VIDEO

LINK: Treating Running Like a Skill-Article

LINK: Lower Extremity Mobility Guide (.pdf)

Mobility Monday: Thoracic Wall Walk

Thoracic mobility can lead to a lot of beneficial things for your shoulders, upper body tightness and pain and eventually increase performance.  It is an area of your body that if you can have the available mobility it can unlock so many things for you when it comes to health and performance.  This is an often overlooked place when it comes to shoulder mobility and performance.  Check this out and give it a try.

Things It Helps
>Thoracic Spine Mobility
>Shoulder Mobility
>Improved Upper Extremity Mechanics

Friday Food: Sweet N' Spicy PeppTater Boat

This recipe looks fantastic and we are glad we found it through a colleague of ours at FitRiss Studios.   the combination of peppers, potatoes and onions sounds really good and especially because you can take your time in getting this one put together and eat when you are ready.  Check it out.

Source: FitRiss Studios FitRecipes

Ingredients:

• 1 red, grey, or yellow bell pepper, halved and unseeded.
• 1 whole sweet potato
• 1 white onion, sliced
• 2 tbsp olive oil
• Dah of Garlic Salt, Pepper and Cayenne Pepper

The Game Plan

1. Add an inch of water and 1 tbsp of olive oil to the bottom of the crock pot
2. After washing sweet potato and piercing it several times with a sharp knife, placed it in the crock pot.  Leave on medium heat for 6-7 hours, or high heat for 4-5 hours.
3. After placing sweet potato in crock pot, line backing sheet with tin foil.
4. Grab each half of the bell pepper and drizzle each with olive oil.  Add spices and refrigerate on a baking sheet lined with tin foil.
5. Head out for the day and let it cook.
6. Upon arrival home, preheat oven to 400 degF and place bell pepper halves into oven.  Bake for 25-30 minutes (or until you see some wrinkles start to form in the pepper).
7. Cut open and scope out the sweet potato into a serving dish. Mash up.
8. Scoop half the mashed sweet potato out of the bowl and add it to each bell pepper boat.
9. The onion should still be in the crock pot at this time, half the onion batch with a spatula and add to the top of the mashed potatoes.
10. Enjoy.

Study Spotlight: Cryotherapy on 3D Ankle Kinematics During Cutting

By: Joel Luedke

We have thoroughly challenged the idea of icing all your aches, pains and injuries and have really asked if it is truly the best way to treat those conditions (see links below).  That being said we never want to stop looking into ways to prove ourselves wrong and then we stumbled upon this article.  It's 14 years old but anytime we can find something that make us challenge what we are doing we think it is worth checking out.  See how icing can affect the ankles motion in a cutting movement.

What They Did: 

Researchers took 21 healthy subjects and had them perform a 45deg sidestep cut prior to and after

limb cooling for 10 minutes.  They used biomechanics analysis to look at the kinematics of the ankle joint and if the displacements and velocities would be affected at all by the cooling.

What They Found:

Results showed that there was no statistical difference between the PRE and POST icing conditions when it came to the displacements and velocities of the ankle joint during a 45deg sidestep cut.

What It All Means:

The researchers used a 10 minute cooling period to mimic what could potentially happen in sport if someone were to suffer an ankle injury and want to ice it at half time.  Based on the outcomes of this study it would show that there would be in theory no changes to how the ankle moved coming back after that cooling period and returning to the game if you were able to with the injury.  This does give some evidence to that being a good case scenario if you choose to use ice as your treatment modality.

They did not look at the effects of cooling for longer periods of time and if that would cause any different effects when it came to movement nor did they look at any of the movements of the rest of the leg during the cut (while not directly affecting the hip due to icing the ankle the general movement potentially could play a role).

This lends back to what I have said for quite sometime with the athletes I work with.  If you believe that ice helps and can get you back to where you want to be, by all means put a bag of ice on it.  If you are unsure if it helps or just do it out of routine, is there a 'better' way we could approach the injury and what we could do during that halftime period to help maximize your results.  I generally choose to go to the later and encourage as much pain free movement as possible in order to keep blood flow high through the ankle and limit the amount of potentially 'damage' that could occur by potential swelling.

In the end, know what works for you and have you purpose when it comes to the treatment and recovery modalities that you choose, it'll serve you better in the long run.

Limitations:

The greatest limitations the researchers noted was not doing biomechanics analysis of the whole leg during the cutting movement and not standardizing shoes (expenses) and having the cut performed barefoot.  By doing it barefoot that would have messed with some of the kinematics as it isn't the most natural way to do the movement when it comes to sport.

Source: Atnip, B. The Effect of Cryotherapy on Three Dimensional Ankle Kinematics during a Sidestep Cutting Maneuver.  Journal of Sports Science and Medicine (2004) 3, 83-90.

TAT Resources:
LINK: Can I get a bag of ice? Can you tell me why?
LINK: Study Spotlight: Is Ice Right?
LINK: Inflammation and Swelling, More to the Story
LINK: Gary Reinl-The Anti Ice Guy

Mobility Monday: Working Upstream and Downstream

Pain is a symptom and it doesn't always occur in the location of the problem that is it's source.  Often pain and settle in one location and while that is what you're feeling and there might be injured or damaged tissue there but when we really break down what is going on we often find that the reason that pain is occurring is from tissue or structures that are upstream or down stream from where you are feeling it.  This video gives you a great breakdown on how to identify it and work through it all.

Things It Helps:
-Looking beyond the pain
-Finding tissues that need to be addressed
-Greater pain relief

Study Spotlight: Self Myofascial Release vs. IASTM on Vertical and Horizontal Power

By: Joel Luedke

Soft tissue work can be really beneficial in both the prevention and recovery of injury.  Could it also be helpful in increasing performance in both vertical and horizontal power? This Study Spotlight takes a look a couple different versions of soft tissue work and exactly how it

corresponds to power output.

What They Did:

This study looked at whether doing pre-exercise self myofascial release (SMR) and instrument assisted soft tissue mobilization (IASTM) would improve performance on measures of vertical jump height and 40 yard sprint time in recreational.  They also took a look at perceived pain levels.  Both soft tissue work groups had work done on the quadriceps, hamstrings and gastroc-soleus complex.

What They Found:

There was no interaction between the massage intervention between the massage intervention and sex for both the vertical jump and 40 yard sprint tests. There was a significant main effect for vertical jump.

What It All Means:

This study is in interesting as it corresponds with a previous Study Spotlight on Dry Needling and vertical jump.  While the results of the study show some promise that you can increase your performance with simple techniques there are a couple things to take into account here when it comes to athletics and performance.

In the study the researchers used a 5 minute bike warm up followed directly by soft tissue work in either group and then the performance of the task of vertical jump or 40 yard dash.   In the world of  'proper' warm ups we don't believe that this would count as something that would count and by just doing a more extensive and intensive warm up on its own could yield some of the same results that this study did with simple myofascial release.

The utilization of recreational athletes is also something to take into account with this study.  You can't take the results of this study and do a blanket application to all athletes.  If it were that simple to get a performance increase I think there would be more occurring in athletics when it comes to targeted soft tissue work to increase athletic performance.  The results of this study give ideas that soft tissue work can show benefits to performance but be careful in applying it to everyone.

Limitations:

As we mentioned above, the biggest limitation in this study is to be careful to not apply this one to everyone and every situation as the way the study was run doesn't fully mimic 'proper' athletic warm up.  Further research with extended periods of warm up and different sets of athletes could provide more information as we move forward.

Resource: Stroiney, D. Examination of self-myofascial release vs instrument assisted soft tissue mobilization techniques on vertical and horizontal power in recreational athletes. Journal of Strength and Conditioning Research. 2018.

Immediate Injury Management

By: Joel Luedke

Anytime you are engaged in an athletic activity you risk injury.  Those injuries can range from something acute and traumatic that can set you back from a long time and lead to surgery to something that builds over time and then causes chronic pain and problems.  How you manage those injuries especially early on can have a huge impact on how your recovery process plays out.

In this short article we want to take a look at how to manage an acute injury like an ankle sprain or minor knee sprain to help jump start the healing process.

Protect and Move

Seems counterproductive to try and do both but it really is a huge part of getting your body in the right spot to start healing.  We want to protect for as much of the day/night that we can and put your body in the best position to heal during those times.  In the example of an ankle sprain that means a walking boot which is not a death sentence but more a treatment during the day.  We want no pain so we can be set up to have the best treatment and rehabilitation setting that we can.

That is where the movement part comes in.  "Use your brain, no pain" is our slogan when it comes to movement early on in the process. Going along with our ankle sprain example this means ankle pumps, writing the ABCs with your big toe and getting the bodies natural swelling removal system to do its thing in helping the injury process.  As you progress through the injury you want to increase the level of movement and work your way to return to play.

Rest as Much as You Need to but No More

This can be the hard part of the rehab process.  When to start moving forward and when to hold back in the rehab process. We want to make sure that we do take some rest early on, let the healing process get started and then introduce movement as soon as we can but no sooner.  This is where the testing process comes in and makes the protection portion from above so vital.  You can get the rest in between rehab sessions along with returning to activity.  Don't wait too long but make sure you listen to your body as you go.

Is Ice Right

Without getting too far into the argument (please see the links below) ice is really your decision.  Do we think it adds to the rehab process?  Not so much and in fact can actually slow things down during the process.  There is little to no solid evidence showing how it enhances the function of trying to get swelling to evacuate and get more into the rehab process.  If it makes you feel that much better, by all means, but don't just throw a bag on for the sake of doing it.

LINK: Is Ice Right?
LINK: "Can I have a Bag of Ice?"

Mobility Monday: TMJ Work

You don't realize how important the tempero-mandibular joint is until it flares up and lets you know how important it is.  The pain and dysfunction can be excruciating but the good news is you can do a lot of work on your own to make sure that it doesn't become an issue.  Check it out below.

Things It Helps: 
-TMJ Pain and Soreness
-Tension Headaches
-Associated Neck Pain