THOUGHTS ON:
Training, Rehabilitation,
&
Best Care Practices
New Year - New Goals: Setting & Achieving Your Goals This Year.
If you are like me, you love to set goals, spend hours on action plans to achieve those goals, and ponder on the impact and improvements you can make to yourself, your company, your family, your health, and everything else around you.
Fast forward from when we originally posted this blog, it is now 2020! Wow!
If you are like me, you love to set goals, spend hours on action plans to achieve those goals, and ponder on the impact and improvements you can make to yourself, your company, your family, your health, and everything else around you.
While you will not find a shortage of articles telling you how to set goals. Or how by February 1st, over 80% of people will have already abandoned their resolutions, let’s just keep this short and to the point in hopes that you are aiming to be part of the 20% who holds on, pushes through, and progresses not just your life, but your family’s, and everyone you interact with.
When gearing up for the new year, or getting back on track, set your aim high and work these 3 steps.
BE SMART
We have all heard of the ‘SMART’ acronym about goal setting.
Specific: Be as specific as possible with your goals, they are easier to break up and achieve if they are clearly defined.
Measurable: This is usually the easiest part. How will you know when you have achieved your goal? When you hit your mark. 1000 miles running - $100K in growth - 2 full weeks of vacation time with your family. Put a number to it!
Attainable: Don’t make your goals too easy. Set your goals just at the end of your reach. Goals that make you work and dig down deep create the best feelings of accomplishment when completed.
Relevant: Is this goal important to you? Does it help you become a better person? Can accomplishing this goal help and serve others?
Time-Based: Every goal must have a deadline, or it is just a thought; a dream; an everyday task.
Break down each goal you have set into smaller, workable, SMART pieces.
THE ONE THING - BUILD YOUR FOUNDATION
Studies have shown that we are incapable of multi-tasking! Don’t believe me, just try to do three things at once and see how well they are completed, if at all. The new year brings about much excitement about the possibilities and opportunities ahead, but if our focus shifts to too many things at once, it will all quickly fall apart. Start by reading ‘The One Thing’ by Gary Keller and focus all of your attention on one goal at a time. See it through to completion and then move on to the next.
When I sit down to plan out my year, quarter, or week, I review my One Thing, that big goal for the year. But, it has to be broken down further than that. Humans simply can’t focus on one thing for an entire year! You know the saying, ‘The way to eat an elephant is one bite at a time,’ it’s true. If you want to reach your BIG goal, break it down.
I have shifted my life, personal and professional, to ROCKS. This isn’t a fancy acronym, but I do like to think of these rock as the material needed to build the foundation of what I hope to achieve and provide to the world during my life. ROCKS are 2-3 small steps that can be taken each 90 days that move you a step closer to your ONE BIG THING. Science has shown us that the extent of our ability to focus on a task is 90 days, so this method works perfectly. Break your big goal down into 10-12 steps and put all your focus into 2 or 3 of them every quarter.
This works the same in business as it does running—every quarter, you have to change cycles. You may want to run a 3:30 marathon this year. You have four macrocycles of training to complete this year, each composed of 2-3 microcycles. Just going out and haphazardly running will not get you to your goal, you have to plan and focus.
10X EVERYTHING
Look at your goals. Look at the energy, time, commitment, and focus it will require, and 10 X it! In Grant Cardone’s ‘The 10X Rule’, he discusses that anything worth accomplishing will require ten times more time, energy, and resources than you initially thought. How do you attack this, with massive action.
In summary, take an hour this week, work through your goals and develop an action plan. Assure they are SMART, begin by focusing on just one, and TAKE MASSIVE ACTION!
- Happy New Year -
Dr. Reheisse is a Board Certified Chiropractic Sports Physician practicing in Cottonwood Heights Utah. Revive Sport & Spine provides evidence-supported chiropractic care and conservative sports injury management. If you have an injury that is preventing you from doing the things you enjoy, call or schedule now.
Sciatica Pain Relief Part 4: Treatment & Rehabilitation
As we gather to close out this series on Sciatica, talking this time on what care looks like in our office when someone presents with Sciatic Nerve pain, you will recognize some similarities from the previous Sciatica-related articles. That is because rehabilitation for Sciatica is similar to the self-care and prevention exercises we shared previously. So…if you haven’t taken a look at our Sciatica Pain Relief series parts 1-3, click the links below and check them out. Our goal is to have you work through those modules before seeking care. You will often find that spending a week on the exercises we shared, might relieve your pain, and if maintained with some frequency, may prevent future occurrences. Nevertheless, if you are here, are located in Salt Lake City and the surrounding area, we are here to help.
As we gather to close out this series on Sciatica, talking this time on what care looks like in our office when someone presents with Sciatic Nerve pain, you will recognize some similarities from the previous Sciatica-related articles. That is because rehabilitation for Sciatica is similar to the self-care and prevention exercises we shared previously. So…if you haven’t taken a look at our Sciatica Pain Relief series parts 1-3, click the links below and check them out. Our goal is to have you work through those modules before seeking care. You will often find that spending a week on the exercises we shared, might relieve your pain, and if maintained with some frequency, may prevent future occurrences. Nevertheless, if you are here, are located in Salt Lake City and the surrounding area, we are here to help.
Treatment surrounding Sciatica takes on two parts: (1) Addressing the low back, regardless if low back pain is present and (2) Addressing the posterior hip, associated musculature, and its interaction with the sciatic nerve. One of these (#2) we can affect directly and often provide immediate relief. The other (#1) can be addressed by focused and modified daily action, joint mobility, decreased muscle tension, and…TIME.
Let's start with the low hanging fruit here. We have already discussed the association of the Sciatic Nerve and the muscles of the posterior hip. When it comes to treatment, our goal is to enact a change as fast as possible. We hope that patients come in having already tried stretching rolling, and increased movement to decrease the tightness and tension of the muscles in the back of the hip. From there, our job is to change the tissue in ways most can not do themselves.
Our typical treatment here is a combination or assisted progressive stretching, active and passive myofascial release movement, and dry needling…almost always dry needling.
To help understand what these treatments look like, check out these video demonstrations. These treatments have proven extremely effective in assisting patients to recover quickly from sciatica and sciatic nerve issues.
When it comes to rehabilitation, it is essential to understand that for the majority of people, even though the sciatic nerve radiating pain down the leg may have come on suddenly, it most likely took months to get to that point, leaving us with a bit of chronic muscle tension to address. THIS TAKES TIME.
When helping patients with their home care exercise plans, we look to address two areas, (#1) The Lumbar Spine, (#2) The Posterior Hip Muscles. If your problem is primarily in the hip/thigh region, exercise and daily life modification (usually sitting less) will bring quick and lasting relief. If your problem is primarily in the lumbar spine, our goal is to keep you as mobile and active as possible while the injury heals. Again…TIME.
POSTERIOR HIP MOBILITY
NERVE FLOSSING: Sciatic Nerve
LUMBAR SPINE MOBILITY & STABILITY
Sciatica is a common complaint, with a wide variety of causes. If you worked through our Sciatica Relief Series here and are still dealing with radiating leg and low back pain, please reach out to us with questions or come in for a consultation to further discuss your condition. If we can help you, we will let you know; if we can’t, we will get you to the best provider for your case.
Dr. Reheisse is a Board Certified Chiropractic Sports Physician practicing in Cottonwood Heights Utah. Revive Sport & Spine provides evidence-supported chiropractic care and conservative sports injury management.
New Year - New Goals: Running To Better Health
Improved health tops nearly every new year's resolution list ever made, 2019 will be no different. From this, running comes to the forefront of our ‘get in shape’ plan because of its ease (almost everyone can shuffle one foot in front of the other, not saying it is easy) and relatively low cost (a decent pair of shoes and some running gear is all you need). While this plan seems fool-proof, there is a reason 60%+ of the people we see in our clinic are runners, new and old.
Improved health tops nearly every new year's resolution list ever made, 2019 will be no different. From this, running comes to the forefront of our ‘get in shape’ plan because of its ease (almost everyone can shuffle one foot in front of the other, not saying it is easy) and relatively low cost (a decent pair of shoes and some running gear is all you need). While this plan seems fool-proof, there is a reason 60%+ of the people we see in our clinic are runners, new and old.
While running seems easy to do, there are many things to consider. Are you a runner? Have you ran since high school, or ever? Did you know your body type matters? Can you cover 1-2 miles and not be in misery the next day? Do you have good shoes? Do you have a partner to run with, accountability is essential for follow-through? You didn’t think about any of that, did you? While we will have more running and running-related injury articles to share with you in 2019, let’s start with some current research (Nerd-Alert).
Who:
In this study, the authors gave 914 novice runners a GPS watch and tracked them over a year to study their habits and direction of their running habits. The group was divided into 3 groups based on their BMI (Normal, Overweight, & Obese) to help determine if there were any differences and similarities in their training selection.
What They Found:
The first interesting finding was that in this self-guided exercise program, all categories selected similar training doses. The authors suggest that this may explain the higher injury risk among overweight and obese runners compared with normal-weight runners.
Normal weight runners ran faster and farther than their overweight and obese counterparts. This is anticipated as these are all novice runners, but the perceived effort was not established and could be an interesting metric to develop.
Suggestions:
Starting a new exercise program is exciting, but one must also be willing to understand and see that they are at a starting point. Novice runners are at high risk of injury if they start too fast, or do too much too soon. An initial dose of high volume can lead to an injury that causes you to become inactive, losing any benefits you sought to gain in the first place.
BMI is important to consider. Have a higher BMI does not mean you can or should not run, it means that the programming must be different. Training has to do with ‘load,’ and by that, we mean that if you are 200 lbs, it is a bit more challenging and harder on your body to run 3 miles than for someone who is 150 lbs. This changes as we continue training and adapt, but at first, we must take things slow.
Any activity is better than a sedentary lifestyle! Remember to take things slowly. Your body will be sore, but that is to be expected. If you have pain, or your soreness lasts longer than a few days after exercise, seek professional guidance on preparing your body and running programming.
Who:
The authors of this study followed 447 runners over a 24-week running program. Their goal was to determine the risk associated with high-intensity running plans and high-volume running plans.
Before the study began, they hypothesized that runners on the high-intensity program would have higher rates of Achilles tendinopathy, calf injuries, and plantar fasciitis while runners on the high-volume program would experience more runners knee, iliotibial band syndrome, and patellar tendinopathy.
What they found:
Over the 24-week training program, 80 runners sustained an injury. However, the authors found no difference in the risk of injuries related to training volume or intensity.
Suggestions:
The others suggest this discrepancy between these results and other related studies and running-related injury beliefs are related to the periodization of the running schedules, the scheduled running intensities, and the categorizations of injuries.
Runners or all shape, sizes, and abilities will eventually run into injury. Prevention by adhering to a solid warm-up routine, frequent attention to weaknesses and immobilities, while also modifying a training plan to one's abilities can help prevent injury.
When beginning a new running plan, or increasing your volume or intensity, it is suggested to do one at a time. Listen to your body and take time off as needed.
If you are taking up running again, or for the first time, and you have questions, we are here to help. Running injuries are common. You often do not have to stop running, just a rework and refocus of your training plan. Train Hard & Train Smart.
Happy & Healthy 2019!
Dr. Reheisse is a Board Certified Chiropractic Sports Physician practicing in Cottonwood Heights Utah. Revive Sport & Spine provides evidence-supported chiropractic care and conservative sports injury management.
Resolve Low Back Issues Part 7: What Happens When You Need To Seek Care?
Our intention with this series on Low Back Pain has been to inform and empower you, or your loved ones, to take action and realize that movement can help, as well as, prevent low back pain. That your low back pain is not a life sentence.
Care & Rehab For Low Back Pain
Supporting The Greater Salt Lake Valley. Helping You Get Back To The Activities You Enjoy.
Our intention with this series on Low Back Pain has been to inform and empower you, or your loved ones, to take action and realize that movement can help, as well as, prevent low back pain. That your low back pain is not a life sentence.
While all of this information is useful and should be utilized before, during, and after a Back Pain episode, the reality is that some people will need to seek care.
You have had a front-row seat to one pillar of our care, the education and exercise component. When seeking care for low back pain, putting your faith solely in one person, and relying on them for everything is not advised and will severely hinder your progress.
YOU (YES, YOU) HAVE TO PUT IN THE WORK, TIME, & EFFORT!
As a Sports Chiropractor that treats low back pain every single day…we see it time and again in our patients… If home care is not adhered to and a person does not take their situation seriously and put in the effort, back pain will take forever (or it seems that way) to resolve.
Today we are going to give you another up-close look at our care process, this time what we actually do here in the office. Our goals are to (1) Determine the cause of your pain/injury (2) Provide care in the office that helps you toward your goal of running, golfing, sleeping, moving again…pain-free, and (3) Give you the tools and education to help yourself.
We structure our care around 3 pillars: Soft Tissue, Joint Motion, Exercise. We have exhausted our opinion and writing on exercise, please refer to parts 1-6 for direction. Now, lets briefly take a look at what care looks like inside the office.
SOFT TISSUE CARE
JOINT MANIPULATION
Dr. Reheisse is a Board Certified Chiropractic Sports Physician practicing in Cottonwood Heights Utah. Revive Sport & Spine provides evidence-supported chiropractic care and conservative sports injury management.
Resolve Low Back Issues Part 6: Self-Care - What You Can Do For Low Back Pain
Over the last 5 weeks, we have discussed everything from what low back pain is, most common causes, some of the most common myths associated with low back pain, and when to consider imaging studies (x-ray, MRI, CT) due to red flags that lead us to something more severe being the cause. We even covered a few tips to help when you find yourself traveling for work or vacation.
We have been building up toward the actual care of low back pain but wanted to fully educate on how common low back pain is, what we know about low back pain at this time, and help you focus on life outside of back pain.
Low Back Pain Self-Care
Over the last 5 weeks, we have discussed everything from what low back pain is, most common causes, some of the most common myths associated with low back pain, and when to consider imaging studies (x-ray, MRI, CT) due to red flags that lead us to something more severe being the cause. We even covered a few tips to help when you find yourself traveling for work or vacation.
We have been building up toward the actual care of low back pain but wanted to fully educate on how common low back pain is, what we know about low back pain at this time, and help you focus on life outside of back pain.
Today, we are going to do just that.
When we look to decrease disability from low back pain and encourage and support patients back to an active lifestyle, this is done in two ways. EDUCATION & EXERCISE. We have already discussed the education component. Now it is time for exercise. Below are 5 ways to help manage and prevent your low back pain with exercise and stretching routines that can be done at home, the gym, or even at the office.
Side Bar -> If anyone gives you a hard time, or tosses a laugh in your way for stretching at the office, I will leave it up to you to either invite them to join (because they need to do this too), or, wait until they start having an issue with low back pain and then pass them our card! Seriously though, invite your co-works to join in, make it an office party, it will be fun.
Fix Your Low Back With These 5 Easy Exercises & Stretches You Can Do At Home or Work.
STEP 1: Get Out Of Bed With Our Morning Routine.
After a good night’s sleep, it is common for our muscles to want to remain in bed. Because of this, early morning activities can challenge our bodies more than they are ready to handle, resulting in a nice low back strain injury. If you are already dealing with low back pain, you know that morning stiffness can prevent you from even rolling over, not to mention actually get up out of said bed.
STEP 2: Desk Sitters - Get Up & Move
While things are improving, the seats we subject ourselves too in our cars, on the train, and at the office are just comfortable enough to keep you seated for an extensive period of time, but provide little support to keep you from tightening up in the process. Start this NOW -> Set an alarm on your phone that goes off every 1-2 hours. Walk around the office, hand-deliver a message, and then take 30 seconds and perform these stretches.
STEP 3: Pre-Workout Hip Mobility
We are going to assume you have a daily routine of some exercise? If you do not, reset, and start adding some exercise to your life, no other method is as impactful on helping your low back issues. Once you get to the gym, or home if you prefer, go through a GOOD HIP MOBILITY routine. We know that the more we improve the mobility of our hips, the less our low back has to work…overwork.
STEP 4: Post-Workout Core Strength
The same goes for core strength as hip mobility. The stronger our core, the less our low backs have to work. Now…I don’t mean getting down on the floor and performing a half-hearted set or some sorry excuse for crunch/sit-up type exercise. We are talking functional here. Planks, Side Planks, Plank Rolls, Heavy Farmer and Suitcase Walks, as well as The Big 3.
STEP 5: Strength For Life
Most people who have dealt with low back pain have since, and forever will, shy away from true strength movements. But let me just plug that as humans, you should be able to squat as well as pick something heavy off the ground without fear of hurting yourself. As you work on hip mobility and core strength, you have to start working in squats and dead-lifts. Start with these modifications and work on control and endurance.
Exercise is considered the best medicine for low back pain. While this is true and I strongly support this. Our actual goal with care is to get our patients back to these activities. But often, patients present in enough pain that they are unable to run, ski, bike, weight lift, etc. With that said, most can start with basic stretching and mobility until the pain is relieved. From there, exercise can prevent flair-ups, or at least decrease their intensity and length of the episode. Either way, low back pain has to have a component that includes YOU doing some, if not most, of the work.
Next week we will look at some of the traditional, as well as, new developments in conservative care low back pain. Until then, and if you are craving more reading, check out our ‘12 Ways..’ Tips guide to further help your low back pain.
Dr. Reheisse is a Board Certified Chiropractic Sports Physician practicing in Cottonwood Heights Utah. Revive Sport & Spine provides evidence-supported chiropractic care and conservative sports injury management.
Resolve Low Back Issues Part 4: Most Common Myths Of Low Back Pain
Few musculoskeletal conditions have a cult-like following of myths as Low Back Pain, many of which have been said by various healthcare providers across all specialties. To help clear the air, let's take a look at the 5 most common misunderstandings and myths that we encounter in our chiropractic clinic that could actually make your low back pain worse.
Low Back Pain Myths
Few musculoskeletal conditions have a cult-like following of myths as Low Back Pain, many of which have been said by various healthcare providers across all specialties. To help clear the air, let's take a look at the 5 most common misunderstandings and myths that we encounter in our chiropractic clinic that could actually make your low back pain worse.
Before we get started…
These myths and misunderstandings are not aimed at making low back pain seem 'made-up,’ it is a very real and challenging condition. These myths are just folklore passed down from old, unsubstantiated in the research, ways of thinking. Our truth is that, if you believe one thing and that makes you feel that your low back is wrecked for life, a long road of pain is what you are in store for. We call this fear-avoidance and catastrophizing, the medicalization of a condition. We will touch more on this when we cover imaging next week. But a big part of recovering from low back pain is believing that you can get better. It may sound silly, but no more ridiculous than believing these myths below!
NUMBER 1: Your back pain is from a misalignment, bone out of place, or a ‘subluxation.’
We don’t practice this way any longer, stop using explanations from this era.
These are common descriptions patients and doctors alike will give when describing their back pain. The most common being...you threw your back out, and it is now misaligned...commonly spoken by chiropractors of a generation ago or current doctors, chiropractors, and physical therapists that have not caught up with current research. The truth to this is that your spine is a dynamic structure designed to move, what we ACTUALLY find is that the pain you are feeling is often associated with immobility, or areas of the spine that should be moving, but due to tight muscles and previous injury, may not be moving well or correctly anymore. Spinal manipulation or an ‘adjustment’ is designed to restore normal motion to these restricted areas.
A bone did not shift out of place and therefore needs to be put back in! That’s not how it works.
NUMBER 2: Arthritis is the root of all evil!
Arthritis is like wrinkles on your face…lets just keep it nice and say they are signs of wisdom. Truthfully, if you live and play hard and long enough, we will all experience some degree of degeneration. However, and please understand this, it is a natural process and does not necessarily equate to pain! When conditions present that are more challenging, using arthritis as the ‘fall guy’ is the easy way out for a provider and an often acceptable answer for the patient.
NUMBER 3: “But…I have scoliosis and a short leg” that is the cause of my back pain.
Just like arthritis, scoliosis and an actual short leg (1cm or shorter than the other) are comfortable areas to place blame when someone presents with back pain. Both can absolutely lead to dysfunction, and if unaddressed, pain and discomfort. To a certain degree, uneven leg lengths and spinal rotation/curvature are normal variants, meaning most people have these at a mild level and are unlikely to be a pain generator. For most (not all) look to place the blame elsewhere.
NUMBER 4: Rest is what I need to recover, right?
The days of ‘take 2 of these, rest, and call me in the morning’ are long gone. You likely have a relative who spent a good amount of their life with back pain that limited some or all of their activity. When you see a case like this or someone who is much too young to be experiencing recurrent back pain, it may seem like the right thing to do is rest up for a while. Fortunately, we now have stacks of research that supports the fact that bed rest is the worst (top 3 at least) idea when it comes to low back pain. The new adage is ‘Movement is Medicine.’ When someone presents to our office, we are not only just trying to relieve pain, but to relieve pain SO THEY CAN GET OUT AND MOVE. Even walking, WALKING, has been shown to reduce low back discomfort and be a great tool to prevent future occurrences.
NUMBER 5: Slap a brace on it & it will be fine.
Brace low back pain long term & you should join the circus with that thinking.
This is excellent advice if you are looking to weaken your core muscles completely. Did you know that powerlifters use the belt to their advantage to complete amazing feats of strength not to brace their low back, but to give their stomach something to press in to, creating intraabdominal pressure (think bracing your stomach if someone was to punch you) that stabilizes the spine from the inside? Our bodies are amazing, it has its own ‘weight belt’ built-in. Using straps, belts, or any other contraption like this for extended periods of time tells your body that you do not need it to do its job anymore. This core weakness and inability to naturally brace yourself through muscle control —> LEADS TO CHRONIC LOW BACK PAIN.
In summary, things change. Our treatment methods and your outlook on your condition must change. Every single one of these five myths is still spouted today in an office somewhere near you. Knowing the validity of that is often more important than the care you receive. While in certain circumstances, these can be valid reasons for low back pain. For most, especially those who come through our Cottonwood Heights, Utah Chiropractic and Rehabilitation clinic, we want a better answer. One that helps address and correct the dysfunction. One that promotes confidence and encourages the patient to try harder, that they can feel better and live a life they enjoy.
Next week, in part 5 of our Fix Your Low Back Series, we are going to discuss red flags, when you need imagining, and why you shouldn’t always rest your diagnosis and pain on those images.
Dr. Reheisse is a Board Certified Chiropractic Sports Physician practicing in Cottonwood Heights Utah. Revive Sport & Spine provides evidence-supported chiropractic care and conservative sports injury management.
Resolve Low Back Issues Part 3: Most Common Cause Of Low Back Pain & What You Can Do About It.
In part one of our ‘Fix Your Low Back’ series, we discussed the 3 categories of back pain; Functional, Structural, and Pathological. As we learn about low back pain, we find that these groups interact with each other frequently. Essentially, these are medical definitions used to categorize your low back pain, but let’s step back and take a look at how your everyday actions could be the primary cause of your discomfort.
As an example, let’s say you sit at a desk for 8 hours each day. From here, you head to the gym where you like to lift weights and improve your cardio. It has been shown that repeatedly lifting heavy objects with a rounded spike (functional), can lead to disc bulges (structural). For many, we just hit the nail on the head as to where your back pain is coming from, for others, we are going to dive into the most common’s and discuss how a simple change in activity can make all the difference.
The Most Common Causes Of Low Back Pain
In part one of our ‘Fix Your Low Back’ series, we discussed the 3 categories of back pain; Functional, Structural, and Pathological. As we learn about low back pain, we find that these groups interact with each other frequently. Essentially, these are medical definitions used to categorize your low back pain, but let’s step back and take a look at how your everyday actions could be the primary cause of your discomfort.
As an example, let’s say you sit at a desk for 8 hours each day. From here, you head to the gym where you like to lift weights and improve your cardio. It has been shown that repeatedly lifting heavy objects with a rounded spike (functional), can lead to disc bulges (structural). For many, we just hit the nail on the head as to where your back pain is coming from, for others, we are going to dive into the most common’s and discuss how a simple change in activity can make all the difference.
THE THREE MOST COMMON CAUSES OF LOW BACK PAIN
While our cohort population is small, we have found that low back pain presenting to our chiropractic clinic in the Salt Lake City, Utah valley typically falls into three categories:
SEDENTARY LIFESTYLE & WORK ENVIRONMENT
Studies show that people sit on average, 8 hours per day, with some sitting upwards of 15 hours. Honest question...do you sit with good posture? I know I don’t! After 5-10 minutes, I feel like I am hunched over. As a result of this, the muscles of our hips and pelvis begin to tighten and the muscles of our core begin to disengage. This leads to what is called an anterior pelvic tilt which prevents a neutral and happy spine, causing abnormal compression and stress on the disc and excess strain on the low back muscles as they over engage trying to perform the job of the core and hip muscles, essentially causing what we call Lower Crossed Syndrome. It is said that sitting is the new smoking, this may not be exactly true, but I get the reference. Either way, you look at this, the truth is that we have to get up off your butt, move, and do it often.
Solutions To A Sedentary Work Environment
Walk to deliver messages instead of using email.
Take the stairs and park farther away.
Halfway through your morning and afternoon, get out of your chair and perform the following
Wall Push-Ups x 10
Body Weight Squat x 10
Hip Flexor Lunge Stretch x 10
Plank x 30 seconds
BUTT & GUT SYNDROME
The Butt & Gut Syndrome has developed out of the sedentary lifestyle. When we sit for long periods of time, day in and day out, we are unable to use the muscles of our Butt & Gut efficiently. If you are sitting on your glutes (butt) all day, they are unable to contract, the same goes for our core when we sit hunched over a keyboard/desk/cell phone all day. This weakening of the main supporting cast of our lower spine causes the muscles of the back to overwork as it is now doing the job of these weakened muscles when you are walking, running, cycling, lifting weights, gardening, or just sitting on the couch. Simply put, you have to get your core ACTIVE!
Solutions To Help Your Sedentary Home-Lifestyle:
Walk with family after dinner.
Perform the TV challenge - 10 Reps each of Push-ups, Sit-Ups, and Body-Weight Squats EVERY commercial break.
IMMOBILITY & STIFFNESS
Not only does sitting for long periods weaken muscles, but it can also lead to stiffness above and below the low back area. Many of us have felt the pain between our shoulder blades, or feel like our hips just don’t move like they once did…you know….back in our prime. Did you know that this stiffness can come from a low back issue, but more times than not, this is the root cause of the problem? When we have stiffness through the middle back and hips, the low back must adapt from a stable environment to act as a mobile environment, something it should not do and is very dangerous to your overall wellbeing and function. When the low back compensates for other areas of joint stiffness, problems can and will occur.
Solutions To Help with Immobility & Stiffness:
Start or increase the amount you walk each day.
Develop a stretching routine you can maintain.
Lift weights, run, swim, play tennis, take up yoga, just do something that makes you move!
Improve your mobility with one of these routines.
Have you started noticing the pattern here yet? If you have picked up on the fact that we sit too much, and activity as simple as walking can bring lasting relief, you are correct. A recent study in the Journal of Disability Rehabilitation showed that walking was effective in improving pain, disability, quality of life, and fear-avoidance among chronic low back pain sufferers. With that said, I want to end part 3 of this series with a light of hope…
…most back pain is treatable and preventable!
Stay tuned for part 4 of our fix your low back series. We will be discussing common myths that need to be cleared up as well as red flags that must be addressed before treatment can begin.
Dr. Reheisse is a Board Certified Chiropractic Sports Physician practicing in Cottonwood Heights Utah. Revive Sport & Spine provides evidence-supported chiropractic care and conservative sports injury management.
Injury Prevention For Runners: Tips To Support Your Training
As runners, we really only have 2 goals...
Run faster/farther than we ever have before.
Remain injury free.
For the last 4 years, it has been our goal at Revive Sport & Spine to be the leading sports chiropractic clinic serving the greater Salt Lake City area when it comes to running-related injuries and prevention. Having aimed for the same goals mentioned above through my own running the last 20+ years, there are few endurance sport related injuries that I have not encountered either personally or clinically.
While we field questions about running form, injury prevention, running shoes, pre-race meals, training plans, strength training, etc., some questions are better answered by those who work in that arena day in and day out.
Over that last few months, we were able to sit down with a few local specialists in sports nutrition, mental skills training, strength training, and running shoes. Our goal was to find out how each component can aid runners with injury prevention.
As runners, we really only have 2 goals...
Run faster/farther than we ever have before.
Remain injury-free.
For the last 4 years, our goal at Revive Sport & Spine has been to be the leading sports chiropractic clinic serving the greater Salt Lake City area for running-related injuries and prevention. Having pursued the same goals mentioned above through my own running for the last 20+ years, I have not encountered many endurance-sport-related injuries, either personally or clinically.
While we field questions about running form, injury prevention, running shoes, pre-race meals, training plans, strength training, etc., some questions are better answered by those who work in that arena day in and day out.
Over the last few months, we were able to sit down with a few local specialists in sports nutrition, mental skills training, strength training, and running shoes. Our goal was to find out how each component can aid runners with injury prevention.
INTERVIEW 1: Nutrition Tips For Runners with Dietitian Tayla Russell.
INTERVIEW HIGHLIGHTS:
Runners and other endurance athletes are different from athletes who play soccer, football, baseball, etc., and therefore have higher specific nutritional needs that fluctuate depending on the distance and type of race. One must is that we need more carbs during our training cycles. Choose good carbs like grains, fresh fruit, and fresh vegetables.
As runners, injuries are inevitable. Know what foods can help during the healing cycles can speed up your recovery and get you back out on the road or trails quickly. Great Anti-Inflammatory foods include healthy fats like avocados, nuts, and seeds, high anti-inflammatory fruits like pineapple, and spices such as ginger and turmeric.
Myth: All runners must carb load before a race? False, while long-distance runners do need some extra for energy stores later in the race, most people just over-eat the night before a race. So if you are waking early the next morning for a 5k or 10k race, you are better served to have a light dinner of fresh veggies, lean protein, and a small amount of carbohydrates.
Contact: Tayla Russell - dietitiantayla@gmail.com - 435.553.5698 - Max Muscle Cottonwood
INTERVIEW 2: Mental Skills Training with Nate Last, M.S. from Mental Grit Consulting
INTERVIEW HIGHLIGHTS:
Negative Self Talk: Negative talk puts us in our own way on our path to our goals. Everyone does it and it is a major contributor to not performing at our best.
Ideal Mindset: We have an ideal mindset, we have to practice it just like everything else we are working on. Understand you can accomplish your goals, we can and will fail at things in the process, but use it as a building tool to strengthen your mindset.
Process Before Outcome: When training and racing, focus on the basics, focus on doing everything you can do RIGHT NOW, in the moment that will help you perform better in the future. It is okay to think ahead and dream about the future, but don't stay there! Bring yourself back to the process.
When Injured: Stay on track through an injury. Believe your body is capable of healing and training again. When you believe this, it will happen, and it will likely happen faster.
Contact: Nate Last - Mental Grit Consulting - 801.368.7564
INTERVIEW 3: Strength Training For Runners with Ryan Carver, CSCS from Leverage Fitness Solutions.
INTERVIEW HIGHLIGHTS:
Should Runners Weight Train: YES! Weight training can help prevent injury by building the strength of not just your muscle, but ligaments, tendons, and joints. Weight training can also make you faster by improving your overall economy and efficiency.
Increase The Weight Or Volume: As runners, we spend most of our time doing high volume training. So when it comes to weightlifting, increasing the weight and shift toward lower reps is ideal to obtain the most benefit. Also, just because we run or cycle, we still need to lift with our legs, don't shy away from the squats, lunges, and deadlifts.
Top Exercises For Runners: (1) Weighted Step-Ups (2) Nordic Curls - Hamstring (3) Hip-Hike (4) Shin Strength - Toes To Shin w/ Resistance (5) Stir-The-Pot Core Exercise.
Contact: Ryan Carver - Leverage Fitness Solutions - 385.985.3603
INTERVIEW 4: Running Shoes & Injury Prevention with Darrell Phippen from Wasatch Running Center.
INTERVIEW HIGHLIGHTS
New Technology: All name brands have great technology, but which one is best for you and your running style and goals? Shoes are lighter, have better and more comfortable uppers, and have more fits than ever before. Getting a correct fit, and finding the best shoe for YOU, is almost as important as your training plan.
Shoe Fitting: Trying a shoe on is not enough to make a decision. How does it feel with movement, walking and running? Working with the professionals who have been trained in shoe fitting can make all the difference in finding the right shoe to help you remain injury free.
How Many Shoes Do You Need: As runners, more shoes is always better. But when you look at the average mileage of shoes, 250-350, and how often you run, having multiple shoes has its advantages. Our suggestion is to have a minimum of 2 shoes if you are primarily a one surface runner, 3 if you mix trails with road running. This allows them to last longer, continually challenge your feet and allow them to adapt to a variety of surfaces, and help prevent injury.
Contact: Darrell Phippen - Wasatch Running Center - 801.566.8786
Dr. Reheisse is a Board Certified Chiropractic Sports Physician practicing in Murray, Utah. Revive Sport & Spine provides evidence-supported chiropractic care and conservative sports injury management.
Current Status: Low Back Pain Care
Low Back Pain is one of the most common reasons for an office visit and affects upwards of 540 MILLION people. Providers from all walks of healthcare encounter these patients daily, but have we made any headway in providing pain relief and direction for low back pain?
Low Back Pain is the leading cause of disability, missed time, and loss of wages due to injury worldwide. It is now estimated that over 540 MILLION people are affected each and every day. If we look at the glaring statistics, we find that low back pain is a normal part of life, with up to 80% of the population experiencing low back pain at some point and upwards of 40% experiencing low back pain each year… but the question is, have we made any headway in the CARE FOR LOW BACK PAIN over the past few decades?
It wasn’t too long ago that the go-to treatment suggestion/prescription was bed rest! On top of that, muscle relaxers and pain relieving narcotics were handed out almost haphazardly. Now don’t misunderstand, there is most certainly a time and place for pharmacology in the treatment of low back pain, but as we will soon discuss, it is near the end of available treatment options. What we truly have is a gap between current research and what is actually being offered inside Chiropractic, Physical Therapy, and Primary Care Clinics as well as Emergency Departments.
ACTIVE CARE
THE BIG 3 - AT HOME EXERCISES TO HELP WITH LOW BACK PAIN.
Too long have we relied upon passive care methods and anti-cohesive approaches in healthcare regarding musculoskeletal issues, especially low back pain. Fortunately, that is all changing. Recently, The Lancet released a series of papers focused on low back pain, our shortcomings in common care practices, and opens a new conversation on how we look at the treatment of low back pain. Their suggestions center around a cohesive care model between medical and conservative methods with an emphasis on a non-pharmacological, conservative, and active approach (such as chiropractic and physical therapy) to low back pain care in both early and late stages. Their suggestions are aimed to limit the use of injections and surgery early in the care process outside of rare and emergency situations.
These articles come on top of recent releases from the Journal of the American Medical Association, American College of Physicians, American Chiropractic Association, and other leading journals and medical institutions that are pressing hard to expand the conservative care options available for low back pain sufferers within the traditional medical model of care.
At Revive Sport & Spine, we aim to be Utah’s leading sports chiropractic and low back pain clinic. We fully support these papers as our aim is to always educate our patients, guide them back to the right path through soft tissue therapy, spinal manipulation, and active exercise rehabilitation that will enable them to be self-sufficient and take charge of their low back pain.
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Dr. Reheisse is a Board-Certified Chiropractic Sports Physician practicing in Murray, Utah. Revive Sport & Spine provides evidence-supported chiropractic care and conservative sports injury management.
Hamstring: Proximal Strain & Tendinopathy
Hamstring injuries can be a beast; they drag you down mentally and physically as treatment tends to draw out and disrupt your training plans and goals. They present with pain and tenderness near the gluteal fold and over the posterior thigh, making it sometimes difficult to run, ride, walk and even sit. What I would like to do here today is briefly (as a longer post is to come later) give you some basic suggestions based on research findings, what patients have responded positively to, as well as what to do about your training and overall fitness.
As the weather cools down, a thought of last year comes to mind. During this time I was beginning my sports residency in St. Louis under one of the best conservative care sports physicians I have had the pleasure to work with. Of all the cases we encountered, one injury (many actually) sticks out as a very common occurrence this time of the year….Proximal Hamstring Strain & Tendinopathy.
Hamstring injuries can be a beast; they drag you down mentally and physically as treatment tends to draw out and disrupt your training plans and goals. They present with pain and tenderness near the gluteal fold and over the posterior thigh, making it sometimes difficult to run, ride, walk and even sit. What I would like to do here today is briefly (as a longer post is to come later) give you some basic suggestions based on research findings, what patients have responded positively to, as well as what to do about your training and overall fitness.
There are many misconceptions out there about hamstring tightness and what can be done about it. What we do know is that stretching, and stretching, and stretching the hamstrings some more, trying your hardest to touch the floor is not very effective, even counterproductive (1). It may lengthen the muscle for a short period of time but the stress it places on the enthesis and the myotendinous junction could set you up for further injury if care is not taken.
In the acute or reactive phase of a hamstring tendinopathy, there are a few key thoughts to consider that can aid in recovery. At REVIVE Sport & Spine we focus on treating our athletes while keeping them active in sport but sometimes a decrease in activity is needed while a select few may need to shut down for a few weeks. When working with tendinopathy issues, offloading the tendon from compressive and tensile loads is key (2). Compressive loads are just what they sound like, anything that can compress the muscle or tendon such as sitting. Tensile loads on the other hand are more dynamic in nature including activities like running and jumping. Our goal in maintaining activity during treatment is to decrease both compressive and tensile loads while completely eliminating movements that combine the two such as hill running, static stretching and over striding (common with treadmill running, one reason I dislike this winter running option and also what I believe causes so many proximal hamstring issues in the winter months). What can you do for activity during treatment? Running on flat, soft surfaces at a decreased intensity and lower volume is one option. Begin strengthen the hamstrings, gently with slow progression, utilizing isometric and eccentric type exercises (3) while also decreasing the time spent compressing the tendon in activities like sitting and static stretching. Besides, too much sitting is just not good for your health in general!
While this is just the tip of the iceberg, we will dive deeper into hamstring issues in the near future focusing more on possible causes and some ideas as to what you can do to speed up your progress. We will look at glute strength, hamstring exercise progression, the effect of tight hip flexors and weak abdominals as well as anterior pelvic tilt and poor lumbopelvic stability.
As always, be sure to consult your personal physician before taking on any exercise or self prevention plan, self diagnosis and treatment is never a good option. If you feel you are developing a hamstring issues and want to get ahead of it quickly, the team at REVIVE Sport & Spine is ready to help you build and get the most out of your winter training. Happy Holidays and Happy Movement!
Resources:
Sole G, Milosavlijevic S, Nicholson H, Sullivan J. Selective Strength Loss and Decreased Muscle Activity in Hamstring Injury. J Orthop Sports Phys Ther 2011;41(5):354–363, Epub2 February 2011. doi:10.2519/jospt.2011.3268
Cook JL, Purdam C. Is Compressive Load a factor in the Development of Tendinopathy? Br J Sports Med. 2012 Mar;46(3):163-8. doi: 10.1136/bjsports-2011-090414.
Jayaseelan DJ, Moats N, Ricardo CR. Rehabilitation of Proximal Hamstring Tendinopathy utilizing eccentric training, lumbopelvic stabilization, and trigger point dry needling. Journal of Orthopaedic and Sports Physical Therapy. 2014 Mar;44(3):198-205. doi: 10.2519/jospt.2014.4905. Epub 2013 Nov 21.
