Opportunity for mastery from an injury

The silver lining of sustaining an overuse injury is that you are forced to learn how to use your body properly. The forced reduction in training volume, load, and complexity forces us to master simple basic movements. For example shoulder subdeltoid bursitis can be painful but all rotator cuff and shoulder structures are intact. Pain from elevating the arm and doing simple tasks such as putting on a shirt, reaching for the seatbelt, reaching over head can cause a sharp twinge that shoots down the arm to the elbow. What can often accompany this is weakness of the scapular, rotator cuff, thoracic muscles that hold the shoulder girdle up. Without this stability, forward head, shoulder impingement, and throacic flexion tend to rule the balance regarding how we can hold our body. This in turn exacerbates the shoulder pain each time we reach with the arm, excess forces are concentrated on the deltoid and its associated bursaes. If we strengthen the muscles that are responsible for distributing load out of the limb and into the trunk the bursae stress can reduce and heal. In going through this injury process we learn more efficient and ultimately more powerful movement patterns that set the stage for grater capacity later. Without these challenges we would never be forced to improve upon a poor movement pattern. IF we do not have proper scap stability and strength we might miss out on the opportuniyt to learn how to press up into a handstand, breakthorugh personal records on bench press. Not to mention reducing risk of injury to other body regions in the future. See your injuries as forced opportunities to grow. Linear progress is a myth in all realms, there is no better teacher than pain.

Sleep deprivation and exercise

The feeling of sleep deprivation makes everything feel difficult. What does it feel like?

What are the most common health impacts of sleep deprivation,

The priority for health, function, and athletic performance is to sleep more. During periods such as taking care of a new baby or a sick parent this is not always possible. What role does exercise play in helping to restore health after a period of decrease sleep?

Do we know the answers to these questions? I feel like how each person does this can vary however if we wait to feel perfectly rested to start our exercise routine this is likely to bring us up against constant interruption to exercise consistency which marks a decline over weeks to months of our basic endurance, muscle strength, joint mobility, and activity tolerance. Physical exercise can be overdone and can exacerbate fatigue, overtraining, sleep disruption. However at the proper intensity physical exercise is profoundly beneficial even for restoring hormone, endocrine, and energy balance. These factors can helpammeliorate the detriments of disrupted sleep.

But I don't have time to exercise, Engineering exercise into your life

Let’s play a mental exercise for a moment where we don’t have to take responsibility for how our life currently works or doesn’t work. Let’s blame big forces, corporations, politicians, advertising from decades past for how our work, home, and leisure time all go by without anyneed for physial activity built in. No single person designed the way we live, collectively we all accepted conveniences because they were convenient and gave us comfort, safety, predictability from the weather, from hard back breaking work, and to live with a standard of living better than the prior generation. This movement carried forward for not even 3 decades before our society started paying costs for this movement of comfort and convenience above all else. Now we can wake up and take a warm shower, eat packaged microwaved egg and cheese sandwich, get into an air conditioned car to drive to work where our air conditioning and packaged food continues while we sit and exert our mental energy without having to exert or use our body’s capabilities.

Engineering exercise into our lives will be the difference. The marketing of the health and wellness industry pumps us up with before and after photos of success stories and rocking badass bodies that might shame us or inspire us to do something different tomorrow. But when tomorrow comes we are squeezed by the grind of the schedule we have accepted like a hand me down suit from our fathers that still doesn’t fit. We want more from life when it comes to feeling better today, setting ourselves up for better health in the future, and having a sense of balance where we can give our own needs attention, self challenge, and physical movement that simply feels good.

First what can we do with our daily schedule by making small tweaks that don’t rock the boat. To negotiate 30min to 1 hour away from the office or homelife to balance out. Additionally how can we make meetings, phone calls, socializing, family time physically active?

Now for the big questions, is there a way you can change where you live, work, inspire your social circle that will make a radical shift that will by design make your life more active? If you lived walking distance to work, shops, parks you would likely walk more. This is the difference between hoping you will find the time to start that new workout routine at the gym a 30 minute drive away or simply lacing up your shoes and heading out the door. The difference between the few big trips to a national park in a decade or the few weekend hikes in state parks do not have as big an impact on your life as how you spend an average day when you are simply going about your typical unsexy business. Even on the days you do not feel inspired to work out you are active. This is the difference between engineering physical activity into your life and waiting and planning for inspiration and time to be abundantly available for your health and physical fitness to take prescendence. If we wait for this to happen we are more prone to our health being forced upon us as we get slowly gradually weaker and more prone to chronic disease. It is more important to seek a typical day in which your activity level was at least moderately engaged with along with all the other demands of your life than to try to play catch up. Similarly to proper sleep, we can never get back a lost or interrupted night of sleep. Binging during the weekend on exercise and being sedentary during the week does not work, this is a recipe for weekend warrior syndrome where we get injured from overdoing our activity in big long sessions rather than doing smaller chunks more days per week that would build to fitness that would reasonably support larger adventures in the national parks, long bike rides.

Action list, take charge of what you can now to make small changes. Get the people in your life on board too, by leading through your own action, not by being a nag. Then make massive change to make a stepwise shift in your quality of life.

Cyclists are the T-Rex of Athletes

Cyclists have incredible lower body endurance, can climb mountain roads for hours and convert kilos of bread and pasta to power output in 500M sprints. Like a T rex with leg power to chase down prey, they are remarkably vulnerable to problems that arise outside a narrow spectrum of situations. What about life off the bike? what about the long term ability to take care of lifting the bike off the rack not to mention yardwork, lifting dogs and kids up. And have you been able to carry your partner to bed this decade?

Off the bike many cyclists I help are lacking even basic postural muscle strength to hold the head and shoulder girdle in a neutral position. This places undue strain on the nerve tracts that travel from the neck to the fingers that may contribute to some nerve radiculopathy into the fingers.

There is always more exercise and training and recovery to do. The key is fitting in a few sets of exercise with your training. The principle of habit stacking, learning to incorporate a new task or behavior that may be hard to start with something you are already good at initiating. This can look like doing a set of shoulder and core exercises before a ride and finishing the sets when you get home. Body weight exercise will not take energy away from your ride, and the upside over many years of cycling without balance will take a few weeks to have positive benefit but if you do these routines you will build strength in the crucial supporting muscles around the spine, shoulders, and neck.

Try these routines

Prone ITV and cobra 12x 3-4 sets when you can do 20 of 3 sets work in a 4th set, work up to 20 reps of 4 sets then we find new exercises

Quadruped rotation: 6-12 x each side

plank to dd

Plank leg lift

Classic theraband shoulder external rotation, horizontal abduction, pull down

It Takes Endurance to be a new parent

In the lead-up to becoming a new father I would find myself squeezing in an extra few miles while out on the bike or out on a run. To appreciate that the new demands of a new baby would necessitate a change in my priorities and most likely some reckoning of a new set-point for what time would be available for my own training and how little time I would want to spend away from my baby. With the last month flying by of baby Sofia being my new early morning training partner I can tell you that I appreciate what endurance and physical ability I have to be able to care for her. Also I see a daily need for exercise not as an indulgence but as necessary for me to have the physical energy to take on all the tasks of fatherhood at this stage not to mention my long term health to be around for all the important points of life.

When a baby starts audibly fussing seems to be shortly before they reach the threshold of crying where they are overwhelmed with whatever sensation they are experiencing that they are only beginning to develop the operating systems to cope with. Being on call at all times day or night to pick up the baby and coordinate the steps necessary to physically address the baby’s needs takes significant physical ability. Just like exercise, the more directly, calmly, and routine your actions are, the less of an emergency the situation will be when dealing with a child. If you are physically stressed by simply bending over to pick up the baby and hold it pressed up against your chest, no way are you going to be able to set up changing, feeding, and supplies while soothing the child in your arms.

The parental wellbeing is one side of this issue, when you are physically fit and well, you have a greater threshold of what you can deal with before experiencing feeling of being overwhelmed which effect your conception of what you are capable of, while also might impact your confident discharge of basic duties to calm the baby, and also placing additional burden on your caregiver that you are less able to take on your share of responsibilities.

Having a exercise routine that incorporates your daily childcare routine, work, no matter how you are feeling will allow you to slot exercises into daily tasks when baby is awake and when they are sleeping which they do a lot of , just not in uninterrupted 8 hour chunks. Why do I say no matter how you are feeling? I don’t mean to simply say push harder that you should hammer out sprints or max deadlifts or burbees until you puke anytime of day when you have a free second. It is all in having the right intensity of threshold. If you work out too hard above this threshold one day, you feel this effort in your body and extreme stress when your baby wakes you in the middle of a sleep cycle and interrupting important cellular repair necessitated by a workout that you could not buffer with aerobic function. The exercise I find helpful is under the aerobic threshold. This exercise builds activity level over time yet has minimal refractory period. Its not to say you can never workout hard again, but when are you going to have uninterupted sleep for the next few months maybe 2 years? If you wait around until you have the mental energy to get up and do that awesome crossfit workout or sprint internval session, you will lose valuable basic function in the meantime, you could be maintaining and building endurance ability for your whole body.

Walking- aerobic exercise measured in miles that you can do with you baby in a stroller and depending on your neighborhood you can accomplish errands. What the baby might experience is acclimating to different stimuli, start with short walks around the block and slowly progress. Heat and cold stress is a real concern that can happen quickly with small bodies and the stroller seat is a lot hotter than open air so plan for the best time of day for baby if it is going to be sunny go early and choose a route out of the path of the East.

Babies like being active. They like being picked up, they like movement. When our baby is fussy despite having a dry diaper and not wanting to feed. Sometimes picking her up and doing a set of squats and lunges with her in my arms is all it takes to get her calm again. Even by the 2nd repetition she is more calm.

Endurance is built from the ground up. A lot of the day spent on low intensity activity builds endurance with a lower energy tax and little to no recovery. Conversely, low intensity exercise helps hormone regulation, shunting blood sugar into the muscles, improving the ability to be active more of the day.

Don’t wait for the perfect window, try a few simple exercises while being active with your baby, you are modeling good behavior by challenging yourself to do something that takes a little bit of energy now, but gives you greater capacity as time goes on. This has a profound benefit in viewing this new joy in your life of the child not as an interruption to your health but a challenge to focus on what is essential and the health and function of the parent is enhanced by finding time to carve out time for wellbeing or at least appreciating all the activity you can do with your baby.

Cycling to the grocery store

For exericse sets and reps endurance is done at a load you are able to perform 12-20 reps or more for 4-6 sets.

How you might expects

Squats, lunges with your baby in your arms done safely.

when baby is resting doing upper body ro

What is a Cat 2 Road Cyclist

Grant earned his upgrade to Category 2 from the cycling’s governing body USACycling.

Now as a Category 2 Grant will have the opportunity to line up wheel to wheel against fellow elite amateurs as well as Category 1 and professionals. New cyclists start participating in races as Category 5 and have to earn upgrade points through the ranks by placing consistently in the top 5- top 10 over the course of the long season from February through August. Grant has been a road racer since 2007 and was at the cusp of receiving this coveted Category 2 status in 2010 but came up against overuse injury in the form of pelvic muscle pain. He worked tirelessly with the help of PTs, yoga teachers, coaches to understand his own injuries while studying to become a physical therapist himself. Gradually building endurance and high end power on a foundation of good alignment, proper bike fit, recovery, yoga, he slowly got back on pace to his goals of riding his bike every day to work and race on the weekend at a high level.

2017 Road Season Recap

I competed in 30 road races in 2017 from February 28th through August 14.

These races brought me to travel as far as northern california, eastern Oregon and as deep into towns close to Portland. I had to contend with rain, cold, extreme heat over 100 degrees, altitude changes, and avoiding crashes in the bunch. Nutrition difficulties were from the early season in trying to figure out how to eat to not gain weight then at the end of the spring how to eat enough not to bonk or have indigestion. As the races piled up a feeling of fatigue was present each morning as I became less enthused to bounce out of bed and onto my trainer. When I figured out how to eat enough to fuel my workouts, how to rush less in my morning routine to leave enough time to get ready for the day before my first client and after my cycle training, and how to work with what my body gave me each day, I felt that racing and training made me stronger and more vibrant for all people around me. I made many great aquaintances and friends. I deepened my relationship with my partner and with the region around me. We got to visit many small towns and farms. Exploring local eats and hikes along the way. We read books and listened to great podcasts and music along the way. The road season is a party that gets me out of the routine of my small world out into the countryside yet there is enough discipline to appease the order seeking side of my brain. There is a quality of staying on track and working towards a goal and building slowly in each race and pedal stroke towards a depth of understanding about how to convert work into the art of experiencing the world. It is like flying when you are able to combine the right amount of effort with the task at hand. It is like struggle and pain when the connection between body and bike is not ready when the race dictates. But with a mind for feeling what is gong on first and easing into it rather than fighting the body for what its not ready for is a way to get on good terms with what needs to be done. The people in the group help eachother do more as one unit that each individual. We each make it harder by attacking and pulling through harder and easier 

I did not accomplish my highest objective of earning enough points to qualify for an upgrade to category 2. I need to use my power more effectively next season to make decisive brakeaways that are more daunting to undertake but potentially more rewarding than earning a lesser place. For instance I was often working at the front of the group to keep a race from splitting instead of starting or contributing to good brakeaways sticking later in a race. This is more risky but the reward of finishing off the podium is not a good reward. The goal for next season is to mete out my power at particular focused times during the race. This will require astute attention on my competitors and torrential and frightening feelings of jumping into the deep ocean and off on my own away from the comfort of the pack. 

I am starting earlier this year by reflecting and then preparing. I am excited by the potential to improve.

Experimentation is the key to not burning out

How to get stronger without burning out

Slow approach daily micro habits, weekly cycles, fit into quarterly results.

Being ok with sidestepping, backtracking, or staying at the same level when you are working with quality.

Go for it everyday, push your boundaries.

This can be applied to growing your fitness and your business

Paying attention to only the micro can leave you with a shortsighted view of how you are progressing.

If you do something new and you do not see results in the first few days and feel the pain of trying new habits, no need to fret. Balance how you feel in the moment while having patience for what will take time. Everything in our modern world of progress works on a lag time, so the work and habits or laziness and procrastination are going to have their effect on your life in several weeks or months but right now we have to have delayed gratification.

Contradictory I know.

Your in the moment physical being instrument is all about comfort, survival, satiety, low energy cost, stimulation. These are our primitive instincts. These are useful to make sure we survive. Thankfully not many times these instincts are called upon for legitimate threats to our survival. In our modern world there is danger for sure from car accidents, household accidents, forces of nature, things can go bad really quickly. But when we are behind on paperwork or are stressing about bills, we can confuse these modern day stresses with survival fear.

We can instead use our primitive instincts to help us change habits by paying attention to them to keep us in check from trying to change habits too fast. For instance, trying to go paleo and cut out all grains and carbs? You can try to go cold turkey but that might lead to burnout after a few days and splurging on beer and pizza, frustration and never returning to new challenges. With intermittent fasting or changing to a high fat diet we can strive to make daily and weekly improvements to get cleaner while still indulging as we wean ourselves off of a habit that we may want to reduce but sprinting to the end for a few days does not lay down sustainable habits.

Making hard changes takes hard work, there is mental pain and physical pangs in changing habits out of comfort in the moment to making lasting changes. There is no way around it. You have to harness the immense mental power to overcome these barriers. There does not have to be a conflict between our body and mind. They are both always communicating to each other.

There is a lot of talk by what I have learned from yoga teachers about denigrating the power of the mind and listening only to what the body tells you. “empty your mind” there is a place for this, but misapplied can bring you pain in not being able to take full experience in what modern life of humanity has to offer. If you are filled with fear about how to put one foot infront of the other on a project or a workout plan, a measure of embodiment can be helpful, listening to the sensations of the body, the key is without judgement. If you are hungry, eat, if you are tired sleep, if you are awake then move.

The other end of the spectrum is the power of the mind. When he are racing up a hill on a bicycle and our lungs and legs are burning and we feel our body talking to us, our mind can judge and say “no more” I am going to drop out, my body can do no more” try the opposite saying “ I can, I deserve to be here, I am contributing to this group and I am hurting no more than my fellow competitors. Psyching yourself up is our way of upregulating our central fatigue limits. In physiology we have terms such as VO2 max is the maximum level of oxygen the body can consume when tested to our physiological limits when after reaching our limit we immediately collapse without any control. What most of us get to is a VO2 peak where we get up to a level that is extremely uncomfortable and we decide to stop the test. We are afraid of feeling so much. In research studies we know that external verbal encouragement can have a significant benefit in pushing further past our VO2 peak and closer to our true maximum. What is our mental talk, what is the influence of people around us? Are they telling us to relax and not work too hard and live a balanced life or are our peers and mentors telling us to keep going dig deeper? Is it more satisfying when at a pivotal moment in our life we could have done no more and we failed or when we stopped short of our true potential? We do not even know where our limits are. Kelly Starrett says that in this age we are understanding more about having it all from our greater understanding to measure and reach our potential. “You have no idea what you are capable of”

Using the beauty of our human experience, understanding, art and science, objective measurements to help us see where we are falling short in our long term goals so that we can learn how to be the master of what we do. To own what we feel and not be owned by our feelings, to use the power of the nervous system to do what we love rather than being a victim to poor mentality or untrained urges.

Suppleness of mind and body so they can communicate without conflict. Push your limits and when you find them, celebrate that you have found a peak and keep searching and challenging the boundaries.

What's working this week

Monday monring 5:00am alarm.
The only way to get in what we need is to wake up an hour earlier. I need to get in my movement before I teach others for the remainder of the day. Also, the first hour of my day is spent on learning and getting my brain and body primed instead of just waking up and getting straight into work and teaching clients. 
If you feel like the day is getting away from you, give yourself more time for your own routines. I get to the weekend and I do not feel like I need to take a vacation from my life and lay about. Instead I hit the weekend full steam ahead into activities with people I love.

How to make 5AM work for you? Pack your bag and get as much ready for the next morning before you hit bed. There is no way to organize your stuff to make it to the gym and wake up. Any resistance is more reason to stay in bed.

The point is not to wake up and do more chores, the point is to wake up and do something that will make you feel much more energetic for the rest of the day. This is stoking internal fuel, through movement, challenging yourself in new movements or taking your current routine and tweaking the perspective, so that you are making it a new experience.

Burnout is easy if it is about doing more. Make it about your own process of meeting the day with what you have.

What I am finding helpful at this early hour is easing out of the house on the bike and making it to a weight lifting group, crossfit group, or pilates to work out with people and learn from a teacher first thing. This has helped me be accountable, by paying and by my teammates to stick to a routine despite feeling tired. Although I know enough to make myself workout at a gym solo, 

My current schedule is Monday- Morning group at form & function
Tuesday at Crossfit 503
Wednesday Form & Function
Thursday private pilates or gyrotonic lesson
Friday Crossfit
Saturday Group Ride
Sunday Group Ride

This has given me over the past 3 weeks power by being around positive people, having my own experience for myself first, and allowing myself more time to ease into the work day.

On the bike on my commute in the morning I listen to a philosophy book that was written before modern advertisements. This is like washing the brain out of modern concepts. Right now I am listening on my Audible to "Meditations" by Marcus Aurelius.
On the way home or doing chores at home I listen to a book on health, right now listening to Going Wild by John Rattey.

Towards bed I do some gentle passive yoga, a little meditation while I do the dishes or some home task per day so I can actively appreciate my home and my Sara who also takes care of it.

If you are stuck in a rut and need some tools to help you start some momentum, start with good books and use curiosity in movement to get you going along with good work out buddies to stimulate your social bug in the morning. Filling your day with good things begets another good day and the decisions you make start to add up to keep this machine of positive things moving for your own benefit.

Training with The Pros

Last night at 6:15pm the smiling faces trickled in one by one and then all at once right before 6:30 after a long work day to make up the Training Like the Pros class. If you dont yet know what this is you dont know what you are missing.

I’m the new guy at Bridgetown and let me say thanks to all the friends of the clinic that have welcomed me. I am inspired by this lot of folks who have come to Bridgetown for their own reasons including looking for help getting over a training injury, personal training to get to the next level of performance, or upon the referral of a friend or family and stay with us every week to make a community of people that come together to get fit, work on our weak points, and have a laugh about me looking like a noobie falling over on the hurdles!

 

Training like the pros group is taught by co-owner Dr. Josh Kernan PT, DPT. Josh practices what he preaches, he is a marathon runner and you can catch him on the river walk running or doing strength work in the studio between treating patients. What compelled me to be a PT are therapists like Josh and the rest of our team who have the information and then test it out on ourselves, using the body like a laboratory testing different training strategies to extend our physical capacities and heal injuries.

 

The class starts out with an active warm up, line drills getting all the major hip motions warmed up, passing each other we get to check in and see what people have going on their day and what exciting weekend plans are coming up. We get a kickin’ workout but with this group whatever extra air is used to have a nice conversation.

 

Then the meat of the circuit workout starts with the countdown clock yelling every 45 seconds to work and switch stations. The combination of tasks is designed by Josh each week to focus on a different combination of physical benefits from explosivity, balance, endurance, strength, agility, and mobility. It is an accomplishment each round through and lots of high fives and comaraderie once the workout is complete.

 

The equipment is familiar but beyond what is available in a typical gym and way more challenging that what most physical therapy clinics have. We believe that recovery is complete when you are able to do the full load of your goal activity properly and without pain and we have some really cool equipment to challenge you here in a controlled environment with our skilled eye. This is in contrast to what I have had to do at other places I have worked is releasing my patient once able to complete basic body weight or light resistance exercise and hoping they are getting along well once back in their work or gym routine. At Bridgetown once we get you back to doing what you love pain free, we find many people want to stay on a regular personal training schedule to keep progressing in the good times. This is hugely energizing for us therapists to see our patients thriving when once we knew them as being in pain.

 

Thanks to all the regular clients at Training Like the Pros and Bridgetown. Each person’s hard work and smiles inspires the others in the room to keep showing up to work on fitness goals together. Thank you for trusting us with your wellness and for sending your friends and family into our doors.

 

See you all at the next class


-Grant

Knee Pain: Waking up the Posterior Chain

Knees hurt? Try using your hips.

When you first learned how to squat or ride a bicycle jump, you likely received no formal training in the fundamentals in how to do it. You just got on a started riding.

What I see in my own movements in learning weight lifting, in my bicycling and running and in a number of my clients with aching knees is we don’t know how to use our hips.

 

We have super strong muscles in the buttocks, gluteus maximus, gluteus medius,

The strength of the hamstring muscle group broken down are the biceps femoris, semimembranosus on the, semitendinosus on the. When this muscle contracts when the feet are planted it helps produce hip extension. When the leg is free in the air (open chain) it primarily bends the knee.

And super strong muscles to maintain our posture when loaded in the abdominals, notably transversus abdominus, the

 

What about the quadriceps muscle group? Its strong in straightening the knee and the rectus femoris and psoas work together to actively bend the hip. The calf muscles can help us come up from the bottom of a squat or pedal a bicycle but if we are relying on them as primary power drivers it may lead to tightness and pain.

Now on the issue of knee and back pain, a few tweaks to our emphasis of which parts of our body to use and the alignment of the pelvis will help us to use the powerful muscles of the backs of the legs and buttocks and allow the quads to be a balancing muscle with the back of the legs.

It is not to say it is wrong to use the quads or that we should overemphasize the posterior tucking of our pelvis. There are extremes on both ends. Discernment goes a long way here.

Some strategies to wake up the posterior chain are to squeeze the butt muscles together as you end many of your typical motions.

Straight leg variations

1.       Turned out leg extension.

 

2.       2quadruped opposite arm leg, watch out for the back excessively rounding, try to use the core as you reach one leg back and the opposite arm reaching forward

 

3.       Kettlebell Russian Swing, keep the knees relatively straight, reach behind you and squeeze the butt and push down into the heels as the bell floats up to eye level. Resist the tendency to collapse down and reach with your arms

 

4.       Deadlift by pushing into the heels and only lowering as far as your hips can reach back

 

5.       Roman Chair Extensions- push into the heels and squeeze the buttocks to return from a bent over position- if the back is trying to take over let it relax and emphasize the legs

 

Now in bent knee variations the tendency is even greater to overemphasize the quads at the expense of missing out on the great power of the posterior chain.

Using the hips has great implications for being able to move efficiently, powerfully, and explosively and even further if your hips are shut down we are missing out on a lot of enjoyment of the full movements in sex, dancing, and true integrated motion that we can repeat daily without breaking down. If we rely on just a few muscle groups perhaps those structures and the joints may be taking more load. With more load distributed to larger muscle groups and more structures it may stand to reason that there is less risk of reaching a stress point and on the performance side, opening up capability for greater capacity.

Long and short of it, push into those heels and squeeze the butt. As this becomes more natural don’t over do these cues, bring it all together and let it flow naturally even a good thing overdone can lead to overuse. 

Shoulder Subluxation

When I come to terms with the fact that yes I am injured, yes there is something I can do about it, then I can find the opportunity to learn from an injury. That initial step of acceptance and not fighting the circumstance is no easy feat but it is something crucial to understand before trying to go about business as usual in denying that their is pain, or just laying in bed not doing anything, both lead to worse outcomes in recovery from an injury and using the injury period as an opportunity to reflect and find purpose in the recovery process can be immense opportunities to learning that can give deeper wells of experience if they are addressed. Like petina aging on your favorite boots and pair of jeans, dealing with obstacles gives us character, those who try to bust through walls miss out on these lessons that ultimately teach us in mini doses how to deal with dealing with changes as our bodies age.

 Lets get into some steps that may help you. Guidelines,

Don't rush the healing process, it could take 6-8 weeks to return to activity

Continue to be active and treat your recovery activities with the same zeal you give to your favorite activities

1. Immobilize and get some elevation of the GH, 
     -Get a sling or Heavy Duty McConnel Tape
This will help your glenohumeral ligaments heal  and may give a bit better congruity between the head of the humerus and the glenoid (the ball and the socket)

Kinesiotape to give a little support to the healing rotator cuff and GH ligaments. Thanks Darla and Josh for taping me everyday for a week.

Kinesiotape to give a little support to the healing rotator cuff and GH ligaments. Thanks Darla and Josh for taping me everyday for a week.

cp408-9781455704187.jpg

2. Start with basic isometric shoulder exercises, you are making tension in the rotator cuff muscles without motion, this will help the muscles that may have been strained regain their strength and normal length.

3. Active range of motion to PAINFREE degree. It is important to keep moving and not lose more motion. We must balance this with what the shoulder can support.

4. Go to physical therapy, I am a physical therapist and I needed an outside perspective to make sure I was not progressing too fast. My progress kept getting interrupted before I took advice to simply rest and let the tissues heal.

5. When you have full active range of motion that is painfree, you can incorporate some resistance, slowly. Start with easy resistance bands, prone on hands and knees core exercise, and modified planks before using exernal weight. Before increasing in difficulty ask yourself if the easier step was possible painfree.

Other things I noticed that I had to figure out was out how put on shirts and jackets. Driving was problematic, turning the wheel with my left arm. The benefits of a sling in social setting is people will not whack you on the arm or squeeze your shoulder.

Remember there is always something you can do even if you are injured. Treat your rehab like anything else you enjoy. The more you miss the playing field, the faster you can return if you keep a lid on your enthusiasm, take it slow, and focus on the small step to get full shoulder function back. See your physical therapist for the individualized plan of action to get back to full speed.

-Grant
 

Why health apps fail and how to use tech to help you

Objective data helps us overcome our own shortsightedness and can help us have a greater perspective of days, weeks, months, and years that our primitive moment-to moment brain is not set up to be sensitive to. Technology that we have in our phones and tracking devices have been around for years. The problem of public health in our modern societies that can be helped by daily habits of movement and food choices have not gotten better with more technology. 
With every new purchase of an app or new device, we get a rush of excitement at the feeling of potential of what we want to do with this device, how this will be the turning point in our lifestyle to get us out of our rut and up to our potential. This excitement leads to disappointment without a few important things.

Tracking a body weight exercise routine on Bodyspace App

Tracking a body weight exercise routine on Bodyspace App

We need to start with awareness of ourselves, appreciating what our capabilities and deficits are, identifying the obstacles and stories in our heads of what is working and what is not working. This is also an opportunity to identify the why we want to make a change. Our being is smart in that if we are working for a superficial goal or a goal that is an imitation of someone else's then we will sabotage ourselves out of reaching further. We need to understand the seeds of what makes us motivates to get up and go.  
New technology cannot take the place of awareness, we can hit ignore on our reminders, we can fill out all the food logs but if we do not know why we are doing it we are exerting energy to conform, doing more in confusing and getting further away from our understanding of what makes us tick, we build up walls of data that give us a false sense of what is important to achieving superficial goals.
Objectivity is a tool as is subjectivity in helping us express ourselves and take advantage of all that is on offer in our little world. Denying objectivity can lead to capriciousness and resentment and misunderstanding of innovation. As Sam Harris writes about in the Moral Landscape, if scientists continue to vacate the moral landscape, we are all missing out on how our increasing objective knowledge can inform our moral decision. Just as objectivity denied in taking care of our health can leave immense opportunity for taking advantage of advances in technology, medicine, physiology, science. The people that use science as a tool and have knowledge will have the benefit over those who do not have opportunity or cringe away from technology because they are put off by being shown in hard data how the body is working or not working. If people who base their decisions on intuition alone continue to eschew objective measures they are putting themselves at the mercy of the flightiness of their primitive brain centers who want to indulge in salt, sugar, and fat because it feels good and we are evolved to be drawn to these fuel sources that are tied to survival. To deny that this is in all of us is to deny what we understand about how the brain lights up when stimulated by these substances. 
That which gets measured improves.
Objective measurement tests in terms of weight, power to weight ratio, underwater weighing, maximum lifting capacity, VO2Max, circumference, blood lactate levels, hormone response, sleep cycles, resting heart rate. All these items can give us a wider lens to be the partner to how we feel on a given day, at a given moment.
Feeling of restfulness, satiety, thirst, hunger, desire, irritability, all these states can influence our ability to accomplish the one brick in front of us that will build the building that represents the artful application of our skill, knowledge.
Robert Pirsig describes art as the marriage of conceptual with objective skill. Like a sculpture who has an idea of beauty, what he likes, and has developed the skill to make a physical version of his vision a reality.
Using health apps give us the tools to bring our dreams to reality if used for us, rather than letting them use us.
 
Some items in creating a system of apps and devices that can help us:
We need:
1. easy or automatic to input data- this reduces drag to us collecting data, very important for the creative person to have little resistance to the act of gathering data.
2. Apps need to be able to share data so that we can see how diet, exercise, subjective feelings, and performance relate to each other
3. Take advantage of biases; social bias- sharing on social media, feedback for kudos and comments
4. Goal Tracking-- help us see where we are going based on our daily inputs so that we can correct or stay on our current course.

Traking a bike ride on Strava: segments comparing you to others who have ridden the same segment.

Traking a bike ride on Strava: segments comparing you to others who have ridden the same segment.

I have been through different phases with trying to use technology and different exercise regimes. If our principles are general enough we can apply them to help us in our journey. If they are too narrow our intelligence will be insulted and we will throw out our methods even if they had kernels of the truth. This is why we go through phases with different exercise routines, always doing a new thing looking for the holy grail. Creative and intelligent people have a blindspot for leaving good methods on the table because it does not encompass everything. Have you ever been critical of a teacher who did not have all the answers? If you find a good teacher learn whatever they have to give. and use the knowledge as a tool, not the end in and of itself.
This will help us in choosing and staying with methods long enough to let them work while not trying to grasp on to any one method of exercise, guru, or data set with a false pretense that this holds the one key to health.

For tracking daily basic health, Apple health brings in data from many apps, they track daily steps and sleep.
For tracking my cycling data I use a Garmin Edge 500 synced with my Strava account which is linked to my facebook. I do this to be able to have social bias to give me external motivation and compare and compete with others in order to know if I am improving compared to others in my competitive bracket. Linking to facebook and social media allows me to share the art of my love for cycling and to inspire others to join me and find their own journey. Also linked to my Strava is Myfitness Pal which I use as a food log to track what I am putting into my body. How many hershey kisses did you eat? 2 or 9? the difference is 200calories. No calories are not everything, but ignore this one data point to your peril. Energy in and out does not represent the whole truth when it comes to nutrition but it does help us see if we are way off in not eating enough- explaining why we do not have enough energy to continue our pursuits, or too much-explaining why we gained 10pounds in the last 2 months. 
It is easy to get caught up in the day to day, this is why long term data tracking helps us transcend our tunnel vision.

MyFitnessPal How I track my meals, they have the brands and quantities of many foods to get us pretty close to our food intake, this app is connected to my Strava account so it shows my morning bike ride and takes that energy expenditure into account for the estimate of my recommended caloric intake to maintain my weight, pretty great when apps talk to each other.

MyFitnessPal How I track my meals, they have the brands and quantities of many foods to get us pretty close to our food intake, this app is connected to my Strava account so it shows my morning bike ride and takes that energy expenditure into account for the estimate of my recommended caloric intake to maintain my weight, pretty great when apps talk to each other.



To keep track of body weight and gym workouts I use Bodyspace- this app does not link up with  my fitness pal, so I do not yet have a closed ecosystem where all my inputs and outputs are talking to each other.
I like to connect these building blocks each day with art, this is why I like photos with Instagram so I can have a visual boost when I look back at my data and I can tell a story, much more effective at keeping us engaged in our path and motivating others to join us in finding their own path to health through enjoyment.

Having the discipline to input the data and having apps talk to each other and liberating the data to other platforms and making it easy to use. This is how we use data to make our vision come out. Celebrate and let people see what you are experiencing, it may help inspire someone else, and yes it feels goood to get a kudo or like on our steps along the way.

Today, download Strava, MyFitness Pal, get a device like a Garmin to track your workouts, go for a ride or a run, take an instagram picture, share it with your friends and family and write a story about what you learned about yourself and the world around you.
 

Perfect Breathing: Interview with Al Lee

I sat down with Al Lee at a cafe and we chatted about breathing. Al Lee talks about breathing as the first and foremost important skill that one needs for performance in athletics, business, martial arts, relationships, sex, mindfulness. 

This one elemental thing we all do can be a huge source of energy and healing for all the systems of the body if we do it right, if we do it wrong, we are leaving a lot on the table at the least and could be the cornerstone of overcoming health issues.

Al talks a lot about how breathing has helped him in business situations be open to creativity in decision making and dealing with stress in the professional space.

I asked him how to teach the breath. He says you must practice. It is not enough to have experienced it in the past or to know about the benefits of breathing.

He places an important on not judging your breath, its about practicing awareness.

Thanks a lot to Al for his time and sharing his take on breathing that ties us to our primitive selves and takes us into our daily lives with focus and full performance.

Excuse the barista sounds, this is my favorite place to interview because it feels like two friends just shooting the breeze about our interests. 

ACTION STEP: Do this, in your reminder list on your phone, set it to remind you to do 5 minutes of breathing work first thing and at the end of the work day.

Set the timer for 5 minutes, sit down, close your eyes. Focus on what parts of your body move or feel stuck while you breathe.

Remember that knowing is not enough, daily practice is what allows us to access these benefits. There is no replacement for daily practice. 

Having a teacher is the best way I know how to instill better practices in my life. 
If you want to elevate your performance in all aspects of life, it starts with a step in the right direction.
Set up an appointment with me  at Bridgetown Physical Therapy & Training Studio and I will show you the techniques that help me access the powerful skill of breathing and how to instill discipline in practice everyday. Call my office at 503-222-1955 or email gheadley@bridgetownpt.com

 

 

Physical Therapy to Personal Training

Physical Training and Physical Therapy, what are their roles?

What is the point of taking care of the body and attempting to improve capacity, function, performance? These issues are better addressed by physical training with the guidance of a teacher or trainer.

Training solo is a must, this is how we learn to listen to our body, learn the strength and satisfaction that comes from creating a physical challenge and meeting the challenge.

However having guidance from a trainer or coach can add new perspectives and freshness. An outside perspective can teach in contrast to what you are comfortable with and can identify aspects in form and alignment that you are not able to see on your own.

 

 

What can physical therapy help with?

Physical Therapy is best utilized when an injury is limiting our basic daily function such as difficulty dressing, washing, transitioning between activities, getting to work, simply participating in what we enjoy, the point is all about restoring to our prior level so that we do not make extra time and energy on basic activities. A physical therapist is a clinician with training in evaluation and treating musculoskeletal dysfunction, constantly evaluating if the patient is improving under their care to determine if that person needs further medical or surgical intervention for their issue while also having knowledge in how underlying systemic conditions can manifest as pain or what may seem at first like an issue that PT can help, we seek to always ensure the patient does not have something more serious going on that they must see a medical specialist or emergency care to treat.

With this out of the way, when a patient is appropriate for PT we focus on improving function. Our primary ways of doing this are through exercises, education, and sometimes manual therapy to reduce pain or show proper movement patterns. These interventions are focused exclusively on the narrow scope of supporting the healing of the body to restore normal range of motion and strength. Modern PT does not simply look at the body as individual body parts knit together, our interventions while focused on the main issue at hand seek to integrate this area of injury back into the whole body and improve function overall.

When patients come to us for a specific problem we focus on what is most important to return to work, family, community function while also seeking to look for quality in the whole picture of the body. For instance if a person has inability to dress without pain and increased time due to difficulty, we are going to focus on exercises that work on improving the strength and range of motion of that one area of the body and the structures that contribute to helping that action regain its fluidity. Often in helping one aspect of the body we address the whole picture underlying posture or movement faults that contribute to that injury or impede further progress in healing. When the area under pain improves as supported by physical therapy and the natural healing of the body, along with how the whole mechanics of the body have been addressed, if the person has increased capacity and movement quality overall we have achieved our primary goal of restoring function of the injured aspect as well as improved the overall health and function. We track the changes of a person in physical therapy with tests and measures of strength and range of motion, as well as subjective measures of how the person feels their function is progressing or not. This process ensures we are helping with their primary concern and encourage them to experience the body as resilient. We encourage PT patient to continue to challenge their physical limitations to always be improving and learning about the body to maintain the ability to do what we want to do. Injuries happen but it is the quality with how we address them that can turn a pain into an opportunity to grow physically and mentally.

 

When someone is active normally to their own standard of normal, without pain or limitation in strength of range of motion, the training paradigm shifts more wide open to challenging the body as a whole while elevating the person’s current level of performance and wellness.

 

The way I design a session for my clients is always individual. Each person has unique strengths and weaknesses and goals. We must together find the right mix of challenge in different aspects from strength, mobility, balance, stability, and endurance. I think it is essential that I have first practiced the routine myself to feel how the exercises flow together into a session. For instance I may rotate between pushing and pulling activities or upper and lower body activities to keep the session active so that we do not feel that we need more than a few breaths of rest between sets. This way we are also challenging multiple energy systems and packing in more volume in the session without overtraining.


Here at Bridgetown, the physical therapists help people heal from injury and then help people continue their journey in learning about their body through one-on-one and group training sessions, yoga, and pilates. These different tools help people grow in a balanced way toward their wellness goals. I love seeing my former patients who I met when they were in a lot of pain now completing exercise sessions feeling great. Creating a plan for each session of PT or training and fitting each session into a progression toward the person’s goals is like an artform and our patients and clients are active participants in this creative process.

Interview

Todd Wymer and his lovely lady and fellow accupuncturist Kaecee and I sat down to coffee for an stimulating conversation that I decided to record. What I get stimulated by is a health professional with deep domain knowledge in his specific art but sees the inroads and parallels with other perspectives. This is the antidote to gurus and finding the flawed quest to find the one true answer to health or anything else. Todd just received his doctorate in Japanese accupuncture. Additionally he is a badass in Kali, a Filipino martial art that uses knives. He practices his knowledge of integrated body movement in his art of Kali that is a direct application and helps him feel what he is teaching his patients. 

Where in your community can you meet and learn from someone in a parallel practice that can help give us fresh perspective and just as martial arts and eastern practices teach us, a lot of old wisdom is becoming new and popular as Western thinking opens up to it.  

Check out the audio below

What is missing from your movement, Integration

I am a recently new student to Tai Chi and Qigong. This discipline is unlike anything I in my repertoire of endurance, strength, mobility training. These old arts stress integration of the whole body moving together. Now our modern methods are studying Tai Chi and finding the benefits. Part of the problem I find in my practices of exercise and how I am trained to teach exercise is in isolation. Exercises designed to isolate the core, the arms, the legs, the cardio system, stretching. The language we use to describe what we intend to get out of our movement sets us up to have a self-limited experience. The parts might be moving as we train them but when it comes to power in the real world to move, what we miss out on is how we can feel tension in our body before it becomes pathological and using our tension in a smart way that takes advantage of energy return instead of burning out. 

Try this video of my Sara teaching a little Qigong practice and see how you feel,

Take care.

Pelvic pain impacting your relationship and family role?

Is pain in your pelvis holding you back from being your whole self with your family and relationships?

 

 

Pelvic dysfunction affects both women and men. Here is some recent research that presents how pelvic pain can affect our lives and how we can help heal and be the man or woman we want to be for ourselves and the others in our lives.

The latest this month from The Journal Physical Therapy describes that after childbirth the study by Wuytack et. al brings to light that mothers describe 3 main themes of mothers with pelvic pain: 1. The more they do after giving birth, the more pain there is 2. New Mothers tend to push through this pain to get their work done and take care of their baby, and 3. How mothers describe their role and self-image as different, in part because of this pain. in almost 20% of women, this pain does not subside on its own. Seeking help from a physical therapist for pelvic pain can help in determining which structures may be involved in contributing to this pelvic pain and building a plan to work back to function that will help the new mother meet her new life demands with improved strength, posture control, and tolerance of different functional postures like lifting heavy babies and reaching with carseats.

How can a physical therapist help?

We first create a professional and caring relationship where you can describe what is painful and we help verbalize what important things you are having difficulty with being able to do. As pain can affect us in many ways understanding why rehabilitation is important is an important first step in having open communication before we jump into the treatments. Then we keep the converstation going by testing basic function in functional tasks like squatting, bending, lifting, the strength the the major movements and range of motion of aspects of the body that connect to the pain you are experiencing. Additionally we look at posture and how the body stabilizes under progressive challenges in a safe and controlled environment that determines the whole picture of where the function is now. Then we build a plan to where you want to go with exercises that incorporate basic functional exercise that mirror your real life demands and specific training on how to use the pelvic muscles, breathing, posture, and coordinate these aspects to work together.

 

 

 

Men likewise suffer from issues related to dysfunction of the pelvic muscles that impact their role to participate fully in relationships from pain with basic motions and postures that prevents them from working and fulfilling their duty in the home as well as diminishing a healthy normal sexual function that is a vital part of intimacy and relationships. Lavoisier et al describes in his paper from 2014 that pelvic muscle rehabilitation is one important and overlooked aspect in men that suffer from erectile dysfunction and premature ejaculation. That’s right, instead of a little blue pill, we need to work on muscle control, relaxation, and control to optimize sexual performance and overcome these common and oft swept under the carpet issues that come down to posture, mobility, breathing, ability to relax and contract. The Lavoisier study shows that 20 sessions of pelvic muscle rehabilitation increased blood flow 87% in men with erectile dysfunction and premature ejaculation. If you or someone you know is suffering from these issues, I hope this can be an encouragement that these issues can be resolved and through understanding how to use our pelvic muscles and how to use our bodies to optimize the function of our pelvis. Anytime we can solve a scary problem with a little guidance from a PT and learning how to control and appreciate our own bodies, it can be powerful in helping us reconnect with our own ability to heal ourselves and rely on the signals our body is giving us. It takes some work and attention to change ingrained habits no doubt, but we can solve this. If you are in the Portland area call me at Bridgetown Physical Therapy & Training Studio @ 503-222-1485

If you are looking for help where you are, search out a PT who specializes in men’s & women’s health.

 

I have been through pelvic pain myself. It is difficult to find help and understand where to begin to heal. I feel that patience is key, it may be a long process but keep seeking the answers and the teachers available to you to integrate awareness of the pelvis into your everyday movements.

 

Links to articles:

http://www.ncbi.nlm.nih.gov/pubmed/25929535


http://www.ncbi.nlm.nih.gov/pubmed/25082919

Pelvic pain and cycling? Finding Soft Power

I became a PT partially because I was fascinated with the science and art of healing from my own injuries and the connection I had with my first PT. I have been through a lot of injuries and painful times in my life when despite rest and more effort I only got back in the same place.

Back and pelvic pain is something that afflicts a lot more cyclists than would like to admit. A lot of us amateurs approach training time sandwiched in between work and family as trying to work harder to get more out of it. This adds to the physical stress not to mention missing out on the enjoyment of our solitary training or group rides. 

Pain is a whole picture, it is not just tight muscles. The pain is effected by what you believe is causing the pain and the beliefs around the pain such as "my pelvic pain is preventing me from doing the thing that connects me to my friends and my primary way to express my self." This is where I was a few years ago and these negative pain beliefs took the place of the positive benefits I was getting from this activity. I felt helpless.

Just acknowledging what your beliefs are and reading them on a piece of paper was a step that was hugely beneficial and was a foundation to me moving on from my pain.

There is just as much mental work as there are physical steps to overcoming pain. The main thing is you have to own your obstacles and use them as opportunities. 

I found it beneficial to go through some cognitive coaching through books but also counselors and psychologists can be beneficial. 

Some resources I found hugely beneficial to putting a language to my pain were

thework.com, a practical approach to identifying the beliefs and dethorning the cognitive side around your pain so you can move forward with changing the way you are moving the body.

Also the books by David Wise including Paradoxical Relaxation, and Headache in the Pelvis.

My mentor Claudia von Hammerstein, a physical therapist here in Portland says that pain in the pelvis is very important to deal with the mental aspects to be able to change the manifestation of that pain in the body. To my physical therapy colleagues, pain education is an important area we can help people as we train them on physical aspects, also having a partnership with a good counselor and mental therapist if the issues are deeper than we are able to address.

When it comes to getting back to what you want to do whether its cycling, running, work, sex with your partner; it is up to you to pay attention to your body and find what works and what does not and have the patients to stick with the plan when it does not help immediately. 

Reading The Mindful Athlete by George Mumford, the mental coach to Michael Jordan, he talks about tricking yourself in seeing challenges as opportunities and anxiety as indication that you are going through hard change. 

Awareness of Breathing techniques are the best way I have found to practice the concept of connecting mind and body or as Elliot Hulse and various Zen texts talk about as abolishing the concept of mind body separateness. If this sounds too esoteric, try it. If you have been working harder to no avail or injury, or you have reached your small goal but feel exhausted or no fulfillment from your effort, breathing from beginning to end and when things get especially overwhelming practicing awareness of breath keeps you open to the entirety of experience and helps you notice when you are tightening your body. 

This practice of awareness of breath has references from many different disciplines from martial arts, yoga, meditation, and now western science is studying the effects of these techniques to try to bring intellectual understanding to how breathing consciously effects the body. I could insert lots of research papers here like this one: Evaluating mobile apps for breathing training: The effectiveness of visualization,

But you might as well try this, where ever you are;

1. exhale all your air

2. let the next breath come in and happen on its own

3. feel which places in your body move on the inhale

4. Notice which parts of your body soften or tighten on an exhale

Repeat 5x 

Go back to normal life and repeat as normal

Here is an exciting video of my most recent cross race, see if your heart beat raises and notice if your breath constricts with the anticipation of the whistle going off.

https://y<iframe width="560" height="315" src="https://www.youtube.com/embed/J80hY4GZzsU" frameborder="0" allowfullscreen></iframe>outu.be/J80hY4GZzsU