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EBM rehab

Why getting that MRI won't help you get any better.

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Why getting that MRI won't help you get any better.

MRIs can be very good at detecting certain “problems” in and around the spine. MRI demonstrated high sensitivity for spinal soft tissue injuries. However, MRI showed a definite trend to overestimate interspinous ligament, intervertebral disc, and paraspinal muscle injuries [6].

Don’t get too wrapped up in googling the vocab words above. Here’s part of the problem with the above information. If the doctor is trying to appease the patient by ordering the MRI or the patient has demanded one, they will find something.

Whether that something is the actual problem is another discussion completely.

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5 best ways to improve knee pain.

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5 best ways to improve knee pain.

Nothing will make you feel old like a bum pair of knees. Walking can be a laborious. Climbing stairs resembles climbing some snow-covered mountain. Even sitting and standing can become an Olympic event.

Maybe you want to start exercising to take off some lbs so you can save your knees. Not a bad plan until you follow a bad plan.

Following the wrong program when you have bad knees will absolutely make them worse!

I am going to go over each in more detail, but the 5 strategies are:

  1. Remove/modify pain stimulus - this often means things like squats, lunges, running and jumping need to be tabled or altered.

  2. Soft Tisse Mobilization (STM) - this is a $2 word for massage. Issues with your quads, IT bands, hamstrings, adductors and calfs need to be addressed.

  3. Ankle mobility - when your ankles do not move, your knees try to move more to compensate. This is bad news for your knees.

  4. Hip-dominant movements - this serves two purposes. It assists #1 and it builds up a part of your body that is probably weak to begin with.

  5. Deloaded knee-dominant movements and controlling knee valgus - all the squats and lunges and running and jumping that we took away in the beginning are brought back to finish your rehab.

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The best guide to rehabbing injuries.

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The best guide to rehabbing injuries.

At some point you are going to deal some sort of an injury. Maybe you are already have. Maybe you are dealing with something right now.

I am going to walk you through some different ideas as you approach different scenarios or pain and rehabbing injuries.

There are going to be 6 parts to this post, with each part having its own video.

  1. General guidelines for rehabbing injuries.

  2. Post surgery.

  3. Your post-surgery home exercise program.

  4. Chronic pain.

  5. The idea of layers. Fixing one problem often reveals another one.

  6. Modify your approach to sets and reps.

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Your poor balance is probably not a balance issue.

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Your poor balance is probably not a balance issue.

Many of us know someone who seems to be a little more clumsy. Maybe they trip a lot, stumble often and sometimes even fall. Maybe I am describing you.

Occasionally losing your balance or stumbling here or there is not a balance problem.

Vertigo is a true balance disorder. Issues that involve the vestibular system (which is a fascinating system) are true balance disorders. These can be triggered by head, neck and eye movements and are often associated with nausea, dizziness and true loss of balance (LOB) which often results in a fall.

Balance is a difficult thing to quantify since it involves many systems and many variables. Your balance is maintained by a dynamic interplay between three systems in the body. In the ideal world, all three systems would work harmoniously together.

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5 best ways to improve shoulder pain.

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5 best ways to improve shoulder pain.

These ideas work best for chronic shoulder pain. If you recently hurt your shoulder, I would not start messing with these strategies unless you have been evaluated and they are indicated for your rehab.

All of the strategies will have multiple videos to help guide you through the process. These are strategies I have used with both clients and patients to not just manage but ultimately resolve their shoulder pain.

I am going to go over each in more detail, but the 5 strategies are:

  1. Thoracic mobility - if the t-spine lacks mobility the shoulder and neck try to compensate.

  2. Assisted range of motion (ROM) - if your ROM is limited, use something to help assess and improve your ability to move the shoulder and arm.

  3. Supine exercises - this position helps utilize improved thoracic mobility, supports the body and makes controlling shoulder movements easier.

  4. Rows - rows are shoulder-friendly and most people do not do enough of them - especially those who have shoulder pain.

  5. Isometrics - learning how you can engage the muscles around the shoulder is key to managing pain. These are way harder than they look.

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Should you eat differently when recovering from an injury?

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Should you eat differently when recovering from an injury?

At some point in your life you are going to deal with an injury. If you are lucky, it will be minor and not limit you much at all.

The other side of that coin is if you get injured regularly and just seem to find ways to hurt yourself as if it was your part-time job. It’s like you have one of those rain clouds following you around everywhere.

So, should you eat differently when you are recovering from an injury? Possibly. I guess differently depends on where you are starting from.

Who knows? Maybe changing how you eat while you are recovering can be the thing that jump starts you changing your eating behaviors and habits for good.

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5 best strategies to manage low back pain.

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5 best strategies to manage low back pain.

Low back pain (LBP) is common. Way too common. Treating it is difficult as there are often many factors contributing to your pain. The strategies I am going to share are meant to improve your situation. At worst, they should do nothing, meaning they will not make it worse.

All of the strategies will have multiple videos to help guide you through the process. These are strategies I have used with both clients and patients to not just manage, but ultimately resolve their LBP.

I am going to go over each in more detail, but the 5 strategies are:

  1. Supine deloading - I will also share how to deload in sitting and standing

  2. Core stabilization - it’s not so much what you do but HOW you do it

  3. Glute exercises - in general, when the glutes are strong there are less issues with the knees and low back

  4. Hip mobility - when the hips are tight, there tends to be more movement through the low back to compensate

  5. Hip hinge - poor awareness and understanding of how to properly bend at the hips will routinely flare up the back

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Lat stretch tutorial. [video]

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Lat stretch tutorial. [video]

Low back tightness is common. Feeling some tightness in the low back is not uncommon. The reasons why the back can be tight are numerous. Most do not even involve the low back itself.

Other problems in the body (weakness, tightness and poor mechanics when moving) tend to manifest as low back pain. Sneaky sneaky.

Because of this, stretching the low back directly is often not the solution.

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Do not let tight ankles ruin a good time. [video]

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Do not let tight ankles ruin a good time. [video]

Don’t just start running. At some juncture, people realize they need to exercise. Or maybe they used to and they want to get back into it. They grab their favorite shoes and go for a run. Sounds harmless, right?

Wrong!

Don’t just start jumping. Maybe you were never much of a runner. You decide to join a gym. Or maybe you already belong to a gym but visit it “occasionally”. You think about taking some strength training class the gym offers.

It’s day one and you are squatting, lunging, pushuping and jumping more than you have in months. You feel like a dish rag when you are done. You are on your way, right?

Wrong!

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Thoracic mobility tutorial. [video]

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Thoracic mobility tutorial. [video]

Shoulder pain.

Neck pain.

Headaches.

Decreased shoulder range of motion.

Decreased neck range of motion.

Numbness and/or tingling in the arm or hand.

Any of these issues can have an origin within your thoracic spine. In case you are not familiar, the thoracic spine is that fancy piece of real estate between the neck and the low back.

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Core stabilization tutorial. [video]

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Core stabilization tutorial. [video]

LBP is complex. No one thing is going to resolve your back pain so stop looking for it. If you truly want to resolve your pain, you will have to tackle this on multiple levels. This means you will have to:

  • strengthen some areas

  • stretch others

  • change how you sit

  • change how you move

  • change how you lift

  • change how you bend

  • spend time focusing on movements that you have been doing for a long time and routinely do not think about

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How to dominate the holidays. Part 2. [9 videos]

Let’s keep the holiday train rolling along. In Part 1, we discussed just getting moving more using dynamic warm-ups.

In Part 2, we are going to look at a bunch of different stretches that you can utilize to avoid ending up a complete ball of stress and knots come January.

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How to dominate the holidays. Part 1.

Back on Thanksgiving morning, I started sharing different ways to help get people through the holiday season without having to give up exercise.

I even suggested that it is NOT a crazy thought to begin doing some extra activity or exercise during this time of year.

Understanding that many people would view that as crazy advice, I gave examples of things you can do.

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Pulling exercises. You're doing it wrong (video).

Rows, pulldowns, pull-ups, and other movements that initiate movement through the scapula should make up a good amount of your upper body exercises in your program.

Rows and other horizontal pulling movements should outnumber both pressing movements and vertical pulling movements. 

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Standing thoracic mobility (video)

Stand in front of a bar (or another surface that is stable and will not move - kitchen counters also work great for this).

Walk the feet back, perform a hip hinge and pivot forward until you feel so resistance to the movement in the thoracic spine. Hold this position for 5-6 seconds. Repeat as needed.

NOTE: this may cause the back to crack. Not getting a crack in the back does not mean the movement was ineffective.

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1st rib mobilization (video)

Mobilizing the first rib is not something many people know about which is unfortunate. The first rib is right under your collarbone and can be elevated which causes all sorts of issues for the neck and shoulder(s). Check out the video to see how to mobilize the fist rib.

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Spiderman hip stretch (video)

This is an excellent movement for mobilizing and stretching the hips. Start with the first position and progress to the others as needed. Remember, focus on a mild-to-moderate intensity in the hip and glute area when performing these. Start in a pushup position. Bring one leg forward to the outside of the arm. In the second video, bend the elbow and try to get it as close to the floor as you can. In the third video, rotate the arm up towards the ceiling. Make sure to rotate the body, not just the arm. One way to help do this is to keep your eyes on your hand. The arm should not travel where the eyes cannot follow it.

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How to train around PAIN.

The fact of the matter is, pain can bring each one of these situations to a grinding halt. Even worse, if the pain is left unchecked it usually gets worse and can even cause pain in different parts of the body.

It is not uncommon for a right ankle or knee issue to cause pain in the low back or the opposite hip and knee. I will explain how at a later date. The short answer as to how this happens is that everything is connected. 

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