3 exercises to do NOW to help fix your “work from home” posture

It’s day 1,329,902 of quarantine. or at least it feels like it some days.

And while I know many people have figured out a “better” desk or work space situation by now, our bodies are still taking a toll. We have seen an increase in low back and neck pain in our office in the past few months for sure. 

Granted…we’re chiropractors, so we DO see those conditions often, but as a sports practice we see many more shoulder and knee issues on average that issues with posture.

Below are three things you can do RIGHT NOW to help get your body moving again.

Get up and do at least ONE OF THEM NOW.

These are designed to be quick exercises/mobility drills that you can fit in throughout your day OR do as a series. Whatever you want. Just do them.

1. Snow angels

For this drill you will need a foam roller. If you don’t have a foam roller, you can use a stack of pillow or blankets. 

Lay with your back pressed flat into the roller and arms stretched out by your side, palms towards the ceiling. Begin to move your arms in a snow angel pattern, keeping your hands in contact with the ground. Just go up to about where you feel a stretch in the pecs and then return your arms back down by your side. It is important that you’re not trying to FORCE the arms up into the overhead position. 

Keep the arms moving up and down slowly for 2 minutes.

This is a great drill to open the chest, stretch the pecs, AND move the scapula around the ribs and thoracic spine, promoting good shoulder mobility. Do it after a long day at the desk.

2. Couch Stretch 

The couch stretch is one of the “go-to’s” for lots of crossfit coaches, chiros, or PT’s when a patient/athlete reports low back pain, and for good reason. When done properly, this stretch allows the hip flexor tendon and psoas to lengthen; decreasing tension on these muscles which can cause pulling into the low back. 

Yes, that is my dog on the couch behind me, not a fuzzy blanket.

Kneel down in from of your couch, or just on a pillow with a wall behind you. Keeping one knee on the ground, bring the other knee up into a lunge position.

The KEY here is that you MUST keep the glute of the knee which is on the floor (the hip flexor you are actively stretching) SQUEEZED. 

When you keep that glute squeezed, it allows the front side of the hip to relax (it’s called reciprocal inhibition if you must know).

Hold each side for 1-2 minutes, adding in the arm over-head position as demonstrated in the picture if you need some extra oomph. 

Make sure that you are keeping your back nice and neutral and not over-arching your back when you do this stretch.

3. Superman Holds/reps

After sitting for much of the day (let’s be honest, even if you have a standing desk, we end up sitting a lot as a culture) we could all use some posterior chain activation. I like these exercises because there are endless possibilities…okay, maybe not endless, but at least three. 

Option 1: Just hold

Start by lying on the ground on your stomach. Keeping your hight squeezed together, lift both your lower body and your upper body slightly off the ground using your low back and your glutes. Keep your neck in a neutral position so it’s not cranked up towards the ceiling. Make sure that your stomach/core is engaged…think of this as the way you might tighten your stomach is someone was going to punch you in the stomach. You don’t need to actively pull the bellybutton in or push it out. 

A good place to start is 3x 30 seconds of holding.

Option 2: Reps

Start in the same position, but this time lift the upper body and the lower body from the floor at the same time with a 1-2 sec hold at the top. Repeat  2-3 sets 10-15x. 

Option 3: Alternating reps

An oldie but still a goodie. Alternate back and forth from lifting the left leg and right arm together, then right arm and left leg together. Start with 3 sets of 10 reps each side. 

Of course, if you need extra help our doctors at Seattle Sports Chiropractic are always here for you! let us know what you think after giving these a try!

The Top Three Mistakes I see in Experienced Crossfitters: Part 2

Part 2: Initiating the squat with the knees

First of all, I can’t EVEN with the above picture. Hope you enjoy it as much as I do!

Moving on.

Hopefully you read part one of this article; if not you can do so HERE. 

The second squat fault that I see in experienced crossfitters is initiating the squat with the knees. At first, it seems like this would be a rookie mistake, but in reality it can be SO SUBTLE that even the strongest squatter might not realize they’re doing it. 

I like to tell my patients who are learning to squat “whichever joint moves first will move the most.” It’s a good reminder for those of us who have been squatting for years as well. I say this to mean, if you start the squat by breaking at the knees, instead of sending the butt backwards, you are MOST likely going to overload the anterior knee and not engage the booty as much as you wish you were (or I wish you were.) 

Initiating the knees first also makes it MUCH more likely that you are going to end up with your knees in front of your toes at the bottom of your squat, especially if you have good mobility.  

Letting the knees travel in front of the toes is a controversial topic if you are a movement-nerd like me, but in my CLINICAL experience, the more you can keep you knee in line with the toes (vertically speaking)  the less likely you are to end up with knee pain from squatting.

In my experience, it takes a LOT of squats to finally feel that overload that is occurring at the infrapatellar tendon, but once you do, it is hard to alleviate it without CHANGING the way you squat.

It doesn’t get that way over night, and it doesn’t fix itself overnight either.

Another way to keep from overloading the anterior chain (quads and knees) is to ever-so-slightly lower the bar on your back. There is a reason that power lifters chose a low-bar back squat over a high-bar back squat; you’re able to load more weight into your posterior chain (glutes and hammys) this way. I’m not suggesting everyone adopt a low-bar position, just simply roll the bar 1/2 inch down the back to use a kind of hybrid-position. This will help center the weight more over the center of your mass.

So next time you’re squatting, have someone watch you or set up your phone and film yourself. Make sure that you are breaking SLIGHTLY at the hips first instead of at the knees. It is a relatively easy fix that can alleviate a lot of knee pain down the road.

Look out for Part 3 next week!!

The top three squat mistakes I see in experienced crossfitters

By: Karlie Causey DC, MS, CCSP, CSCS

Part ONE

I started writing this post after addressing PRACTICALLY the same issue in 7 different athletes in just a few days in my office. None of these athletes were games athletes but none of them were beginners either. On average, they had all been doing crossfit for 6 years, and most  have competed in small, local competitions. I also noted that most of these athletes have above average 1RM squats and are the type of athlete who sort of gets overlooked by coaches in the gym, because there is always someone newer and greener who REALLY needs attention.

As I started to think through other patients/athletes I had seen with similar issues, I realized that there were definite patterns of compensation that if addressed, could help reduce the need for these guys to come into my office for treatment in the long term. 

It might be bad business sense for me to write this post, but I’ve never been a very good business person and I’m a pretty damn good doctor. 

So here goes. Here is part one. Read on and squat on. 

Squat fault numero uno:

Poor whole foot/big toe engagement 

When we first learn to squat, it seems that coaches emphasize keeping the weight in the heels. I can’t count how many athletes (of all types) I have heard repeat this mantra. But in reality, we want the entire foot on the ground for good balance and to actually recruit the lateral hip muscles. You may also have heard the cue “screw the feet into the floor.” Perhaps without realizing it, these coaches are asking their athletes to engage their intrinsic foot muscles, and NOT just keep the weight in the heels. 

When we press the big toe into the ground and pull it back slightly (I like to use the cue ”act like you’re wiping gum off the bottom of your toe”) we engage the arch and cause the foot to supinate. This causes a chain reaction; driving the knees out as well as firing the muscles in the lateral hip and increases stability in the entire chain.

Think of your foot as the base of your support. Because… it is. It doesn’t make sense that you wouldn’t want weight evenly distributed and muscles turned on during the entire range of motion. I’m not suggesting you be forward on your toes, I’m simply recommending you get the rest of your foot in on the squat party, and not leave all the fun to your heels. 

I should also note that working on engaging the foot works best WHEN YOU ARE BAREFOOT. Too many of us are in shoes all the time. Our feet have a lot of sensory receptors in them, which essentially get shut down or “quieted” because we are constantly in shoes and socks. Take off your shoes AND your socks and squat BAREFOOT. You will quickly become more aware of what your feet are doing while you squat, and how different it feels to keep the big toe engaged through the entire squat. 

I often have patients with knee pain switch over to barefoot squatting because it immediately increases their awareness of what their entire lower extremity is doing and helps them automatically fix or recognize compensation patterns. 

It should be noted here, that not everyone is blessed by the mobility-gods. In our office, we encourage those who are working on barefoot squatting and squat re-patterning to not worry so much about their depth or range of motion at first. It can also be helpful to use a bench or a box to squat to; this gives your booty something to reach for (more about that in upcoming posts). It should also go without saying (but I’ll say it anyway) that while working on making these small changes, it is ideal to lighten the weight/load.

If you're wondering, the chief complaint of the athletes mentioned earlier when presenting in my office was KNEE PAIN.

Read on next week for more tips of fixing your squat as well as potentially reducing knee pain.

Keep on squatting my friends. 

Bro, Do you even Breathe?

Poor breathing habits can impact your ability to think, move, exercise/workout, and manage stress.  One breath can impact your body for a full 7 minutes. Breathing is essential to our existence and without proper oxygenation, your tissues suffer and disease develops. Yet, something so obvious and simple is misunderstood and often not performed correctly.  Humans are born with a natural ability to breathe well, but through life experience and in-experience, many people develop poor breathing habits.  

Come to our Health & Fitness Fair Jan 27th, 10am - 3pm, to learn from Tamara Gillest (Certified Buteyko Method Instructor and Yoga Therapist) some tips on healthy breathing habits regardless of whatever activity you are doing.

Shoulder Risk?!?!

Do you have pain, popping, clicking or limited mobility in one or both of your shoulders? Do you find yourself endlessly rolling your shoulders with a lacrosse ball or foam roller, only to make limited improvement? Maybe it is time to have someone check that out for you!

At our Health & Fitness Fair on January 27th, 10am - 3pm we will be offering the opportunity for individuals to have a brief shoulder evaluation including multiple orthopedic and functional tests to give you an idea of what may be going on with your shoulders.  We will also be sure to give you some tangible homework and take-aways on how you can make improvements on your own at home!

If you would like to participate in the Free Assessment sign up through our website <here>

Inside out Risk?!?!

If you are interested in determining your risk of disease from the "inside out" you should join us at our Health & Fitness Fair on January 27th, 10am - 3pm.

In addition to our physical injury risk assessments, at our Health & Fitness Fair on January 27th, 10am - 3pm, we will be offering the opportunity for individuals to get a simple blood draw from Dr. Ryan Campbell, ND, LAc.

Dr. Campbell will preform the simple blood draw at the Fair, and then when he gets the results from the Lab a few days afterwards, he will follow-up with a 30min phone call to advise you on the results.  The blood draw will include:

• Complete blood count (red and white blood cell counts)
• Comprehensive metabolic panel (includes blood sugar, electrolytes, liver and kidney function)
• Lipid panel (total cholesterol, triglycerides, LDL, HDL, non-HDL)
• TSH (general thyroid function)

Fasting 9-12 hours before would be ideal, but not 100% necessary. Not fasting will potentially affect fasting blood sugar and triglycerides; but if we know the individual hasn’t been fasting we can interpret the labs appropriately.

This complete, but simple blood draw, with the 30 minute follow-up phone call, which can normally cost upwards of $200, is only $45 at our Health & Fitness Fair.

If you would like to schedule your time to get this blood draw, sign up through our website <here>

More Risk?!? (What Risk?)

Over the years, a very prominent tool for determining an individuals risk of developing a sports or activity related injury is the Functional Movement Screen (FMS).  With this low-tech test, a qualified practitioner can assess your risk, and then give you specific recommendations on things you can do to reduce your risk of injury.

We are fortunate to have on our staff, Dr. Nate Moore DC, who is qualified and certified to administer the FMS.

At our Health & Fitness Fair on January 27th, 10am - 3pm we will be offering the opportunity for individuals to take this simple test, and from there be giving specific HomeWork on how to decrease your risk.

If you would like to participate in the Free Assessment sign up through our website <here>.

Beardsley, C., & Contreras, B. (2014a). The Functional Movement Screen: A Review. Strength & Conditioning Journal, 36(5), 72-80

What's Your Risk?!?!?

In 1964, Jørgen Hansen conducted a study in which he found a simple test, that requires no special equipment, that can determine an individuals risk of developing Low Back Trouble (pain, dysfunction, weakness, etc.).  Since then, numerous other studies including the landmark study by Biering-Sorensen in 1984, have examined the validity, reliability, and reproducibility of the original work by Hansen.

This simple test is now referred to as the "Gold Standard" to determine an individual's risk of developing Low Back Trouble for up to a year afterwards.

At our Health & Fitness Fair on January 27th, 10am - 3pm we will be offering the opportunity for individuals to take this simple test, and from there be giving specific HomeWork on how to decrease your risk.

If you would like to participate in the Free Assessment sign up through our website <here>.

References:

Jørgen W. Hansen (1964) Postoperative Management in Lumbar Disc Protrusions: I Indications, Method and Results, II Follow-up on a Trained and an Untrained Group of Patients, Acta Orthopaedica Scandinavica, 35:sup71, 3-47

Biering-Sorensen (1984) Physical Measurements as risk indicators for low-back trouble over a one-year period, Spine, 9(2), 106-119

Movement Of The Whenever - Twists

1 of the 7 (or 8) basic human movements, and one that gets overlooked quite frequently in a majority of training programs.

Why “resting” an injury is dumb.

First things first.

 I am not telling you to keep squatting on an ACL that you blew out last Sunday while skiing.  Or to not take the proper time post surgical repair to let things heal.

What I am referring to is the following type of situation. Imagine if you will:
Your knee has been hurting you for a few weeks. Mostly when you run, but increasingly when you’re just walking, especially upstairs. There was not trauma to your knee; it just started slowly over time.
You go see your doctor (primary care, physical therapist, chiropractor, pick your poison) and they tell you there is nothing seriously wrong (great news!)  and you should “Take some ibuprofen, give it a break and rest it for a few weeks.”

Wait, what?

YOUR KNEE DOESN’T NEED A BREAK, IT NEEDS ANSWERS!

This boils my blood, and if this scenario sounds ridiculous and incomplete to you, that’s because it is.  

Taking ibuprofen will help with the inflammation (more on that some other time…) which may help you move better, and more pain free, but this is only a valuable tool if you are also given the rehab exercises to be performed while moving better.

Taking “time off” when nursing an injury doesn’t do jack squat if you don’t do something to FIX the injury.

If my bike had a flat tire, and I put it in the corner to “rest” for two weeks and then tried to ride it again, the tire would still be flat and I would just look like an idiot.

If you take two weeks off of your preferred exercise routine, but don’t do anything to change the current condition of the injury, then you are going to go back to your fitness routine de-conditioned, in worse shape than you started,

AND YOU WILL STILL HAVE AN INJURY.

Insert exercise modification and rehab exercises here.

In the scenario listed above, there are SO MANY things we could look at to help this athlete/patient make improvements...

What does your running gait look like? Do we need to make changes to your gait so that you don’t continue to overload your knee?

How is your hip strength? Are there exercises we could give you to stabilize the hip and knee long term?

What’s going on with the other leg and/or both ankles? Do you need increased ankle mobility to take stress off of the injured knee?

In my opinion, any athlete (and yes, I believe we are all athletes in some way, shape, or form) who has been told to stop doing what they love without being given something to help move them move towards healing, has been done a disservice.

So let’s dig a little deeper next time an injury pops up. 

Sometimes it is something as easy as getting a specific stretch or dynamic warm up from a coach or personal trainer and sometimes it takes a medical professional evaluating your movement patterns and then giving you some homework. Either way, let’s try to patch and fill the bike tire instead of just letting it “rest” pathetically in the corner with dirty laundry hanging off the handles.

Biering-Sorensen, Broken Record, & Back Extensions

Open workout 17.1, otherwise known as Biering- Sorenson told you so…
Across the board, from beginner to elite, the most common comment I saw regarding the 17.1 WOD is the after effects of a tired, tight, and/or downright painful low back.
From what I observed, in the handful of people I saw doing the WOD, the reason for this is the natural rounding of the low back that occurred as every competitor reached fatigue.
We spend the overwhelming majority of our time during workouts attempting to maintain midline stability, keeping our backs 'set', and engaging our posterior chain. During CrossFit, and weightlifting, a rounded low back is a crime punishable by a beating with a PVC stick and lots and lots of burpees.

The problem occurs when we get appropriately fatigued, and start losing our midline stability and 'set' back during intense efforts like those displayed during the 17.1 WOD.  Because, as we know, if we don't train the movement we will not be very good at the movement.

This is where the Biering-Sorensen, otherwise known as the back extension, exercise comes into play. During the 17.1 WOD the risk of low back rounding potential increased as people approached 150 reps. So the only way we could have prepared for 150 rounding of the low back, is to practice 150 roundings of the low back.  Which most people do not.
If you know me, and my cohorts at SODO CrossFit – Darrick and BeckyJo - you know that we preach the gospel of high repetition back extensions. And now you know the reason.
When performing a back extension repetition properly the pelvis and hips are blocked and the majority of movement comes from the low back. This is very similar, if not the same, as the rounding of the low back that occurs normally during high-intensity workouts and/orcompetitions.
In addition, from a performance standpoint, if you felt as though your low back was limiting your ability to go longer or faster during this particular work out, that most likely was the cause.  So high rep back extension training, could have prevented the post competition low back blues, as well as improved your performance.
So, it's too late now for 17.1, but going forward remember that back extensions, specifically higher repetitions (in the 100+ range), are not just for clinical low back pain treatment.

New Introduction Video!

A new, succinct, video explaining what Dr. Ross and the gang do here at SODO Health & Performance.

Done for us by the great team at:

CHRIS LANDRY
PHOTO & VIDEO PRODUCTIONS
Commercial & Advertising Media
 http://www.landryphoto.com

Phelps Cupping???

Copyright Sports Illustrated, 2016

If you have been watching any of the Olympics, you have undoubtedly seen the circular'bruising' on Michael Phelps (and other athletes).

While there are many well documented & anecdotal benefits to "cupping" by Chinese & Oriental Medicine Practitioners (OM), there is not a lot of science/data to support it.  In OM, the thought is that the 'cupping' can affect the flow of energy, blood, and/or Chi.  In the Manual Therapy world, we utilize 'cupping' to provide a level of decompression to the tissues in the hope that this will aid in the break-up and reduction of adhesions and/or scar tissue in the underlying fascia and/or muscles.

Dr. Ross has been utilizing 'cupping' with a suction device and 'cups' for 12 years in his clinical practice.  In combination with manual therapy, the results appear to be more beneficial than with manual therapy alone.

Here is Dr. Ross applying 'cupping' to BeckyJo (one of the owners of SODO CrossFit & CrossFit RE)

The cupping leaves the distinctive circular bruising on the skin.  In 12 years of cupping, Dr. Ross has never seen clotting, permanent damage, and/or any other ill effects from the use of suction/cupping.

Here is the typical bruising:

Dr. Ross explains it as helping to 'tease apart' the adhesions and/or scarring that results from a wide range of tissue trauma (acute injuries, overuse injuries, trauma, etc.).  Whereas, manual therapy aims to separate tissue layers, adhesions, and/or scar tissue, through the application of a specific force along the muscle and fasica layers, the action of cupping is to pull apart the layers.

In the following photo, the drawing above is demonstrating the cup pulling apart the layers of tissue, while the drawing below (where Dr. Ross is simulating the application of manual therapy with his thumb) is demonstrating the separating of tissue layers with manual therapy.

If you have any questions about cupping specific to manual therapy, feel free to contact us at office@sodohp.com

Strong Foot, Strong Mind.

When talking about the Fulcrums & Levers of the body and the relationship between these and injury prevention as well as performance enhancement, it all begins with the Fulcrum & Lever closest to the ground, the foot and ankle.  In the human functional body, the foot is designed to provide stability, while the ankle is designed to provide mobility.  Without stability of the foot, the body will attempt to 'compensate' and find the stability somewhere up the bio-mechanical chain in order to push, pull, squat, lunge, twist flex, or extend, whether in the gym or in everyday life.  The next link in the chain up the body is the ankle.  With an unstable (weak) foot, the ankle will try to take up the slack and may become locked up and function will be decreased. In order to prevent this from occurring, a relatively simple fix is to strengthen/stabilize the foot (fulcrum) so that the ankle can maintain it's mobility.  A very common exercise (and well researched) is the "Short Foot" (as developed and popularized by the very famous orthopedic researcher, Vladimir Janda - <link>).  Around here at SODO Health & Performance we like to call it "Strong Foot" (sounds more fun!).

The basic premise is to strengthen the 'intrinsic' muscles of the foot, thereby taking the demand off the ankle (and further structures up the bio-mechanical chain of the body).  <StrongFoot link> Practicing this daily, in bare feet, can improve the stability of the foot and therefore improve overall function, performance, and decrease the risk of injury.

Dump NOT Drop

Working immediately next door to SODO CrossFit has its up and downs.  All day I get to hear people making their lives better 'one workout/rep at a time".  It is truly motivating.

However, what I hear and observe quite often that concerns me is the habit of "dropping" the barbell.  Especially with heavy deadlifts, and when the workout calls for heavy weights overhead, the common trend of letting the loaded barbell "drop" is extremely dangerous to the training of the athlete.  I am not talking about the dangers of a falling weight landing on something or someone.  What I am referring to is the lack of effective training that is occurring when people miss out on a very important, and very "injury preventative", aspect of the workout movement.  For this reason, athletes should "dump" the weight when needed and not "drop" the weight when they are done with their workout movement.  Here is what I mean and why.

In any functional muscle contraction (during a workout) there are two phases of the movement/muscle, the concentric (shortening) phase and the eccentric (lengthening) phase. In a deadlift, for example, the concentric phase (mainly for the hamstrings, glutes, and low back) is the phase of lifting the barbell off the ground to your waist.  The eccentric phase is when the barbell is lowered back down to the ground.  Science tells us that a very important part of a workout movement is the eccentric loading phase.  The eccentric phase is when the most loading of the muscle occurs and when the most force is produced in the muscle.  Research has shown that this phase of the movement is also the phase that provides the most injury prevention to the muscle.  In a nutshell, this is because most activity-related muscle injuries occurs as the muscle is being lengthened (eccentric phase) and the most effective way to prevent injury during this phase is to train this phase, i.e. train the lengthening (eccentric) phase of the movement.

When a barbell is dropped two things occurs.  Puppies die a miserable death, and the eccentric phase of the muscle contraction is NOT trained.  Performing a deadlift and lifting the bar to your waist and then dropping it back to the ground only trains half of the process, the concentric phase of the movement.  This is only half the job, and leaves out the injury prevention aspect of the movement/workout.

This is NOT to say that you should not "dump" the weight when in a dangerous situation.  This is completely different from "dropping" the weight because you choose to.  Dumping a barbell should not be a choice, it should be a necessity based upon risk of injury.

The old adage, "don't pick it up unless you can safely put it back down" is a great rule to follow in order to improve your injury prevention aspect of your workout.

Dr. Ross's Coffee

CrossFit "PreHab"

Quite often, other physicians and practitioners ask me about CrossFit.  Specifically, the dangers of CrossFit and also where I think it is going as a health and physical fitness endeavor.  Both of these questions have the same answer.

On a weekly basis I see at least 10 or 12 patients who regularly 'do CrossFit'.  Of these, approximately 75% have an injury that they think may have been associated with their CrossFit activity.   Most of the time, as I explain to my patients, the specific act of CrossFit does not cause the injury, it merely brings their weakness to the surface and they get injured by doing something that they have not done very often and thus can not do very well.  Out of a full week of life they are doing these challenging CrossFit movements, that are out of their norm, at most 4-6 hours.  This equates to about 3-4% of their weekly activities of daily living.  No matter how careful you are, how great the exercise/movement is for you, and/or how great of a coach you have, doing something mildly to significantly challenging for only 3-4% of your week means that you will not be very good at it and thus your risk of injury is increased.

Our lives of sitting more than we want, using "iObjects" (phone, computer, tablets, etc.), and not being as consistently active as we would like (or nearly as active as our grandparents) has put us all way 'out of balance' in terms of health and especially fitness.  It is a constant struggle for all of us to maintain a base level of health and fitness in our busy/successful/over worked/under recovered/couple ofkids/compromised nutrition lives.  If we go into our favorite CrossFit box in this 'out of balance' condition and get "better, faster, stronger" over a period of time, we end up being better, faster, stronger, yet still out of balance.  This equates to an increased risk of getting injured, because no matter how heavy our 1RM deadlift, we are still out of balance and that is what causes injury.

 Which leads us to what we do here at SODO Health & Performance.  We take our patients through, what we now refer to as, CrossFit PreHabilitation (CrossFit PreHab).

 As opposed to rehabilitation AFTER an injury occurs, the goal is to PREvent the injury through focused specific exercises that address weak areas that might otherwise result in injury upon undertaking CrossFit, or any other number of physical activities.   Unfortunately, it does not appear to be effective enough to simply incorporate some 'warm-up' or 'joint-prep' movements/light activities prior to a CrossFit WOD.  Because we are already starting out in a deficit or 'out of balance', we need to put significant time and effort into re-balancing ourselves before we, or as we, start to undertake the challenging demands of CrossFit.  Yes, this means a return to some isolation exercises targeted at strengthening weak areas, weak biomechanical functions, and/or weak functional capacities.

The majority of injuries I see in CrossFit members here at SODO H&amp;P, are most effectively treated with specific therapeutic exercises AWAY from their regular CrossFit WODs.

In addition, more and more, I am having individuals come to see me for homework to balance out their weak areas AS they are starting CrossFit.  Many of them still have existing membership to a 'globo-gym' and this works perfect for doing 2 days per week of PreHab while ramping up/into 3 days of CrossFit.  After a couple of months, they transition fully (5-6 days per week) into CrossFit and are able to maintain their physical fitness 'balance' with the incorporation of some of their specific PreHab exercises into their warm-up before class.  By prescribing specific PreHab homework we have seen a significant reduction in injuries from CrossFit as well as other challenging workouts and exercises regimens that our patients/athletes undertake.

A great deal of the PreHab programs center around our focus on the Fulcrum -> Lever -> Sport continuum.  In order to do sports, you need good strong levering ability, and in order to have good strong levering ability you need to have durable fulcrums to support them.  Not a strong core, but strong fulcrums of the body, specifically durable scapulo-costal fulcrums and durable lumbo-pelvic-hip fulcrums (the subject of other blog posts here).

For CrossFit to have longevity, keeping people able to participate is paramount.  We have found that this is achieved through decreased injuries associated with CrossFit.  An injured member/athlete will cancel their membership and go find something else.  Pain free members/athletes stick with it over the long term and have better results.

Dr. Ross Breakfast.

Apple Cider Vinegar

Four Powerful Uses for Apple Cider Vinegar
By Dan Riley

Yes, you can clean your windows with it and use some in your salad dressing. However the amazing thing about apple cider vinegar, (ACV) is how your body can use it for powerful results, inside and outside. Below are some specific uses however many people use as a daily preventative tonic and for general wellness. The information presented here is based on using raw ACV.

Colds & Sinus. At the first sign of symptoms, mix two tablespoons in a glass of water and drink this twice per day, preferably on an empty stomach. Many people report relief within a day or two, sometimes almost immediately. Add a teaspoon of honey to the mix for a tasty beverage.

Indigestion & Heartburn. ACV is a PH balancer in the stomach and helps alleviate the over or under production of stomach acid, which we need for digestion but can lead to stress in some cases. Mix the ACV in a glass of water and take immediately.

Hair & Dandruff. The vitamins, minerals and acids in ACV are particularly useful to our scalp and hair. Mix with water or apply directly to the hair - leave on for an hour or less then rinse. Do this once a month for shiny, healthy hair and relief from dandruff. No chemical dandruff shampoo needed!

Better Sleep. The results most likely are related to the mineral content, both potassium and magnesium, as well as the the calming effects on the digestive system. Before heading to bed mix two tablespoons in water and add honey if preferred.

Read hundreds of actual user testimonials, for and against the use of natural remedies at www.earthclinic.com/remedies/acvinegar   Be warned however. This site can be a serious time-sink because of all the great stories from users all over the world.

A "Take Home" item from a recent Lecture

So my notes from a recent lecture, "Performance Eating for Endurance Activities", are simply notes for me and don't mean much to anyone else reading them. Merely outline headers as prompts for me on the information that I wanted to share. But, here is one of the main take-home items from the overall information:
Reduce Inflammation for increased Endurance Capacity in Life.
Here's why and here's how...

The Why.
When it comes to food and our bodies there are two major factors that underline everything else: "Absorption and Utilization".
Basically, in order to 'utilize' anything that we consume, we need to be able to effectively (and hopefully efficiently) 'absorb' the food, water, vitamin, supplement, etc. into our body through our gastrointestinal tract. In order to rebuild muscle, rehydrate, and/or heal from injury or working out, we need to be able to get the nutrients into the bloodstream and then dispersed to the correct tissue or organ.
This happens through food or supplement being broken down into it's basic components (protein, carbohydrate, fat, water, vitamin, and/or mineral) and binding to the appropriate receptors on the intestinal lining. If the item does not bind to the appropriate receptor then it continues through the intestinal tract and comes out as an "expensive urine or bowel movement". Expensive because the high quality, organic, "free-range", grass-fed, or expensive supplement or vitamin goes straight through the body and is not put to good use.

One of the two ways that Inflammation can negatively affect your Endurance Capacity is to inhibit the absorption of the food/supplement item.
The lining of your intestinal tract has millions of tiny finger-like projections, called villi, that have the receptors for the basic components of food to be absorbed through on their surface. Using a hand and finger-like analogy, these receptors are all over each finger including down in the webbing between the fingers/villi. In the presence of an irritating substance, these villi become irritated and inflamed and much like a hand swelling up from inflammation, the receptors are 'covered up' by the surface of the swollen finger(s) on either side. The number of receptors that are available and accessible for the food components to be absorbed through are significantly reduced. So, as an example, if there are 100 items to be absorbed, the reduced number of accessible receptors means that perhaps only 50 of the items will be absorbed. Less absorbed means less transported through the intestinal lining and into the bloodstream and therefore, less utilized. So, whatever 'expensive' supplement or food you take in is not fully absorbed and therefore not fully utilized. A specific example might be someone who wants to benefit from a specific and researched supplement X. The research says that the correct amount of X to take in order to see benefits is 2 grams. Well, with the scenario outlined above, the 2 grams is consumed, but only 1 gram of X may be absorbed and therefore the benefit will not be seen. The conclusion might be, "The supplement X does not work for me...". When in fact it would work if it was properly absorbed.

The second way in which Inflammation can negatively affect your Endurance Capacity is through a protein secreted by the Liver and fat cells called CrP (C-Reactive Protein). CrP is secreted in the presence of inflammation which the body interprets as irritation and/or injury. CrP has been linked to increase occurrence of cardiovascular disease, diabetes, high blood pressure and cancer. Bad stuff to say the least and big detriments to Endurance Capacity. Irritating, and therefore inflamming, the intestinal tract can increase the production of CrP which causes a myriad of other health problems which negatively affects your Endurance Capacity.

The How.
How do you decrease the likelihood that this will happen?
Simple, eat "Food".
Food, made up of protein, carbohydrates, fat, water, vitamins, and minerals is easily absorbed and utilized by the body because the intestinal tract does not get irritated when it is consumed.
What does irritate the intestinal tract is "non-Food".

Here is a short list of "non-Food" items that irritate and inflame the intestinal tract:
Partially Hydrogenated ______
Modified ______ Starch
Autolyzed ________ Extract (MSG)
Hydrolyzed _________ Protein
MonoSodium Glutamate (MSG)
MaltoDextrin (MSG)
Artificial Flavor
Artificial Color
Acesulfames
Artificial Sweetener
Aspartame
Sucralose
Phenylalanine
__________ Benzoate
Red, Blue, Yellow
Sometimes Natural Flavor (depending on the source can be MSG)
Sometimes Wheat

Sometimes Dairy
For these last two, I recommend if you have a question to see a Naturopath who can do a complete exam and find out what "non-Foods" cause inflammation in your intestine.

So do your best to reduce or eliminate these "non-Food" items from your diet. So that anything you consume will be 'utilized' to the utmost and increase your ability to fuel your system and thereby improve your Endurance Capacity.

I hope you find this information helpful and/or useful.

Dr. Ross