How I Recovered from a Shoulder Injury and Still Got Stronger

How I Recovered from a Shoulder Injury and Still Got Stronger

 

Shoulder painShoulder injuries are brutal. Whether you’re an athlete, a fitness enthusiast, or someone that uses their arm/hands for a living, a shoulder injury can get in the way of your performance.

The shoulder is a complex joint with a lot going on in the name of muscles, joints, ligaments, and neurovascular tissue that can be triggers for pain. Because it has the most mobility of any joint in our body, it also means that it has the greatest risk of injury and instability.

For the sake of this article, we’re not going to talk about injuries like shoulder dislocations, complete rotator cuff tears, labrum tears, or injuries to the brachial plexus. Those are more serious orthopedic injuries that should be evaluated by an ortho, PT, or chiro.

 

Why Rest May Not Be the Answer

Most of the shoulder injuries that happen in the gym or work place are a result of inflammation or strains in tendons or muscles of the shoulder joint. I work with a lot of gym rats in my practice. One of the most frustrating things a gym rat encounters is a strict recommendation for rest and ibuprofin as a prescription for recovery.

New research in rehabilitation typically tells us that this line of thinking is outdated. Most every condition from pneumonia, to post-surgical recovery, to concussion, to ankle sprains all have favorable responses by starting a movement and exercise program sooner rather than later. Proper rest from exercise is important, but one of the most important lessons you can learn about recovery is this:

“Exercise is medicine”

Not just in the sense that it promotes weight loss and prevents cardiovascular disease, because any schmo on the street is aware of that now. But increased movement, mobility, and exercise is associated with improvement in almost all of the most common conditions and causes of disability that we know of.

 What Did You Do Doc?shoulder-anatomy

About 6 months ago, I started showing signs and symptoms of an injury to my left shoulder. Shoulder injuries are nothing new to me, in fact, it’s part of the reason I became interested in chirorpactic. After years of playing baseball, I was used to the feeling of a sore shoulder full of rotator cuff tendonosis.

After getting a little too ambitious on some gymnastic rings, I developed pain in my left shoulder which had always been my healthier limb. I was side lined from muscle ups, hand stand push-ups, thrusters, and push presses because they triggered pain with each repetition.

It’s tough to stick with a sport or activity when you can’t perform most of the basic elements. So what can you do? You can avoid the activity and limb altogether and eventually time off will probably make the joint pain-free.

But what will happen to all of my gains?!

Or you can strategize your training so that you can recover and continue to build strength and fitness.

Here’s a run down on how I approached my injury. I won’t get into specific exercises and stretches that I did myself because those things will be unique to your specific injury. Today, I just want you to become familiar with the thought process of building strength in an injured limb.

  1. When mobility plateaus, Get Outside Help – Listen. Even the best doctors and therapists in the world cannot treat their own case. When I got injured, I sought help from my chiropractor. For situations like this, it helps to find a doctor, PT, or chiro that understands athletic performance and sports injury. I also find it particularly helpful if your doctor trains or is an athlete themselves. A combination of prescribed exercises along with certain adjustments and manual therapies can do wonders in restoring pain free range of motion.
  2. Protecting the Injured Wing – Single Arm Metcons – What do you do when you can’t do barbell movements because of an injured shoulder?Research shows that training a single arm can still provide strength gains to the opposite arm. The neurological and vascular changes that happen when you exercise will apply to both sides over the course of a few weeks. When a workout called for a barbell clean, I did dumbbell cleans with the healthy shoulder. When they involved presses, I used kettlebells. Injury doesn’t mean you have to stay home and rest. Even if the arm is too painful to use early on, your other shoulder is still capable or keeping your conditioning up.
  3. Strengthen the Injured Wing – Start simple, get complex – When you have an injured shoulder, it will take some time to make it strong enough to do work again.When I couldn’t do complex lifts like jerks, dips, or muscle ups, I was still able to do the most basic movement. A push up.You can start with a simplistic movement with a similar goal. For presses a push up is a simple as it gets. For a pull up, a banded row, or ring row may fit the bill. Find one that you can do without pain. As you train, you can gradually increase the load (weight) and then incrase complexity. I went from push up to a bench press. I then went from bench press, shoulder press, shoulder press to dips, dips to the bar muscle up, and bar muscle up to the ring muscle up.You will run into blocks where the movement is slightly painful which means you still need to scale back and keep developing the strength and skill to get towards pain free again.
  4. Dumbbell Freedom – A bar bell or pull up rig can reduce the free range of motion you use to accomplish a movement. Thankfully dumbbells were created for this reason. A dumbbell or kettlebell allows your body to use slight variation in your range of motion to find a zone that is pain free. I found that my normal barbell grip didn’t allow for a good amount of internal and external rotation of my shoulder. When I used a dumbbell for presses, I was able to add torque into the movement which provided extra stability while my shoulder was recovering. Using dumbbells to explore your pain-free range of motion may allow you to quickly progress through movements while you strengthen your injured limb.
  5. Get strict and get strong – Don’t get me wrong. I love doing movements with speed and efficiency. Kipping pull ups, kipping ring dips, push presses, push jerks are fun. It’s a big reason why I enjoy Crossfit.However, we can often lose some of the best strength benefits for our bodies by avoiding strict movements. Strict movements provide targeted load onto the tendon and muscle tissue that allow the tissue to become stronger and more resiliant. They also add different loading patterns to stress the muscle in different ways that promote control and stability. Plus, there’s just no substitute for being stronger. Being stronger is correlated with resiliancy to injury of all causes.Additionally, if you’re kipping on a bad wing, you expose your joints to an increased probability of tissue shear.I went with a Grease the Groove approach to strict movements.5×5 Strict press 50%
    5×5 Strict Ring Dip
    5×5 Strict Pull up

 Results:

Pre Injury:
Clean and Jerk Max – 245 lbs
Max Bar muscle up – 3 reps
Max Strict muscle up – 0 reps

Post Injury:
Clean and Jerk Max – 250 lbs
Max Bar muscle up – 7 reps
Max Strict muscle up – 2 reps

Despite the injury, my performance went up in 3 different exercises that require strong shoulder output. While my handstand push up is still a little uncomfortable, movements like the thruster, jerk, and shoulder press feel lighter than they have before I got hurt.

Injuries don’t have to wreck your gym schedule. They don’t even have to prevent you from getting stronger.

They do require strategy and a little outside help to explore the full function and output of your body.

 

Did you like this article? Feel free to share it with the people you care about and see if a Complimentary Consultation is the next step to regain their health.

Dr. Chung is a practicing Structural Chiropractor in the West Palm Beach area. He has been published in peer reviewed scientific journals and is a sought after speaker in health and wellness. Follow his blog at http://chiropractorwellington.com/category/keystone-chiropractic-blog/ or find him on twitter at @drjonathanchung

One Stunning Image That Redefines What We Know About Aging

One Stunning Image That Redefines What We Know About Aging

One of the coolest things about social media is the way that it allows you to learn and interact with people that you may never have interacted with in the past. Using sites like Twitter and Facebook have given us unprecedented access to follow our favorite athletes and celebrities, and actually give them an opportunity to interact with you.

I’m not really a celebrity type guy, and I don’t really get too star struck, but I do geek out over the chance to follow and interact with people that are smarter and more innovative than I am. It allows me to see what other practitioners are doing, and gives me the chance to give my patients better care.

One of these guys is Dr. Brian Tiu. Brian is a Structural Chiropractor in Seattle that has a strong background in sports. If you’re not following him on Twitter, make sure you do today. Lots of good free stuff from him on a daily basis. You can find him here.

Anyway, here’s one of his posts that came across my newsfeed that really blew my mind about exercise and lean muscle mass:

If you missed the arrows, the white part of the image is fat tissue, and the dark gray parts are muscle. That’s amazing! The fact that men in their 70’s could maintain their muscle mass, prevent fat from invading muscle tissue, and maintain a level of fitness to run in triathalons is simply phenomenal.
The image is taken from a study that compared the muscle composition of chronic exercisers (they couldn’t find a better term for this? Really?) versus healthy controls. They performed MRI studies on the thighs of both groups and evaluated fat to muscle ratios and how much fat had infiltrated muscle tissue.
Before I talk about the results of the study, let’s make sure to mention this.

Conventional Theory

Current theories on aging  simply state that muscle mass will fade once you hit the age of 30.  Once you hit the age of 40 you start losing about 1% of muscle mass per year. Once you hit 70, you may lose an average of 15% in 10 years.

Here’s what happens to people as they lose muscle mass:

  • Increase in overall mortality
  • Osteoporosis
  • Increased risk of fractures
  • Increased risk of disability
  • Use assistive devices (canes,wheelchairs)
  • Poor balance and prone to falls

Essentially, a bulk of the problems associated with aging.

Now it’s a bit silly to say that you can stop the clock, and stop the body from getting older. That’s why I’ve always found the term anti-aging to be rather silly. However, with that being said, aging is so profoundly affects quality of life, that we should be encouraged to use tools to mitigate their effects.

When you’ve finally reached retirement, you have the freedom to see the world, time take on hobbies, and ability do things that you didn’t have time or money for in your earlier ages. Why would you want to spend those years with immobility, wheel chairs, and fearing the next fall?

The problem is that these studies were focused on people that were reported as “healthy” because they didn’t show any symptoms….(because symptoms are the only thing that matter in health….a topic I’ll tackle on another day).

The Study

The study was published in  The Physician and Sports Medicine in 2011. The image that they use in the journal article is actually even more striking than the one in Dr. Tiu’s post above. Let’s take a look.

Image Credit: Wrobleski et al. The Physician and Sport Medicine. Volume 39 Issue 3. 2011

Image Credit: Wrobleski et al. The Physician and Sport Medicine. Volume 39 Issue 3. 2011

The bottom two images are the leg muscles of 2 men in their 70’s. You can see that the sedentary man muscles are atrophied, and there’s actually bits of fat in the middle of gray muscle tissue which indicates that the man’s muscles are becoming less functional. The top image is a thigh of a man in his 40’s.

Now if you compare the image of the 40-year-old thigh versus the 70-year-old thigh you can see that the muscle density is pretty similar. So in a span of 30 years, where muscle mass should have dropped about 25%, the 70-year-old athlete was able to maintain just about all of his muscle.

What Does This Mean For You?

This study looked at people who are sedentary and compared them to people who do some pretty intense training for triathalons. You’re basically looking at polar opposites in terms of what someone’s day to day life looks like. One is doing almost no exercise at all outside of what it takes to live, the other is probably running, swimming, biking, or weight lifting multiple times a day, a few days a week.

What does this mean for the casual exerciser? Can you achieve similar results if you start exercising later in life?

It’s hard to say just from this study, but my guess is that you can still achieve great muscle mass without triathalon levels of training. The key is finding the right exercise for you, and using that as a way to be consistent. Here are some tips:

  1. Learn to love squats – most of us are probably worried about how squats can affect your back or your knees. I’ll address some of those concerns in another post, but just know that squats can be done safely to take advantage of some amazing benefits.Squatting stimulates the release of growth hormone and induces muscle hypertrophy better than almost any other exercise around. Finding a good trainer and getting on a regiment of squatting 2 times a week can make some dramatic changes in your body composition.
  2. Find Movement You Love – Not everyone enjoys working out and running. The truth is if you dread your exercise routine, you will give up on it before long, no matter how dedicated you are. Movement is more important than the concept of exercising. Moving our bodies is like food for our brain and our muscles. Some people love dancing. Some love rock climbing. Others enjoy going on a bike ride in the city. Lots of my patients just like working in a garden. All of these activities can help you maintain some level of muscle mass and reduce fat infiltration. It may take a LOT more dancing, biking, and gardening to achieve the same outcome as a good gym regiment, but at least you know that you’ll keep going.
  3. Give Yourself Something to Work For Multiple Times per Year – Human beings are driven by excitement and enthusiasm towards a goal. Here’s a short list of ways to use a goal to drive an exercise program you love to do:

    Runners/Bikers/Swimmers – compete in a 5k/half-marathon/triathalon 2-3 times per year so that you are always working towards a race.

    Gardeners – choose a project you want to accomplish for your home once per year. You’ll be kept busy by regular up-keep as well

    Dancers – look into local competitions so you can focus on improving your skills and find a platform to show off once in a while

    Outdoor enthusiasts – don’t like exercising, but you enjoy being outdoors. Check out sites like meetup.com to find groups that have your same interests. There are almost always groups that have get togethers for hiking, beach yoga, and a variety of other activities

Your ability to move is tied directly to your health as you age. The big key is turning our activity into things that we enjoy so that we can turn that into a sustainable habit that will be with us through our lives.

There are even new thoughts in the scientific community that believe muscle can serve as protein storage houses for building antibodies, a key tool in immune function. When we lose muscle mass, we lose one of the building blocks of our cells and immune function.

Don’t fall into the trap of people selling you anti-aging creams, juices, and miracle supplements. The most valuable nutrient you can have in your life, is free, and you can take it everyday. All you have to do is get up and move.

Did you like this article? Feel free to share it with the people you care about and see if a Complimentary Consultation is the next step to regain their health.

Dr. Chung is a practicing Structural Chiropractor in the West Palm Beach area. He has been published in peer reviewed scientific journals and is a sought after speaker in health and wellness. Follow his blog at http://keystonechiropractic.smbusinesswebsite.com/category/keystone-chiropractic-blog/ or find him on twitter at @drjonathanchung

Hurt Your Arm? Caught the Injury Bug? Can You Train with One Arm?

Hurt Your Arm? Caught the Injury Bug? Can You Train with One Arm?

Last week I posted an interesting article on my Facebook Page and Twitter that talked about the benefits of training with just one of your extremities (arms). The link to the abstract of that article is here if you’re a little geeky like me and want some more details.

This study looked at the effects of doing maximal resistance strength training on just one arm for the span of 2 months. The results added to the growing amount of evidence that exercising and engaging just one limb still provides gains for the side that wasn’t used.

Popeye ArmsWhen people are introduced to the concept of doing more work on one compared to the other, many people think their arms will look like this goofy guy on the left. It’s even funny to have the conversation with people, because a lot of people will go out of their way to make sure that each arm gets the exact same number of reps so that they don’t become asymetrical.

The evidence points to the fact that our bodies are not designed for that. Any repetitions you do on one arm are going to have a partial affect on the opposite side. While this should provide you with great relief that you won’t have to worry about having one popeye arm, and one bad arm, studies like this have wider implications for training and injury rehabilitation.

So you just caught the injury bug…..

So let’s say that you’re an olympic weight lifter, Crossfitter, or all around gym rat. There are no shortage of injuries that can occur in your upper extremity, and let’s be honest. No matter how good your form is, when you train as often and as hard as you do, you can’t be perfect all of the time. It just takes a weight that is a little heavy to sit on a bad shoulder position at the wrong time to cause an injury. Here are some of the common problems:

  • Rotator Cuff Tendonitis
  • Elbow tendonitis
  • Pec strain
  • Trap strain
  • Bicep tendonitis
  • Labrum tear
  • Sprained wrist
  • Shoulder dislocation

Some of these injuries are more severe than others, but they are all variations of things people seek help with from a PT, Chiropractor, or Orthopedist. The danger is in the expectation that pain relief should be the main concern.

Anti inflammatories and prophylactic shots can take the edge of some of the pain, but the dysfunction is still going to remain. While there are certainly therapies and movement strategies you can use to address the dysfunction, the pain may still remain for a weeks or months. Ultimately, the truth is this:

Some injuries rest to heal

Rest the joint, Work the Body

When patients come to see me  with one of these types of injuries, I try to have a frank conversation with them about what to expect. While I try my hardest to help people maintain their normal routine with in injury, there are times when rest is really the only solution.

A prescription for time off is usually a plan doomed to fail for someone who is very passionate about their fitness. They’re usually going to load up on anti-inflammatories until they can’t feel their shoulder anymore, and they push through their workouts. Why? Because when there’s no pain , there’s no problem.

My alternative plan for gym warriors is to stop the use of the injured extremity, and start customizing an athlete’s workout for single arm variations.

How I Worked with an Injured Wrist

2 months ago, I injured my right wrist while I was at the gym. I could not grip a bar over head, I couldn’t press over head, pretty much any exercise that involved gripping with my right hand was a no-go.

So what did I do?

1. I took the opportunity to get stronger with my lower body. Lots of back squatting, box jumps, pistol squats, etc.

2. For every upper body exercise, I found a single arm alternative. Dumb bell thrusters, single armed kettle bell swings, dumb bell cleans, and dumb bell snatches.

I did programmed these movements into my workouts for 1 month while my right wrist recovered.

2 months later, my wrist had healed and I was able to jump back into my normal routine without any loss of production on my lifts.

In fact, because of my new focus on squatting, you could actually make the case that I was stronger after the injury than I was before.

How Does that Rested Arm Get Stronger?

The verdict is out on exactly what happens when working out 1 arm causes strength gains in both arms. What is certain is that strength is coming from more efficient connection of the brain and spinal cord.

Here’s a fun fact: Most of your strength gains when you start working out has almost nothing to do with muscle growth.

Read that again just to be clear. You are getting stronger without changing anything about the size of your muscles.

Strength gains are found through a combination of muscle growth and neurological function. While muscle growth is certainly an important source of LONG TERM gains, it is actually our brain and nervous system that does a lot of the heavy lifting in the short term.

The more you do an exercise, the greater the number of connections your nerves make to that pathway. The more synapses form for an exercise, the easier and more efficiently you will perform a given movement. The cool thing is, your brain does not care if just one side is doing work or if both sides are doing work. All it knows is that the body is doing work and creating movement.

This tells the central nervous system to build stronger connections with your muscles so that the work will become easier over time.

Does that mean I don’t need to see a doctor?

Maybe you do, maybe you don’t. It’s not to say that a doctor or therapist can’t help you improve your mechanics and treat damaged tissue in the injured extremity, because many of them can. However, there is no substitute for allotting your body enough time to heal from injury.

I’ve seen it too many times where someone has an injury in one joint, they workout in spite of the pain, then other parts of the body start getting injured because of the bad compensatory movement strategies that you take to cover for the bad joint. Proper care, improved movement, and appropriate rest is a recipe for success.

In my view, resting doesn’t mean losing your fitness, it means being STRATEGIC about your workouts to maximize your results even while injured.

Did you like this article? Feel free to share it with the people you care about and see if a Complimentary Consultation is the next step to regain their health.

Dr. Chung is a practicing Structural Chiropractor in the West Palm Beach area. He has been published in peer reviewed scientific journals and is a sought after speaker in health and wellness. Follow his blog at http://keystonechiropractic.smbusinesswebsite.com/category/keystone-chiropractic-blog/ or find him on twitter at @drjonathanchung

The Crossfit Games – Watching with a Chiropractor’s Eyes

The Crossfit Games – Watching with a Chiropractor’s Eyes

 crossfit games

It’s one of my favorite athletic events of the year: The Reebok Crossfit Games.

For most people, the games are about watching their friends compete (Go Team Crossfit Hardcore!), getting motivated to achieve a chiseled physique, and of course there’s the sheer excitement and joy of watching someone do the same workouts you do, but perform them at truly elite levels.

Of course, most viewers will be paying attention to amount of weight the athletes can put up or the speed at which people can perform a grueling chipper. As for myself, I’m a junkie for observing adaptation and control.

When we take the time to really watch how the best in the world do work, they leave clues to their success.

The Rich Fronings and Julie Fouchers of the world don’t succeed by muscling through lifts or haphazardly stumble through movements.

When you see them tackling the Midline March, watch at how the athletes prepare to load their spine for endurance. You’re not going to see gross hyperextension of the lumbar spine to keep the weight over the shoulders. You will see the best athletes maintaining a straight, and upright position as they tackle the overhead lunges.

The straight spine of a Games athlete versus the hyperextended spine

The straight spine of a Games athlete versus the hyperextended spine

What the Average Gym Goer Can Take Away

We often look at Games Athletes and envy them for their strength, stamina, and body. Our first impulse is to imitate their programming and diet so you can be as strong and as fast as they are.

However, when we look up to these incredible athletes, it’s very important to watch them for HOW they move.

The training regiment and programming for these athletes is insane. For the average gym goer to start doing Games programming will inevitably lead to a litany of injuries. How does the elite Crossfit Athlete not just survive, but thrive with this kind of workload?

1. Impeccable Movement in Training = Great Movement in Competition – Rich Froning is far and away the most dominant athlete in the sport. When watching him compete, you notice that every rep looks crisp, efficient, and well executed. For people that watch his training videos, it’s not just like that in the Games, it’s like that in his training as well.

You don’t see Rich going into bad compensatory movements to get the last rep. In fact, his form still looks excellent as the workout nears completion. This allows for a couple of important things.

Rich is never injured. You never see him covered in Rock Tape, or limping off the arena floor.

Rich nevere wastes energy. You don’t see hyperextension on any lift. You don’t see his knees buckle in on squats. You don’t see him collapsing on his head during a hand stand pushup.

When many of us train, we are doing all kinds of crazy motions to get the last several reps. When we do, we are embedding bad habits into our nervous system and muscle memory. It’s also setting us up injury if we catch our selves on a day where we’ve had poor sleep or malnourished. It only takes a few bad reps to wreak havoc on a seemingly healthy body.

2. Fitness Includes Stability – One thing that the Crossfit Games did this year was expose people who don’t have great strategies for having a stable midline.

HandStandWalks

Handstand walks are all about stability training

This year’s athletes needed to prove that they could do things like long handstand walks, do heavy overhead squats, and perform strict hand stand push ups.

It’s no longer good enough to simply move quickly. You also have to show an ability to move quickly with great control. Stability is about having greater ability to control your body through every phase of movement. The strongest and fastest athletes are also the ones that have the greatest control of their bodies in whatever movement is demanded of them.

Showing greater stability is also a sure fire way to keep the athlete safer during workouts. Crossfit is making a statement to the local competitions that new standards should include stability as a primary part of fitness, and therefore promote athletic safety.

3. There are Primal Rules for Adaptation

Every year, there’s some kind of crazy contraption that the athletes have never seen before. Whether it’s the Worm in the team event, or some kind of new sled contraption, the Games have a way of putting athletes into a situation they have never trained for.

However, the guys that are great at lifting barbells, doing pull ups, and climbing ropes are still the best people to figure out how to move a giant log on their shoulders.

Is it strictly a matter of strength? Sure, strength plays a big role.

But even more important is the fact that there are basic rules and archetypes for performing a certain activity. Picking up a barbell has many of the same basic rules as picking up a stone, or picking up an object that you’ve never seen before.

The best athletes understand this, and apply the same rules to make that motion happen. They understand that pushing or pulling a sled requires the effective use of leverage, and how to make their bodies use that leverage.

Neuromuscular Control = Movement Mastery

Before you decide to tackle the Super Duper Programming to get you to the games, I think it’s important to realize that having mastery over your body must precede a training program of outrageous volume

The more you develop your ability to control every part of an athletic movement, the easier it will be to push for those extra reps, get stronger, and take on more work.

Developing Neuromuscular Control requires 3 main things:

1. Feedback – you need someone telling you when you’re doing things poorly, and when you’re doing things right. Being used to doing something one way gives you a false impression of doing things correctly. Getting feedback to REINFORCE good pattern will help you develop the inner sense for what correct feels like

2. Practice – When you know what Correct feels like, then you have to practice until Correct feels normal. Then do THAT over and over again.

3. Getting rid of maladaptive compensations – When there is something dysfunctional happening in the body, the body begins to take on compensatory patterns. The only way you can make the body stop compensating is by addressing the primary dysfunction in someone’s body. Of course, this is where a good chiro or physio can come into play

Did you like this article? Feel free to share it with the people you care about and see if a Complimentary Consultation is the next step to regain their health.

 

 

Becoming a Supple Leopard – A Chiro’s Perspective on Crossfit’s Mobility Cert

Becoming a Supple Leopard – A Chiro’s Perspective on Kelly Starrett’s Mobility Cert

handstand

Handstand Push ups on the Great Wall of China? No big deal

With Crossfit’s infamous stories of injury, it may seem unusual that I would subject my body to the potential abuse; particularly for someone who relies on using their body for a living. I first got introduced to Crossfit while I was in chiropractic school through one of my classmates. The workout was short, but it left me laying on the floor exhausted and wondering what just happened to me…I was hooked.

I became a sponge for information. I watched hundreds of videos on how to perform a kipping pull up, cleans, and muscle-ups. I read articles about the benefits of performing exercise at high-intensity. I watched people flip tires and walk on their hands, and knew I wanted to be able to do all of those things.

However, I knew the fun couldn’t last if I knew it was something that I couldn’t do safely. An injury to my spine, shoulders, or legs would cost me the ability to take care of patients and make a living.  If my chances for serious injury were high, the risk of getting hurt would force me to put away my fun new hobby.

 

 

That’s when I stumbled upon the Crossfit Journal and the work of Dr. Kelly Starrett. He’s a Doctor of Physical Therapy, a Crossfit Coach, and an international expert who has consulted with NFL teams, Olympic Athletes, and the U.S. Military on enhancing the safety and efficacy of their training programs. He’s most recently known for his regular contributions to mobilitywod.com and his new book “Becoming a Supple Leopard”. The Journal was a treasure trove of articles and videos where he details effective methods of doing the workouts safely, AND more efficiently. It was a beautiful system where the better I learned how to perform the exercises safely, the faster I got and the better my workout times.

As I got better at doing the movements safely, my times and my strength improved. As a professional who has been an athlete and has worked with athletes, it is difficult to teach someone how to move safely. However, if the movement makes you better and faster, then it was worthwhile. Safe is not sexy, performance is.

Thus my addiction was validated. I had the information necessary to do what I loved to do with the tools and assurance that I could perform safely, and I’ve done so for the past 5 years.

As I finished school, I realized that I had a different set of eyes then what I had before I started school. I could watch people exercise and see where their movements may lead to future problems. Whether it was weight lifting, jumping, running, or throwing, the eyes of someone who is intimately familiar with the body’s architecture . Though I could see the problems happening before my eyes, I didn’t have great tools to help the person fix the underlying problem that would lead to injury; their faulty movement patterns.

Tilted Overhead SquatBoxJumps

Though my primary focus has never been on athletes or athletic performance, I’ve taken care of quite a few athletes who were in need of Structural Correction. One of the most pressing concerns for these girls and guys is how to stay on the training floor while recovering from injury. They’ve been to numerous doctors that tell them to shut the training down for weeks to months, which is like telling a singer to stop singing or a dancer to stop dancing. They would rather not exist than exist without their passion. While in Chiropractic School, I had teachers who worked with elite athletes from NHL/NFL stars to Olympic sprinters. The problem was their ability to put the information they used everyday into a workable framework to use in practice; it wasn’t workable.

This past weekend, I registered and attended Dr. Kelly Starrett’s Mobility Certification offered through Crossfit’s training program. The course is sold out for months in gyms across the country, and by a little bit of luck, I was able to find some open spaces in my own backyard.

 The Mobility Cert

starrettKelly began the course with a concept that was elegantly described and very familiar to those in chiropractic. Just like chiropractic, many people see the world of Mobility framed around a response to pain. While pain frequently puts people in a position to see a professional or to take better care of themselves, it is a system that is forcing the collapse of the modern health care. The cost of treating diseases like diabetes, heart disease, and stroke are staggering. The worst part is that most cases of these diseases are completely preventable. They arise as a  result from the population treating their bodies poorly for years, and not taking action until symptoms show.

What Starrett is able to do is use simple to use tools that are commonly taught  in chiropractic and physical therapy programs, and make them usable for the public at large using inexpensive tools. Things like trigger point therapy, PNF stretching, and targeted stretching programs have been utilized and provided by PT’s and chiros for years are now available for basic problems of the musculoskeletal system.

 

Now you might be thinking “Wouldn’t giving these tools to people hurt your business?”

On the contrary, I think it makes me a stronger and more credible doctor to teach people how to better care for their own pain. In my world, Structural Chiropractic is not about treating someone’s musculoskeletal pain or Secondary Conditions. It’s about restoring the body back to normal through optimal alignment of the spine. It’s about achieving the full potential of the central intelligence of the brain and spinal cord, because a healthy brain can take better care of you than most any doctor. It’s about returning the person’s nervous system into a state that Starrett called fully human. 

I didn’t get into chiropractic to treat someone’s uncomplicated muscle pain. I got into chiropractic to restore someone’s life to the way it was meant to be lived.

Starrett’s concept of being fully human  is the most elegant description of being fully expressed that I’ve heard delivered to date. Movement is life, and is what drives the function of the nervous system. If the human body is designed to move in certain ways, any deviation or interference to your ability to move takes away from your ability to be fully expressed as a human being. Sure, it means moving pain free, but more importantly, it means moving to the best of your ability, with great performance and intensity.

Finally, and this is something that I shared with Starrett at the seminar, is the fact that I wished professors in school had the ability to simplify these principles of functional restoration in my classes. Kelly’s ability to understand the neurological and biomechanical implications of his material, but make it digestible for regular people to understand was fantastic. He also made it easier to put his material to use by giving people a framework of Crossfit’s basic movements as a diagnostic guide to identifying movement dysfunction in the gym itself.

Where it used to take minutes to identify and understand the cause of someone’s movement deficiencies, I can now readily identify in seconds. Thanks to his concept of using the” gym as a lab”.

K-Star showing Keystone Chiropractic some love

K-Star showing Keystone Chiropractic some love

Whether you’re a professional (chiropractor/MD/PT), a coach, a Crossfitter looking to be in the Games, or just a person looking to become more human, if you have the opportunity to take this certification, make sure you jump at it. Get the tools to help others become Supple Leopards, that way, I can focus on what do best, and that’s Structural based, upper cervical chiropractic.

The underlying theme in all of this? Learn the tools to take the best care of yourself. Take control of your own health, and use the professionals as teachers as the word “Doctor” was originally intended.

Is High Intensity Training (H.I.T.) Right for Me?

Is High Intensity Training (H.I.T.) right for me?

One of the hottest trends in fitness today is focused on something called high intensity training or H.I.T. The basic premise of H.I.T. involves exercising harder in short periods of time while decreasing the amount of volume and time spent exercising. Rather than someone spending hours in a gym working out, H.I.T. workouts typically last no more than 30 minutes, and performed a maximum of three times per week. The coolest part of all?? Scientific studies have shown that people on H.I.T. programs can achieve the same strength and cardiovascular benefits of those who take on moderate and time consuming program.

Pros: Short workouts (<30min), similar results as moderate daily exercise (3x/week H.I.T. = daily moderate exercise)

Cons: Easy to over train if you exercise daily, H.I.T. will put you out of your comfort zone

If you’re the type of person that really enjoys being in the gym, spending time doing reps, and working at your own pace, then H.I.T. really may not be for you. How do I know? Because that used to be me! I really loved spending time in the gym before.

However, for today’s people on the go, H.I.T. has become a great help to stay in shape while keeping my most precious currency; time. Additionally, it helps break routines and help achieve new plateaus in strength.

No matter how you choose to get fit, just remember that regular functional movement is essential to the health of the body and the nervous system. Make sure that you consult with a personal trainer who pays close attention to your form and isn’t compromising the structural health of your spine.

Don’t Pop That Achilles Crossfitters! 13.2 Words of Wisdom

Don’t  Pop That Achilles Crossfitters! 13.2 Words of Wisdom

Open 13.2 is a fast and furious workout that can leave you open to injury. Prep properly this weekend!

The Crossfit Open is a call to all Crossfitters to challenge their fitness levels and compare themselves to the best athletes around the world. With that being said, it’s safe to say that we are not all in the same class as Rich Froning, Annie Thorisdotter, and company where our livlihood is dependent on your Games performance. I may get some bad feedback from some people in the Crossfit community for this, but I have to say what is right from my perspective as a health care practitioner.

Let’s take a look at 13.2:

Complete as many rounds and reps as possible in 10 minutes of: BoxJumps
115 pound Shoulder to overhead, 5 reps
115 pound Deadlift, 10 reps
15 Box jumps, 24″ box 

 

 

 

On the surface it looks pretty tame. It’s a manageable weight for most people to go overhead for 5 reps, and it’s a very light weight for a deadlift at 10 reps. It’s really the box jumps that concern me this week.

Most Crossfitters take the approach of bounding up and down off the box in a plyometric fashion. It’s certainly the fastest way to progress through the reps, so if you are one of the handful of people serious about getting into Regionals, then maybe this is right for you.

The good thing about this guy is that his achilles won't rupture

The good thing about this guy is that his achilles won’t rupture

 

Now for the 95% of us who are doing this for fun, and Regionals isn’t even in the back of our mind, please read on.

Here’s the problem. Large volume of box jumps can put a tremendous amount of strain on the achilles tendon. If you don’t  believe me, just google the terms “Crossfit and box jumps and achilles”. In fact, several of the open WoDs from years passed have all seen spikes in achilles tendon injuries following a high volume box jump WoD.

Does that mean Box Jumps are a bad exercise?

No! Box jumps are great! They develop power in your lower extremities, make you more explosive, and add a great cardiovascular dimension to any WOD.

The problem is that our achilles tendon and our knees aren’t structured to handle sheer volume of that high impact/bounding movement. They were meant for powerful short burst movements.

 

First, here are ways to save your achilles from the box jump:

1. STEP DOWN FROM THE BOX – if it’s good enough for Julie Foucher, a future medical doctor and well known Crossfit machine, then it’s good enough for you. Watch how she did the WOD and you will see that she stepped down for every rep.

2. Warm up your calf and achilles thoroughly. Heel/toe rocking and stretching the achilles on the wall are important warm up routines for any plyometric routine.

3. Land with your feet flush on the box. Read about it here.

 

Second, check out this video by crossfitmobility.com for some strategy and mobility techniques to help prep your body for this burner.

 

YouTube Preview Image

 

Have a great WOD everyone, and most importantly, stay safe. Just remember this:

You will never remember that you placed 1000 in the world at Crossfit, but you will never forget that time when you couldn’t WOD for 3 months.

Is This Silent Problem Killing Your Workout?

Killing Your Workout

Structural Abnormalities and Lifting Efficiency

Anyone that knows me or has been following my work knows that I’m pretty passionate about exercise and fitness. Today’s blog is not about the benefits of exercise; at this point, I think we all have a good grasp of that concept. Today is about identifying road blocks that may be making your workouts less efficient, and more prone to injury.

But first, let’s take a look at a couple of pictures:

A Squat with a tilted pelvis will cause the weight overhead to be tilted as well. The body will absorb the compressive stress of gravity unequally.

A Squat with a tilted pelvis will cause the weight overhead to be tilted as well. The body will absorb the compressive stress of gravity unequally.

Level weight, level pelvis, gravity acts on the structure of the spine equally.

Level weight, level pelvis, gravity acts on the structure of the spine equally.

 

 

 

 

 

 

 

 

 

 

 

Now looking at each of these pictures, let’s ask a few questions:

Which lifter is going to be more efficient?
Which lifter will be able to support more weight in the squat position?
Which lifter is likely to reduce their chance of injury?

My money is on the lifter on the left. It just makes sense. A level foundation is a critical element to power lifting. It’s not optional.

Now this is a problem that can be fixed by many approaches. It can be addressed by fixing some issues involving technique. It may be a flexibility/muscular issue. It can be a wide variety of things. My job is not to become your new strength coach, physical therapist, or trainer. If you are having issues in those departments, then seek your appropriate professional.

However, in many cases that I see in my practice, the problem is a Structural Abnormality. While most people will look at someone’s lifting posture on the surface, I’m actually assessing what they look like on the inside. If they look like this image on the right, then no amount of training or therapy is going to help protect this man’s lifting ability.

A structural x-ray assessment of a near normal pelvis and spine.

A structural x-ray assessment of a near normal pelvis and spine.

A structural x-ray assessment shows that the pelvis and spine are clearly tilted to the left. Can this affect a lift?

 

 

 

 

 

 

 

 

 

 

In the past few years, I’ve had the pleasure of working with dozens of ball players,  triathlon athletes, runners, power lifters, and Crossfit athletes. With the sheer amount of training and work that they put their bodies through, structural abnormalities can be almost inevitable.

The worst part is that many times, shifts like these can occur without pain or secondary conditions. Athletes are typically looking for a performance edge. To run a little bit faster. To lift a little heavier. To throw a little farther. All of which requires a normally functioning spine and nervous system.

Think about it, if your body was like a house  would you ever allow the foundation to be built unlevel? Of course not. The house would come apart. Then once that starts affecting vital structures like the plumbing and electrical system, then you REALLY have a problem on your hands.

If you’re serious about achieving new strength/fitness goals, and if you’re serious about the long term sustainability of your body, then a structural assessment will be a critical part to your growth as an athlete.

Can Running Hurt my Structure?

Can running hurt my structure?

Running is #1 exercise of choice for people seeking to increase their fitness. Programs like Couch to 5k have spurned millions of Americans to strap on some running shoes and hit the streets toward better health.

However, running is the most common source of sports related injury in the country. Injuries to the foot/ankle, knee, hip, and low back can often side line a runner for weeks, while knocking the wheels off their fitness goals. I see this far too often when taking care of runners with chronic injuries.

Running like this over time will cause structural shifts, and pain. What's wrong in this picture?

Running like this over time will cause structural shifts, and pain. What’s wrong in this picture?

Many times, the problem isn’t the sport itself, but the way the sport is performed. Improper running form from poor running posture or repetitive heel striking are the most common culprits. Over the course of dozens of miles, heel striking can jar all of the joints of the lower extremity causing the spine to shift out of place. Of course, once the spine shifts out of place, then secondary conditions will inevitably result.

So how can you make running safe?

  1. Change your form. Go to your local running store like “The Runner’s Depot” which usually give great classes on Natural Running, POSE, or Chi Running.
  2. Evaluate your footwear. If you’re wearing the wrong shoes, then you will continue to get injured. Most local running stores have experts ready to fit you for the right shoe for your specific foot.
  3. Get checked for any underlying structural shifts that may be causing weak running posture and reduce your body’s ability to heal and repair.

Don’t let injury knock you off track from your weight loss and fitness goals. Run long, and run safe.

Ladies. I know you're just admiring my form....my running form

Ladies. I know you’re just admiring my form….my running form

ALSO. There’s a FREE intro to Chi Running at the Runner’s Depot Store in Davie on Saturday February 9th.

Chi Running Class
11:00AM – 12Noon
Runner’s Depot – Davie
Learn proper running form that will keep you performing your best and running injury-free. Certified Chi Running Instructor, Dr. Alan Miller will explain and demonstrate the proper technique for good running form and run you through some quick drills that you can use in everyday practice to keep you running healthy and happy!
FREE Class – Open to Everyone – Limited Space
Call now to reserve your spot – (954) 474-4074