Mobility Monday: Airplane Back Survival Guide

Whether you are sitting on a plane for hours and hours or you have a long car ride and there just isn't a good place to stop your back can take the brunt of it.  The long hours of sitting and the compression that results on your spinal column can be extremely tough and agonizing.  Simple tricks can help take off the pressure on your back and make your trip a little less sore.  Give it a try.

Things It Helps:
-Low Back Pain
-Helping with Sitting for Long Periods of Time

Mobility Monday: Death by Desk

If you're going to be anything like me this holiday season you may find yourself sitting quite a bit and enjoying the down time (and being a little lazy).  While that can be all well and good for your mental health and relaxation it can be extremely hard on your body.  Who knew that sitting in something comfortable for while could really be that hard on you body.  Dr. Starrett breaks it all down and gives you some great ideas to help combat sitting.

Things It Helps: 
-Tight hip flexors
-Low back pain
-Generalized stiff hips

Friday Food: Garlic Brown Sugar Glazed Salmon

We are huge fans of salmon and there are so many health benefits from eating it.  It is high in protein content which is always a good thing but also the health fatty acids salmon can bring with it make it a favorite.  Combine that with some garlic and its own health boosting properties and you're all set to go.  Give this one a try with the added brown sugar to give a little sweetness.

Ingredients:

• 2 pounds salmon
• 2 tbsp olive oil
• 1/4 cup brown sugar
• 1/4 cup soy sauce
• 3 garlic cloves, minced
• Juice of one lemon
• 1 tsp salt
• 1/2 tsp pepper
• Garnish with sliced lemons and chopped parsley if desired.

The Game Plan: 

1. Preheat over to 350 degrees.  Line a baking sheet with aluminum foil.  Lay the salmon on top and sprinkle with salt and pepper.  Fold up the sides of the aluminum foil around the salmon.
2. In a small bowl whisk together the olive oil, brown sugar, soy sauce, garlic, lemon juice, salt and pepper.  pour the glaze over the salmon.  Top the salmon with aluminum foil and seal.
3. Bake for 20-25 minutes or until salmon is cooked throughout.  Take the foil off of the top and baste the salmon with the sauce in the foil.  Broil for 3-5 minutes until brown and caramelized. Garnish with lemon slices and chopped parsley if desired.

Resource: The Recipe Critic

Practice Based Evidence

By: Joel Luedke

Evidence occurs along spectrum and how you utilize it should also occur along a spectrum.  Evidence based practice (EBP) has been a major push for a long time in a lot of professions.  Lately the increased focused on EBP worked its way through the field of athletic training.*

Evidence is great and the research is needed but I am going to talk about in this post is why we can't jump all in on just EBP and go on to say "there is not evidence" and let that make something we are doing not worth doing.

More Questions than Answers

I read a good amount of research and while there are connections you can make out of the studies there is almost never a study that directly applies to what population you are working with or the issue that you are dealing with.  This makes the transfer of evidence difficult.  Along with this issue there is the problem of repeatability.  Several studies may look at similar circumstances and based on a number of factors come out with extremely different results.  So which one do you use?  Do you use nothing at all?

The research problem is also difficult in that there has to be a long progression of studies building on themselves in order figure out the root of an issue or problem.  That can also be a frustration with research in that most studies leave more questions asked than questions answered.  Problems are identified but rarely are answer ever clear.  This makes implementation difficult.

Individual Response

I would argue training and treatment is just as much art as it is science.  Everyone is so individual in their response to the same stimulus that is it almost impossible to expect success with the same treatment or intervention.  I believe this is where an idea I stumbled upon of 'Practice Based Evidence' comes into play.  While it may not be double blinded or randomized controlled if something works, then it works and I think that is important in and of itself.

By looking at basic concepts that can be found in research (i.e. principles of training or soft tissue work) the partitioner can then find the right instrument for the right person that facilities the best outcomes.  At the end of the day I believe this should be the ultimate goal in getting the client/patient/athlete the best and most efficient outcomes they are searching after.

Research is vital but getting caught up in only practicing a certain way I think leads us down a path of missing things and not fully providing the best practice we are able to.  Ground what you do in research and stay on the cutting edge and most importantly have a 'why' in terms of everything you do but never forget the importance of patient outcomes.

*At no point am I saying that research and evidence shouldn't be a major part of everything we do, it just shouldn't be the only thing focus on.

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

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.

Limitations:

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.

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.

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

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.

Ingredients:

• 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.

Source: The Recipe Critic

The Importance of Inter-Professional Collaboration

By: Joel Luedke

In a world where specialization is the norm and you can be bounced around from one appointment to the next and sometimes vision can get narrowed and that can be dangerous...for you.

Having a team that works together and collaborates for your health can be one of the most `powerful things in healthcare, wellness and performance.  This article's purpose is talk about how that inter professional collaboration, what you should look for, and why it'll benefit you.

I believe one of the best things about inter-professional collaboration is that it can benefit the patient the most and at the end of it all, that's what is important.  This can occur mainly because for professionals to work together and build off of each others knowledge base they have to check their ego at the door, this is paramount.  Having the practitioner be able to look outside themselves and ask for assistance and another point of view means the world to getting something figured out to help the patient.

As the patient you should look for a practitioner that works in an integrative practice as then they have those instant resources.  That isn't always possible to find so looking for someone that has gone outside what their deemed 'comfort zone'.  While we do believe that being a 'jack of all trades' can be beneficial we also think that at some point you either need to specialize to benefit the patient or be able to refer our in order to match the person with who they need to help benefit them the most.

Inter-Professional collaboration is an in-vogue term bouncing around the medical profession but at no time has it been more important.  Finding a team that can put your interest first and their ego behind them is best for you and anyone else that they come in contact with.

Practitioners, know what you know and know what you don't know.

Patients, find someone that is willing to ask the question and puts your health first.

Mobility Monday: Torque is King

THIS IS THE VIDEO!!!  If you can focus on getting significant torque through your hips and training your body to do it on a regular basis the results are well worth it.  Your hips are the transition point between lower body and upper body and the more you can control the position and torque of your hips the better the performance and body control.  Check it out to implement these simple techniques.

Things It Helps:
-Correcting anterior pelvic tilt
-Relieving low back pain
-Increasing power through your hips