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Longmont Sports Medicine

See the Forest for the trees........

See the Forest for the trees........

   When rehabbing an injury it's important not to lose sight of your goals.  Many time in traditional, old-school thought of rehab, the clinician and patient get so focused on individual muscles to be activated they fail to recognize the dysfunctional system, hence the "forest for the trees" comment.

   Rehabbing individual muscles does not make a dysfunctional system functional.  that sort of thinking would be no different than thinking a replacing the engine of a rundown old junker suddenly makes it a hot rod! There can be some muscular rehab for some injuries but to apply that to all scenarios and limit rehab to isolated muscle activation would be ineffective.

    The emerging trend in rehab is to train the system.  The muscles you would normally rehab have to function appropriately within the system they are a part of in order for the system to be efficient.  Therefore it only makes sense to train the system as a whole.  

   In order to do so, you have to remove the stress of being upright, weight bearing.  If/when the system fails in weight bearing you take it down to non-weight bearing, like kneeling or sitting.  If that is still too much for the system take it down further to a suspended spine (hands and knees).  And if this is still unstable then you take it back to the most basic of positions, on you your back.  From here you are in the simplest of position and have removed all postural stability requirements.  In this position you can perform any exercise without a need for postural stabilization, allowing the brain to focus on the unimpeded motion in the joint.  Once you can perform proper ranges of motion without pain with stability, you start climbing the ladder back to standing.

   For some people even laying on their back is unstable.  For those folks, we focus on breathing, because when the diaphragm isn't being utilized as designed, nothing can be stabilized.  It may not seem like much but relearning to breathe with the right muscles is the foundation of spinal stability which is necessary to achieve extremity stability.

   Anybody can get by without stability for a period of time but eventually, the compensations will fail and the system fails.  This is where you start noticing pain, some worse than others.  At the point of pain you know has dysfunction, to postpone rehabbing said dysfunction means you move in pain regularly which also means you move differently in an attempt to reduce painful movements.  These compensation further destabilize the system and only prolong the road to recovery.

 

Block vs. Random Training

Block vs. Random Training

Agility ladders are a good example of Blocked training, which can be beneficial for introducing and refining basic movements that are the basis for developing more complex movements.

New year, New you! Planning for the New Years resolution.

New year, New you! Planning for the New Years resolution.

New Years resolutions are coming soon and after the gluttony of Thanksgiving and Christmas, they are well overdue! So I thought I might throw a little info out there for you to help succeed in the diet changes you are looking to make.

1. Plan ahead: Going "cold turkey" on anything is setting yourself up for failure. Take the next couple weeks to clear the pantry. If you want the new diet to take you have to get rid of all the temptations in the house. You also should start tapering the "bad" out of your diet the month leading up to the new diet.

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2. Eliminate Bags, Boxes or Bottles from your diet. Anything coming in the above packaging contains preservatives and aren't quality food. Everything in a container must be pasteurized for health purposes. this involves heating to kill bacteria, this also kills the nutrients found in raw foods. Processed foods also have loads of salt and/or sugars.

3. Choose nutrient-dense foods. Calories and nutrient levels are inversely proportional. As the nutrient level increases the calories decrease and vice versa. Raw vegetables have trace amounts of calories, the brighter (green, yellow, red, orange etc.) the color the better.

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4. Up the cardio. Muscles are nice but cardio is where the calories are burned! You want to lose weight, get on the cardio! If you insist on hitting the weights, thats fine. Implement a circuit workout where you are hitting all your lifts in succession with minimal rest in between sets. You'll want to drop the weight but this will keep your heart rate up, burning more calories. Optimal calorie burn is around 60% of your max heart rate.

5. Cook less. Too often the vegetables we eat are overcooked, heat kills the good stuff in food. Vegetables are most nutritious when eaten raw. If you need to cook them, brussel sprouts, do so minimally. We have a hard enough time getting proper nutrition these days, let's not cook out the small amount of nutrients left in the foods.

6. Cut out the dairy and wheat. Yes, they can be good for you, but they are calorie dense and not necessary. Everything you get from dairy you can get from meats and veggies with a fraction of the calories. For you fitness athletes, you don't need as many carbs as you think! 

7. Eliminate the sugars. We eat too much sugar as it is! Diabetes (symptom) is the biggest issue with kids these days.... SUGAR is the root problem! Regardless of the source (honey, granular, fruit, etc...) we eat too much sugar. I know I eat far too much, we all need to decrease our sugar consumption!!

8. reduce the alcohol. Yeah, I said it... booze has a TON of empty calories! I'd challenge you to eliminate alcohol for 60 days and see how much extra weight you lose. I lost 15 pounds last year when i did it. It wasn't fun but I felt 10 years younger in the morning!!

9. Hydration!  Drink water, not tea, diet soda, coffee, Red Bull or GATORADE etc..  Water is what keeps your muscles, skin, and heart healthy.  It's not sexy but it works!  It's what is needed.  All the others have sugars and toxins.  None of it helps at game-time like you would be lead to believe.  Do you want to prevent cramping?  Drink water.  Do you want to feel energized regularly? Drink water.  Do you want to perform at your best? Drink water!! Water! Water!! Water!!! #rantoverlol

If you liked what you read, have questions, please feel free to make an appointment to discuss more. Have a safe and very merry Christmas!

Hot vs. Cold

Hot vs. Cold

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   People are regularly asking me what to use, heat or ice?  So I thought I'd take this time to give a little feedback, for the record.  Before I do, I need to explain a thing or two.  First, There is no research that has definitively linked heat or ice to any significant change in recovery.  Considering that most research design has an inherent flaw, some more flawed than others, there is just as much research supporting hot/cold therapy as there is refuting it.  Most research suggest neither manage to effect tissue more than 1/8-1/2" deep, the skin is normally about 1 sheet of paper thick.  There will be body parts it can be more effective than others, ankle v. gluteals, but overall the research is inconclusive.  Secondly, considering that half the game is in the athletes head, if you think it helps..... IT HELPS!! haha!  Seriously though, this isn't the only treatment out there that science has failed to confirm or deny that is still widely used.  So with that said if you like to take contrast baths after a big game to prep for the next game, be my guest.  One thing science hasn't done is prove it hurts to ice or contrast!  So if it provides you a mental edge, then don't hesitate!  I know I used to do it all the time when playing, I'll be the last person to tell you "stop".   So with that said, on to the point of this article.

There are numerous forms of heat that can be useful.  Just make sure to be aware of too much heat.  Too much can cause burns that can complicate your achy muscles.

There are numerous forms of heat that can be useful.  Just make sure to be aware of too much heat.  Too much can cause burns that can complicate your achy muscles.

     Heat should only be used on a subacute injury (old or chronic injuries) before activity.  Heat is something you would use to start the day or before your workout.  The body responds to heat by sending more blood to the area, through vascular dilation, increasing blood flow to the area.   The additional blood to the area helps increase the core temperature of the muscles of the area of application.  The increased muscle temperature helps to prevent muscle damage like strains and/or tears.  Its the same principle behind dynamic stretching.  They both are used to increase blood flow to the area.  With increased blood flow comes increased temperature and increased elasticity.  To get a nice visual, try taking 2 rubber bands, freeze one and put the other in a warm water bath then try stretching them and see which one snaps first.  Although a little exaggerated, this is very similar to how your muscles work.  cold muscles are fragile and warm ones are responsive and adaptive, which is key in injury prevention.

Old school bags of ice cubes or frozen veggies are out of style these days with all the different colds packs made these days but they can be expensive and don't work any better than your "old reliable"!

Old school bags of ice cubes or frozen veggies are out of style these days with all the different colds packs made these days but they can be expensive and don't work any better than your "old reliable"!

     Ice should be applied at the end of the day when all activity is completed.  Ice will aid in lower the core temperature of the muscles/joint over the area applied.  Cold causes vascular constriction in the area of application, this reduces the amount of blood that makes it to the area.  This is the bodies response to cold in an effort to maintain core body temperature, much like when you are outside in the winter and you feel fine but your fingers and toes go numb.  Its the bodies natural response for staying alive.  The use of ice helps decrease inflammation in the area.  Its especially helpful in the event of an acute injury (new), like an ankle sprain, to prevent/limit secondary injury due to excessive swelling.  With a new injury tissues are torn, including capillaries, causing blood to flood into the muscle compartments.  If the swelling is left unchecked it can overfill these compartments resulting in rupture of the fascial dividers and further injury.  It can also cause compression of other structure restricting blood flow and sensation, which can lead to necrosis (death) of compressed tissue (muscle and nerves alike) if left long enough.  It's imperative to make sure the PRICE (Protect, Rest, Ice, Compress, Elevate) guidelines are implemented immediately following injury.  Here's a general rule of thumb for ice usage is 20/40 (20-minutes on followed by 40-minutes off) with compression till bedtime.  Some people like to use contrast baths for recovery.  As mentioned above, the research is inconclusive but if that's part of your routine and you feel it helps, by all means, keep it up!

    I hope this was useful.  Please don't hesitate to reach out with any questions or concerns.  Hope to see you soon on the field or in the office.  Until then take care and best of luck!  Cheers!

The Importance of Your Diaphram

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Do you know what your Diaphragm muscle is, or where and what it does?  So that we are all on the same page, its the muscle separating the intestines from the lungs.  a thin sheet of muscle attached at the bottom of the ribs that's designed to be the primary muscle for respiration.  On inhale it pushes down into the belly and on exhalation is pulls back up into the chest forcing the air from the lungs.  You know what else it does...... CORE STABILITY!! If you are not a belly breather, most of us are not, One of the biggest and best core muscles isn't being utilized which will eventually lead to core instability and low back or pelvic dysfunction.  So how do you work that particular muscle, I know I've never seen a "diaphragm" station in the gym!! Breath, yes, just breath! Lay flat on the floor with your legs elevated and just breath in and out of the stomach.  On a side note, if you have a problem with acid reflux, this may help with that as well.  The cardiac sphincter, meant to prevent acid backflowing into the esophagus is connected to the diaphragm.  If the diaphragm is weak would it not make sense the cardiac sphincter could be weak as well?  So if you get the diaphragm working right you could in-turn, stifle your acid reflux.  

Pre-season Injuries

Pre-season Injuries

One of the benefits of being a patient of a sports specialist is finding your weaknesses and getting accurate information on how you can train them into strengths to keep you on the field of competition instead of on the side-line with recurring injuries.

Are you getting the most out of the gym?

Are you getting the most out of the gym?

Let us help you understand your best approach to accomplishing your goals in the gym. We blend a sports medicine, physical therapy, chiropractic, manual medicine principles in solving your health issues.

The Sports Medicine Approach

The Sports Medicine Approach

Dr. Ray writes about the modern day sports medicine approach and how a more tailored treatment plan is far more effective.